An Ending at the Beginning

As I write what is to be the first blog entry of my new site, I find myself compelled to share a story about an ending.  Not too long ago a young patient who had struggled with anxiety came in for session full of energy, family in tow.  I sat ready to set an agenda for the day’s session.  Instead, my patient told me with a smile to sit back, watch and listen.  So all of us sat back in my office and were treated to a 20 minute, one-person show (complete with props) about how to defeat the “Worry Monster.”

In case you’re wondering, the Worry Monster is a generic term some therapists use to helpIMG_1687 younger patients conceptualize their anxiety.  We talk about anxiety or worry like it’s a bully who keeps coming by to boss you around.  Defeating the Worry Monster means learning how to boss back and put him (or her) into his place.  Many of my young patients quickly latch onto this concept and delight in doing some bossing around of their own.

So…back to the session.  This play was so thorough, so complete in its understanding of anxiety, its description of how to overcome it and the breadth of tools it employed to be victorious that I was completely giddy.  I immediately congratulated my patient, and the whole family, on becoming so well informed and on understanding how to implement that knowledge.  What I knew, upon seeing this play, was that we were at the beginning of the end of treatment.

This was not the first time that I’ve been schooled by a patient in the ways of dealing with anxiety.  Hopefully, it will not be the last.  What it represents for me is what treatment is all about – getting patients to the point where they don’t need to be seeing me regularly anymore.  No matter what goal treatment starts with, there is one underlying goal that is common among the people I treat – to get their situation to the point where they intrinsically know how to respond to potential struggles and they no longer need me in order to cope well.  When I am working with anxiety, parents and patients often ask me how we will know when it is time to stop treatment.  One of the things I tell them is:  “We will know it’s time to stop treatment when you (or your child) start coming in and telling me how to intervene, and you actually are able to go ahead and successfully use the interventions you come up with.”

When I work with anxiety, a good deal of what I do is to teach.  I work to educate children and adults about what anxiety is, what maintains it and what puts it in its place and makes it manageable.  I find that when people have a way to understand their struggles, a frame to put it in, that treatment makes much more sense.  Even my youngest patients can understand anxiety when I put it in their terms.  When they understand, they feel more powerful…and they delight in taking charge of their lives.

When my young patient arrived for treatment and taught ME how to deal with anxiety, I knew we were at the beginning of the end of treatment.  I’m not sure who was more delighted at this prospect – me or patient and family.  We had strived together to get to this point.  The payoff was a child who had emerged from fear, who felt powerful instead of powerless and who felt ready to take on what anxiety might dispatch.  I think that this experience, and others like it, is what I bring into the beginning of treatment with each new patient.  I bring the belief that with each new beginning, each first step into treatment for people who are struggling with fear and worry, there is hope for a more empowered ending.  And it is my honor to be told to sit back, watch and listen as they move forward to live their lives.