Treatment

Part IV

Component #5: CONNECTION: (C)

Have you ever thought about what would happen if a cataclysmic event threatened the lives of everyone on our planet? I realize, of course, that this is a most unpleasant thought to consider. It is also a highly esoteric question, ideally suited for science fiction enthusiasts. But let’s think hypothetically for a moment and imagine the following scenario:

Without warning, a mammoth asteroid the size of Texas has suddenly fallen out of its orbit. On a direct collision course with earth, it will impact our planet in less than three months. There is nowhere for anyone to hide, and unfortunately, there is nothing anyone can do to stop it. This really does sound like a scene from a science fiction movie, wouldn’t you agree? But surprisingly, giving serious thought to the consequences that would follow a dire situation such as this can greatly enhance our understanding of anxiety.

We can begin in this effort by addressing the following related questions. How would an event of this magnitude impact or affect people? What would be their reaction? How would they feel? What would they do? And, after realizing their collective destiny, how might they be inclined to behave toward one another? Answering these questions is, of course, the next step. Accordingly, to illustrate the relation between anxiety and our hypothetical scenario, let’s consider some typical real-life situations, specifically, ones that reflect three of the more common anxiety disorders: public speaking anxiety, social anxiety, and generalized anxiety.

First, we’ll consider the case of a businessman in his mid-forties who has severe public speaking anxiety. Suppose that after learning of his destiny, the fleeting thought about an upcoming oral presentation flashed through his mind. In the past, such thoughts invariably made him extremely nervous. He would become even more anxious during his typical routine of preparing for, rehearsing, and delivering the presentation to colleagues. What about now? How nervous do you think he would be? Would he experience any real anxiety?

Next, suppose a woman in her late thirties, who has severe social anxiety, had planned to attend a social gathering a few days hence, consisting mainly of people she didn’t know. Normally, just thinking about these events would arouse strong anxiety in her. But given the imminent finality of her life on earth, how anxious do you imagine she would get? Do you think she would be at all nervous?

Finally, what about financial concerns, especially bothersome to someone with generalized anxiety disorder? Would anyone, even the most compulsive “worry wart” give a moment’s thought to this issue? Considering the destiny awaiting us, would wealth, possessions, or money truly matter to anybody, even an inveterate worrier?

Please take a minute or so, if you would, and give some serious thought to these questions. Well, what did you discover? Perhaps you learned something new? I myself came to some surprising – if not startling – conclusions. First, I am convinced that an event of this magnitude would be what I refer to as the “great equalizer.” More specifically, I mean to suggest that the moment mankind’s destiny became manifest, our collective status as human beings would instantly and permanently equalize. Thus, a high school janitor would have no less prestige than a senator; a waitress would be equal in stature to an Oscar-winning actress; an elementary school teacher would hold virtually the identical prominence of a Nobel Prize-winning physicist.

I understand that this may sound hard to believe. But if I am indeed correct in my conclusion, the question now becomes, why? Why would this happen? And more importantly, how does this enhance our understanding of anxiety?
The answer, quite simply, has to do with the notion of personal significance. Do you remember this concept? If not, you may wish to pause for a moment to read or briefly review the section entitled WHAT IS ANXIETY.

The central point is that along with the realization of our inevitable destiny, everyone’s perspective would change dramatically. As a result, the usual affairs of living would become entirely unimportant, having no real consequence. These matters would have no personal significance to anyone. You may recall my earlier explanation about the relationship between personal significance and anxiety: The lower the degree of personal significance, the less anxiety we are apt to experience. Instinctively, people would realize the utter insignificance of almost everything.

Moreover, they would understand at the deepest level of their being that their possessions, assets, prestige, status, wealth and all other “earthly” affairs, once so dear to them, would simply not matter any more. Why? Because they would realize that in a very short time they would not be alive to enjoy them. And as far as anyone knows, when we die, we can take nothing of psychological value (e.g., ego, self esteem, achievements, etc.) with us.

Now let’s turn briefly to another question. What thoughts, ideas and questions might we, as human beings, contemplate during the short time we have remaining on earth? Do you wonder about this? I do. I can only imagine that curiosity, a sense of spirituality, love and perhaps the wish to rectify our iniquities, transgressions, and hurtful acts towards others are essentially all that would remain in our collective consciousness. But what about you? After giving some thought to our imaginary scenario, have you come to a different conclusion? If so, please let me know. Perhaps we’ll have the chance to discuss your views at some time in the future.

The second conclusion focuses on how people might behave toward each other, were this event to take place. Unlikely though it may seem I feel certain that humans would be drawn together in close intimacy. They would seek one another out, regardless of race, creed, religion, ethnic persuasion or other differences.

