“When there is worry in a man’s heart, he should suppress it; let a good thing convert it to gladness” (Mishlei 12:25).
One of the first things the therapist should do is help you identify the ways in which you respond to emotional stress. People with anxiety can have mood swings, and this makes it difficult to slow down and control stress responses. Knowing more about what personal triggers are and pinpointing how your response to stress progresses can help you understand exactly what is happening to you. If you develop insight into your physical and emotional reactions, it becomes possible to learn the proper coping techniques, which will deactivate triggers.
Progressive Relaxation Therapy (PRT) may also be helpful. It teaches you techniques to relax the entire body step by step. It is something you should consider exploring with a therapist.
“To one person, a demon appears and does harm; to two people, a demon appears yet does no harm…” (Berachos 43b).
Many anxiety sufferers, especially in the Orthodox Jewish community, are inclined to “go it alone.” Often this is from fear of the community (or even family members) finding out. In addition, our culture doesn’t generally encourage the sharing of intimate thoughts and concerns, certainly not to a “stranger.” Yet the “demon” of anxiety is best faced with the strength of another’s assistance. A treatment professional is also ethically bound to not release any information about a patient without a written release signed by the patient himself.
Who is the Right Therapist?
It is vitally important that your therapist is someone who has experience in treating anxiety disorders and is someone you feel comfortable with; not every therapist is the right choice for every patient. Personality has a lot to do with the correct choice. Therapy for simple anxiety (without complicating factors, such as substance abuse or mental illness) can begin to be effectively addressed in a few sessions. If there are other complicating factors, therapy is usually longer term.
There are quite a few competent therapists with experience in treating anxiety disorders. Many are able to work with observant and non-observant patients. I recommend seeking someone with at least four or five years experience who you feel can respect your cultural and religious outlook. Your therapist should have successfully treated patients with anxiety disorders in the past.
Don’t be afraid to ask about your therapist’s qualifications, and if necessary, interview more than one therapist. This may very well be the most important person you “hire” in your life. Therapists are very willing to share their background information. They understand that a patient deserves to make an educated decision. Therapists also know that treatment will only be as effective as the strength of the therapeutic bond between patient and therapist.
Leah’s* Story
Leah S., a mother in her 30’s, came to see me after two years of weekly therapy. She had been diagnosed with anxiety and depression, which she felt was caused by the death of her mother. She was often fearful and very “grouchy.” She was seeing no improvement despite therapy, and told me she felt even more depressed than when she began. Her husband and even her children were concerned about her.
I administered a comprehensive mental health evaluation. I decided she would benefit from a medical evaluation as well, and referred her to a psychiatrist. He prescribed low-dosage anti-anxiety and anti-depression medicines to start. Leah came to see me every two weeks to evaluate the effectiveness of the medication. I monitored Leah’s response to the medication, and the psychiatrist adjusted her dosage as needed.
Within a very short period of time, the medicine stabilized her mood so she could begin to address her problems. She was visibly calmer, and began to smile again. She decided to give weekly therapy another chance. We talked about the grieving process and the root causes of her fears and worries. We also enlisted the support of her husband. Together they agreed to work on some simple techniques to help with her anxiety. Within a few months, her medication dosage decreased. Within the year, she no longer needed medication.
What is the Best Treatment for Anxiety?