Meditation on the Phenomena of Anxiety in CAT Clinical Training

Dunn, M., 1993. Meditation on the Phenomena of Anxiety in CAT Clinical Training. Reformulation, ACAT News Autumn, p.x.


Meditation on the Phenomena of Anxiety in CAT Clinical Training

Mark Dunn

If anxious then attempt perfect control or suffer a complete mess.

New therapists are anxious generally because a) they do not feel very competent to can’t out the tasks required and b) they do not feel very competent in handling the relationship; they often expect to be attacked critically by the patient and humiliated. Therapists’ anxiety is reduced generally by enacting neurotic procedures but often more specifically the procedure - being tightly in control of tasks and relationship; this procedure is detrimental to the patient, stifling discussion and dissent. It results in the therapist imposing her understanding on the patient which negates the patient’s developing awareness process, closing it down. As the patient is unlikely to feel strong enough to challenge this process then she will close down and become more depressed as another opportunity to open up and express is lost. The therapist wonders what has gone wrong. The patient will often go away from therapy.

New patients are anxious generally because a) they do not know what their role and task is in therapy and b) they do not know if they have the resources to manage; they expect to be exposed or attacked, criticised and humiliated. Patients reduce their anxiety by enacting their predominant procedures (defensive) either placating, avoiding, giving in, controlling, attacking, seducing, perfectly striving, passively resisting, cutting off from, etc. This is detrimental to the patients and the aim of therapy. The patient imposes her procedures on the therapy closing down potential increases in awareness and learning. As the therapist is likely to be an intelligent and aware person, she is likely to feel frustrated and cross and is likely to become critical and attacking reinforcing the patient’s belief causing the anxiety in the first place.

Teachers’ are often anxious because a) they feel unsure about their ability to carry out the tasks required and b) unsure of their competence to handle the group; they feel that they might be attacked critically by the group and humiliated. Teachers’ anxiety is reduced generally by enacting neurotic procedures but often more specifically the procedure - tightly in control of task and group process, stifling discussion and dissent; this is detrimental to the group. It results in the teacher imposing her understanding on the group, closing down the group’s exploration and learning process. As the group are likely to be intelligent and aware persons then they will feel frustrated and cross and are likely to become critical and attacking reinforcing the teacher’s belief causing the anxiety in the first place.

There is the idea that therapists tend to try to be tightly in control to reduce their anxiety before they can loosen up but this is likely to lead to premature hardening of the attitudes and conceptual clots resulting in emotional / empathic heart attack.

To become competent at therapeutic tasks, managing relationships, roles and teaching, takes much time and energy, One should accept failure humbly as part of the learning process and not try to create premature success by enacting neurotic procedures (controlling, striving, placating or otherwise…).

Mark Dunn

Full Reference

Dunn, M., 1993. Meditation on the Phenomena of Anxiety in CAT Clinical Training. Reformulation, ACAT News Autumn, p.x.

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