When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

Facing the inadequacies of a marriage, the unrewarding nature of a job, the extent of conflicts with a child, or difficulties relating to friends can cause intense anxiety. So, to avoid this anxiety, we frequently "defend against" these realizations: we try to uphold the belief that our marriages are just fine, that things are OK between us and our children, that our jobs are at least tolerable—that, in spite of some problems "here and there," we can get along all right. We do, in short, try to see our lives through rose-tinted glasses.

We continue to do this until our negative feelings become too strong, until we have expended so much energy to maintain our defenses that we are emotionally exhausted. If we reach such a state of real depletion, and our defenses can no longer hold against the building pressure of our feelings, the result is nervous breakdown. This is the layman's name for a variety of psychological conditions that develop due to a burned-out emotional fuse.

A fuse is a protective device that prevents an overload of electricity. Our defense mechanisms are analogous devices that protect us against emotional overload. When an emotional fuse burns out, it is often because we have maintained defenses too long in the face of increasing inner frustration and pain. The result may involve severe depression, incapacitating anxiety, or serious withdrawal.

Now, when you decide to change in some psychologically fundamental way, you must push against the rigid framework of certain of these protective defenses. When you do this, you will feel anxiety. You are forcing your emotional fuses to adjust to a different pattern of behavior and feelings.

Your sense of personal identity is made up of a network of ways you have come to perceive yourself, your loved ones, your work, and your world. Any attempt—even if it is your own, entered into through your own choosing—to change patterns that are psychologically basic to your sense of identity will threaten that established identity and produce a measure of anxiety.

The longer these habitual patterns of behavior and feeling have been in force, the more deeply rooted they become in your sense of identity, and the more unsettling and anxiety-producing an attempt to change them will be.

Although your defenses protect against emotional overload, they also stand in your way of change. They are fundamentally conservative mechanisms: established habits of thought, feeling, and behavior are familiar, and familiarity reduces the anxiety brought about by uncertainty. If you are considering making significant changes in your life, your defenses will rally to protect the equilibrium of habits you have formed in the past. If you push yourself to change, you will face a predictable degree of anxiety. Fortunately, there are, as we shall see, many ways of coping with the anxiety brought about by change; therapy offers some of these, and some are available to us all if we draw on inner resources.

As long as you are alive it is possible to change. Ultimately, the decision to change is an expression of your choice and will. When change is achieved, it usually comes after long and arduous trying. We are all aware of the heroic efforts some people can and do make to overcome a physical handicap. Overcoming deeply entrenched emotional habits can require similar tenacity and commitment. If you want to bring about some basic changes in yourself or in your relationships with others, your inner strength and resolve will be essential.

Frequently, individuals expect a therapist to accomplish change for them: they are willing to come for an hour's consultation once or twice a week, and they will be very cooperative during each visit, but they seem unwilling or unable to develop the initiative to carry on efforts begun in the therapist's office.

Some clients, in spite of what they say, do not really want to change. Their habits are deeply ingrained, serving purposes they may be only dimly aware of at the beginning of therapy. Sometimes it becomes necessary in therapy to reappraise the goals that have been set. The decision to pursue a certain course of change may result in so much anxiety and upset that both therapist and client must pause to reconsider. Some changes may turn out to be too difficult, too taxing; some clients may be unwilling to put in the work required to bring about a certain change.