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Male in his mid-thirties, a professional Nurse, presented with more than 15 years history of anxiety episodes. For past 12 years he had been on psychiatric medicines. Starting with one type of medicine for depression and anxiety, other medicines were added over the time for gaining better stability. Now, he was taking 4 different medicines; two types of antidepressants, one mood stabilizer, and one sleep inducing tablet, as well as one tablet (as SOS) for aborting acute anxiety or panic attacks. 

On presentation, he was still employed in a hospital, but was fearful of losing his job anytime. Working in Shifts as a Nurse, he had to adapt to change in Shift hours (Rotation of Shifts). Shift changes provoked high anxiety. After Weekend break, he often felt panic reaction and intense avoidance to start the first day of the next work week and often used his sick leave to cover those days. Now, he had exhausted all sick leaves, was anticipating a memo from his supervisors, had poor sleep, mood swings, reduced appetite, physical symptoms of panic reactions and was socially isolating himself from any interpersonal contact. He would not pick up any phone calls, even from known contacts or family members. He would return a phone call after a few days, even then, only if he surely knew who is calling and for what specific purpose! His answers would be brief, rehearsed in his Mind and any unknown situation would be experienced as ‘Brain Freeze’. 

He had not visited his Hometown for many years and on the few occasions when he had to drive out of the city, he would take an Anxiety pill during the break, to abort the panic and bring himself to complete the journey. 

At the start of therapeutic engagement, missing appointments and not showing up for urgently scheduled appointments was usual. Fear and Guilt towards therapist added to his confusion. The engagement and rapport improved over few months. Weekly once sessions became consistent, with add-on sessions for situational urgency as an option under his control. Content of the sessions were kept fluid, without a strict rigid format of expectations from the therapist. Principle of ‘Free Association’ allowed the patient to find his comfort zones in the Relational dyad with Therapist. ‘Flight’ or ‘Freeze’ reactions of the Mind and its emotions, reduced. Trust sprouted and evolved. Mistrust and Fear reduced in scale and intensity. 

Over a six-month period, his workplace behaviors stabilized. No sick leave was taken. He could negotiate his shifts with his supervisor, to suit his needs. He felt happier about his patient interactions and work performances, as his attention towards tasks improved and his Mind and its Skills were more flexibly expressed. Rumination, Self-criticism, fear of making mistakes, reduced. Self-Confidence expanded.  

Over the next six months, he started enjoying the process of Self-discovery. Curiosity about trying and testing his abilities returned. He emerged out of a sense of Complete Lockdown of his inner sense of Life force. He was risk aware (often exaggerated fears) and his feelings swung between optimism and pessimism. His Relational sense with therapist moved from ‘Dependency’ to ‘Sounding Board’. With each successful Initiative, he felt increasingly connected to his sense of Self-Worth. He started believing in his ability to think, deduce and evaluate the situations and his responses. Cognitive abilities returned and he felt functional enough to Cognize and Re-Cognize Circumstances and Challenges. 

Individual sense of Life became exciting. He attended Conferences on CME (continuing medical education), selective social outing with friends, attended Rock concerts in Los Angeles, drove by himself to his Hometown and ancestral house without needing an anxiety pill. He learnt not to avoid communication, but to embrace reasonable communication. Instead of looking at the telephone as a dreaded device, he made and received telephone calls and found it a suitable ally. 

One and half years from the initial interface between the Client and Therapist, he expressed his desire to disengage from therapy sessions. The parting statements were, “I want to experience and enjoy this sense of normal Life now, explore doing the things I had only imagined in my past. I will come back for further Growth when I am ready”. 

For the Therapist, this Journey is worth the remembrance!