“This bridge freaks me out, Mama,” says my 6 year old as we get ready to enter the National Zoo.
“I know baby. Sometimes I get nervous on bridges, too. What’s going on?” I ask.
“It makes my legs feel funny. It feels like we’re high up in the trees and the water is so far below,” she explains.
“You know what’s cool about that? I ask, getting her attention, “Your body is real smart & that’s your body’s way of asking - Is this safe?
And, what’s cool is that you can look around, make sure you’re safe & give your body an answer.
So, what’s the answer? Are you safe?”
My big girl looks at me, and then all around. “Yeah, but I still feel funny.”
“Let’s look at the bridge,” I suggest. “Hmm - looks strong – lots of people are on it – cars, too.
Let’s check the railing (we try to shake it). Nice and sturdy.
What can we tell our body now?”
“It’s ok body. I’m safe,” she tells herself out loud, smiling.
“That’s right & that funny feeling in your legs & tummy will slowly go away. Maybe it has already. And, if it doesn’t for a while, that’s ok too.”
“It’s gone already,” she tells me.
“Alright, baby. Let’s go to the zoo!”
“Yeah! I want to go see the monkeys!”
Sunday, August 24, 2008
Monday, August 18, 2008
Tunnel Vision
We were on vacation at the beach last week & I wanted to share a moment from the journey.
To get to the beach, our route takes us over a handful of bridges and a tunnel that goes underwater. I could have easily gotten my husband to drive, but I knew that I needed to "stir up trouble" for myself & this was a good opportunity to do so. "You driving today?" he asked. "Yeah" I responded & smiled, "No problem." Of course, it's easy to be brave when the offending bridges & tunnel are not in view.
As we approached the bridge/tunnel/bridge area, I started questioning why I was doing this, when a perfectly good, non-anxious driver was sitting next to me. I had to keep reminding myself to invite the symptoms - to try & make them stronger - to ask them to stay around - because, all of a sudden, I really didn't want to be driving & thought, 'Make them stronger? Are you crazy?'
As I descended into the tunnel, I started wondering how strong the walls were & musing about how this is really an unnatural thing to do - driving underwater and such. Before I knew it, the visual images were rolling in of water crashing in all around us as the light from the exit faded into darkness & I wanted to slam down the gas pedal and get out of there quick!
My 8 year old daughter must have known that I needed a reminder to invite in more sensation. Just as we were about half way through, she chimed in and asked, "Do these tunnels ever flood? What would happen if they did? Would we all drown?" My husband & I smiled at each other & her impeccable timing. We told her that, yes, it would be bad if the tunnel flooded, but that it was built to be extremely strong. And, besides, there are people whose only job is to check it's safety all the time. And, isn't it cool that someone came up with the idea to make a tunnel that goes under the water & boats can travel over? (More sensation thinking about being underneath a boat).
I drove us safely into the light and, after that, the bridges didn't phase me that much. We had a fun week in a beach house with 17 people & I decided that it was alright to take the passenger seat on the way home.
To get to the beach, our route takes us over a handful of bridges and a tunnel that goes underwater. I could have easily gotten my husband to drive, but I knew that I needed to "stir up trouble" for myself & this was a good opportunity to do so. "You driving today?" he asked. "Yeah" I responded & smiled, "No problem." Of course, it's easy to be brave when the offending bridges & tunnel are not in view.
As we approached the bridge/tunnel/bridge area, I started questioning why I was doing this, when a perfectly good, non-anxious driver was sitting next to me. I had to keep reminding myself to invite the symptoms - to try & make them stronger - to ask them to stay around - because, all of a sudden, I really didn't want to be driving & thought, 'Make them stronger? Are you crazy?'
As I descended into the tunnel, I started wondering how strong the walls were & musing about how this is really an unnatural thing to do - driving underwater and such. Before I knew it, the visual images were rolling in of water crashing in all around us as the light from the exit faded into darkness & I wanted to slam down the gas pedal and get out of there quick!
My 8 year old daughter must have known that I needed a reminder to invite in more sensation. Just as we were about half way through, she chimed in and asked, "Do these tunnels ever flood? What would happen if they did? Would we all drown?" My husband & I smiled at each other & her impeccable timing. We told her that, yes, it would be bad if the tunnel flooded, but that it was built to be extremely strong. And, besides, there are people whose only job is to check it's safety all the time. And, isn't it cool that someone came up with the idea to make a tunnel that goes under the water & boats can travel over? (More sensation thinking about being underneath a boat).
I drove us safely into the light and, after that, the bridges didn't phase me that much. We had a fun week in a beach house with 17 people & I decided that it was alright to take the passenger seat on the way home.
My Treatment Resume
Subtitles: No wonder more people don’t seek out help when they need it; and, What’s up with all the counselors pushing medication?
