I said, almost gleefully, "A few years ago? So you're due for another episode any time now, aren't you?" Now she was looking at me with something approaching alarm, as though wondering, What's this character up to anyhow?
What I was up to doesn't look or sound like the standard, empathic, rapport-building opening moves of a senior therapist. In fact, to Renee, I must have seemed careless, provocative, insensitive, maybe even clueless. She'd entered my consulting room in a state of nearly full panic and I'd said I was pleased. She feared losing control, and I'd reminded her she's wasn't really in control at the moment. She was avoiding panic by not attending to her heart, and I'd suggested we should pay attention to her heart. She hadn't had a full panic attack in a few years, and I'd suggested she was due for one. What kind of therapy is this? What was I doing?
Now, in therapy, I dedicate myself to helping people learn to accept, even welcome, their symptoms. I try to teach them to run toward rather than from what they fear and hate most about their disorders. I insist that instead of trying to evade, stifle, override, or distract themselves from these symptoms, they work as hard as they can to make the symptoms worse. I do all this as a therapist dedicated to helping them genuinely recover from the suffering caused not only by their anxiety but, more to the point, by the endless and often counterproductive tactics they use to escape it. I invite clients--as I invited Renee--to join me in looking directly at their problem with curiosity, humor, and compassion.
My therapeutic premise is that people's worries can be signals warning them about something they need to attend to. But the repetitious, unproductive, obsessive thoughts that accompany anxiety disorders are simply distressing noise. If clients can change the frame of reference from "my obsessive thoughts are in response to a real and dangerous threat" to "my obsessive thoughts are pointless noise unrelated to a real threat," they have a steady platform from which to change their entire world view (and, incidentally, make the symptom go away).