To Be Both Client and Clinician

Vincent J. Fitzgerald

I sit in serene, soft light and contemplate what is safe to share, and what I should withhold. My war against anxiety is fought on many fronts, and I am battle weary from its barrage of multiple manifestations. Across from me a person waits for my offering on the subject, and before I speak I extend an affirming nod to convey understanding of racing thoughts, crippling fears, and sensations of dying. I choose only to nod because in this therapy session I am the therapist, and therapists do not divulge vulnerabilities to our clients. Sometimes we divulge our vulnerabilities to no one at all.

The walls in the safe house I have built for clients must remain sturdy as there would be no sense of safety should I reveal my frailties and self-perceived incompetency. My understanding stems from more than clinical experience. I have spent hundreds of hours in the other chair as my embattled relationship with anxiety predates acquisition of the social work license I was driven to acquire by witnessing my mother’s depression and my father’s anxiety. Each time a new client asks if I have experience with anxiety disorders, I nod and think, more than I would wish on anyone.”

I was asked to write a bit about the genesis of my anxiety, and have narrowed its origins to my birth. I was born into anxiety, and it is my birthright. What have changed as I have aged are degrees of severity and levels of disorder. In 5th grade it presented only as embarrassment. I was too mortified to inform teachers I never learned to tie laces, forcing me to tuck them into the sides of my shoes rather than face a humiliating confession. I also refrained from telling my parents for fear even they would ridicule me. There is not safety in the house of anxiety.

Afraid to fail, I never tried sports in high school, and avoided rejection by ignoring girls, deferring to the confident guys who had the smooth lines of bullshit. So frightened was I of being asked to dance at senior prom, I skipped it, and tried to sound cool by telling people “I don’t do proms,” rather than reveal awkwardness that also forced me to skip yearbook pictures. I have no memories of prom, and am not immortalized on glossy yearbook paper. In college I feared group projects and oral presentations. Weeks in advance I predicted stuttering and spitting words resembling languages created for Star Wars. These were but anxiety appetizers before I was fed a foul main course in adulthood.

Parenthood was my first severe trigger of disordered thought. When my daughter started walking, I followed her around in lockstep to ensure she would not bump her head or swallow small objects laying somewhere outside reality. When she graduated to solid food, I monitored her chewing and implored her to bite small because I believed she would choke. Anxiety doubled when my son was born and I depleted joy at amusement parks because intrusive visions of them being flung from rides haunted me. So crippled was I by imagining sickness, I skipped family outings to spare myself perseverations about their safety. My anxiety was misconstrued as apathy, and laid the groundwork for eventual divorce. All wars have collateral damage.

Social anxiety at my first job in mental health rendered phone calls in front of coworkers impossible. Convinced I sounded inept, I snuck them when my teammates were away. If one reappeared, I hung up and announced wrong number. Anxiety tried convincing me I had no business working in mental health if I was not mentally healthy, but fear of stigma prevented me from seeking treatment.

After my divorce, parenting my children alone was too much to bear. Anxiety returned in the form of globus hystericus, the sensation of an invisible lump in my throat resulting in relentless gag impulses leaving me bedridden until my doctor diagnosed me with generalized anxiety disorder and relieved my physical symptoms with Xanax. What I once explained away as nerves and shyness mutated to monstrous manifestations with each new stressor in my life.

Within months of getting y generalized anxiety somewhat under control, my bubbling anxiety erupted into a colossal panic attack suffered as my daughter rode shotgun, unaware of my internal explosion. When we arrived at her soccer tournament, I begged her mom to pick her up so I could cower home where I retreated to bed and impugned myself as a failed parent. I recovered by the next day, but was less fortunate when a second attack struck on my way to watch football with friends. The attack en route to a fun activity scarred my brain and kept me housebound for a week.

Attacks snowballed into disorder and it was weeks before I dared venture anywhere besides the nearby school in which I served as a school social worker. Driving to my kids’ home was impossible; I stopped taking them on weekends without explanation, and I isolated myself from family and friends. After my Zoloft kicked in, I ventured to the home of a friend I had not seen in weeks. I was stung by stigma when he compared me to Howard Hughes and asked if I was “done doing the hermit thing.” My disorder was mistaken for choice at a time when I was without choice. I cowered at the notion I was mentally ill, and told him I was just “doing me.”

I continue to weave through my anxiety obstacle course, achieving licensure to be the therapist I desired to be, while following my own therapist’s request to pursue writing. To be a therapist not in treatment would feel hypocritical to me, and in order to normalize my clients’ need for therapy, I share my experiences after a few sessions. I want them to know I am not only leading them into battle against their own mental illness, I fight alongside them in unified brotherhood as well.

IMG_1400Vincent is a practicing psychotherapist and writer with a Masters
Degree in Social Work from Fordham University. He is a lifelong
resident of Jersey City, NJ and remarried father of two awesome
children. He hopes to continue forging universal connections through
personal stories. Vincent owes a his professional desire to his
persevering mother, his drive to his hard working father, and his
accomplishments to his incredible wife, Gemma.

Vincent can be found on his blog, Facebook, and Twitter