Anxious young women file into my office, one after the other. Smart, kind, pretty, talented, high school and college students seek help for debilitating anxiety. Most have been struggling for years by the time they seek help. They hoped they would feel better over time, but more often the anxiety turns to panic. The women come from every kind of family, and have all different personalities. They do however share specific attributes. Most noticeable is the inability to cope with their own feelings while often being keenly aware of others’ reactions and needs.
Usually being high achievers,they will go about the day pushing their own feelings aside, unaware of what is really going on inside themselves. At some point, they might feel like exploding without having any sense of what is wrong. As a consequence, they may experience shaking, a rapid heart beat, stomach aches, sweat, want to hide under the covers, obsess, or just dissolve into a puddle of tears without even knowing why they are so distraught. These young women only know that moments of panic seem to come more often and with more intensity.
Usually there are many forces to culminate the perfect storm of anxiety and depression. Our culture has gone haywire with academic expectations now starting in preschool. Teens learned A’s indicate intelligence and are necessary to eventually be self sufficient with a good job. In therapy the discussion centers around how this all or nothing thinking leads to low self worth and a life out of balance. Any time external factors such as grades define self-worth,the danger of excessive anxiety lurks. Other external factors could include a boyfriend’s comments, a friend’s bad mood, or feeling excluded from the group. When the esteem barometer is on the outside, young women will do whatever it takes to please in an attempt to control, ultimately jeopardizing how she feels about herself.
Unfortunately, the good feelings that come from, say, attaining a good grade, are fleeting because they have no internal, sustainable self love. When one’s self worth is contingent on everything and everyone else, one’s feelings are as unpredictable as the world around them. Feeling good quickly turns when there either is no outside source of esteem to be had, or stumbling blocks present themselves as always happens in real life.
The more these young women search for a way to prove themselves by pleasing others, the more they chip away at their own identity, until they have no idea who they actually are and what they want. They become increasingly more detached from their inner feelings, creating a vicious cycle, which makes them work harder to find outside sources of esteem. Feelings of depression and anxiety ping pong back and forth as they try unsuccessfully to make themselves okay. Often, coping mechanisms meant to self soothe get out of hand. Exercise, alcohol, drugs, shopping, hair pulling, eating disorders, all work for the short term but eventually make the problem at hand worse. It is not until this pattern is broken that they can begin to nurture themselves and grow their own sense of selves which includes knowing their own wants and needs and how to balance them with those of others.
In an effort to turn their focus from outside to inside, a helpful construct is to visualize one’s own inner child. For example, during discomfort, instead of just pushing those uncomfortable feelings away and continuing to do things as usual, young women learn to tune into the little girl inside. Understanding the little girl’s feelings helps her stay conscious and cope. This process knocks her out of her default mode of ignoring feelings. At first this can sound like a Saturday Night Live skit, but accessing one’s own inner adult to help the scared, angry, sad or overwhelmed child within is powerful and easy to remember. For example if the little girl inside feels rebuffed, the inner adult will help her identify the feeling and then might help her leave the situation if that’s what’s best, or coach her to speak up, just as she would help any other little girl. These young women always have ideas on how they could help another little girl or a friend in a similar circumstance. They just have little practice tuning into their own little girls.
Little by little, these young women learn to take care of themselves in all situations, even when it means reigning in the limitless little girl who can’t stop studying, or doesn’t want to pay attention to self care. These skills can be used when addictions have taken over or when any part of life is out of balance. They learn to tolerate angry, disappointed, or guilty hooks from others without getting suckered or guilted in. They learn that they can manage and benefit from putting their own needs first when necessary and when and what to compromise. They ultimately learn that trying to control others to stabilize themselves is futile. This tuning-into-yourself process is an effective way to decrease anxiety and depression while also building a sense of self. The icing on the cake is when they observe how others actually respect them more for responding to their own needs. Rather than allowing themselves to be treated as doormats, they feel the power of a strong self which leads to healthier relationships.