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In-depth study of anxiety cleared by better social system around - By Dr. Alvin Ng- 13-Oct-2017
Case 1: A history of Functional Anxiety
"A 22-year-old male student diagnosed with general anxiety disorder after a mental breakdown while studying overseas. He had an authoritarian mother who believed he had been disturbed in spirit and sought a few Chinese faith healers to help remove the evil spirit disturbing him. However, at that time, his girl friend was a staunch Christian and refuted his mothers beliefs, and so he was constantly caught in between the mother-girlfriend conflict. He was put on medications his psychiatrist while I tried helping him to learn relaxation skills to manage his anxiety, and also cognitive techniques to cope with his disturbing thoughts.
I found that after a few sessions, and while he was on medication, he was not functioning as his usual self. The conflict between his mother and girlfriend continued. While he was less anxious, he was not functioning at his usual effective level in his studies or other daily activities. I suspected that his anxiety could have been a main factor for his ability to function as he needed the relative stress to be able to be motivated enough to manage his studies and daily living. So I discussed with the psychiatrist to reduce his dose of anti-anxiety medicine and allowed him to go back to his high-strung self to see how well he functioned.
While he was having his dose reduced, I worked on teaching him skills to manage his anxiety with cognitive and behavioural methods. I also started teaching him assertive skills in managing his mothers and girlfriends nagging. Parallelly, worked with his mother and girlfriend to start focusing more on the positive aspects of his functioning and strengthen them by encouraging him rather than criticising his anxious mannerisms.
Gradually, as his relationship with his mother and girlfriend improved, I also worked on their conflicts. It turned out that he realised he was a kind of person that functions best being slightly anxious but his mother was not able to accept his nervousness and kept saying it was a big problem.
Once communication skills improved between mother and son, it was found that his dysfunctional anxiety disappeared but he had a certain level of anxiety that was obviously higher than average but he knew how to explain to people that that was how he is and that it was ok for him. That helped people to accept him better and his anxiety did not have to be a problem anymore, because it was functional for him.
This case shows that with communication and self-regulation skills, one can reduce dysfunction and also increase social support in personal difficulties. As such part of the intervention of this particular case involved engaging the social system around the individual to be part of the change needed for his treatment.
