Clinical Separation Anxiety in Adults
Friday, August 12th, 2011
Abstract:
This article examines the difficulty of separation anxiety in adults which for women can lead to anxiety in relationships, a lack of self worth and desperation leading to suicide attempts while in men can lead to obsessive relationship behavior, over controlling and violence. How does this happen to people and how can they in a therapeutic environment learn to control and deal with their emotional responses.
Introduction:
The origins of separation anxiety (Bowlby 1956) come from when a child feels their carer (in most cases the mother) have abandoned them both emotionally and physically. In children this can be seen in their everyday behavior with such activities as increased demands on the mother and aggressiveness, clinging behavior in which the child physically holds onto the mother afraid to let her out of their site and grip. You can often see evidence in supermarkets where a child is hanging onto the mother’s skirts and will not let go. The child will throw a tantrum, when the mother is out of sight, in another isle of the store. Often these children have been let down by the mother (in the child’s view) when she had to leave home for a short period, perhaps to have a second child or illness. The child feels abandoned and even when the mother returns often reject her as a defense to protect themselves from further abandonment. This leads the child to become more self sufficient so that it does not have to rely on the mother so much. This can cause a swing between clinging behavior and detachment from time to time. Some children start to complain of imaginary illness to gain attention and control the parent’s activity this may later lead to anorexia in teenage years or OCD (obsessive compulsive disorder). One of the other obvious abandonment issues in our modern world is divorce. Here the loss of one parent sets up a future anxiety over relationships with others – trust issues are at the foremost here for being also divorced in the child’s future life. Another issue is economics, where both parents need to work in order to make ends meet in a world of spiraling costs and uncertainty. Recently many couples around the world suffered financial hardship as property markets collapsed and banks needed to be rescued from tax income to survive. This situation left many families without homes, on the move, without any funds for early education and much more. For children placed with grandparents for long periods of time while the parents try to rebuild their lives and find new work and homes. The children once again can feel abandoned by the parents left with virtual strangers for periods of time.
Consequences for Adult Relationships:
The Man:
Many women will tell you the stories of men who become so obsessive with them that they are constantly checking up on them, asking where have they been, who have they seen, checking their text messages on the mobile phone, maintaining that the woman has no right to privacy and he should have all the passwords to internet social sites, (Facebook etc) and email accounts. The men check them regularly and the histories of messenger accounts (MSN. Yahoo, QQ) to see what was said in chat conversations. The man constantly questions the woman about every aspect her life – not in a caring way about how she is spending her time but in an inquisitive way that demands answers. When he is frustrated by the answers or feels she has some secret from him he turns to threats of breaking up and violence towards her. This is all equivalent to clinging behavior as a child – constantly worried his mother will leave him again. So with all women in his adult life – control is the key to reducing anxiety. Where control fails – violence follows – stalking is common (following the girl secretly). Another manifest behavior is promiscuity, if you cannot trust any girl then never keep one but go from one casual relationship to another. Often these men only love themselves and see sexual encounters as self love – the girl in fact is treated as an object and not a person. When the man feels himself beginning to attach to one girl he immediately sleeps with others to reduce his reliance on that one girl. The number one emotional driving force is jealousy, they can have many girls but all the girls can only be with him. So he is often violent in everyday situations, arguing, holding tightly to the point of pain, grabbing, slapping, holding as in swaddling (prevents the girl from disengaging the hug) and if all else fails then extreme violence and damage to the girl physically to the point of hospitalization. During sexual encounters he will often not orgasm for a long time as he is not emotionally invested in the girl, the girl may mistake this as a good lover, when in fact his aggressive love making, often violent and painful is his mentally punishing the girl – just as he would have done to his mother if he was strong enough as a child. Masturbation is common even when sex is freely available – he does not need to fantasize about a girl while touching as it is an act of self love and gratification – only rely on yourself.
