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Breaking Through to the Present


Let's return now to Renee, the client with panic disorder who was beginning to think she'd ended up with one strange therapist. Halfway through that first session, she was explaining that the lump in her throat was currently causing her the most anxiety. I suggested she ask her anxiety, "Would you please make my lump get stronger?"

Her eyes bulged. She exclaimed, "It sounds scary!"

I asked what she thought would happen.

She said, "I'll either stay the same or get worse. I can hardly imagine getting better by telling it to get worse." After some teasing and persuading, she agreed to try it anyway. What courage! Her first attempt being exceedingly feeble, so I modeled for her: "Anxiety, I beg you to make this knot stronger. I want it to be so large; I want it to be as big as a marble. I want it to be--how about a golf ball? Could you make it a golf ball? I'd like it to be so large that people start to see my neck protrude with this big ball in there. I want to make it so big that to swallow, my saliva has to go all the way around this lump and then down my throat. If you'd do that, it would make me sooo happy. It's so important. All these years I've done so much for you! I'm asking you one simple thing: to make my lump larger, my knot bigger. Please do this one thing for me."

I asked her to try her own version, "as if you're auditioning for a role, and this is your job, and if you don't do this persuasively you don't get the part. Are you willing to try this again?"

Renee nodded and addressed her anxiety in the beseeching voice of a lovelorn swain: "Anxiety, I beg you to make that knot much, much bigger." She laughed, "This just seems so unreal." She laughed again and said with more conviction, "Anxiety, make this knot as big as you possibley can!" Then she paused, looking surprised, and said, "It's not there, anymore."

"Excuse me, Renee?" I said in mock astonishment. "Try harder. Make it as big as you can."

She concentrated for a minute and then looked at me. "It's just not there."

"What do you mean, it's not there?" I asked severely.

"It's just gone," she giggled.

And there it is: Renee accepted her present discomfort and embraced her uncertainty. She set aside her worries about future discomfort and challenged her nemesis. In her anxiety, she wanted to hold back out of fear of her symptoms. Instead, she played her own game of pleading with anxiety to make her more uncomfortable, and the symptoms disappeared. We continued the session in this same provoking style, hyperventilating together until her legs were shaking and hands were tingling and I was sweating and seeing stars. Then she demanded the symptoms worsen and watched as they slowly dissipated.

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