*Almost done with graduate school, having fun doing exploratory work in counseling (recommended for social workers) & I have my first panic attack driving on the highway in Colorado. Grad school counselor sends me to campus doctor to get a prescription for xanax. Doctor says to take it before driving (label says “don’t operate heavy machinery after using”) & to give up caffeine. Counseling stops with the end of school with the message, “you’ll be fine”.
*6 months later I receive a six week sample pack of Prozac. I take it for six weeks and then stop because of the side effects.
*About a year later, I try again & seek out an anxiety center in my area. The shrink is very nice, we have a great rapport, but he doesn’t really do counseling. He does a thorough social history, establishes that I have excellent memory skills in repeating number sequences and sends me on my way with one month worth of Paxil samples. He, too, offers me xanax & this time I say no thanks. As I’m leaving, he tells me that once I beat my anxiety, I should come back and talk to him about a counseling job. I take Paxil for one month and then stop because of the side effects &, really, this isn’t helping.
*A co-worker recommends her counselor. He says that I just need to relax & have a little fun, lighten up a bit. I say, “I have a great, happy life except for anxiety, which is a pain in the ass”. We try EMDR. I try to help the process along and bring my own treatment plans and info that I’ve gleaned from reading. After a few more sessions & more “relax more & just do yoga” messages, I know that this is not what’s going to help & give up on counseling for a while.
*After having my first two babies, I’m ready to try again. Anxiety doesn’t own me, but I’m not driving on the highway much. I still remember what it felt like before anxiety infringed on my territory and I want it gone. I find more resources & begin reading everything I can find on the subject of “how can I get over this”. I begin exposure work on my own & make progress “taking back the roads”. I set up an appointment with a recommended counselor & it’s not a great fit. I go three times & keep looking.
*Second try: nice lady, a little rough around the edges, but she goes out in the field with clients & I like her spunk. I tell her that I don’t want to do meds, but she says that if I go on celexa for 2 years & do behavioral work at the same time that my anxiety will be gone. I try it, but don’t like it. I switch to Zoloft & stay on it for about 6 mos. We drive a number of bridges and highway stretches together. She’s got the behavioral piece down. I say that I’d like to work on the cognitive piece, that in some places on the highway, I’m still feeling really anxious & there must be something I can be doing differently. She says, I’m not sure why the exposure isn’t working for you, keep trying & the anxiety will go away. We part ways & I keep working on my own.
*Third try: I contact a psychologist friend of mine & say, Look this time I really need to find someone who’s an EXPERT on this anxiety stuff, won’t push meds & is up on the current research. I find Dr. C. who is fantastic & I really like, but still encourages I try meds. She’s worked in anxiety for years & has trained most of the area clinicians in CBT. I go on Lexapro & do a lot of great work with her. She says that I’m a dream client, that no one works as hard as I do and that it’s part biology & that I really need to work on acceptance. “I know you don’t want anxiety, but you got it. You have to accept what is.” True, acceptance is important, but I’m still feeling like with all the work I’m doing, I’m still missing an important piece. After monthly visits for a year, I feel done for the time being.
*I go off Lexapro during my 3rd pregnancy, experience big waves of panic in my third trimester and it comes back with a vengeance at about 12 -14 weeks postpartum. I go back for 2 or 3 “booster sessions” with Dr. C. and go back on Lexapro (after getting the green light from my midwife & an international breastfeeding expert). Things get better slowly. I come out of hiding and begin telling everyone. This helps tremendously & others begin sharing their stories. I’m dying for community. I start up a workbook study group (with some very cool, fellow anxiety super heroes) that meets inconsistently for a couple of months & fizzles out.
*Currently – I’m “off the junk” & not seeing a counselor. I don’t have anxiety mastered as much as I would like, but I'm realizing that what I was missing was not just the acceptance, but inviting & provoking the symptoms and, yes, acceptance. Good practice means doing something that guarantees that I'll feel anxious. I wish I could transport Dave Carbonell, Reid Wilson or David Burns to my hometown so that I could work with an anxiety guru and kick this thing once and for all (well, at least feel stronger in my skills and ready for the expected ups & downs).
Looking back over all the steps it’s taken to get good treatment, I see why so many people can live with this disorder much of their lives and never learn to beat it. Access to good information, counseling & community (plus a big dose of tenacity) makes a huge difference. When I get to be an anxiety master, I am going to open my own clinic & help offer others a more efficient path. More about that later!
*Almost done with graduate school, having fun doing exploratory work in counseling (recommended for social workers) & I have my first panic attack driving on the highway in Colorado. Grad school counselor sends me to campus doctor to get a prescription for xanax. Doctor says to take it before driving (label says “don’t operate heavy machinery after using”) & to give up caffeine. Counseling stops with the end of school with the message, “you’ll be fine”.
*6 months later I receive a six week sample pack of Prozac. I take it for six weeks and then stop because of the side effects.
