Anxiety Treatment: Gestalt Therapy Results

In the first post in this series I looked at Gestalt Therapy Theory, and how we conceive of anxiety as an interruption of the excitement of creative growth, when the excitement does not have enough support in the organism or environment to emerge freely.  In the second post I explored how anxiety is treated in gestalt therapy in session, how we attend to the actual bodily experience, the meaning of the anxiety, and look for clues of what the anxiety is doing for you, how it is protecting you, as we experiment with your own anxiety mechanism.

in this post I want to describe a few examples of results of ongoing gestalt therapy for different kinds of anxiety. These examples are all composites of issues that people have worked with in my practice, and it is my hope that in reading together these different examples you can get a flavor of what is possible.

Martha suffered from acute panic attacks

Martha came to see me for a sudden spike in her anxiety from more or less manageable, “normal” feelings of worry.  She had several panic attacks that came up around social events, overcrowded streets, and driving. The panic attacks were scary and debilitating when they happened and Martha was constantly on edge that a panic attack could happen at any time.  She started limiting herself in her daily life.  She avoided driving, many social events and anything she could think of that might have  triggered an attack.

First, Martha learned to pay attention to her symptoms and together we unpacked the meaning that she was making in the moments when her anxiety started escalating.  She discovered that she believed there was something wrong with her when in fact she was experiencing a reaction to something in the world that sometimes needed her attention, and sometimes was simply something she didn’t like but didn’t need to do anything about. She also got clearer in our work about what she could influence and what she could control, and what she could not, so that she could feel her impact on the world more clearly.  This helped to lessen her sense of powerlessness and, on the other side, her need to feel in control all the time.

Physically, Martha began to feel her whole body more clearly and especially her feet. She found when she was driving or walking the streets of New York she was able to tune in to the sense of her body moving and interacting with the environment that allowed her to notice her ability to respond to what was happening.

Martha finished therapy when she had been free from panic attacks for about 9 months, but more importantly, felt confident in her ability to stay with her own experience and was no longer anxious about having them. She also understood that if she had a panic attack again she could get herself through it and then figure out what had happened and how she might need to respond to the new situation.

Thomas suffered from social anxiety

Thomas  felt ill at ease around groups of people, preferred to work alone, and was starting to feel that his shyness and social anxiety were getting in the way of his work life as well as his circle of friends. He was able to date, but had trouble going to parties and social events and would make excuses not to attend. He also suffered from chronic tension in his back and neck.

Learning to focus on his anxiety as it showed up in his everyday life, Thomas quickly understood that his back and neck tension was part of how he held himself together in social situations.

Together we wondered about the meaning of the tension. What did he imagine was behind him? What was he holding at bay? Was he holding himself together or defending against a blow?

Thomas discovered that he felt there was no one behind him in his current life and when he was a child.  His strategy was to make the best of it and create that tension to propel him forward into social situations. He began to understand how he was actively creating the  situation in his choice of friends, dates and the work colleagues he spent his time with. He seemed drawn to people, as far as he was pursuing any relationships, who weren’t really there for him and didn’t have his back. In one very clear example, a work colleague actually disappeared from a project when Thomas was up for review and he had to fend for himself.

The work with Thomas involved noticing what was there to support him and how in many cases he cut himself off from it, feeling empty inside as well as his tense and hard back body. Thomas experimented with what he imagined was behind him, what he wanted behind him and even what was actually behind him, the back of my sofa. Slowly he learned how he hardened and softened, and found that softening the back he was able to feel his upright spine, which then took on the job of holding him up and centering him.

As Thomas was able to reorganize inside, he also found it easier to approach people he wanted to approach and allow himself to be on his own when he wanted that too. He was able to take pleasure in some social events and allow himself to come out of his shell, while at the same time taking healthy retreat and finding the balance that works for him now.

Jill was plagued with worry

Jill was an example of someone who worried a lot, about her job, her family, and the state of the world. In her 20s, she had seen enough of life to wonder if she was going to be able to have any happiness, since she met almost all situations with worry and dread.

When Jill and I worked on her worrying habit, it became clear  that her whole family were worriers and that worrying was a way she could prove that she belonged. So she had a two-fold challenge; a habit of worrying that was strongly entrenched and a function of it that kept her connected to other people, especially her parents and sibling.

The work with Jill was to concentrate on how her worrying actually felt when she did it. What was she getting by worrying with me, and what was she missing? What felt good, and what felt bad, and how did she know? She was able to stay with the ambivalence of wanting to change and not wanting to change long enough to figure out that she was ready to experiment with not worrying so much to see what happened.

The turning point for Jill came when she uncovered a deeper level of her theme, “I worry so I can be like you, I worry to belong and stay attached to you”. Jill had some very early fears of being abandoned, and realized that her child self could not risk being different from her family, but as an adult she actually was different. She got interested in what it would be like to express that difference in her behavior, and found that although it felt wobbly and weird, it was very exciting and she could live through it.

It was especially important for Jill to have the relationship with me, the therapist, so that she could test out her ideas of belonging, and have another place where she belonged as she explored her identity. In gestalt therapy we have a fluid, creative concept of the self, that who we are is constantly being made in relation to the other. The therapy relationship was what allowed her to explore how she might belong and be connected without worry being the connection between us, and to test out what an identity might be like that was not centered around common worrying.

And you?

However your anxiety manifests, I believe it was originally doing something important in your life.  I also believe that your experience of it today contains clues about what it means, what it is doing, and what you need to do if you want to change.

Read the other articles in this series (Anxiety and Gestalt Therapy Theory and Gestalt Interventions for Anxiety) and if you are interested in trying this kind of work for anxiety feel free to be in touch. You can email me, call, or use my client portal to schedule a complimentary consultation.