I began working with 13 year-old Amanda following a suicide attempt. She initially talked endlessly about her horrible life and her intense feelings of sadness. An outsider would probably have described her as very fortunate. She had loving parents, attended a good school and was an accomplished student and musician.
Amanda experienced her world very differently. She had no friends and felt isolated from her peers. She had a generalized anxiety disorder that prevented her from reaching out to other kids. After a particularly tough day, she impulsively decided it would be better to be dead than lonely.
We could have spent time in therapy talking about Amanda’s feelings or trying to come up with a pseudo-reason from her childhood that explained her behavior. We did neither.
Two approaches worked great with Amanda. First, I asked her to imagine the worst possible outcomes of what would occur if she attempted to make friends and failed. As we discussed each situation, Amanda realized that most of her fears were extremely unlikely to occur. Even if she failed in her efforts, nothing really bad would happen.
Second, I asked Amanda to make some very modest efforts to reach out and try to make friends. We did various role plays in the office, and Amanda began to feel more comfortable and confident in her new skills. As expected, she experienced success in making some friends, and her feelings of isolation decreased substantially.
Amanda’s problems weren’t caused by her parents or her genetics, but by the way she thought about the world. She anticipated that bad things would happen. She had unrealistic expectations for herself and others. She feared any type of rejection or failure.
Amanda’s unhealthy and irrational thought patterns were confronted and replaced by more realistic ways of dealing with the world. She learned a sense of optimism and resiliency that resulted in dramatic changes in her behavior. As she began to feel more in control of her world, her anxiety substantially decreased.
Simply talking incessantly about your problems or feelings may make you temporarily feel better, but solves nothing. Change your way of thinking and you can change your world.
Next week: Questions from readers.
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