A white man in a dress shirt holding his hands to his chin. He looks worried.

Anxiety, Get Thee Behind Me

One of the most common experiences that leads people to seek therapy is anxiety. Which makes sense. Anxiety is an uncomfortable feeling you’re having, maybe along with worries you can’t shake, so why not look for help from someone whose job it is to understand anxiety and to know what to do about it?

I treat a lot of different presentations of anxiety, and one of the first conversations I have with a client on this topic will be:

What’s the goal of our work on anxiety?

This might sound like an unnecessary question. Isn’t the obvious answer, to get rid of the anxiety?

Addressing that question, and clarifying the goals of anxiety work in therapy, suggests a first question:

What is anxiety for? Why does it exists in the human experience?

Anxiety isn’t a mistake or a dysfunction; it serves a purpose. Anxiety is there, built in to our system, to warn of us impending danger, and to feel uncomfortable enough to make us take some action to make the danger go away before the feeling of anxiety withdraws. And when I say “danger,” this could be physical danger or emotional danger. Sometimes the perceived threat is about a concrete event happening; sometimes it’s about a relational situation that feels frightening to experience. That second type can sometimes take a little reflections to sniff out.

Now: since anxiety is a built-in survival mechanism, we wouldn’t be trying to make it so that you never feel anxiety again. That’s too high a bar, and also it would rob you of a crucial survival tool. Let me suggest more feasible and healthy goals for anxiety work:

Let’s make it so that when you feel anxiety:

  1. You can identify the reason you’re feeling anxious; and
  2. The amount of anxiety you feel is proportional to what’s actually going on.

If you can get to that point, then you don’t have to add the worry that when you feel anxious it means that there’s something wrong with you. Because a lot of the time, it doesn’t.

Read More
A young biracial man looks sadly into the distance

Mistakes and Fallibility

“I can’t believe I did that. I’m a screw-up. How can I ever be proud of myself again?”

I know how much it can hurt when we look back and realize that we’ve made a mistake — particularly a large one. And a painful truth is: No one (at least so far) ever gets access to a time machine. So we don’t get the chance to go back and fix mistakes in the past. How, then, do we live in a world where we did that ill-advised thing, and that we can’t change that it happened?

But here’s the thing:

People get to be fallible.

Because no one has the option to be infallible.

What follows from this is that everyone is going to make mistakes. Pretty frequently, in fact. That can be a hard thing to face, especially if you’ve been given messages from others, maybe parents or influential adults when you were young, that making mistakes is not OK. The problem with this message is that if the expectation is that you’ll never mess up, no one can meet that standard. 

The task is not to make it so that we never make consequential mistakes. The task is to make it so that when we inevitably make mistakes, we can live with the fact that we did something imperfectly, badly or unwisely.

But how?

Let me make a distinction here — between character and behavior.
Character is who you are; behavior is what you do. 

I’m going to suggest that when we make a decision, take an action, that turns out to be a mistake, that’s about Behavior — something that we did. And so when that happens, feeling some Regret makes sense. We all have regrets about past decisions and actions that turned out not to be such a great idea. I know I do. But since regrets are about past Behavior, there’s always the opportunity to change behaviors in the future. We can’t go back and change the past, and sometimes we make messes that we then have to clean up — but we can always act differently in the future, informed by what we learned from the mistake.

When we think that mistakes are about flaws in our essential Character, that feeling is Shame. The danger here is hopelessness, because it feels like our character can’t be changed.

So let’s take the approach that mistakes are about Regret, not Shame. Mistakes we make — even the big ones — don’t define our character. They’re about actions and decisions that we’ve made in the past, and in no way determine future actions and decisions. 

Accepting our regrets, learning from them, improving our decisions over time — that’s a pretty good way to live.

Read More

Presentation: Counseling Internet and Online Issues

I’m presenting a program on “Counseling Internet and Online Issues” at the 2nd Virtual Conference on Counseling — in Second Life!

I’ll be talking about historical context, basic psychological features of cyberspace, and applicable examples of situations.

It’s next Wednesday, 9/15, at 3 pm Pacific/6 pm Eastern, at the Counselor Education in Second Life center SLURL Port Dervon 44, 65, 26.

It’s free. Please stop by!
Read More

Time Online: How Much Is Too Much?

There’s a new survey released by Rasmussen Reports — most commonly known for their political polling — that describes peoples’ perceptions of online use. The bottom-line statistic is that 23% of adults surveyed believe that they spend too much time online. Drill down the numbers, and it gets more interesting.

(more…)

Read More

Cyberchondria: An Example of Misplaced Focus

Among the daily multitude of news coverage discussing the psychological and social impacts of the Internet comes an article describing “cyberchondria“:

But what really ails me? Cyberchondria, loosely defined as the baseless fueling of fears and anxiety about common health symptoms due to Internet research, or, as I like to think of it, Googling oneself into a state of absolute, clinical hysteria over every last pain, itch and strange freckle on your body.

It’s easy to lose our bearings on a phenomenon like this and blame the Internet itself as the new social hazard that gives rise to this condition. It’s even in the language used here: cyberchondria as a diagnosis, and web searches as the cause. But actually (and the article does acknowledge, if not fully explore, this point), what we’re seeing here is an anxiety problem that isn’t created online — it just expresses itself there. People have had excessive worry and imagined catastrophic outcomes from mild symptoms for centuries — they just got their medical information elsewhere, until very recently.

If a person is having excessive anxiety about nightmarish health scenarios whenever a cough or itch starts, then it’s the obsessive thoughts and the compulsions to act on them that we should be examining and working to relieve. The Internet is just the arena in which those obsessions or compulsions play out. Google and WebMD do make it a lot easier and faster to act upon an impulse than, say, traveling to a medical school library — but it’s a mistake to conclude that a person is developing health-related anxieties because so much unfiltered medical information is now available online.

The good news is that with skilled counseling, these types of problems are treatable. And so I say again: “Don’t blame the Internet!”

Read More