One reader asks if hypnosis can help with social anxiety.
The answer is yes, most of the time. Although most of the clients I have treated for this problem have found rapid improvement in their symptoms, there have been a few who have had difficulty moving into a state of relaxation deep enough to allow the intervention to be successful. For those clients, EMDR, guided imagery, or other methods have worked better.
Savielly Tartakover, a Grand Master of chess from Poland, was quoted as saying, “Tactics is knowing what to do when there is something to do. Strategy is knowing what to do when there is nothing to do.”
I have been reminded of this time and again when I meet with clients who have survived tremendous hardship and abuse as children. There was truly nothing that they could do to change their worlds. Yet they found ingenious strategies to preserve their spirits and maintain their sense of hope and possibility. Along with the nightmares and the panic attacks and the tears, they bring to my office determination and courage and inner strength. These are the transcenders who inspire me.
Long before I began my graduate education, I happened to meet an LPN who worked in a hospital psychiatric unit. Since I was contemplating a career in psychology, I asked her what her job was like. She assured me that she found her work satisfying. After thinking a moment, she added, “The longer I work here, the more I realize that if I had faced the same problems that these patients have, I’d be exactly where they are.”
That conversation happened 25 years ago. I think of her and her insight often. She helped shape my understanding of mental health and the individuals who would come through my door. We are, all of us, far more alike than we are different. Remembering that is a gift we give ourselves and those around us.
Karl Menninger once said, “The adjuration to be ‘normal’ seems shockingly repellant to me; I see neither hope nor comfort in sinking to that low level. I think it is ignorance that makes people think of abnormality only with horror and allows them to remain undismayed at the proximity of “normal” to average and mediocre. For surely anyone who achieves anything is, essentially, abnormal.” US Psychiatrist (1893-1990).
This quote is for all of us who felt like square pegs, misfits, and fringe material at some point in our lives, especially in that microcosm of torment known as high school. It is the arena in which “fitting in” is most tantamount to survival, equaled only by the pressure to conform exerted by extreme fundamentalist groups and weirdly familial corporations. But, even after surviving high school, few of us dare to stand out from the crowd, to be labeled as different. We snuggle into the comfort of the familiar, the routine, and the expected. Yet, it is only by stepping away from the crowd that we have room to spread our wings and soar.
So–when is being different unique, and when is it an illness? Where is the dividing line? Sigmund Freud stated that mental and emotional health is the ability to work and love. Although he said many other things that are largely discounted, it is still reasonable to assume that a psychologically healthy individual is able to manage intimate relationships and to engage in productivity. If a person’s symptoms or behavior patterns interfere with those activities, then they have crossed the line into a disorder.
If a person washes his or her hands or straightens papers or sharpens pencils many times a day, but still manages to get to work and complete the necessary tasks, then it’s a behavior quirk that may appear odd but isn’t a disorder. If they spend so much time sharpening the pencils that they never get to the job they need them for, it’s a disorder.
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I am frequently stunned by the ability of individuals to use their minds to overcome longstanding problems. One woman I interviewed as a participant in a research project was experiencing symptoms of posttraumatic stress disorder due to having lived in domestic violence. I asked her to describe the inkblots in the Rorschach Test (yes, they really are inkblots) and she gave responses typical of a battering victim. However, on the fourth blot, she pointed to a small shadowed area near the bottom of the card. “There.” she said, “That’s the Warrior Princess. I can’t believe she’s on there. That’s me. That’s what I could be. I can be strong like her.” The woman stood up straighter, her voice stronger, her presence more powerful.
Now, if I squinted and held the card just right, I could almost see what she was indicating. But I was there only as a catalyst. What mattered was that she could see that blotch of dark and light as a symbol of her potential. It was the start of a journey that led her out of abuse and into a satisfying life.
As an intern, one of my very first clients was Martha C*, a tiny lady, middle-aged, about 5’2”. Now, 5’2” is not extremely short, but this woman seemed very small. She looked at the floor, hunched her shoulders, and wrapped her arms tightly around her torso. Her steps were mincing and her voice a whisper. I got the distinct impression that she felt she deserved as little room in the world as possible.