*About a year later, I try again & seek out an anxiety center in my area. The shrink is very nice, we have a great rapport, but he doesn’t really do counseling. He does a thorough social history, establishes that I have excellent memory skills in repeating number sequences and sends me on my way with one month worth of Paxil samples. He, too, offers me xanax & this time I say no thanks. As I’m leaving, he tells me that once I beat my anxiety, I should come back and talk to him about a counseling job. I take Paxil for one month and then stop because of the side effects &, really, this isn’t helping.
*A co-worker recommends her counselor. He says that I just need to relax & have a little fun, lighten up a bit. I say, “I have a great, happy life except for anxiety, which is a pain in the ass”. We try EMDR. I try to help the process along and bring my own treatment plans and info that I’ve gleaned from reading. After a few more sessions & more “relax more & just do yoga” messages, I know that this is not what’s going to help & give up on counseling for a while.
*After having my first two babies, I’m ready to try again. Anxiety doesn’t own me, but I’m not driving on the highway much. I still remember what it felt like before anxiety infringed on my territory and I want it gone. I find more resources & begin reading everything I can find on the subject of “how can I get over this”. I begin exposure work on my own & make progress “taking back the roads”. I set up an appointment with a recommended counselor & it’s not a great fit. I go three times & keep looking.
*Second try: nice lady, a little rough around the edges, but she goes out in the field with clients & I like her spunk. I tell her that I don’t want to do meds, but she says that if I go on celexa for 2 years & do behavioral work at the same time that my anxiety will be gone. I try it, but don’t like it. I switch to Zoloft & stay on it for about 6 mos. We drive a number of bridges and highway stretches together. She’s got the behavioral piece down. I say that I’d like to work on the cognitive piece, that in some places on the highway, I’m still feeling really anxious & there must be something I can be doing differently. She says, I’m not sure why the exposure isn’t working for you, keep trying & the anxiety will go away. We part ways & I keep working on my own.
*Third try: I contact a psychologist friend of mine & say, Look this time I really need to find someone who’s an EXPERT on this anxiety stuff, won’t push meds & is up on the current research. I find Dr. C. who is fantastic & I really like, but still encourages I try meds. She’s worked in anxiety for years & has trained most of the area clinicians in CBT. I go on Lexapro & do a lot of great work with her. She says that I’m a dream client, that no one works as hard as I do and that it’s part biology & that I really need to work on acceptance. “I know you don’t want anxiety, but you got it. You have to accept what is.” True, acceptance is important, but I’m still feeling like with all the work I’m doing, I’m still missing an important piece. After monthly visits for a year, I feel done for the time being.
*I go off Lexapro during my 3rd pregnancy, experience big waves of panic in my third trimester and it comes back with a vengeance at about 12 -14 weeks postpartum. I go back for 2 or 3 “booster sessions” with Dr. C. and go back on Lexapro (after getting the green light from my midwife & an international breastfeeding expert). Things get better slowly. I come out of hiding and begin telling everyone. This helps tremendously & others begin sharing their stories. I’m dying for community. I start up a workbook study group (with some very cool, fellow anxiety super heroes) that meets inconsistently for a couple of months & fizzles out.
*Currently – I’m “off the junk” & not seeing a counselor. I don’t have anxiety mastered as much as I would like, but I'm realizing that what I was missing was not just the acceptance, but inviting & provoking the symptoms and, yes, acceptance. Good practice means doing something that guarantees that I'll feel anxious. I wish I could transport Dave Carbonell, Reid Wilson or David Burns to my hometown so that I could work with an anxiety guru and kick this thing once and for all (well, at least feel stronger in my skills and ready for the expected ups & downs).
Looking back over all the steps it’s taken to get good treatment, I see why so many people can live with this disorder much of their lives and never learn to beat it. Access to good information, counseling & community (plus a big dose of tenacity) makes a huge difference. When I get to be an anxiety master, I am going to open my own clinic & help offer others a more efficient path. More about that later!
Wednesday, July 30, 2008
Showing up
Woody Allen said that 80% of life is showing up. This is a great reminder for everyone, but especially so for people with anxiety. So often when I'm working through anticipatory anxiety, I remind myself - all you gotta do is just show up.
One of my big pitfalls with doing exposure work in the past was that I measured my success by whether or not I experienced anxiety & panic. Even though I felt good about the fact that I was regularly going out and driving parts of the highway that were hard for me & sticking it out, I wasn't satisfied because I still had spots on the road where I would get huge waves of adrenaline & experience that familiar doubt of "can I really do this?" I kept waiting for those feelings to go away.
Now I realize that good practice and getting past anxiety is to take the power back & upset the normal pattern of anxious thoughts & symptoms which can lead to panic. . . I realize that I can choose to be excited when I feel anxious in a situation & see it as an opportunity for good practice. Whenever I can, I try to say "yes" to my symptoms, even if I don't really mean it at first.
In Dave Carbonell's workbook, he says that you should ask yourself these questions to measure your success in doing exposure work.