In so doing, the common humanity all of us share would become much more palpable. Our lives would be imbued with more richness, caring, sincerity, kindness and love, as we endeavor in the short time left to discover our true purpose and the meaning of life. Owing to our imminent demise, in the precious time that remains, I am convinced people would experience what I call connection.

Connection is a simple word, to be sure. But mind you, I am not referring in this instance to something superficial or ephemeral. Quite the contrary, I am speaking of a deep, transcendent connection. A profound, unifying force, reflecting the inevitable shared destiny and fundamental sameness (i.e., qualities and characteristics that make people more alike than different), that uniquely and eternally binds all human beings. I am further suggesting that with what time remained we would be joined together, at almost complete peace with one another.

The petty differences that previously separated and disconnected us from each other would vanish. For the majority of us, in their place I believe would be a pleasant stillness – and an absence of negative emotions (e.g., anger, resentment, jealousy, etc.) – promoting greater harmony with our fellow man.

What about anxiety, you ask? Well, in my considered opinion, very few people would feel truly anxious. It would almost cease to exist. Remember, anxiety cannot be sustained under conditions of absolute certainty. And, since our common fate would be certain to everyone, virtually no one would feel any anxiety. Wouldn’t that be nice!

Now, at this point you may well be wondering, “What does all this mean”? Is the foregoing merely an interesting abstraction. Or, does it bear some concrete relation to the problem of anxiety; the anxiety people often experience in their everyday lives? The answer is yes; it does. And, as we near the end of this section on treatment, there are two important points that remain to be clarified with regard to the notion of connection.

First, the relationship between connection and anxiety (as I have described it), is an inverse one. This means that as our interpersonal connections strengthen, anxiety tends to decrease. Thus, the more we are able to make meaningful connections with others during the course of our lives, the less anxiety we are apt to feel. Perhaps you can now better appreciate why I consider connection to be so important. So important in fact, that as we improve our ability to connect with others, we simultaneously enhance our ability to master and control anxiety. But please, do not simply accept what I’m saying at face value. Instead, I encourage you to make an earnest effort to validate, in your own experience, the relationship between connection and anxiety. Once you take a small risk (e.g., initiating a conversation with a stranger, or some other action that normally occasions your anxiety), I’m certain you’ll discover that it isn’t so difficult. Besides, what do you truly have to lose?

Second, we know that the probability of a catastrophic, life-ending event threatening our planet any time soon is extremely remote. Therefore, the question to be asked is: Can we enhance the degree of connectedness during our lives, in the absence of a life threatening event?

In a word, the answer is yes. I am confident that indeed we can. The possibility exists for human beings, over a period of time, to gradually become more interpersonally connected. Our species need not face mortal peril in order for this to occur.

And last of course, there is the question, how? How do we go about becoming better connected? What is it we have to do? Well, there are a number of ways to begin this process. Let’s briefly review just a few examples that most of us should find fairly practical:

1. Acquire the habit of making consistently good eye contact every time we converse with another person;
2. As much as we can, take a genuine interest in the lives and affairs of others;
3. As a corollary to the second, try to be sincere in our interactions with others (i.e., mean what we say).
4. Take advantage of opportunities to interact with people more frequently (e.g., at the drug store, supermarket, toll plaza, etc.), and for longer periods of time.
5. And finally, practice becoming less judgmental and more tolerant of others, especially those whom we find offensive. This means that we try to become more aware of our normal tendency to make dichotomous judgments about people (e.g., he/she is good/bad, nice/mean, interesting/boring, etc.).
   
   Instead, we simply allow others to be as they are, accepting them wholly and completely, in spite of their faults, weaknesses, character defects, etc. This of course, is not easy to do. But with time and effort it becomes easier, and results in surprising changes (mainly for the practitioner!).

Now before you click on to another part of the website, let me say thank you for taking the time to read this lengthy section. It is my sincere hope that the time invested on your part has been worth the while. If you have questions about connection or want more information, please feel free to let me know.

Following are two more Case Studies gleaned from my experience with clients, over the years. I have chosen these two cases in particular, because I think they will help you to better understand the nature and cause(s) of anxiety-related suffering:

CASE STUDY #4: Test Anxiety

During my one year internship I was most fortunate to be able to work at the Georgia State University Counseling Center. This setting was ideal because it allowed me to complete my dissertation work on the subject of test anxiety. Based on my research, I designed a treatment protocol for test anxious students.

Although the treatment was administered in a group format, I should mention that it could also be carried out individually. The treatment program consisted essentially of two components.

1. A didactic part, in which I reviewed the tenets of my dissertation research and explained what I believed to be the root cause of test anxiety; and,
2. An experiential component, which focused on each student’s personal experience related to test anxiety (i.e., a process of phenomenological reduction that allowed each participant to systematically examine the nature and process of his/her anxiety experience).

