When life suddenly turns anxious
A man in his 30s comes to see me. He is doing well in his career. He is in a relationship that he is optimistic about. He is the last person who would have thought he needed psychotherapy.
But over the last few months things have started to change. He has started to become anxious and uncertain. He is sleeping badly and obsessively worrying about things.
Making sense of psychological symptoms
I always try to find out more about what was going on when the symptoms developed. I tend to find that most psychological symptoms are socially intelligible. If you can think about how the symptom fits into the person’s time line you are on the way to understanding a lot.
He tells me that it all seemed to start when he went to dinner at a restaurant and was told he didn’t have a reservation. It had surprised him how much it upset him, he could see his reaction was disproportionate.
He dates his anxiety and unease from that moment. In sessions with me he starts to talk about how, although he comes across as confident, outgoing and gregarious, he is aware that he likes to be absolutely certain about any arrangements he is involved in. He never goes to a restaurant without having booked.
Initially it appears a fairly straightforward story. A degree of obsessive control is part of how he lives. But then we start to see how disturbed he is by any changes in how he experiences me and my consulting room. If a chair is moved he picks up on it. Ordinary changes upset him. I understand this to mean that his anxiety is older than the restaurant experience.
When traumatic experiences are ignored
He tells a story of being a child on an organised school theatre trip. When they got to the theatre his name had been left off the list of children who had places. In the event he was left to sit on the school bus while his classmates watched the play.
It was clearly a distressing experience. As he starts to recall the event with me it becomes clear that though in his family this story has become something of a family joke which he had gone along with. There was nothing funny about it for him.
Underneath the confident persona we see that a disturbing and traumatic experience has left his personality with a kind of damaged traumatic substrata. A traumatic wound exists. Where he has built his life on projecting his easy-going success, since being denied his reservation at the restaurant he has started to feel shaky and anxious.
The distressing events of the school theatre trip all those years ago have remained, unacknowledged, and the disturbance at the restaurant a few months ago have suddenly brought the emotional upset of the past back to mind. This is an instance of what psychoanalysts would call; the return of the repressed.
Though this story is unique to this client, its basic constituents are common. There are lots of cases where early unacknowledged childhood traumas have been left behind because no one knew how, or thought, to give them the right attention at the time.
When we have been overwhelmed by trauma the impact of the event penetrates the mind or psyche and if the experience is ignored then the mind can respond by splitting the event off and, as it were, putting it in a separate compartment.
This is part of what we refer to as dissociation. When an event was so overwhelming that the way of dealing with it was to split it off from the rest of consciousness.
This works as an emergency temporary measure but in the longer run we may find that further attention is needed to repair the split and restore the traumatic event to our minds.
When these kinds of experiences are split off, they haunt the person
Because they are pushed to one side they never get the chance to fit properly into our time lines and histories. But they are still there. At some point they may need to be attended to so that we can recognise the trauma and by doing so enable it to become part of our past.
It remains an awful experience to have gone through, but we become clear that the thing that is provoking anxiety in the present is less to do with the sense of shock at finding we don’t have a reservation at a restaurant.
We become better able to see that the reason the event feels so disproportionately powerful is more to do with the past trauma and less to do with the present.
The benefit of this is that we become better able to relax in the present.