Did you show up?
Did you work through the AWARE steps to the best of your ability?
And, after reading Reid Wilson's article (The Anxiety Disorders Game) I would add that you get extra credit for these -
Did you try & provoke your anxiety symptoms? Did you invite & say yes to them? Did you try & make the symptoms stronger & keep them stonger for at least 45 minutes?
Sometimes this is exciting work for me - I get psyched up and am ready to face anything. Other times, this is hard, hard work and I just want anxiety to go back to where it came from. But, I know that showing up time and time again and saying yes to my anxiety is the way to freedom for me. What kinds of tools/techniques are working for others out there - whether you're working through your own anxiety or helping someone through theirs?
One of my big pitfalls with doing exposure work in the past was that I measured my success by whether or not I experienced anxiety & panic. Even though I felt good about the fact that I was regularly going out and driving parts of the highway that were hard for me & sticking it out, I wasn't satisfied because I still had spots on the road where I would get huge waves of adrenaline & experience that familiar doubt of "can I really do this?" I kept waiting for those feelings to go away.
Now I realize that good practice and getting past anxiety is to take the power back & upset the normal pattern of anxious thoughts & symptoms which can lead to panic. . . I realize that I can choose to be excited when I feel anxious in a situation & see it as an opportunity for good practice. Whenever I can, I try to say "yes" to my symptoms, even if I don't really mean it at first.
In Dave Carbonell's workbook, he says that you should ask yourself these questions to measure your success in doing exposure work.
Did you show up?
Did you work through the AWARE steps to the best of your ability?
And, after reading Reid Wilson's article (The Anxiety Disorders Game) I would add that you get extra credit for these -
Did you try & provoke your anxiety symptoms? Did you invite & say yes to them? Did you try & make the symptoms stronger & keep them stonger for at least 45 minutes?
Sometimes this is exciting work for me - I get psyched up and am ready to face anything. Other times, this is hard, hard work and I just want anxiety to go back to where it came from. But, I know that showing up time and time again and saying yes to my anxiety is the way to freedom for me. What kinds of tools/techniques are working for others out there - whether you're working through your own anxiety or helping someone through theirs?
Monday, July 28, 2008
I don't want to
Sometimes anxiety means “I don’t want to”. I’ve read about anxiety sometimes being related to hidden emotions and had an interesting experience with it just last month. First of all, I’m one of those women who hates shopping for clothes. I have a hard time finding clothes that I like in my price range and often feel like I’ve wasted my time, coming home empty handed. (If only I was a trust fund kid) But recently two things happened - my Mom & I were looking through old photos and there I am wearing the same cranberry turtleneck and black skirt in a decades worth of holiday photos. Then, we were having dinner with friends and my girlfriend commented on liking the color green in my shirt. “Oh, I’ve had this shirt since we were in grad school together”, I told her. Smiling, she said, “Oh, I know.”
It was time to venture out.
I pulled together a short list of what I was looking for and drove toward the mall. I dropped into a few stores, not seeing anything I wanted. A few more and now I’m checking my watch. Shoot, I only have an hour before I need to be back to nurse the baby. What am I doing here on this beautiful day?
The phone rang and it was my husband checking in – “How’s it going? Have you found anything yet? We’re fine, don’t worry.” I heard the joyful chortles of my kids in the background. As I walked toward the dressing room, armed with about 20 items, I felt a sudden surge of adrenaline and began feeling panicky. My first response was – “What’s this?” I questioned why I would feel panicky while I was out shopping – that’s not a trigger for me.
In the dressing room, I looked at myself in the mirror and utilized the paradox technique thinking, “Do you wanna freak out here? Bring it on.” It took a little while, but I realized that sometimes anxiety means I don’t want to; or I feel guilty. I felt guilty that I was away from my family; I felt silly for spending so much time with nothing to show for it and I wasn’t having much fun. Bingo – my anxiety was telling me to either change my attitude or just go home.
Looking back, I can think of other times I’ve had similar experiences. Maybe not panic, but that cocktail of “I don’t want to” mixed with adrenaline – for example: dragging 3 tired & strung out kids through the grocery store while they all beg for something – Can we get a cookie? Why can’t we get a cookie now? Is it time yet? Or, times when I agreed to volunteer for something just because I couldn’t find a good reason not to or a way to nicely say no.
I did end up finding a few cute things. I stopped to grab a cup of coffee and kicked up my feet to really feel like I got a break from parenting. And, when I got home, my family was excited to see the goods and welcome me back like I’d never been gone.
It was time to venture out.
I pulled together a short list of what I was looking for and drove toward the mall. I dropped into a few stores, not seeing anything I wanted. A few more and now I’m checking my watch. Shoot, I only have an hour before I need to be back to nurse the baby. What am I doing here on this beautiful day?