After about five weeks, I had presented all of the didactic material to the students. I had also given each participant the chance to share his/her experience with the group. The final step then, was to review the data (i.e., the written record I had compiled and condensed, to reflect the common elements of each participant’s experience).
The results provided a fascinating, if not surprising, conclusion. Every student in the group, without exception, expressed almost the exact feeling (paraphrased), with regard to why they became anxious while taking important tests: “If I don’t pass the Regent’s test – a requirement for all Georgia college students – my life will be over!” In other words, they had put all their eggs in the “academic basket.” Talk about pressure!

Fortunately, once they realized this most important fact, their experience changed dramatically. Each student again took the Georgia Regent’s test. Not only did each one of them pass – after having failed the test previously – but they also reported feeling much less anxious during the test. Needless to say, the students were most pleased. In addition, one of the group members, a delightful elderly woman who hadn’t been to college in over forty years – told me after taking her first exam: “If I had had your telephone number, I would not have hesitated to call you at two o’clock in the morning to tell you that I got an A on my test!” That was some news. Hearing it was truly gratifying and convinced me that the treatment program had been a success.

Finally, I would like to emphasize one additional important point: If you’ve read the section entitled WHAT IS ANXIETY, you may recall that I articulated what I believe represents the core of the anxiety experience: a sense of trepidation that things are not going to turn out OK.

Now, let’s briefly consider the psychological message each student gave to himself/herself (prior to participating in the group). By thinking and believing that passing the Regent’s test was absolutely critical to their success, they left themselves no viable alterative concerning their future. Put another way, if they failed this test they had no “back-up” plan, and thus were not able to feel secure about their future.

As I reflect on the experience these students shared, it brings to mind the old adage, timeworn though it is, “Don’t put all your eggs in one basket!” – For if you do, things may not turn out the way you would like.

CASE STUDY #5: Panic Attack

Recently, I had the pleasure of treating an Hispanic male, in his early forties (whom we’ll call Ricardo), who had sought help for frequent and often intense, panic attacks. Ricardo was a highly intelligent, soft-spoken, married man with four children.

He was also very articulate, well dressed, and well-mannered, in short, a true gentleman. It was a pleasure treating him, because Ricardo was simply the type of person you could not help liking. Despite his considerable personal assets and financial success, however, Ricardo had struggled with episodes of panic, for over twenty years. Therefore, when he came in for treatment he was highly motivated. Of course, this made it easier for me to help him. Why? Because the more motivated a client is, the more effort he/she normally puts forth. Not surprisingly, motivation tends to correlate highly with the results achieved in therapy.

Ordinarily my protocol for treating panic disorder is fairly extensive, requiring some twelve to fifteen weeks of therapy. Ricardo’s case was no exception. He remained in therapy for about four months and during that time we focused on the specific factors that I felt were critical to the success of treatment.

First, we explored whether the source of Ricardo’s panic episodes was internal or external. Were the attacks due to situations and circumstances or to internal mental processes that Ricardo was not aware of? As is invariably the case, Ricardo acknowledged that the source was indeed internal. What’s more, he made a most important discovery that proved to be of enormous benefit to him.
Ricardo realized that without meaning to, he was generating panic episodes by the way he thought about and reacted to certain bodily sensations.
In brief, he was interpreting a sudden increase in his heart rate as a sure sign of heart trouble. At times, whenever his heart rate would unexpectedly accelerate, he became convinced that he was having a heart attack. In view of this, it is no wonder that he tended to react to these episodes with panic.

Second, once Ricardo empirically validated that the source of his panic episodes was internal, his optimism about therapy increased dramatically. He had, of course, heard me emphasize the importance of “mastery and control” numerous times.

But now the difference was that he himself believed he could acquire it. And from this point forward, Ricardo assumed a more proactive role – rather than depending too much on me – in the treatment process. Some of the more important aspects of his behavior that he paid closer attention to were:

• His anxiety “triggers;” (i.e., the situations/circumstances that occasioned his anxiety);
• His tendency to misinterpret and exaggerate the meaning of certain bodily sensations (e.g., increase in heart rate);
• His negative self talk (e.g., “I’m a basket case”), and
• Finally, his marked propensity to become extremely passive and helpless after experiencing an anxiety episode.

Needless to say, Ricardo’s hard work in therapy paid off. He made considerable progress after some four months, and now believes he is all but immune to future episodes of panic. Now, if his heart rate were to suddenly increase during a business meeting, he would react differently than in the past. Unlike previous instances, the probability of his experiencing symptoms of panic would be low. Instead, he would more likely conclude that his heart is probably OK and, that the true problem concerns anxiety rather than cardiac malfunction.