March 27, 2011
It’s never too late to learn! Yesterday, I saw Mr. X. Mr. X has been seeing me for the past 20 years. He is in his 70s and has been diagnosed and treated for a major anxiety disorder for as long as I have known him. Despite the best that my profession has to offer him, the best medicine, counseling and behavior modification techniques, Mr. X continues to be anxious and worry about everything.
“My knee hurts. Do you think it could be cancer?” Mr. X has seventy-some year old knees and they are worn out. “My shoulder hurts. Do you think it’s a heart attic?” Mr. X carried some heavy boxes from the garage to the attack over the weekend. “I had a headache two days this week. Am I going to have a stroke?” Mr. X’s worries have gotten worse over the years. In retrospect, the harder I try to alleviate his fears, the worse he gets!
It’s never too late to learn! Yesterday, I had an epiphany. Mr. X is a professional worrier. He worries the way some people play golf, shoot pool or play bridge. He is the Tiger Woods of worry. Worry is woven into every facet of his life. It is part of his social being. In his younger years, he worried about work, paying the bills and his children. His worries were less threatening. As he aged and retired, his worries turn inward, focusing on his physical wellbeing. His worries have become increasingly more threatening over time. It’s one thing to worry that your painful knee is arthritis; it’s quite something else to worry that your knee pain is cancer.
My mistake has been trying to take away his worries. Doctors are trained to alleviate pain and suffering. When a patient’s knee hurts, we are taught to diagnose the problem, treat it and provide for future care. When a patient worries excessively, we do the same thing. We try to remove the worry. In the case of a professional worrier, when you say, “Don’t worry, it’s not arthritis. It’s just your age. It’s just a minor sprain,” you take away a benign source of worry and open the door to a malignant worry. “Could it be cancer?”
Live and learn! I should have told Mr. X he has arthritis. He would have been much less threatened by arthritis than by cancer. I’m learning! I talked to Mr. X about his worrying and his need to focus on less threatening worries. I suggested that he buy a lottery ticket and worry about whether or not he would win. I suggested that he should worry about what winning would do to his life. I suggested other things he could worry about.
Not being a psychologist, I consulted with Dr. Lapporte, one of my colleagues. Dr. Lapporte is one of the psychologists who has treated my patients for decades. I wanted to make sure my new treatment approach was valid and safe. He concurred, stating that “distraction” was a viable approach. I think I will prescribe more “distraction” in the future. It’s cheaper with far fewer side effects than medication.
For those of you who are professional worriers, find something harmless to worry about. “Will it snow today,” is an excellent place to start. As you become better at choosing less harmful things to worry about, work on developing healthy worries. “Will I have time to exercise today?”
Most of all, be happy and healthy!