The phone rang and it was my husband checking in – “How’s it going? Have you found anything yet? We’re fine, don’t worry.” I heard the joyful chortles of my kids in the background. As I walked toward the dressing room, armed with about 20 items, I felt a sudden surge of adrenaline and began feeling panicky. My first response was – “What’s this?” I questioned why I would feel panicky while I was out shopping – that’s not a trigger for me.
In the dressing room, I looked at myself in the mirror and utilized the paradox technique thinking, “Do you wanna freak out here? Bring it on.” It took a little while, but I realized that sometimes anxiety means I don’t want to; or I feel guilty. I felt guilty that I was away from my family; I felt silly for spending so much time with nothing to show for it and I wasn’t having much fun. Bingo – my anxiety was telling me to either change my attitude or just go home.
Looking back, I can think of other times I’ve had similar experiences. Maybe not panic, but that cocktail of “I don’t want to” mixed with adrenaline – for example: dragging 3 tired & strung out kids through the grocery store while they all beg for something – Can we get a cookie? Why can’t we get a cookie now? Is it time yet? Or, times when I agreed to volunteer for something just because I couldn’t find a good reason not to or a way to nicely say no.
I did end up finding a few cute things. I stopped to grab a cup of coffee and kicked up my feet to really feel like I got a break from parenting. And, when I got home, my family was excited to see the goods and welcome me back like I’d never been gone.
Friday, July 25, 2008
Super Powers
Are you an anxiety super hero? Sometimes we need to appreciate some of the super qualities that may increase our anxiety, but also make us compassionate human beings.
*Empathy – Are you someone who can walk into a room filled with people and instantly feel everyone else’s emotions? Without talking, can you intuit who’s struggling inside?
*Intuition: Do you consistently get gut feelings about things that usually end up spot on?
*Cat-like reflexes: Fight or flight? No problem. Burning building? You’d be the first one out with someone on your back.
*Courage: Do you regularly choose to practice with intense feelings of anxiety in an effort to accept, surrender and allow anxiety to loosen it’s grip?
*Humor – Do you have the ability to laugh at yourself and find the humor in absurd fears?
*Empathy – Are you someone who can walk into a room filled with people and instantly feel everyone else’s emotions? Without talking, can you intuit who’s struggling inside?
*Intuition: Do you consistently get gut feelings about things that usually end up spot on?
*Cat-like reflexes: Fight or flight? No problem. Burning building? You’d be the first one out with someone on your back.
*Courage: Do you regularly choose to practice with intense feelings of anxiety in an effort to accept, surrender and allow anxiety to loosen it’s grip?
*Humor – Do you have the ability to laugh at yourself and find the humor in absurd fears?
Saturday, July 19, 2008
A love letter from my Dad
*My Dad sent me this with permission to post. I know of some people who, after sharing their experiences with family, came to find out that one of their parents, aunt, uncle, cousin, etc. struggled with anxiety and they never knew. When we put our vulnerabilities out in the open with people we trust, some really lovely connections can occur.*
This is Kristin’s Dad writing. And I relate so intimately to the experiences she describes because I’ve been there and still am sometimes there myself. She comes by it all honestly via biological inheritance; genetics has an odd sense of humor. It reminds me of Mark Twain’s line about getting tarred, feathered and run out of town on a rail. He said something like, “If it weren’t for the honor of the thing, I would have just has soon passed up the experience.” More on that in a bit.
The year was 1957, I was almost 13 years old, it was early on a Sunday morning and I was out on my bike, delivering the Chicago Herald American. It was sunny, the weather was mild and there was nothing in the world to suggest to me that this would be any different from the hundreds of times I’d done my paper route in the past. I had covered the stretch of 112th Place and had just crossed State Street over by Cooney Mortuary – maybe you know the place - when I suddenly felt like I was in a dream – like everything around me was muted and slightly unreal. And then I recall this welling feeling of panic that I was going to die. I can even recall shouting, to see if this was, perhaps, a dream. It wasn’t. But my recollection is that it went away by the time I got home and I said nothing to anyone about it. But a few weeks later, another shoe dropped. I woke up on a Saturday morning with the sensation that I couldn’t feel myself breathing. The panic along with this one drove me downstairs where I blurted the news to my folks. I can’t imagine to this day how jarring and alien this must have been for them but my Dad, who was always good in a crisis, must have instinctively known that getting me calm was a first step to figuring out what was going on, presumably medically. And I remember that a couple of glasses of water and his reassuring arm around my shoulder somehow convinced me that my breathing was OK and that I wasn’t going to die. At least that morning! That summer we went to California and my folks almost turned around and went home when I had a pretty nasty attack of it in Salt Lake City. Fortunately, they didn’t; the trip still carries many wonderful memories.
