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Anxiety: Deciphering Meaning

January 1st, 2015

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J. M. W.  Turner, Snowstorm, 1842

About a year ago, I clipped an article from The Toronto Star (Marcia Kaye, Sunday January 5th, 2014) on a review of Scott Stossel’s book, “My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind”. Stossel points out that an estimated 4o million North Americans have an anxiety disorder in any given year and one in four will suffer an anxiety disorder at some point in their lives. He also suggests that the true numbers are a lot higher since a lot of people press on without mentioning the symptoms to his or her family physician. According to Leyla Sanai’s article in the UK Independent, (January 10, 2014), Stossel first saw a psychiatrist at age 10, since when he has tried 27 different medications not to mention a number of therapies in an effort to assuage his anxiety-related problem.

Feeling now, at the start of a new year and due to the fact that we are unquestionably living in anxious times, the moment seems right to revisit the concept that reflects a treatment orientation from a psychoanalytic perspective or, in particular (despite Stossel’s stated reservations about his own experience with a variety of different therapeutic approaches), how I would approach a patient and their concerns about anxiety.

When a patient uses the word ‘anxiety’, it is usually an attempt by the person to give a name to a feeling. In this sense, I believe that there is a need to find a language that connects in some way to that particular person’s frame of reference. Indeed often, in the very first session, there is the germ of everything that will appear as the central or critical problem of the treatment;  it’s just the case that up until now the person struggling with anxiety has not been able to find a way to resolve an internally based conflict. Anxious feeling states once expressed in words, invariably become far less overwhelming, representable in the mind and hence far more understood and acceptable to the self. It is not uncommon to find that some people live their lives in disregard of their internal world and the part played by the unconscious life. Sometimes an individual will be afraid of entering this space, to find a way out of his or her difficulties, but within the therapeutic process something is awakened and discovered and one can no longer pretend to oneself that it does not exist. I find that people need help in unlocking the door to this unexpected world so that they can discover its’ presence within themselves. While anxious states in some people clearly reflect multiple causal factors, I think that the key in many cases is in helping the patient find a way to de-codify the meaning and give language to something previously experienced as elusive and unrecognizable.

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