The other day, I was approached by a client who expressed powerful feelings of anxiety as soon as she walked through the door. She began her session by sharing the basic outlines of the dilemma she is facing and then asked “What do you think I should do?” I asked a few questions to get more information, and soon saw that her situation was far more complicated than she first conveyed. I reflected this back to her, eliciting even more nuances and factors contributing to her situation. It was clear to me that there was not going to be a quick or easy fix.
I was reminded of what I think of as the “nesting doll syndrome”: you open the doll only to find another inside; you open that to find another, and another, and another. You start out with one problem and realize that the problem nests inside another problem, and another and another,… Her problem was very complex, with multiple moving parts. And in the end, she felt helpless and overwhelmed by anxiety. Midway through the session, she admitted that there wasn’t going to be a quick or easy solution to her problem because the “problem” was really a multitude of problems that nestled within each other, each requiring its own solution. However, I could see that the individual solutions could add up to resolution—and meaningful personal growth for her.
At the time she spoke with me, she felt desperate. I sensed that she needed to feel less alone, less isolated by her problems. She needed someone to affirm that her problems are understandable, someone to help her develop a plan and walk with her as she works toward solutions. She needed empathy and compassion. Experiencing empathy helped her come to the insight that meaningful solutions were going to require an investment in time and energy. That said, though, she also acknowledged that she initially came to me with the hope that the stress, anxiety, and pain would end—now. She admitted that she was looking for an escape hatch, a way out. She felt impulsive, but, as she talked with me, realized that an impulsive solution might not be the best one for her.
Significantly, she admitted that she felt better just by talking with me. She listened to herself as she talked and began to feel less anxious and find her way to a plan. Indeed, we eventually came up with a plan for working on the problems. She agreed that, in addition to problem-solving, she would benefit from taking time to understand how she arrived at her current impasse. She agreed to take time over the long term to look at herself—her beliefs about herself, her relationships with other and the world—in order to understand how she arrived at her current dilemma. She was very clear that, once the current situation is resolved, she wanted to have a new perspective on herself so that she would be better able to face issues and better address them as they arise.
There are reasons that the problems we face arise. We’re not always in control. Things happen. Nothing is permanent. And the ways by which we perceive ourselves and the world often creates the groundwork for the suffering we experience. How we perceive ourselves and others was established long ago by our experiences with caregivers and family. Look deep enough, and it is possible to discern that the problems we experience have patterns, and those patterns can be traced to childhood experiences.
I believe that one of the most meaningful goals of psychotherapy is to help people find greater freedom. By becoming conscious of how the past shapes us—of how we bring the past forward into the present and project it into the future—we can begin to see that many choices for responding to life’s challenges are available to us. We can learn to perceive ourselves and our life situations differently. We then can choose how to respond.
I often talk with clients about the difference between reacting and responding. Reactivity is usually impulsive and arises out of acute emotional distress. Reactivity perceives problems through a lens created by feelings and past experiences, and one defaults to old coping strategies to address present circumstances—not always the best choice. Emotional reactivity is usually a strategy to escape aversive feelings, but it often shuts down thought. Indeed, there is often little conscious thinking that informs reactivity. Reactivity may provide relief, but not resolution.
On the other hand, responsiveness involves conscious perceiving and thinking. There is a quality of openness and an orientation to the present that characterizes responsiveness. Although you may be aware that the current situation seems similar to those you’ve experienced in the past, the solution you used in the past is only one among many that might be available. Responsiveness involves thought and attempts to balance thought with feeling: assessment of the situation, assessment of the feelings that arise, awareness of options, and then conscious choice of a response. Indeed, one decides how to respond to any given situation.
Solutions to problems can be steps to the resolution of dysfunctional perceptions, thinking and behavior. Psychotherapy can help you find solutions, but is more effective when it helps you re-orient yourself to a long-term resolution.