today, in descending order of time spent: reading Zen and the Art of Motorcycle Maintenance, playing video games, watching House, watching Making a Murderer, housework, trying to do a website job, seeing a new client, texting friends.
the only thing of any real productive value that I did today was seeing the new client, who came in for anxiety.
the session was stilted, slow-moving and awkward. lots of it depended on my asking questions designed mostly to maintain a comfortable flow of conversation. after about half an hour of this I struggle and falter – there are only so many relevant, open-ended questions one can ask a person who, because they experience anxiety more intense than average, doesn’t feel able or willing to divulge yet.
sessions with anxiety clients are always, always thus. I ask them about their experience and they do tell me honestly (they want to make an effort; they have conquered their feelings enough to show up to an inherently anxiety-inducing situation), but they do so in a circumspect way. they answer the question with the words they think they should, are expected to, use, but don’t feel comfortable enough to elaborate with whatever else might be going through their head. it is that other stuff that runs through your head, rather than the actual literal answer, that often makes an effective session with a mental health professional. that background noise is the real juice we want, because it *is* the anxiety talking.
anxiety makes people guarded about their words. that guardedness is just exactly what makes a counselling session ineffective.
my job is to facilitate the sense of safety and comfort that might counteract the anxiety a bit. it takes more than one session, more than one hour of chatting, to build a sense of safety and comfort.
unfortunately people who experience anxiety often don’t make it that long. unfortunately we all have high expectations of psychology, psychiatry, social work, whatever. unfortunately talking of things in such a way that might create such an atmosphere of safety.. well it just doesn’t feel productive enough. not to the practitioner (who might feel guilt that they’re not making enough progress quickly enough) and not to the client (who might feel that they’re wasting their money on this fraud because progress is not being made quickly enough).
if the client is not paying, as in my other job, it is worse. the client is receiving a service that is funded by someone else, such as the government. to the client, the service is free. it’s speculated that this results in an underlying belief that the service isn’t worth much. if something is free it is not valuable. if it is not worth money, well, it probably isn’t worth the effort either.
my paying clients are essentially admitting that the service is worth something by doling out the cash. if it is worth the cash, it is also worth the comparatively measly effort of listening to what I say, and putting into practise what I advise. my paying clients almost always have better results than my ‘free’ clients (who simply don’t stop to think that the service *is* being paid for… by their taxes). ‘free’ clients think to themselves, ‘hey, it’s only costing me my time, after all. what’s the harm in giving it a try? i’ll give therapy a chance. if I don’t get results I needn’t continue wasting my time.’
however, whether they’re paying or not, what it means for the anxious client is a cognitive dilemma.
‘that session was really awkward. I knew it would be. I mean, I do want to conquer this anxiety, but talking about the things that make me feel anxious made me feel *unbearably* anxious. i’d rather continue sweeping the relatively mild anxiety I experience at other times under the rug. that sometimes works. that session though? that didn’t work. I didn’t like it. in fact, I felt even worse after it. I’m not making all this effort to feel worse! I can’t bear the thought of going back, and why should I, if it doesn’t work?’
the above thought process has obvious logical fallacies, when it is spelled out in such a way. (assuming you’re aware that confronting anxiety in a structured way in the present has the benefit of needing not to continue trying to avoid it in the future.) but for most people, in the moment, it is probably not quite so explicit. such a reaction is based in emotion, after all. it’s only when you delve into the thoughts that prompt the reaction that you make the illogical nature of it quite clear. once it’s clear, you’re prompted to challenge it. challenging it is hard. much harder than the underside of a rug.
meanwhile, are you serious? hardheadedness is in the dictionary, but guardedness is not?