Thursday, March 17, 2016

Case #175 - Anxiety, options, contact

Frank was nervous, so I invited him to ask me a question. I often prefer to take the focus off of the client, and put it onto myself. A good way to do this is to stop asking the client questions, and ask them to question me.
Frank wanted to know how I dealt with traveling so much - the changes in time zones etc, and still keep healthy.  I explained some of the factors - I enjoy travel, am flexible, meditate and have a good diet.
I also said, 'I like change and variety'.
Frank revealed that he did not cope well with change - he got anxious easily.
I shared how I dealt with my anxiety by risk taking - not thinking much about negative things that could happen.
Frank said that he managed his anxiety by preparing thoroughly. But that he couldnt switch off - he would constantly think about what was coming up, and how to prepare.
I asked him about the context for this in his family (ie a Field question). He explained that his mother was very meticulous in preparing for things - in other words, thats how she managed her anxiety. The day before a school excursion, she would instruct him to make detailed preparations for the next day.
In other words, she taught him to be anxious, and also taught him how to deal with that anxiety.
He said 'this is the only option I have to deal with my anxiety'.
In Gestalt we are interested in expanding options. I asked if he would like more ways than one to deal with it.
So I invited members of the group to share how they dealt - in a healthy way - with anxiety. People shared many things.
These were new ideas for Frank. He was moved to see how many people struggled with anxiety, and in the process, he gained new options.
I suggested he consider these as a menu, and when he felt anxious, he could choose one.
Such behavioural choices are often the way that therapists head. Whilst expanding options is useful, it very much depends on more fundamental factors, including a person's readiness to do so, their resistance, emotional anchors etc. So its something I would monitor in ongoing therapy, to see if its as 'simple' as simply hearing new options. It may be, and it may be that the support of the group could be something that Frank would take in, and integrate.
I did want to take a second step with him, and not just leave it at a list of possible 'solutions', as expanded as that may be.
So I suggested that we now address something of his interpersonal anxiety.
I asked him to look around the group and notice who he felt least anxious with, and most anxious. I then invited him to ask those people to take part in an experiment. The person he was least anxious with I got to sit next to him. The one he was most anxious with - Mark - I asked to sit opposite him.
I suggested Frank tell Mark what it was about Mark that made Frank feel anxious.
He said that Mark reminded him of his father - who would yell at him and hit his hands when he got something wrong.
I invited Mark to reply. Mark said that he was different - he never hit his kids, and was not the kind of person to yell.
I checked with Frank for his feelings - he felt calmer.
We repeated this process several times, with Frank telling Mark what he was anxious about, and Mark telling Frank more about himself.
Frank felt calmer and calmer.
We carry around ideas of who other people are, but these often have elements of projection - disowned aspects of self. This was the first step for Frank in getting a reality check about his anxieties - which were generally  based on his imagination. It also gave Frank the experience of how to deal with interpersonal anxieties - through open and authentic dialogue.
In Gestalt we talk about 'good contact'. This is an example. Being present with another person, sharing your fantasies, checking them out, getting feedback, hearing the reality of the other person. These are grounding experiences, seemingly simple, but rarely performed.

Tuesday, March 8, 2016

Case #174 - Non material success

John was a young man; he raised the issue of his first girlfriend, who left him. He met her at University. Subsequently, he started a business, and invested some money that he had saved up from working. But now he had to close the business, and his girlfriend had left him, because she didn't feel he was successful enough.
Of course, this is just one half of the story. There were probably other things going on for her that she couldn't communicate, or he didn't understand. But anyway, this was his experience. He was heartbroken, and started crying as he was talking about the situation.
I responded to him, telling him I was touched by his openness and authenticity. He was being real, vulnerable, and I highlighted that this in itself was of great value. Whether he went on to become successful or not, this was something that I valued, and that I suggested a woman with similar values might consider important, perhaps more so than his net worth.
Again, he went to his sense of not being enough, of failing, and of losing a woman who mattered to him.
I was empathic - these losses feel very real, and difficult to navigate for anyone.
I also came back to the here and now. There was a young woman in the audience. When John talked about himself, so openly, I saw her nodding - I could see she was appreciating his honesty. And when I commented about the value of his authenticity, I could also see her nodding. So I pointed this out to him - that my feedback was being reinforced by a young woman in the group, who clearly echoed what I was saying.
She spoke up, and gave him some feedback to this effect as well.
The scene was very moving for everyone.
My focus on the present, on the actuality of who John is, and the way he brought himself to contact, helped to take him out of his story of woe, and his sense that he was not much good. This was reinforced by my feedback, and the feedback of the young woman.
There were introjects underneath his story of himself, but we would have to work with these another time.
What was important was to acknowledge his reality, his feelings, at the same time, bring him into contact, into relationship in the present.

© Lifeworks 2012


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