A 35 year old man named John came to see me one day. He was personable, well-spoken and seemed intelligent and reasonably successful. He and his wife had a 4 year old son and they both had good jobs. On the surface, it was a nice life. But when it came to conflicts, John had terrible bouts of anxiety. His anxiety had increased over the years and when he finally came to see me, almost any conflict with his wife or co-workers created extreme anxiety bordering on panic attacks. As a result, John was pulling away from important relationships in his life and he was afraid he’d end up if not completely alone, certainly emotionally alone. Because John knew his emotional life was on the line, he was a great candidate for psychotherapy. Someone who knew he had to do something.
We quickly developed a good rapport and together we began exploring his life. As unlikely as the correlation might seem, after a few sessions I realized that John’s emotional problems mirrored a physical problem he’d overcome seven years earlier. During one of his sessions, John told me about an accident he’d had as a teen. When he was 14, John crashed his bicycle after sliding on some gravel around a turn. He fell and fractured his leg. But at the time, John’s parents didn’t recognize the severity of his injury and figured he just had a bad bruise. John didn’t know any better and he soldiered on. “Be tough – you’re okay,” his father said. While his leg hurt, it seemed to be healing and after a few weeks his pain largely went away. But John tended to avoid putting his full weight on that leg and as he got older he developed a slight limp. Some days were worse than others but he got along. In college, John’s tendency to limp away from that leg started to affect his lower back and his back pain became a problem. Eventually he developed pains in his knee and even his neck. After college John tried to avoid walking or standing for long periods of time. By 28, John was arranging his life to avoid his physical discomfort at all costs – exactly what he was doing with his emotional discomfort now.
When John finally went to an orthopedic specialist, his X-Rays clearly showed the original damage he’d suffered as a teen and they also illuminated the subsequent problems with his back, neck and knee. The specialist described how all John’s problems evolved because of not treating his original injury. The solution, he said, was to re-break the leg, set it, safely protect it in a cast while it healed, and then undergo physical therapy to relearn how to move properly. Without physical therapy, the doctor warned, just fixing the break wouldn’t eliminate John’s ingrained habit of limping, and his back, neck and knee problems would keep getting worse. Just like his relatively minor bicycle accident, John had hurtful experiences as a child that shaped the way he interacted with people as an adult and created the emotional pains, anxiety and avoidance he was experiencing now.
As John and I explored some of his early emotional injuries, he began to recognize that just like re-breaking his leg, the therapy experience could be somewhat painful. But the therapy sessions were also like the safe environment the cast created for his now-healed leg – safe enough for John to finally explore his emotions and begin to heal those early wounds. Gradually, this allowed him to learn to interact more comfortably with others and to cope with his feelings more effectively.
We both found it interesting that John’s physical and emotional problems were actually very similar in that by avoiding them, much more difficult problems developed over the years. Just like his limping had become an ingrained habit that threw his body off balance and led to painful back, neck and knee problems, John’s tendency to avoid conflicts had also become an ingrained habit with serious consequences. And, just as the cast on his leg was only one step in a multi-phase healing process, safely exploring his early, hurtful experiences wasn’t enough. He needed to relearn how to cope with relationships with a new understanding and with new strengths. The heart of John’s therapy was ultimately learning new skills and becoming aware of the old, ingrained habits so that he could instead use new productive ones. As John’s habits changed, he engaged in and created healthier relationships. In time, his schedule became busier and his need for therapy decreased. Eventually, his sessions spread out. Ultimately we said good bye to not only each other, but to John’s old, unhealthy feelings and his unproductive habits of avoiding others too.
© Joshua Kates 2019