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The Frustrations of Anxiety Suffering Clients

Why Many Anxiety Suffering Clients Become Frustrated with Therapy

It starts with the surprising diagnosis …

A person goes to the doctor complaining of palpitations, difficulty in breathing properly and chest pains – they feel like they are having heart trouble. The good doctor after conducting all the necessary tests and after questioning the patient declares that everything is fine, they are healthy.

“But what’s wrong, why am I suffering like this?”

The doctor replies “You are suffering from a general anxiety and panic attack disorder”.

This comes as a shock to the patient, “Is that something psychological?” they want to know. The good doctor concurs that indeed this may well be a psychological issue and that psychotherapy may be the answer. The doctor makes a recommendation for a particular psychotherapist.

The above particular scenario is actually a very standard and typical phenomenon.

 

The Part Where it Becomes Confusing for the Anxiety Suffering Client

 

The client comes to therapy hoping to resolve the issue once and for all. The therapist explains to the client that the anxiety is an effect of a thought process; in fact, the anxiety could not come about if not for the thought process.

The client at this point will likely be troubled. “What thought process is the therapist talking about?  I have an issue with a physical feeling not a thought”.

The therapist continues to question: “What is it that you think about just before you begin to feel the anxiety?”

And the therapist begins his work on the basis that the anxiety has to be about the fear of the anxiety (or the fear of the fear as one can call it).

Considering it from the client’s perspective this will come across as even more confusing. How is it supposed to make any sense? If I started suffering from panic attacks and then I became afraid when thinking  I was about to panic again, it would only seem logical to be afraid of the onset of the anxiety attack, after all, panic is an awful experience to have to go through. Would it not make more sense to deal with the panic or anxiety itself?

In truth, as a therapist, I used  to be convinced that focusing on the fear of the fear is the operational way to get effective results for all cases of general issues of anxiety or panic but  this was partly due to my comprehension  that it is the ‘obsession’ of the problem that is the problem, not the anxiety itself.

What is the client really communicating?

The client is essentially stating “I am experiencing extreme discomfort and I don’t know why”. I have noticed that the majority of clients who have come to see me with the above kind of issue, initially wrote in the in-take form that their goal for the appointment was to gain clarity of their issue, stopping the issue was written only as  secondary to that. It is in my understanding that the most important challenge as a therapist looking to help an anxiety suffering client, is simply to gain clarity and understanding of the intention of the anxiety.

Understanding Anxiety and Panic as it is – Extreme Discomfort

If I see somebody positioning them self in an uptight position which causes them to feel discomfort, I would simply tell them to change their physiological position.

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But with anxiety it’s different, if I do not ask the right questions of the person, the only thing I will ever understand from them is that they are in distress. Hence this will likely be the reason why many get stuck at some point not knowing what to suggest, they don’t actually know anything about the problem.

As a therapist, I have personally seen it as of utmost significance to create a setup for useful interchange and dialogue. These skills involve listening to the words in between the words, to the way the client describes their issue and to the mode it is being presented.

People will frequently verbalize through metaphor and there is immense value in paying attention to this as a communication.  These are the things that will often give to understand the basis of the ‘whys’- why the person is suffering. On a more subconscious level a metaphor can also reveal how and what the individual is doing as a way of coping in their general distresses.

This way of conversing with a client is something I have learned recently in the ‘Metaphors of Movement’ workshop with Andrew Austin. This kind of approach may take much patience and persistence but in the end it means that  my client and I are actually conversing through their inner map of reality instead of despairingly going over and over the symptoms and hoping to heaven that we will find some kind of association, which may by an off chance be connected to the clients current sufferings.

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