Baggage: Getting Through the Packing Tape

On the phone she hadn’t seemed to be carrying more baggage than you’d expect of someone during the pandemic: she was anxious. But she entered the first session lugging a package postmarked in her distant past, and dropped it with a thud in the virtual space between us.  It was so tightly wrapped it practically called out for a bomb squad. 

As she spoke of how the pandemic affected her, she pointed over and over to the THING she had deposited between us. “I have a Social Anxiety Disorder,” she would say, which for her explained it all. Her job in sales required her to interact with many different clients, including the most demanding and intimidating. She stressed repeatedly how her Social Anxiety Disorder made her days unbearable.  She dreaded every single contact. 

Eventually we spoke of many things: a traumatic childhood and adolescence, years of isolation and debilitating depression. But the only issue my patient could relate to was her Social Anxiety Disorder. In her mind it explained everything. She returned to it over and over. And as we stared at that formidably sealed box yet again, she and I came screeching to a familiar, frustrating halt, along with any forward progress and the hope she would reach compassionate self-understanding. 

Curiously, this young lady had another, and opposite, cause of her unhappiness. She was afraid of being alone. That fear permeated her days, woke her from sleep, was her unrelenting companion. She began to be intrigued by the provocative fact that in addition to being afraid of being with people, she was also afraid of being without them. 

This latter fear propelled her to date endlessly and sometimes recklessly. These efforts brought as much pain and hardship as satisfaction. They wedded her anxiety about being with others to her despair about being alone when each relationship failed.

Our sessions fell into a ritual. I first heard about aversive encounters with my patient’s clients at work, and then about dating disappointments and terrible loneliness.  In and out of these stories wove her accounts of supremely angering conversations with her mother, who consistently failed to recognize her needs.

Then one day a session diverged from this pattern, without my patient’s seeming to notice. She had, as usual, started by telling me she had an awful weekend. Yet she described three different dates over the weekend, each reasonably pleasant. Something important was up here, and I was pretty sure it was about the relationship between the two of us. 

Here she was, starting our session with laments again. But this time they were disingenuous laments!  Curious.  I commented that it seemed she actually hadn’t had such a bad weekend.  She admitted being surprised to find that was true. I wondered aloud whether she was seeking distance from me in starting the session in her formulaic off-putting way when she had come in with accomplishments to share. To my delight, she responded as we all do when we discover a truth within: “Yes!”

Now I could remind her how she had often told me it was hard to face me and begin talking. With an ease born of recognition, she named her ambivalence about letting herself feeling close to me, which we both sensed at the beginning of our sessions.  I went on to wonder what it must have been like to grow up with her angry, punitive mother, who was unequipped to respond to her feelings.

For the first time, my patient said she could experience how precarious and angering it felt to be alone with her rageful, inattentive mother, who could become threatening so unpredictably. Her hesitancy about getting close to people finally made sense to her, and she discovered she felt compassion for the child she had been and the grown up she had become. If getting close to others brought fear of their responses and her own, no wonder she felt constant dread at work. Equally, no wonder she feared the intense loneliness she believed would be her lot in life if she couldn’t solve this conundrum and create a lasting, rewarding relationship. 

We had finally unraveled years of packing tape from that Social Anxiety Disorder THING between us.

Therapists know the pandemic has aggravated everyone’s pre-existing struggles. It is not surprising this patient thought she was stymied by an exacerbation of “her” Social Anxiety Disorder, a package she had lugged for years. By contrast, I thought she was burdened with our profession’s present compulsion to attach convenient labels which point to narrow treatment protocols and deny patients opportunities for self-discovery. This would have meant denying my patient, who valued herself enough to pursue intensive treatment, the chance to form an enlarged and enlightened narrative of herself. She is now on the way to creating such a narrative, which will allow her to pursue work and romantic relationships with greater self-understanding and insight.

Written By:

Sydney Langor LCPC is a New York City psychoanalyst with a diverse practice that includes training therapists and extending mental health care to those without insurance.