Dear Patti,
Over the last six months I’ve become more and more anxious over my family’s financial security. My husband and I are doing OK since we both have stable, secure jobs, but I can’t seem to stop worrying whenever I think about this country’s economic crisis. Our son has a serious recurring illness and I stay up nights thinking about what would happen if we ever lost our medical insurance. Our daughter is sweet and smart and wants to go away to college next year, but I start sweating and getting knots in my stomach from worrying we may not to be able to afford it. My heart starts pounding when I imagine scary scenarios like losing our house and everything we’ve worked for. At my husband’s insistence, I went to see our physician, who said I was perfectly healthy and that it was just stress. Psychotherapy was recommended.
Since there’s nothing really stressful in my life, what’s wrong with me? My husband wants me to follow through on counseling, but if it’s all in my imagination, I really don’t see any reason to. I just have to stop worrying. What do you think?
—Janet


Dear Janet,
Many times people think that the absence of stress-inducing, serious problems in their lives cancels out any need for psychotherapeutic treatment. Actually, it can be the exact opposite. If it doesn’t seem to take a lot of stressors to generate angst and summon the serious symptoms you’ve described, it could be a red flag that — regardless of apparent stability — you might have a fragile aspect to your personality that could very well warrant going to a professional, as your doctor advised.

It sounds as if you may be suffering from an anxiety disorder. Therapists often refer to anxiety as a “blanket feeling,” because there are always other emotions lurking underneath. If a criminal came up and robbed you, for instance, you’d probably experience a rapid heart rate, sweaty hands and feet, and knots in your stomach. Fear in such a threatened situation would be considered appropriate. Anxiety brings on the same physical symptoms as fear, but without the external threats from the surrounding environment. Instead, the nervousness about potential outcomes derives from internal feelings that are often at a subconscious level.

Psychotherapy will provide you the opportunity to explore what’s going on inside you. Initially, neither you nor your therapist will know what feelings and issues might come up. For example, even though you may believe everything is fine concerning your family’s finances, you may have buried deep fears concerning your son’s illness or your daughter’s welfare, since she’s planning on leaving for school. You could have hidden feelings about a host of undiscovered issues that relate to your marriage, your relationship with relatives, or other personal issues. The more you begin to access these blanketed feelings and experience them for what they are, the better you’ll be able to reduce your anxiety.

In order to make the therapeutic process as successful as possible, it’s important to make sure you knock down any walls you’ve built between you and your feelings as well as any walls between you and your therapist. Don’t edit what you feel or what you say aloud to your counselor. Whatever arises in therapy — no matter how painful — should come right out into the room so that both of you can face it together in a safe therapeutic environment.

It will also be valuable to learn stress-reduction techniques such as self-hypnosis, yoga and meditation. These will keep you in touch with your body by monitoring the anxiety and the habitual ways you defend against your feelings.

On a good note, the reality is that your family is safe and doing well.