Ten Steps to Relieve Anxiety. H. Michael Zal
and cause harmful effects to all of its members that can last a lifetime. Children of alcoholics often show symptoms of anxiety and depression, feelings of shame, resentment, numbness, helplessness, lack of friends and problems with intimacy. They often live in fear and anticipation of danger. They have a low trust level due to a history of a sea of empty promises. Some have difficulties putting their painful childhood and adolescent memories behind them.
In families such as these, life revolves around the alcoholic. The other members unconsciously give up their own needs and take on roles that are helpful to the family unit in an effort to maintain peace and balance in their dysfunctional world. They can take on the role of caretaker, enabler, responsible one, family hero, cheerleader, mascot or lost child. As they grow older, the children of alcoholics often have trouble giving up these roles. As adults, both Penny and Susan compensated for feelings of inadequacy and helplessness by trying to appear strong. Their anxiety interfered with their enjoyment of life in the present. Both of them needed to learn to refocus, not get lost in the past and realize that they have grown physically and emotionally and have developed many new adult resources since they were entrenched in their threatening childhood world a long time ago.
Penny’s Story
“My anxiety is the way that I avoid becoming the monster. I cannot relax. I’m so worried about what might happen next. I wish my mind could rest. I feel so keyed up. When something is upsetting me, I feel shaky inside. My breathing changes and my mind is not clear. The anxiety overtakes me. My heart feels like it skips a beat. I become short winded and have trouble catching my breath.
“I wake up anxious and afraid. I can’t get enough air. When I make plans and am anticipating a good time at an event, anxiety makes me feel that it won’t happen and even looking forward to something good becomes stressful. Then the negative ‘what ifs’ start. What if something bad happens? What if I lose control?”
Penny became my client when she was forty. She explained that she had a thirty-year history of psychiatric outpatient treatment for anxiety. In her late teens, she had a history of dependency on medications. She had not taken anything since. She was divorced and had three children. She had a good work history. Her alcoholic father had died of a heart attack ten years before. She still remembered his rage, his cursing and his angry voice. “When I think about it, I feel like my brain is throbbing,” she said. She described her father as being outgoing and friendly to others when he was sober, but in the house, he was cold and distant. He often made promises that he didn’t keep. “It was constant chaos,” she said. “My father could easily blow up and be explosive. He once pulled a knife on me. He was physically abusive to my mother. He often hit me so hard that it left welts on my skin. I was so scared. I often hid under the table. I was always afraid of what would happen next. I had to prepare myself and protect myself. He was a monster.”
She also told me that her paternal grandfather had molested her when she was four. She described her mother as a woman who was emotionally disconnected, depressed and fearful, shut away in the house and taking medication for her nerves. Penny worried about her mother and felt that she always had to look out for her and protect her from her father. It was an ambivalent relationship. “She always put me down,” Penny said. “Nothing that I did was good enough. She once threatened to cut my fingers off if I didn’t stop biting my nails.” In spite of the fact that her mother used her as a confidante, she didn’t feel that her mother loved her: “She would wake me up at night to go out and get pizza and beer for my father. I had weight issues. She would make me go to the tap room carrying the empty beer bottles for rebate. I felt embarrassed and degraded with all the men looking at me. I would retreat to my room. It was my sanctuary where I felt safe.”
Penny was left with a lot of anger, lack of connection to others, depression and anxiety. “I have a need to look strong but I always feel lonely and have trust issues,” she said. She constantly struggled with how to deal with her own angry feelings: “I feel a lot of anger sometimes to the point of lunacy and rage…I’m afraid I’ll spaz out on the wrong person and tell them what I think. I’m afraid I’ll hurt someone physically. It’s frightening even to me.” Like many people who are anxious, she suppressed negative feelings and anger, because she was fearful that such feelings would cause a loss of control or disapproval from others. Because of their negative thought patterns, anxiety-prone people tend to be pessimistic. They ruminate, brood and stew. They tend to catastrophize and over-generalize. Their constant fretting clouds their perspective. They are sure that their negative reasoning reflects reality, that they are losers and will fail. This attitude often leads to depression.
Sometimes, Penny became depressed and withdrawn and showed physical symptoms, such as muscle spasms and headaches. She was very sensitive to criticism, yet she would occasionally lose her temper irrationally and push people away. She constantly struggled with wanting to be closer to her children, her boyfriend and her co-workers. However, she had problems with trust and maintaining closeness which interfered with her ability to do this. Her expectations were high and she quickly became frustrated if she felt that others did not respect her. It scared her when people lost their temper at work. Once when a woman screamed at Penny at her job, she said, “I’m afraid of people who talk like that. You never know what’s going to happen. I saw abuse and violence when I was growing up. I can’t deal with it. I have zero tolerance. I’m insecure.”
Although she seemed to be making progress at times, Penny had difficulty maintaining it and things remained the same. Always feeling like the victim, she just could not seem to find a middle ground between her mother’s and father’s behavior. Either she was depressed, passive, withdrawn, avoidant and suffering from vague physical complaints or she was disappointed and angry at everyone. “I can get ugly,” she said. “I scream and curse at my boyfriend. He is judgmental and critical like my parents. Once when we were in my car I got so angry at him that I hit the steering wheel so hard in a rage that I sprained my hand…I don’t feel peaceful inside. I try one way and if that doesn’t work, I try the other way. Something is missing. I always feel a big void. This big emptiness is always there. I feel that I’m not important to anyone.” In between these two sets of behaviors was a constant feeling of anxiety and tension. “I feel afraid that I’m not going to be able to keep my head and maintain control. I feel alone. I have no allies.” At times, she felt like the vulnerable, powerless, ten-year-old child that she once had been.
Penny’s Opinion of What Helped Her Anxiety
“I want the world to see me as strong. Some situations make me feel like when I was ten—emotionally threatened and helpless. I try to remember that I am not ten years old. I am not helpless any more. I try to distract myself and refocus. I take a deep breath and tell myself that I’m okay. I tense my muscles and then relax. No one can see me do this. I tense and relax again, while taking a deep breath and exhaling slowly. My heart rate and breathing will slow. I will feel a sensation of calm, mentally and physically. I relax and realize that I don’t have to be either black or white. I don’t have to be sweet or the monster. I don’t have to retreat to my room to avoid things. I can just be me. My anxiety tells me that I am trying to avoid becoming the monster and trying to stay in control and not lose my temper. I am learning to deal with my resentment differently.”
My Opinion of What Helped Penny’s Anxiety
Penny was raised by two limited parents who both had anger issues. She particularly identified with her father’s rage and was anxious that she would one day act like him. Identification is an unconscious mental process whereby an individual becomes like another person in one or several aspects. Your adaptive and defensive reaction patterns are often attributable to identification with either a loved or feared person. Freud would say that Penny identified with the aggressor (her father), whom she feared. In therapy, we deal with the fact that anger is a normal emotion; however, it is how we deal with it that defines us. When we share our anger, we also have to know with whom we are sharing. What is their level of emotional maturity? A mature person can react to your anger constructively. They may apologize and say something along the lines of “I’m sorry. I didn’t know that that bothered you. I will try to deal with it differently next time.” An emotionally immature person may turn it around, throw the anger back at you,