Negotiating a Frightening World

What Role Can Therapists Play?

Diane Barth
Anxious Asian woman with her hands covering her mouth | Photo by MART PRODUCTION

“Did you hear about the shooting in Maine?” my client Nick asked as he walked into my office. “One more horrible act of violence in the world,” he added without waiting for an answer. “It’s reached a point where I turn on the TV expecting bad news. I’m anxious and worried all the time.” He paused, then sighed. “Frankly, I don’t think there’s anything therapy can do to help.”

Nick isn’t the only one questioning the value of psychotherapy when it comes to dealing with the state of our world. Between fears about world war to more personal, immediate fears about safety, clients and therapists alike are struggling to make sense of a world that feels increasingly dangerous. Even as Nick spoke, I found myself nodding along.

“I know,” I replied. “It’s scary. There’s nothing neurotic about worrying right now.”

“Well, tell that to my wife!” Nick said. “She wants me to stop riding the train to avoid any possible terrorist attacks. When I said sarcastically that maybe we should all go back into lockdown, she got mad at me. The truth is, I am worried; I just don’t know what we should do. But when I told her that, she said my anxiety is getting in the way of my ability to problem-solve with her.” He paused again. “But I don’t think this is my anxiety disorder,” he said. “This is something bigger.” Then, Nick smiled. “Diane, could you just tell me what to do?”

We both laughed. One of Nick’s great strengths is his sense of humor, which has allowed him to laugh at himself even in the middle of his most anxious moments. He’d joked before that he wished I could just give him answers, or wave a magic wand and make his anxiety go away. It was a joke, yes, but also a genuine wish, one that many of my clients share. Even if we can’t tell clients where to find solace during these troubling times, they wish we could.

As I listened to Nick’s worries, I thought about the extra doorman who’d been posted at the front door of my apartment building that morning, precisely because of rumors about an impending terrorist attack. A friend who lives in a rural area had recently told me that she turned into the wrong driveway when the homeowner came running out his front door with a gun, telling her she needed to “get off his property.” Another friend told me that someone had shouted racist and religious slurs at her children at the school playground.

“People of color have been struggling with these things forever,” a colleague recently pointed out. “I’m not sure whether to be relieved or irritated that other people are finally learning how frightening it is to live in a world that doesn’t want you around.”

Therapists have written and spoken about problems in the wider world for decades, but it’s only recently that our field has acknowledged how much these problems affect us, our clients, and our work. Meanwhile, we’ve been struggling to understand what, if anything, we can do that might help.

“I worry all the time,” Nick said. “Lately it’s been about these mass shootings I’m hearing about on the news. My anxiety is driving my wife crazy. It’s driving me crazy. And I’m worried that I’m going to damage my kids. They’re frightened enough by everything that’s going on. I don’t want to pass on my anxiety to them.”

It was clear that the first thing Nick needed was help regulating his anxiety.

“How have you been managing your feelings so far?” I asked.

“Well, my wife has been immensely helpful,” he replied. “She’s very patient with me. She tells me to save all of my worries until the evening, when the kids are getting ready for bed. Then we go into our bedroom and shut the door.” He laughed. “In a normal, healthy family, the children would be right to think we were having sex,” he said. “But instead, this is when I unburden myself and tell my poor wife everything I’m worried about.”

“And does it work?”

“Surprisingly well,” Nick replied. “But for me, not for her. She wanted me to see a professional. She says listening to me makes her more anxious, and then she needs to talk to someone. She says she needs me to be her husband, not another child.”

Saving worrying for a specific time of day is a cognitive behavioral tool frequently used to help people who suffer from anxiety, so I told Nick that it was great that he’d given it a shot.

“But to build on that success,” I continued, “I wonder if, instead of telling your worries to your wife, you could write them down in a journal, then share them with me when our sessions roll around.”

Nick agreed to do so, and as the weeks went on, he found this strategy helpful. We also discussed some other ways he might release stress. Soon, he took up jogging outside in the evenings.

A few weeks later, Nick asked me how I was coping with the plethora of bad news. “You always seem so calm,” he said. “Do you ever feel anxious?”

I’d realized that sometimes it’s helpful to share my own thoughts and feelings. It’s something I’d done a lot less before Covid and remote therapy. I felt that it would be wrong to not give Nick a straight answer. Then, perhaps, we could explore the deeper meaning of his question.

“I do feel anxious, Nick. And I do a lot of the things we talk about to help myself feel calmer, too: I exercise, I talk to friends, I read, and I listen to music. I get outside when I can. But it’s a lot easier, I think, when you don’t have children at home. You have two young lives that you’re trying to nurture. That makes it so much harder.”

Nick was silent for a moment. “Thank you for that,” he said. “This is a hard time.”

Over time, Nick’s anxiety about frightening things happening in the wider world diminished enough that we were able to turn to other issues, ones he’d had for a long time but had never felt comfortable enough to share.

“To tell you the truth,” he said, “at first I didn’t trust the idea of therapy. But you’ve helped me so much, and I’ve learned I can trust you. So I think I’m ready to talk about some other things that have been worrying me, if that’s okay with you.”

Nick and I got to work on some of his more longstanding issues, like his self-esteem, concerns about his masculinity, and doubts about his ability to be a good husband and father. Occasionally, his anxiety would get out of hand, and when it did, I’d remind him about the emotion-regulation tools he had at his disposal.

But, of course, national and international crises continued to arise, and the world felt unstable once again. Climate change, political turmoil, and war and genocide overseas became regular topics in session. Nick’s anxiety was escalating, and mine was too.

“Would you tell me what you’d do if you were in my shoes?” Nick asked after telling me about the argument with his wife about subway safety. I knew he wasn’t asking me to solve his problems; he was asking for something even more important: He wanted me to connect with him, to let him know that he wasn’t alone in this place of uncertainly.

Trauma experts say one of the most valuable things a therapist can do for their client is to bear witness to their difficult experiences and emotions. But this can be painful for therapists too, especially when they share some those experiences and emotions. At the same time, we know that disclosing that we share these feelings too, without burdening our clients, can be therapeutic for us and for our clients.

“Honestly, Nick, I don’t know what I’d do in your position,” I said. “But I can guarantee you that my husband and I would have argued just like you and your wife are doing. We’d be hurt and scared and upset that we didn’t know how to keep our kids safe, and we’d probably take it out on each other, which is what I think the two of you are doing.”

Nick was silent for a moment. “Thank you for sharing that,” he said. “Really, it means a lot. It makes me feel like I’m normal. Like there isn’t something wrong with me.”

The things we share with clients may be more nuanced than what we share with family and friends, but when we do share with clients, we’re sharing our humanity. So much of therapy nowadays offers clients new ways of thinking about what’s happening in the world, and their place in it. But no matter how we approach this work, it’s crucial to remember that, at the end of the day, we’re all human beings making our way through this world together.

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Diane Barth, LCSW, is a psychotherapist, teacher, and author who lives in New York City and Massachusetts. She’s written recently about women’s friendships, aging, and integrative psychotherapy.

 

Photo by MART PRODUCTION