A patient, panic attacks and his Milky Way
Manny (Manuel) came to see me in clinic suffering with extreme anxiety. Everything looked hopeless to him. He lost his flight attendant job of 25 years due to his uncontrollable anxiety that careened into weekly panic attacks. He simply couldn't keep up at work. He'd lost focus. He slept in.....missed flights.
Sleeping in. That just isn’t allowed at airlines.
He was addicted to internet pornography among other things.
He told me: "My parents never seemed to care about me, so I just kept on doing stuff, bad stuff. The truth is, I’m a mess. I really see no hope.” Shaking his head: “I’m a horrible person! I have nothing to live for. Nothing.”
As he opened up more, he started to cry and leaned forward over his chair. Head down, he rubbed his forehead and combed his dark hair violently with his fingers. All he could see was suffocating darkness. Traps. Everywhere he looked. No way out.
I finally spoke: "Oh, I am so sorry you are suffering this. I can understand why you’re so upset. Coming for help takes humility and real courage.
“Yah, well, I feel like a coward. One thing, one mistake just led to the next and the next. Now, I just feel very alone. Cold. Dark. Trapped. Isolated. Afraid. I can’t see a way out or forward.”
I get it. Want to try something right now to help you see things a little differently, maybe?
“Ok. I’m here now. May as well.”
I pointed up and then turned the clinic room lights off. Let’s look up at the ceiling in this small room. Pretend it is very, very dark. Black dark. He looked up, eyes swollen, desolate and broken feeling.
Do you think if there were one light up there that you could see it?
“Yeh, I think I could.”
OK then. Let's put one light up there for you to see. Let's think of something good in your life. Something you’re glad you have. Something you’re maybe even thankful for. Close your eyes. Can you think of anything going right or maybe on the right track? A friend? Family? Co worker? Job skill?
"My relationship with my father is better. We had a little talk a while back. I told dad how sorry I was….I want to say more to him!”
Stop here," I suggested. That’s a light up there. Can you see your dad again this week?
Let's work on lighting up your darkness and not stop--- until the Milky Way is exploding over your head!
“How???”
One light at a time. One tiny repair at a time. One moment at a time. One day and one night at a time. Rest overnight and get up and try again. Your life can be rebuilt. We will also set you up in our addiction program. You are NOT ALONE in this.
At the end of visits doctors usually come up with a plan. This is how Manny’s went:
- Rx for panic attacks: Short term supply of medication that snuffs panic attacks safely. Consider CBT for long term management of anxiety disorder. (Cognitive Behavioral Therapy.) Also longer term SSRI such as sertraline or fluoxetine.
- Homework: Think of one more “light” before I see you next week. Only one. Write it down and bring it in. I'll see you back next Wednesday and let's see what we have. We're not going to stop until we bring on the Milky Way! At the next appointment we will also consider the addiction program here.
Manny was beginning the process of reestablishing relationship with his father by apologizing. Sincere forgiveness brings unity and remarkably deepens friendships. The closest friendships have fought through tough personal battles. Grudge holding and avoidance is deathly to relationships. Besides, we don’t have time to carry grudges another day.
Actively looking for opportunities to apologize and be forgiven is a radical way of life. It requires daily awareness of our own fallen human nature and quickness to apologize and work on repair. Sometimes grievances are very deep and need professional therapy. The rifts may need to be dug up, voiced, then voiced again, then set to heal like a broken bone. Small acts of love quicken the healing. I dare you to send flowers, a small note or small gift card to someone you hurt. Surprise them. Watch how they smile and wonder! Watch how you feel when you see them next! Forgiveness is also a gift to yourself.
In the middle of life and at the end, drawing people close by renewing and deepening friendships significantly improves our overall contentment. It allows us to taste joy and even laugh, despite often grueling health or other circumstances.
If we choose to isolate and turn away, we miss the opportunity for rewarding intimacy with family or old friends. Sadly, that path is often taken. This choice denies them and further hurts us. It leaves our loved ones to deal with our mess and divisions. Let’s leave a better example.
The greatest teaching of forgiveness ever came from the Cross as Jesus Christ was dying in bitter abandonment and agony: “Forgive them Father, for they know not what they're doing.” (Luke 23:24).
They know not what they’re doing……. Consider: Was this possible when they hurt us?
See what Archbishop Fulton J. Sheen said about refusing to forgive:
Take any scene of action, let five people look upon it, and you get five different stories of what happened. No one of them sees all sides. Our Lord does see, and that is why He forgives. But we know nothing about the inside of our neighbors' hearts -- their motives, their good faith, the circumstances surrounding their actions -- and hence we refuse to forgive.
The choice for great relationships is ours. Ideally we work to forgive before they (or we) have a serious accident. Let’s choose to put lights up! Consider for a few minutes: Who have we offended? Give one offer of forgiveness and gain one better relationship at a time.
- Nancy Miller-Johnson, MD #LiveSMOL