The thing was, though, this was the 50’s. And no one seemed to know much of anything about Panic Disorders. After maybe a year of episodic attacks, my father, with his engineer’s way of looking at things, was determined to make a logical and planned assault on the problem. When our family doctor said he didn’t know what this was, Dad took me down to the prestigious University of Chicago Medical Campus for a full work-up. This didn’t quite pan out the way the Old Man planned. They did somewhat of a work-up but, while Panic Disorder wasn’t well recognized in those days, anxiety and phobias were. The 1958 medical establishment answer, of course, was psychoanalytic psychotherapy. And so, I started seeing a psychiatrist at the University of Chicago who, in Freud’s best style, sat there, gazed intently at me - and said almost nothing for 50 minutes at a pop. We stared at each other all summer long and, amazingly, I got better. What I know now, with a doctorate in psychology and a job as the clinical director of a large community mental health system, is that the real cure wasn’t Dr. T’s blank slate act. The “cure” lay in getting on a CTA bus by myself, transferring buses a couple of times, and making the weekly trip down to the University, despite my fears that I’d have an attack along the way. That, and the normal remitting and exacerbating course of a disorder that makes guest appearances and then disappears for months or years at a time. But what I did then on the bus – and what Kristin is doing 50 years later over bridges – carries the same principle of taking it on, practicing, flooding, desensitizing and using cognitive reframes. I would have much preferred an “aha” moment in exploratory psychotherapy, where the key from some childhood experience would be handed to me and the door unlocked. Kicking yourself in the ass and making yourself go beat the snot out of the gorilla, daily, is much less elegant and a hell of a lot more work. Unfortunately, it’s effective.
Over the years, I have had long periods of full remission, mixed periods of on and off stuff and periods where it has tormented me a great deal and made me fear that I’d lose my ability to function or make a living. I have not always fought the good fight and have avoided things far too often. Note that Kristin hit the nail on the head when she identified shame as factor that intensifies and broadens the illness. The script goes something like this: “I ran away from it. I am an awful coward. If people only knew how little courage I have, it would disgust them.” Given the stigma, you now begin to lie so that people won’t know your shameful secret. And, of course, you find yourself deeper in self loathing because you are now labeling yourself – unfairly, of course – not only a coward, but a liar, too. Yet so often in the face of the intensity of panic and the anticipation of its return, avoidance and lies have seemed like a price worth paying in the moment. Unfortunately, the interest on that credit card payment comes due and compounds itself.
But you must recognize your triumphs, too. When Kris and her brother were growing up I went through an awful period of agoraphobia associated with the panic and a dread of getting on I-95 for the wall-to-wall traffic into DC, where I worked as a reporter. Weekends I rarely ventured out of the apartment, finding comfort in my books and home hobbies like amateur radio. During the week, there were days that I called in sick and made excuses to my bosses. But most of the time, I gritted my teeth and endured feeling trapped in the middle of that traffic. What choice was there, really? I had to support my family. It wasn’t noble, it was necessity. And, for all of that, it helped me back into periods of remission, even though I didn’t fully understand the therapeutic part of it way back then.
Over the years, I have had to confront a variety of challenging situations like that and find, in my older age, I confront less – with the somewhat flawed rationalization that I’ve paid my dues and am going on strike against the damned malady. I don’t fly anymore and I climb stairs instead of riding elevators. I avoid big bridges. The flying keeps me from visiting places overseas but, while I regret the impact it has on my family, I don’t personally feel like I’m missing a vital experience. I like road trips and I like trains. As for the stairs, I’m in better physical shape, courtesy of my phobias. Thanks, phobias. My best to the gorilla! This is not an endorsement for selective avoidance – just truth in advertising. Besides, I take on the things I need to take on. I’m not crazy about public speaking, but addressed an assembly of 350 clinicians recently and am emceeing an event this coming Friday. I had to throw those items in because, despite what I tell my patients, I have more than a trace of hypocrisy about stigma and caring what others might think of me. I’ll go back to my Old Man, God rest his soul, and his wisdom. “Kid,” he’d say, “Do what I say, not what I do!”
By the way, I want to take a quick side track here on another matter. I loved Kristin’s comment about the friend who semi-jokingly asked her about hallucinations. It shows the great perceived divide out there between the putatively sane people and the putatively crazy people. But the divide is phony. What I mean is that people in America are so terrified by the concept of mental illness – and that they might catch it - that they conjure up a monolithic image that looks something like Norman Bates - and they whistle through the graveyard convincing themselves that, of course, they are different. Well, I’m here to tell you that mental illness takes on many different forms, is never monolithic and that all of us have our pieces of idiosyncratic thought and behavior. Lincoln, Churchill, Mozart all had mental illnesses and enriched our lives immeasurably and irreversibly. The great psychiatrist Harry Stack Sullivan was fond of saying, “We are all of us more human than otherwise.” Meaning there is no clear demarcation. Thank God. Get over it, America. Especially film makers who get rich playing to our fears.
