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The Anxious Client Reconsidered - Page 7

 

The Uses of Anxiety

Over the time I have worked on anxiety disorders, I have arrived at two basic, closely related, conclusions about the nature of these conditions. First, anxiety disorders are a means of keeping the external world at bay.

To understand this idea, it is valuable to contrast this view of anxiety with the perspective of traditional psychoanalytic theory. From a classical psychoanalytic perspective, anxiety is the attempt to repress unacceptable impulses that arise from within the Id. It prevents disorganized thoughts and forbidden urges from invading the consciousness. In this traditional view, anxiety works to keep impulses down within the psyche. Perhaps the best example of this dynamic occurs when a person who experiences homosexual thoughts responds with great anxiety that is expressed through homophobia.

But in my view, anxiety has less to do with repression than deflection. Anxiety keeps new ideas and information out of a person's awareness. It saves overloaded mental and emotional circuits from additional strain. It is a sea wall built against the tide of physical circumstance.

Unfortunately, anxious individuals pay a severe price for this protection. They have trouble accepting feedback or learning from their experiences. They also have a difficult time adapting to new circumstances. Their approach to life may not work very well, but they have difficulty changing it.

As an illustration, consider the dramatic contrast between the way depressed clients and anxious clients respond to a therapist. Most of my depressed clients can take in what I say and consider it. My comment may or may not influence them. It may or may not be accurate. But they take it in. Anxious people usually don't. It is as though feedback and interpretations bounce off them.

With a depressed person, if I say something as basic as, "The opinions of your parents are very important to you," the observation often begins a dialogue about autonomy or dependence or childhood memories. The same comment to an anxious client brings an unproductive evasion: "Oh, yes, they are. I have often thought they mattered too much, but I could never change that."

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