“When my anxiety is at its worst, I feel like I’ve fallen into a deep abyss,” Sam* tells me during one of our therapy sessions. She is 17, creative, a talented musician, full of dreams, and like so too many young people has had experiences that forced her to grow up and see the awful parts of life too soon.
For her, it was the death of a family member when she was 5, which forced her to learn too young that despite what parents promise, people we care about can leave, bad things can happen, and the world can be a scary place.
“I can get really worried that my friends will abandon me, sometimes I worry so much that I feel like I can’t breathe and need to leave class,” Sam says. “I message my friends and they leave class to help me too or they send supportive messages. And that makes me feel better for a few minutes before I start worrying that I am actually frustrating my friends with my neediness and one day they’ll get sick of helping me.”
I sat and listened, the worry so huge for her. Being rejected by her friends felt like life or death to her.
“But not every day is like that,” she continued, hope returning to her voice. “Some days I can control everything enough to not feel worried about rejection. I can see the abyss still, but I don’t feel like I’m falling. On those days I feel like I am standing at top on solid ground, looking into the deep pit whilst holding tightly onto the safety handrail.”
I was pleased to hear that some days felt more stable for Sam. And at the same time, I reflected on how hard it is to move forward with your life, especially while clinging on to a handrail above the abyss.
We stood up and imagined the handrail in front of us, we both gripped on tight. From our solid position we looked over into the abyss. It went deep. I had no difficulty imagining how awful it would be to feel like you were falling. We looked down at all the thoughts, memories, sensations, and emotions that made it into such a deep dangerous abyss.
Thoughts of ‘what if I’m a burden on my friends? What if they abandon me? What if they see the real me?’
Memories of all the small mistakes and dumb comments she’d made. Friends said they didn’t even notice, but how could they not have?
Sensations such as nausea, shakiness, difficulty breathing and all those other things Sam’s body did when the worries took over and she felt she needed to flee class or the party or wherever she was.
Emotions took up a lot of space in the abyss, there was fear, sadness, loneliness, despair, even some emotions that didn’t seem to have a name but felt so awful.
I stood alongside Sam, and we both held on tightly to that handrail. The handrail was made of all the things she could do to stop her falling. She would spend hours planning what to do and what to wear so that she might avoid making mistakes. Then after school she would go over all the mistakes she did make and talked down to herself for each social faux pas. She would yell at herself to do better tomorrow. She’d check Facebook, Tumblr, and Instagram to see what everyone else doing, keeping track of how many likes each person was getting and noticing who did and didn’t comment on her posts. She would arrive in class telling people she was feeling a bit sick so that if she needed to run out mid-class she already had made her excuse. She avoided social events that might be too awkward or scary. She’d pulled out of the school talent show at the last minute because she worried the song she’d written wasn’t good enough. It had taken her years to build up her handrail, and often it worked.
For a while.
But as she held the handrail she started to notice new painful thoughts and feelings, and had to cling on even tighter. We noticed that she can only hold onto the handrail, looking over the edge for so long before she felt like she was going to fall again.
We stood side by side clinging onto this handrail looking at the abyss we weren’t falling into. It made me curious.
“I can see all the things you’re trying to get away from,” I said. “Where are the things you’re trying to get closer to?”
“What do you mean?” Sam asked.
“Well, we’ve talked about the anxiety and low mood and critical thoughts, and I can see those in front of us. Where are the things you care about? The stuff that matters to you?”
Sam smiled a little. “You mean stuff like my friends, family, music, and protecting the environment?”
She was remembering a discussion we’d already had about what she valued. She held onto our imaginary handrail with one hand, and pointed over her shoulder. “Those things aren’t down the abyss in front of me, so I guess they must be behind me at the moment.”
We noticed how much it can suck to lose sight of the things that matter. Sam has had days and weeks when she was so busy strengthening her handrail to keep from falling, that she hadn’t been able to get any closer to the ideals she wanted her life to be about. It was hard to be a good friend when she had to avoid parties, hard to develop her music when she couldn’t stay in music class or perform in front of people.
“But I feel safe here,” she started. “When I’m here, I don’t fall into the abyss, I don’t have to deal with that crippling anxiety that has been so huge in my life.”
I nodded. Sometimes all we want in life is to feel safe.
“And if I turn towards that other stuff, I’ll have to let go of my safety strategies. It sounds so risky.”
“Especially as you start taking those first steps in those valued directions,” I agreed, “you’re not where you want to be in life yet, and you’re also not actively trying to keep the worries and mean thoughts away.”
Sam took a deep breath and looked around at our imagined land. The fears she wanted to keep away from in one direction, the life she wanted to get closer to in the other direction.
“Maybe I need to let go of the handrail, and take some small steps,” Sam suggested. “Text those friends I’ve been avoiding, play one of my songs to someone, take more care to sort my recycling…”
“Sometimes small steps are all we feel able to take,” I said, “and aren’t you curious to see where these small steps could take you?”
* Sam is based on a combination of a few clients I’ve worked with recently
Ben Sedley is a clinical psychologist and acceptance and commitment therapy (ACT) practitioner with over fifteen years of experience working with kids, adolescents, and families facing mental health difficulties. He is the author of Stuff That Sucks: A Teen's Guide to Accepting What You Can't Change and Committing to What You Can (New Harbinger, 2017). He is also the father of three wonderful noisy kids and loves The Ramones and The Clash.