She came to treatment because she was facing two crises. Her husband, Mac*, had been in prison for two years, but he had called (collect!) every day, cursing and berating her. She had been too terrified to refuse his calls. Now, he was due to be released in a month. To add to her troubles, she’d been bullied at work by an unfair boss, and eventually fired. How would she pay her bills? What would her husband do when he found out she’d lost her job?
I worked with Martha to reduce her anxiety, increase her assertiveness, and improve her understanding of boundary-setting, all seeming without success. We explored childhood experiences. She acknowledged she’d been mistreated, but felt she’d deserved it. She couldn’t see the connection among her many experiences of abuse. We continued to spin our wheels until the day she learned that a three-year-old niece had been molested.
She was furious! And her outrage toward that abuser allowed her to feel angry toward her childhood abusers, her husband, and the bullying boss. She decided to go to court over her job. She also contacted the police prior to her husband’s release about his history of battering her.
“Don’t worry,” a sympathetic police officer said. “If he even threatens you, it will be a violation of his probation. We’ll pick him up right away.”
Her husband was home less than an hour when he threatened to punch her. She immediately contact the authorities. “We’re sorry, Ma’am,” a policeman said. “People can say whatever they want. We can’t arrest someone for that. He’s got to actually do something physical.”
So Martha hung up. A day or two later, when Mac shoved her out the door, Martha called 911 again. “But did he hurt you? A shove isn’t really hurting someone. We can’t do anything about that.”
Soon after, when Mac pinned her against the wall and threatened to kill her, the police officer asked, “Did he leave a mark on you? If he didn’t leave a mark, you’ve got no evidence. We can’t help you. Call us if he leaves a mark.”
The lack of response by the police disheartened and confused Martha. We continued therapy, but she was becoming more and more depressed and hopeless. So I was astounded when she came to the next appointment with her sleeves rolled up, her head high, a broad smile, and a rakish swagger. What had happened since the last session? Had the police finally come through?
Hardly. After Mac threw a heavy ashtray which left a large bruise on Martha’s thigh, she marched into the police station, showed the bruise, and demanded help. “But he didn’t have his hands on you. He needs to have his hands on you before we can arrest him.”
That did it for Martha. She knew it was up to her to save herself. The next time Mac came at her, she shoved him away. “I won’t be treated like that anymore,” she told him. “You can pack your bags and leave right now.” When Mac recovered from the shock of Martha standing up to him, he cried and begged to stay. Martha folded her arms and glared. “We’ll see how you are. If you act like that again, you’re leaving.”
She also had appeared in court where the judge ruled that she’d been fired without cause. He ordered her former employer to restore her job. “I don’t want that job back,” she told me. “I just wanted them to know they couldn’t treat me that way.”
I worked with Martha for several more months while I completed my internship. Her demeanor had changed and she now presented as a strong, self-respecting woman. I still had doubts about whether Mac had changed, but I was confident in Martha’s new-found ability to handle the situation with courage.
She had given herself permission to act on her own behalf and to believe in her ability to save herself. In doing so, she’d found more power than she ever thought possible. When I meet friends or clients who don’t believe in themselves, I tell them about Martha and about the steps we took together to reach her strongest self.
*Names and specific information have been changed to protect the identity of these individuals.
Success does not necessarily mean that we must earn a great deal of money and live in the biggest house in town. It means only that we are daily engaged in striving toward a goal that we have independently chosen and feel is worthy of us as persons. A goal, whatever it may be, is what gives meaning to our existence. It is the carrot on the stick that keeps us striving–that keeps us interested–that gives us a reason for getting out of bed in the morning. —Earl Nightingale
During my 16+ years as a psychologist, I have attended countless classes, a multitude of lectures, and many conferences. I learned much. However, I have learned at least as much, and probably more, from the flashes of insight, words of wisdom, and extraordinary coping strengths of my clients, friends and family members. These real-life skills are what I find myself turning to time and again in the therapy room as well as in my own life.
I have always seen the psychotherapy process as a journey undertaken by therapist and client together. The therapist is not a guru with all the answers, but a fellow seeker of solutions. We walk the path together to see where it leads and what we learn along the way.
What I’ve learned is too good not to share. So, without compromising the identity or breaking the confidentiality of those I’ve worked with, on these pages, I’ll share the best of what has come my way.