How To Solve Carla's Challenge of Anxiety?

Carla says she can't sleep. Her anxiety keeps her up, and she just spent an entire night awake at her computer. The way she describes it, the moment she steps away from the screen the anxiety floods back in, so she keeps avoiding bed even when her body and mind are worn out. A half hour of sleep feels better to her than none at all. The harder part is that the anxiety follows her into sleep itself, and it gets worse on the nights she sleeps alone. Lately she has started to wonder whether what she is dealing with amounts to a genuine disability. She has also ruled out applying for government disability payments, since she doubts the income would be enough to live on.

School sits at the center of her fear. She is in a Nursing program with a brutal grading curve, where an 80 or a 90 percent can still count as failing. Exams she thinks she can manage; given enough study time, she believes she could pass almost any test. Papers are the problem. Back in her first year of undergraduate work, she dodged writing assignments entirely, steering toward classes and tasks that let her perform well without producing an essay. It isn't that she lacks the skill to write one. What frightens her is handing finished work to a professor and living with whatever the professor thinks of it. These assignments are what fuel the all-night attacks. She lies awake turning them over, again and again and again.

To Carla, reassurance misses the point. As she puts it, people may extend a hand and tell you it will be fine, and it changes nothing. She feels her instructors don't grasp what she actually goes through; their answer is usually to refer her to a writing advisor, and she is certain that isn't the fix she needs. On top of that, she is convinced that the second she opens a document to start a paper, the project will swallow twice the time she was given, the work will come in late, and her grade will take the hit for it. That conviction feeds what she calls her procrastination. Her dark predictions about how things will turn out push her to avoid the work, the avoidance drags down the quality of whatever she does produce, and she ends up feeling irresponsible.

Most people, she believes, will never really understand an anxiety problem, so she would rather tell someone she is sick than try to explain the truth. Some of her most painful memories are of teachers and caretakers who read her struggle wrong and decided she was simply lazy. At one point she suspected dyslexia and got tested for it. The results came back negative, which left her still searching for a reason. The fight with anxiety goes back to her childhood, and she traces her current state to those early years. In her words, growing up she never had the safety and security a child requires in order to become a secure adult. Her relationship with her mother holds both things at once: deep love, and an inability to fully trust, because her mother physically abused her as a child under old cultural norms of the place they lived.

Carla has a clear read on her own situation. Almost all the time, she says, she feels unsafe, present but forced to tread carefully, as though she were still twelve years old. She describes zoning out on her computer, on games on her PDA, on any constant activity, just to make it through a day. There is no sense of protection. Even her relationship carries that fragility: she feels she has to watch every word and action or her boyfriend will get angry and leave, and the fear that people will leave is always there. She used to test people by pushing them away, and they always went, so she stopped pushing and started telling them what she needed instead. Her logic became that if she could just be good enough, they might stay. So she bends, accommodates, tolerates, and gives up things she wants, and it still never feels like enough. Her therapist keeps asking her to see that she is the adult now. Her question in return: how can she, when she still feels twelve?

So what should Carla do? Look over the resources here and try to put together a plan for her. Think about what has helped you work through your own difficulties, and what you have seen help other people through theirs. What approach would you take to Carla's situation, and how confident are you that it would actually work?

The person in this account has been called Carla to protect her identity. Her original story appears at experienceproject.com, posted by an anonymous contributor.