Reply To: Live Workshop 3

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Hi everyone. I have a question about regulating anxiety in the moment and how it might relate to validation.

I am working with a 40 year old married father of two young children who is dealing with an episode of depression / anxiety for the first time. He sought treatment with me for “physical symptoms of anxiety.” He has been experiencing disabling migraines. During our last session he mentioned his sensitivity to other people’s emotions and feelings and I commented to him, “you are a very caring person.” He began to get choked up and some tears came. I asked him, what is happening , what are you feeling ? And he said that it felt very unusual, unlike him, different, and I could sense his anxiety rising. So I proceeded to ground him, mentioning his feet were on the floor, he was supported by the chair, I drew attention to a deep breath that he took, and mentioned that “you are safe.” I was pleased that he experienced this wave of emotion during our session. We returned to our conversation.

After we had finished and were making plans for our next session, he told me that what I had said about him “being safe” had made him angry. I was caught off guard as we were done with our session but I felt that I needed to address this. I told him that I was really glad that he told me this (my impression is that he does not do anger— I think he has many situations in his life that make him angry but he keeps it bottled up). He seemed more interested in figuring out why that particular comment “you are safe” made him angry , to which I said that he should give some thought to before next session when we can explore this further. I will be seeing him again later this week.

I am wondering what reactions people may have to this story and whether there might have been a better way to regulate my patient’s anxiety in the moment. I suspect that he did not feel that he was under threat and my comment about his safety may have suggested that he was weak. At the same time, I viewed this as a success as my patient was able to experience both sadness and anger in our session and he shared these feelings with me. I wonder how I might approach future episodes of anxiety with him without evoking feelings of anger – or maybe this is part of the process? Thanks!