The Woman:
Women in most cases not being as physically strong as men cannot resort to violence however they often pick weak men in order to control them and hurt them physically knowing the men often are too caring to fight back or are non-violent themselves. We often talk about domestic violence as the woman as victim but behind many doors there are men suffering at the hands of violent women who throw objects, slap, beat and knife men in attacks over abandonment issues. Sometimes these men lash out in frustration at being constantly abused but only to be left with enormous guilt at hurting a women they love, thus the women in return can use this outburst to further punish the man with guilt over long periods of time often leading the man to abandon a woman he has feelings for in order to escape the abuse. More often in women however they suffer more from anxiety and emotional turmoil than men do in the same situations. In relationships as adults, the child of separation anxiety, will exhibit a lack of self esteem, often believing that the man they are with somehow is only putting up with them and does not really love them, even though they say they do? They believe other women are all better looking, better dressed, more pretty than they are – they are constantly in a situation of social comparison. This means that they fear further abandonment by their husbands or partners as he will become bored, disenchanted with them and want to find a happier, easier woman to be with. They constantly ask the man for confirmation of love, with words, deeds and emotionally. Sexually they often are frigid and only agree to sex as a way of appeasing the man. During sexual encounters they are often thinking about what does this really mean – does he love me or just need satisfaction for himself from my body? During their early relationship just like men they are often promiscuous and move from man to man using sex as a way for looking for love and caring. However soon they realize that the men now only use them for sex and have no investment in a relationship (often the girl becomes known for easy sex amongst men – the slut syndrome). However they continue to use sex as a way to find a man who will not abandon them. Once in a long term relationship then sex becomes annoying to them and a nuisance. They mistake the husbands approach for sex as using her and not loving her – this can in turn cause unhappiness in the relationship as the man is frustrated by his approaches being rebuffed and eventually can lead to a breakdown and a new abandonment. However just as in the men most women will masturbate when alone but again with no fantasy attached but as a form of self relief from tension. Most women here feel they are not worthy of love from anyone (just as they perceive their mother did not love them). So they have a self prophecy that any relationship will end badly – and through their own behavior make the prophecy come true.
Treatment and Therapy:
Many patients arrive at counseling for couple’s therapy hoping to resolve their everyday issues that seem to be pulling them apart. They profess they still love each other and want the relationship to work. However in some cases in becomes apparent that one of the party is an adult separation anxiety case. It is not easy in therapy to deal with this issue; it takes a lot of background education first in order for the couple to understand where their behaviors are coming from. Transactional Analysis can be a useful technique here showing the Karpman triangle of victim, persecutor and rescuer. Many ASA clients see themselves as the victim being persecuted by just about everyone and wanting to be rescued but always rejecting the solutions to hand. In understanding this concept you can then move the client onto an understanding of Bowlby’s separation anxiety in children and how it relates to adult life. Once the concepts are accepted and understood through clarifying techniques (asking the client to explain the concepts back to you) then insight can then occur with relating their current relationship issues in the light of this newly gained knowledge. With the help of the therapist they can start to understand behavior and actions they feel where normal and now see as maladaptive behavior. From this point a switch to cognitive emotive therapy with then challenge the faulty thinking that has led to the clients self doubt, anxiety, and fears and acting out. It takes many session to treat this type of client (over 20 at least and often 60) they have multiple issues to deal with that have become habituated over time, plus they resist the change from their comfort zone to a place that at first seems unbelievable that someone can love them unconditionally. (Although this is rare even in normal relationships which often have an economic emotional balance to them – I will love you – if?) As therapy proceeds the couple may not need to come together but concentrate on the ASA client more – as they have the main issue to deal with and may find talking privately away from the partner more relaxing. Also issues of masturbation may not be known to the partner and so some confidentiality issues should be observed here. In the conclusion of therapy the client often needs reassurance over time – this can be done through short emails – they often relapse to their former condition and so further sessions are needed regularly from time to time – mostly for reassurance that everything is going to plan. For the therapist looking for positive feedback from everyday activity is important.
Conclusion:
Separation anxiety in adults is a serious condition often over looked by conventional therapists who become too concerned in the here and now situation forgetting that histories matter. It is why the failure of positive psychology, humanistic psychology and many other modern fads never address the reality of people’s development as an important concern for therapy. Although psychotherapy is often taught now as historical but not useful concept in the modern world, this is text book arrogance by modern psychology teachers who have no field experience with real clients. Transactional Analysis and CET/CBT are the most useful techniques for ASA and should be utilized. All good therapists and counselors should be eclectic, in other words, use the best from any theory if it helps your client to a better understanding of themselves and their situations, hopefully leading to a better quality of life. It is not an easy condition to treat, 20 or more session are competing with years of anxiety and self doubt – so long term treatment and follow up are often recommended to the client.
References:
J. Bowlby (1969) Attachment & Loss Vol.1 – Penguin Press (line 1 of the introduction). S. F. Myler (2011) Notes from Private Practice – Shanghai, China.
Dr. Stephen Myler is from Leicester in England, an industrial town in the Midlands of the United Kingdom. He holds a B.Sc (Honours) in Psychology from the UK’s Open University the largest in the UK; he also has an M.Sc and Ph.D in Psychology from Knightsbridge University in Denmark. In addition to this Stephen holds many diplomas and awards in a variety of academic areas including journalism, finance, teaching and advanced therapy for mental health. Stephen has as a Professor of Psychology many years teaching experience in colleges and universities in England and China to post 16 young adults, instructing in psychology, sociology, English, marketing and business. He has been fortunate to travel extensively from Australia to Africa to the United Sates, South America, Borneo, most of Europe and Russia. Stephen’s favourite hobby is the study of primates and likes to play badminton. He believes that students who enjoy classes with humour and enthusiasm from the teacher always come back eager to learn more.