At the outset, I mentioned Mark Twain and said that, given the choice at birth, most of us might well have chosen to avoid a lifetime of periodic panic attacks and phobias - - - were it not for the honor of the thing. Well friends, I am biased, but I will assert that there is great honor in the thing. I am absolutely convinced that the majority of people with anxiety disorders are among the most intelligent, creative people around. Almost by definition, it is the intellect and creativity that magnify the biology – dull people don’t create all those elaborate, “what-if” mental scenarios that feed Kristin’s gorilla. There’s an out-of-print book, called “Be Glad You’re Neurotic.” We don’t use that diagnosis anymore, but you’d love the book.
People with panic and anxiety disorders, in my experience, tend to have finely honed senses of humor, plenty of compassion for suffering in others and an uncelebrated and quiet courage in facing daily battles that are often invisible to people around them. Doesn’t that describe people you’d like to be around and have as close friends? Look in that mirror for a while and take it in. For every avoidance, there are far more uncounted successes – uncounted by people with the disorder. As a matter of fact, we grow and develop into people of substance and character from the struggles of our challenges.
In closing, you’ll permit me the parental prerogative, I hope, of bragging on my daughter. An undergraduate degree in writing, a master’s degree in social work, professional work after graduation in a settlement house in the community helping people in great need, birth educator, doula, spouse and one terrific mom to three lovely children. Woman of character and substance. When I saw this blog, it just blew me away. Talk about creativity, courage and giving help and meaning to others! My love for her and pride in the human being she has become is boundless. I write this with a big silly grin of button-bursting emotion on my face. You go, daughter! You’re the best!
Love always, Dad.
This is Kristin’s Dad writing. And I relate so intimately to the experiences she describes because I’ve been there and still am sometimes there myself. She comes by it all honestly via biological inheritance; genetics has an odd sense of humor. It reminds me of Mark Twain’s line about getting tarred, feathered and run out of town on a rail. He said something like, “If it weren’t for the honor of the thing, I would have just has soon passed up the experience.” More on that in a bit.
The year was 1957, I was almost 13 years old, it was early on a Sunday morning and I was out on my bike, delivering the Chicago Herald American. It was sunny, the weather was mild and there was nothing in the world to suggest to me that this would be any different from the hundreds of times I’d done my paper route in the past. I had covered the stretch of 112th Place and had just crossed State Street over by Cooney Mortuary – maybe you know the place - when I suddenly felt like I was in a dream – like everything around me was muted and slightly unreal. And then I recall this welling feeling of panic that I was going to die. I can even recall shouting, to see if this was, perhaps, a dream. It wasn’t. But my recollection is that it went away by the time I got home and I said nothing to anyone about it. But a few weeks later, another shoe dropped. I woke up on a Saturday morning with the sensation that I couldn’t feel myself breathing. The panic along with this one drove me downstairs where I blurted the news to my folks. I can’t imagine to this day how jarring and alien this must have been for them but my Dad, who was always good in a crisis, must have instinctively known that getting me calm was a first step to figuring out what was going on, presumably medically. And I remember that a couple of glasses of water and his reassuring arm around my shoulder somehow convinced me that my breathing was OK and that I wasn’t going to die. At least that morning! That summer we went to California and my folks almost turned around and went home when I had a pretty nasty attack of it in Salt Lake City. Fortunately, they didn’t; the trip still carries many wonderful memories.
The thing was, though, this was the 50’s. And no one seemed to know much of anything about Panic Disorders. After maybe a year of episodic attacks, my father, with his engineer’s way of looking at things, was determined to make a logical and planned assault on the problem. When our family doctor said he didn’t know what this was, Dad took me down to the prestigious University of Chicago Medical Campus for a full work-up. This didn’t quite pan out the way the Old Man planned. They did somewhat of a work-up but, while Panic Disorder wasn’t well recognized in those days, anxiety and phobias were. The 1958 medical establishment answer, of course, was psychoanalytic psychotherapy. And so, I started seeing a psychiatrist at the University of Chicago who, in Freud’s best style, sat there, gazed intently at me - and said almost nothing for 50 minutes at a pop. We stared at each other all summer long and, amazingly, I got better. What I know now, with a doctorate in psychology and a job as the clinical director of a large community mental health system, is that the real cure wasn’t Dr. T’s blank slate act. The “cure” lay in getting on a CTA bus by myself, transferring buses a couple of times, and making the weekly trip down to the University, despite my fears that I’d have an attack along the way. That, and the normal remitting and exacerbating course of a disorder that makes guest appearances and then disappears for months or years at a time. But what I did then on the bus – and what Kristin is doing 50 years later over bridges – carries the same principle of taking it on, practicing, flooding, desensitizing and using cognitive reframes. I would have much preferred an “aha” moment in exploratory psychotherapy, where the key from some childhood experience would be handed to me and the door unlocked. Kicking yourself in the ass and making yourself go beat the snot out of the gorilla, daily, is much less elegant and a hell of a lot more work. Unfortunately, it’s effective.
