Anxiety

Mary is a middle-aged unmarried professional woman.  For many years, she had been experiencing severe anxiety amounting to panic in a number of situations, many of which had proved responsive to psychotherapy.  One problem which had proved unusually resistant had been the intense anxiety she felt when in any situation in which there was no immediate way out.  This included situations in which there was no physical escape, and those in which social norms meant that she could not simply walk out, or leave.  In these situations, she would either panic, or begin thinking about the possibility of a panic attack - which induced such fear that the attack would happen anyway. 

Her annual ordeal was the summer holiday period, when she was expected to travel, with her mother (who lived close to her) to Ireland, to visit other members of the family.  This was a double ordeal: the journey to Ireland was by plane - a situation in which, once the doors were closed, there was no escape - and the period of some weeks in Ireland was a situation in which social pressures meant that she could not simply leave and return home even if she wanted to.  She had for years been used to the fact that she would experience varying degrees of panic and distress during this period, until her return home.

A number of different interventions had been attempted over several weeks, using NLP, hypnosis, and other approaches, without success.  Finally, the therapist suggested Provocative Therapy (PT), explaining a little about this.  With some trepidation, the client agreed to a ten minute Provocative Therapy 'window', within the hour-long therapy session. 

During the ten minute session, the therapist began by gently 'kidding' Mary about what a terrible problem it must be - and then suggested, carefully using the language patterns of PT, that she was not doing the problem properly - that, actually, she needed to have the problem far more severely.  There followed several minutes of the therapist  humorously suggesting increasingly improbable scenarios of panic - to an absurd degree - both on the plane and during the week in Ireland.  Afterwards, the client said that she had enjoyed the session enormously, although she did not expect it to have made any difference.  Throughout this time, the therapist used the language patterns of PT, although to an observer it would have appeared that it was simply a light-hearted chat.

Some weeks later, client and therapist met for a further session.  The therapist asked Mary how the flight and the holiday had been…?  Mary said, with some apparent pride, that she had not once thought about the 'ridiculous imagery' of the previous session. 

When asked again about the flight and the time away, she said that both had gone well - with no sign of the fear and panic which she had been accustomed to feeling at holiday time each year.

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