Crouch End and Muswell Hill
I want to give a general overview of how anxiety can be at the core of relationship difficulties. “John” is not an actual client but rather a typical example that best illustrates what many of my relationship clients say to me, and the work we typically do together to help resolve their relationship problems.
John is a 36-year-old man who has been married to Sarah for the past 3 years. He comes to me seeking psychotherapy to help with depression and relationship issues. He says that he is no longer getting on with Sarah, they bicker all the time, and can’t seem to have a conversation without it turning into an argument.
In fact John discloses that he feels quite intimidated or even scared by Sarah. He is worried that if he says what he actually thinks to her she will lose her temper with him, and so he says nothing as that feels easier.
Over time John has become resentful and feels like the only option he has left is to leave the relationship. However, when he seriously thinks of leaving Sarah, he is aware that this is really not what he wants at all. He fears he will lose access to their young children and also that he will be lonely. Moreover, he’s sure he still loves her. What he really wants is to be able to have the relationship that they used to have, where he felt that they were a team and he was not scared of her irrational angry responses to what he says.
Although John has come to me with depression and relationship issues, that is not what I see as the main cause of the depression and breakdown in his relationship with Sarah.
The depression is there because John cannot imagine a way through the relationship problems and feels trapped and hopeless. He sees his options as being either to stay as things are with a wife he walks on eggshells around and cannot be honest with, or to leave her, giving up his chance at a family life. Both options seem terrible to John. In my opinion, this sense of being trapped, unable to find a way out, is what is causing the depression.
As we work together, John starts to see that he has got into the habit of not being honest with Sarah about his real thoughts and feelings. It doesn’t matter if it’s about what they are going to have for dinner that night or what school to send their child to. Big or small, John often no longer tells Sarah his truth. John has got into the habit of being sensitive to what Sarah wants and then just going along with it. He is worried about what he sees as her irrational and angry reaction to anything he says that she doesn’t agree with.
What started out as a simple case of not telling her his truth so he did not have to deal with her anger has now become an ingrained set of roles in the relationship that both parties have fallen into without even noticing it.
John is doing what we all do when we are suffering from almost any kind of anxiety disorder. He is avoiding short-term pain (the chance of confrontation if he is honest with Sarah), but the outcome of this avoidance is that he experiences long-term, chronic pain instead ( feeling depressed, bitter, resentful, blaming Sarah for the problem, feeling trapped). This may also affect his self-esteem and confidence in other areas of life.
For John it is essential to understand that his partner cannot know what he isn’t telling her. His silence guarantees his ongoing misery and hopelessness. However, it is not as simple as saying to a client like John “Off you go, and tell your partner what you actually think”. This doesn’t work for two reasons.
John’s avoidance of confrontation with his partner is motivated by an ingrained anxiety issue. We work on changing the way John’s problem is unfolding not by just saying “Get on with it and pull your socks up,” but by treating his underlying anxiety which leads to the avoidance.
This is actually good news because anxiety is one of the most well researched and eminently treatable conditions that clients seek help for. If John chooses to work through his issues with Sarah, he is likely to find that he feels empowered by the process and gains in general confidence, as well as helping with the immediate situation.
This is not a gender-specific issue; you can swap John in this story for Sarah, and it will play out in just the same way. The point to take away is that when relationships are not working very well it can sometimes be explained by one party not being willing or able to be honest with the other due to an underlying anxiety that makes them avoid the confrontation that may be involved.
"Andrew helped me get a really precise understanding of what is actually causing my social anxiety, what he called 'the mechanics' of it. We took real-life examples, looked at the mechanics, and designed ways of challenging my thoughts, fears and behaviours.
I felt like I learned a lot about what's been driving me, which felt great; and I felt like I was actually going to be able to do something about it, which also felt great. It was hard work and at times quite challenging. When I look back I can see it was the more challenging stuff that's been most valuable to me now.
I know I've turned a corner, that I have the knowledge and a good set of tools so I can face the situations I used to run away from. It has not been the easiest thing I've ever done, but it has been one of the most rewarding."
George in Crouch End, Counselling for relationship issues and substance use