Over the years, I have had long periods of full remission, mixed periods of on and off stuff and periods where it has tormented me a great deal and made me fear that I’d lose my ability to function or make a living. I have not always fought the good fight and have avoided things far too often. Note that Kristin hit the nail on the head when she identified shame as factor that intensifies and broadens the illness. The script goes something like this: “I ran away from it. I am an awful coward. If people only knew how little courage I have, it would disgust them.” Given the stigma, you now begin to lie so that people won’t know your shameful secret. And, of course, you find yourself deeper in self loathing because you are now labeling yourself – unfairly, of course – not only a coward, but a liar, too. Yet so often in the face of the intensity of panic and the anticipation of its return, avoidance and lies have seemed like a price worth paying in the moment. Unfortunately, the interest on that credit card payment comes due and compounds itself.
But you must recognize your triumphs, too. When Kris and her brother were growing up I went through an awful period of agoraphobia associated with the panic and a dread of getting on I-95 for the wall-to-wall traffic into DC, where I worked as a reporter. Weekends I rarely ventured out of the apartment, finding comfort in my books and home hobbies like amateur radio. During the week, there were days that I called in sick and made excuses to my bosses. But most of the time, I gritted my teeth and endured feeling trapped in the middle of that traffic. What choice was there, really? I had to support my family. It wasn’t noble, it was necessity. And, for all of that, it helped me back into periods of remission, even though I didn’t fully understand the therapeutic part of it way back then.
Over the years, I have had to confront a variety of challenging situations like that and find, in my older age, I confront less – with the somewhat flawed rationalization that I’ve paid my dues and am going on strike against the damned malady. I don’t fly anymore and I climb stairs instead of riding elevators. I avoid big bridges. The flying keeps me from visiting places overseas but, while I regret the impact it has on my family, I don’t personally feel like I’m missing a vital experience. I like road trips and I like trains. As for the stairs, I’m in better physical shape, courtesy of my phobias. Thanks, phobias. My best to the gorilla! This is not an endorsement for selective avoidance – just truth in advertising. Besides, I take on the things I need to take on. I’m not crazy about public speaking, but addressed an assembly of 350 clinicians recently and am emceeing an event this coming Friday. I had to throw those items in because, despite what I tell my patients, I have more than a trace of hypocrisy about stigma and caring what others might think of me. I’ll go back to my Old Man, God rest his soul, and his wisdom. “Kid,” he’d say, “Do what I say, not what I do!”
By the way, I want to take a quick side track here on another matter. I loved Kristin’s comment about the friend who semi-jokingly asked her about hallucinations. It shows the great perceived divide out there between the putatively sane people and the putatively crazy people. But the divide is phony. What I mean is that people in America are so terrified by the concept of mental illness – and that they might catch it - that they conjure up a monolithic image that looks something like Norman Bates - and they whistle through the graveyard convincing themselves that, of course, they are different. Well, I’m here to tell you that mental illness takes on many different forms, is never monolithic and that all of us have our pieces of idiosyncratic thought and behavior. Lincoln, Churchill, Mozart all had mental illnesses and enriched our lives immeasurably and irreversibly. The great psychiatrist Harry Stack Sullivan was fond of saying, “We are all of us more human than otherwise.” Meaning there is no clear demarcation. Thank God. Get over it, America. Especially film makers who get rich playing to our fears.
At the outset, I mentioned Mark Twain and said that, given the choice at birth, most of us might well have chosen to avoid a lifetime of periodic panic attacks and phobias - - - were it not for the honor of the thing. Well friends, I am biased, but I will assert that there is great honor in the thing. I am absolutely convinced that the majority of people with anxiety disorders are among the most intelligent, creative people around. Almost by definition, it is the intellect and creativity that magnify the biology – dull people don’t create all those elaborate, “what-if” mental scenarios that feed Kristin’s gorilla. There’s an out-of-print book, called “Be Glad You’re Neurotic.” We don’t use that diagnosis anymore, but you’d love the book.
People with panic and anxiety disorders, in my experience, tend to have finely honed senses of humor, plenty of compassion for suffering in others and an uncelebrated and quiet courage in facing daily battles that are often invisible to people around them. Doesn’t that describe people you’d like to be around and have as close friends? Look in that mirror for a while and take it in. For every avoidance, there are far more uncounted successes – uncounted by people with the disorder. As a matter of fact, we grow and develop into people of substance and character from the struggles of our challenges.
In closing, you’ll permit me the parental prerogative, I hope, of bragging on my daughter. An undergraduate degree in writing, a master’s degree in social work, professional work after graduation in a settlement house in the community helping people in great need, birth educator, doula, spouse and one terrific mom to three lovely children. Woman of character and substance. When I saw this blog, it just blew me away. Talk about creativity, courage and giving help and meaning to others! My love for her and pride in the human being she has become is boundless. I write this with a big silly grin of button-bursting emotion on my face. You go, daughter! You’re the best!
Love always, Dad.
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