“The only thing we have to fear is fear itself.” As you sidestep the balled-up notebook paper strewn across the floor of your 15-year old daughter’s room on the night before a big math exam, or send off your son on his first (or umpteenth) shidduch date – flustered, self-conscious and sporting cold feet—you think Roosevelt’s wise words are the perfect motivator. Well, you really should know better. The eye-roll or icy stare you receive in response should be glaring evidence for that misapprehension. Quoting a great American president, or giving any advice at all for that matter, may not be the most sensible thing to do when your teenager is stressed out or under pressure.
But while feeling anxious before a date, math test or dental exam is natural and justifiable, an anxiety disorder means that a person’s response to an event or experience—from vague and unsettling discomfort to debilitating fear and dread—is disproportionate to the magnitude of the experience, and can even manifest in real physical symptoms. Clearly, anxiety the emotion and anxiety the disorder, are two very different things.
Almost everyone is familiar with the fight, flight or freeze response—a reaction to a stimulus perceived as an imminent threat to survival. But anxiety disorders lead sufferers to apply these adrenaline-fueled responses to regular day-to-day life. Even if a response originates from clear and present danger, the fear feeding this response doesn’t subside once the threat ceases to exist, and becomes increasingly present, constant or recurring, has a serious impact on daily life and interferes with a person’s ability to function.
In today’s fast-paced and demanding world, forty percent of adults live with constant worry or stress. Anxiety is in fact the number one mental disorder worldwide, surpassing even depression. But despite its high level of treat- ability, the majority of sufferers never seek treatment.
Dr. Sara Genstil, Ph. D in Psychology, uses the Intersubjective Systems Theory in the healing process for anxiety disorders. “Each individual’s perception of the world is based on experiences from early infancy and throughout life. This shapes their individual world view and is defined as their ‘organizing principles’,” says Dr. Genstil. “By investigating and understanding the dynamics of the systems that led to anxiety, clients learn to isolate and strip the original “threatening” experience of its power. Unencumbered by the ghosts of past experi- ences,the client develops new and healthy organizing principles that will eclipse previous perceptions that mercilessly dominated their emotional thought and behavior.”
Let’s imagine three-year old Binah running through the park towards her mother’s outstretched arms. Just before she reaches her mother’s embrace, Binah trips on the gravel and falls face-down in the dirt. Crying and shaken, with grazes on the palms of her hands and on her cheeks, the pediatrician sews a neat, straight row of stitches above her left eye. By next week, the stitches will be out. By next month,the superficial wounds will be gone. In a couple of months, the pink skin repaired by flawless suturing will change color. A hairline scar will remain forever, visible to no-one but Binah herself – but even she will eventually forget as it fades over time into nothing but a vague memory.
Text BoxAs tangible and non-tangible elements of that day knit together, another deeper scar forms. The crunch and drag of the gravel. The smell of the dirt. And the fact that her mother had been just inches away but couldn’t pre- vent her fall. These will form a perception of the world that Binah will carry with her into adulthood. This perception can define how she feels and behaves when she has to cross a gravel parking lot to get to work, or take her own children to the neighborhood park. If Binah doesn’t process and label her childhood experience in a healthy way, she could develop unjustified fears that translate into avoidance of certain situations altogether or taking unreasonable precautions to prevent the danger associated with the experience.
Dr. Genstil emphasizes that her treatment model for anxiety has a beginning, middle and end, throughout which she and her client team up to work through the issues together and witness a process of change. Using guided imagery, dream analysis, empathy and clarification of a client’s subjective world, Dr. Genstil helps clients dig down to their internal bedrock and unearth the life experiences from which their anxiety stems.
Although they appear in many guises, anxiety disorders all follow a pattern of how a person responds to their perception of reality as defined by past experience. Panic disorder is characterized by brief or sudden attacks of intense terror and apprehension that often lead to hypervigilance—interpreting any change in normal body function as a life threatening illness. Phobias are fears and avoidance of an object or situation even if the fear has been acknowledged as irrational. Characteristic elements of Obsessive-Compulsive Disorder (OCD) are repetitive, distressing and intrusive thoughts or actions, and while sufferers usually know that their compulsions are unreasonable or irrational, they need them to alleviate their anxiety. Post-Traumatic Stress Disorder (PTSD) results from previous trauma such as military combat or a serious accident.
But no matter what form the disorder assumes, Dr. Genstil’s treatment model remains the same: “Replace old perceptions of the self and others with new perceptions, and you change the derivative emotions and behavior.” Whether the problem is chemical or emotional, the most effective treatment in the long-term starts at the root. In the long- term, the model helps reduce anticipation of possible future negative events, curb feelings of worry and nervousness, and lessen fear of lurking danger, enabling clients to gain a sense of well-being and control.
“Anxiety is not about living in the past. It’s about feeling and fearing the past,” says Dr. Genstil. “We need to learn how to carry or shed the load that’s weighing us down in order to move forward.”
Dr. Sara Genstil, PhD, is a seasoned psychologist with over 35 years of clinical experience. Dr. Genstil provides counseling for individuals, couples and families. She has experience working with clients both privately and through organizations such as The Ministry of Defense and National Insurance, working with terror victims and their bereaved families. Dr. Genstil is a member and presenter for the International Association for Psychoanalytic and Self Psychology.
Dr. Sara Genstil can be reached at 052-260-9087 or through her website www.therapistjerusalem.com