Tuesday, June 11, 2013

Anticipating Catastrophe

“I’ve started reading your book,” Leah says at the start of her session. “I like the way you’ve done it, going back and forth from your patients to yourself.”

“Thank you.”

“I want to ask you something.  In hindsight, do you think it was worthwhile for you to worry about your husband dying from the beginning of your relationship?”

For those of you who are new to my blog, my book, Love and Loss in Life and in Treatment, traces my relationship with my husband, George, through our meeting, the development of our intense, loving relationship, through his illness and eventual death and its effect on my work with patients. Since my husband was 21 years my senior I always assumed that he would die before me and I always worried about it.

I answer Leah’s question. “I knew not only in hindsight but also in foresight that my worrying about his death didn’t help either me or him. But I couldn’t not worry. It’s not that I worried about his dying every minute of every day. It didn’t take over my life; it didn’t ruin my time with my husband.”

“Oh,” she responds. “That’s different.”

Leah is referring to the fact that she is constantly anticipating catastrophe. And her worries do in fact take over her life. She becomes convinced that her daughter will get run over by a car and checks in on her repeatedly during the day. She becomes frightened that her husband will lose all their money and asks him for an accounting of their finances several times a week. She is afraid of developing breast cancer, often doing a self-breast exam several times a day. At some level she knows that these fears are irrational, but she can’t stop herself. 

“I’d never be able to handle it!” she bemoans.

“What is it that you mean by being unable to handle it?” I ask, a question I have asked many times before.

“I don’t know. I just couldn’t handle it. I’d come apart. My anxiety would overwhelm me. I wouldn’t be able to get out of bed.”

“Is it that you’re afraid you wouldn’t survive?”

“No, I’d survive. I know I’d survive. But there are worse things than not surviving, there’s living in constant torment.”

I find myself thinking about my cat, Pippin, who became sick when she was fifteen. At that point George had been dead for 2 ½ years, my mother for 3 months. For the 16 months before George’s death I lived in a state of constant anxiety as we rode the roller coaster ride of hope followed by the threat of loss, followed again by hope and the threat of loss. And finally the horror of the loss itself. Then came the ups and downs of my mother’s decline with repeated seizures and increasing debilitation. But when Pippin became ill I felt exactly what Leah was expressing. My anxiety felt out of control. I felt I couldn’t handle it. I couldn’t take care of another sick being and I certainly couldn’t bear losing another living creature I loved. I felt “copeless.”  

“Leah,” I say, “I just had a thought. We all have scary, overwhelming experiences as infants and small children, things that feel over-stimulating to us, things we can’t make sense of – your being bitten by the family dog, your mother leaving you to go off to work. These experiences make us feel helpless, powerless, scared. They make us feel copeless. And they stay with us, even if we’re not always aware of them. And if something comes up in the present that feels overwhelming, those feelings can come back to us. We forget about our adult selves and we’re back to being copeless little beings.”

“That makes sense. But why do I keep thinking of all these horrible ‘what ifs?’”

“That’s a good question. Perhaps because you think if you rehearse all the possible catastrophes you’d be able to handle them if they happened.”

“So are you saying it’s a good idea to keep thinking of all of them?”

“No, not at all. I think we need to look at some of those old, scary situations and “grow you up,” so you no longer feel like a helpless child, but rather a capable, competent adult who can deal with life’s difficulties.”

“But what if I got breast cancer? I know I couldn’t  deal with it.”

Once again I’m reminded that neither my words nor my insights translate into a “quick fix” for a patient. Leah and I have a long way to go.   

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