Anxiety - a brief insider view
A counselling room, Tuesday afternoon at 4pm, April 2018, five minutes into the session with a client who has been attending weekly appointments for two months…
Drawn face of a young woman: “I don’t feel myself today. I have a gripping feeling in my tummy and a sense that something bad is going to happen. I keep having worrying thoughts flashing through my mind and I’m finding it hard to concentrate on anything. I just want to get away from this feeling. I woke up with it yesterday and today it‘s even worse.”
Attentive therapist lets the young woman know that she can see how worried she is. She senses that she might be frightened about something so she asks about this carefully and gently:"I can see you’re feeling really unsettled by this. It sounds as if you’re scared about something. Are you feeling scared?"
Face now deeply disturbed: “I don’t know, it doesn’t make any sense, I just want it to go away. I feel worried all the time and even talking about it now isn’t helping the feeling, it’s growing like some kind of monster in my head. I just feel so horrible inside.”
Therapist notes that the young woman is feeling too anxious to talk about the possible cause of her anxiety. She decides to focus on helping her relax by moving away from her anxiety for a while: "I can see and feel how very worried you are, there’s a powerful tension in the room with us today. How do you feel being here with me now?"
Young woman looks around the room and then back at therapist: “I know this room and what’s in it and I’m used to being here with you so that sort of helps me to feel a bit better. I feel a bit silly but I just can’t help it. I keep thinking I’m going mad”
Therapist reassures the young woman and explains that she thinks it might be helpful if they try a relaxation exercise together: “I don’t think you’re going mad and I believe how horrible you say you feel inside. I think it might help if we try something to help you relax. Are you willing to try something with me?"
Young woman’s focus now more on therapist than on anxious feelings: “Anything would be better than where I am now. What do you mean, what do I have to do?”
Therapist keeps her voice calm and steady: “Try not to feel you have to do anything, there’s no right or wrong way with what I’m going to suggest. I’d like to try a short exercise with you that we can do together and it’s about breathing. If you don’t like it we can stop at any time. Are you OK to have a go?"
Face a little less contorted, becoming engaged in what the therapist is suggesting: “OK”
Anxiety can sometimes overwhelm people whereby they experience intense and confusing emotions and feel out of control. The source of anxiety can be hidden because a person may not realise that something in the present is triggering memories of something in the past, something that was disturbing and upsetting. In the case of the vignette above, once the young woman had relaxed through a simple breathing exercise with her therapist for five minutes, she was able to think through what could be troubling her so much.
She reflected on her forthcoming week and a team meeting involving a regional manager with whom she felt unable to express her disagreement with his feedback on an important project she was handling.
As the young woman had previously described a difficult relationship with her father - an eloquent business man who in her opinion had been quick to ridicule her in public when she attempted to voice her own views – the therapist was able to bring this to attention and consider with the young woman, whether she was frightened of being ridiculed by the regional manager. Together they were able to see how the regional manager was acting as a trigger for the young woman’s father.
At an unconscious level the woman was being reminded of how she felt in the past when her father ridiculed her in public and these feelings of anxiety were being carried over to the forthcoming meeting so she was expecting the “worst” based on past experience.
It is as if the mind can act like a reference library – some present or future events being assessed on previous similar events without consideration of differences. Therapy is a useful and practical way in which individuals can fathom possible explanations for confusing and seemingly irrational human responses.
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