Couch is a series about psychotherapy.
When the stock market crashed in 2008, my wife and I were 70. And we saw half of our retirement funds disappear. Before the crash, we felt secure in the belief that we had enough money to last as long as we lived; after the crash, we feared that we would not, and I worried about it a great deal. I had a hard time going to sleep and an even harder time going back to sleep after getting up to go to the bathroom in the middle of the night. I came to hate going into that bathroom because I knew my demons resided there and would invade my consciousness immediately.
By the time the stock market began to recover and our savings were again at a comfortable level, I had become conditioned to associate my nightly bathroom trips with “worry time.” I would worry about everything: home repairs, trip planning, medical issues and all the vicissitudes of old age, fears of infirmity, dying and seeing my friends and loved ones die.
One night two weeks ago, for the first time in seven years, I realized that the worry demons had not appeared and that I had gone several days without hearing from them. This was a direct result, I believe, of changes that I made to my life over the previous two months. My tools consisted of a tiny amount of the tranquilizer clonazepam and three concurrently undertaken therapies, all new to me: psychological therapy, awareness meditation and religion. I call religion new in the sense that I had pretty much stopped believing in God when I was 20 years old. I call it a therapy because it helped to heal what ailed me.
My call to action began one evening when my blood pressure reached 199. For the previous six months my blood pressure had been jumping around. I had started monitoring it myself with a home machine. For two weeks I would take my blood pressure, meditate, check it again, meditate more, etc. At first, I was able to correlate a finding that proved to me that my blood pressure dropped after meditating, but on this night the numbers went the other way. My blood pressure increased after meditating and I panicked. I checked it repeatedly until it hit 199. I rushed to the bedroom and told my wife that she might have to call 9-1-1. She recommended that I take a Xanax, lie down and try to relax, and for God’s sake stop taking my blood pressure. (She has since hidden my machine.)
The next morning we saw our family doctor. He gave me a prescription for clonazepam and said he thought I would be fine. I was more concerned than he was, and I asked if he could recommend a psychologist. Soon I began weekly visits with a clinical psychologist, Dr. Henry Kimmel, in Encino, Calif. I also started meditating regularly for one hour each night, with the aid of a free online service through the Mindful Awareness Research Center at the University of California, Los Angeles. I now had two therapies plus a drug to help arm me against the nighttime attacks in my bathroom.
In the first session with Dr. Kimmel I described the nature of my current demons. They had become almost exclusively twofold: a health issue of my wife’s, which was not life-threatening but still very serious, and a situation with another family member that was also serious. I didn’t know which worried me the most, but I spent many waking hours imagining the worst-case scenario for each.
Dr. Kimmel began with word definitions. He said it was natural to be “concerned” about my family, but “worrying” represented a higher level of concern, and too much worry could lead to “anxiety,” which could be very unhealthy. He also reminded me that I could consider the possibility that both of my worries could have happier endings than I was imagining. And he used the word “faith,” certainly in the secular sense because I had told him I was not religious. He said that I could have faith that my loved ones could get better. He could have used another word and said that I could believe things could get better, but he had used the word “faith,” which triggered memories of my adolescent years in the Catholic church.
What Dr. Kimmel had given me was the idea that I could choose to believe what I wanted to believe about the eventual outcomes of my particular worries. I began to consider that I could also choose to have “faith” in the religious sense of the word.
Since my college days in the 1960s, when Existentialism was all the rage, I had believed in a godless world in which each individual had to decide what he or she believed in and what ethics and rules to live by. I remember asking questions of priests and nuns that were answered with a seeming mantra that you simply had to have faith. I had assumed faith to be a gift from God, that God gave faith to some and not to others. I was now developing a new thinking, that I could choose to believe in certain aspects of religious faith without necessarily contradicting my basic agnosticism. I didn’t have to buy the whole package; I could believe in and use the things that made me feel good, and that made me feel a part of something larger than myself.
I started going to Catholic Mass every Sunday. I went because of the way it made me feel. I recalled happy days of early adolescence when I loved God. I now saw children making their first holy communion, the little boys in their white suits, and I longed to be one of them, to go back to those days of pure innocence. I was aware of the irony that I had taken control of my ability to choose to have religious feelings which, in turn, required me to relinquish control to the notion of a higher power. And a funny thing happened: I found joy in being part of the congregation, a group which I had previously not respected because I thought of them as mindless sheep being led around by a questionable liturgy. Now I was one of the flock. Relinquishing control felt wonderful.
I was equally struck by the language that I heard and read in church, the vocabulary of love, joy, happiness, helping others, really caring about others, wishing everyone good health and freedom from worry. I was struck because this was the very same vocabulary of the awareness meditation that I had recently begun.
The only thing I know about meditation is what I have learned from the website of the Mindful Awareness Research Center, which provides eight meditations that you can listen to, ranging from three to 19 minutes long. A special one I always listen to is called “Loving Kindness Meditation.” It asks us to select a friend or loved one and send to that person feelings of love, kindness, well-being, health, freedom from worry and as many such positive wishes as we can think of.
Then we try to think of how that makes us feel when we send those feelings. Then we imagine that person sending all those wishes back to us, and we try to sense how that makes us feel. Then we try to imagine sending those things to ourselves. Finally we practice sending those messages to everyone in the world, hoping that everyone enjoys love, kindness, etc. — all the things a religious person might ask God to send to someone or to all people. In prayer we ask God to send all these positive things, just as we wish for in meditation.
Meditation also seeks to discover how emotions, good and bad, that come into the mind have a physical component, a “body sensation.” If a thought has a strong negative emotion attached, you are urged to identify and name that emotion, and use body awareness to feel exactly where and how that emotion manifests itself physically. It might be a tightness in the chest or stomach, or shoulders. When you determine the location, you are supposed to concentrate on it, sink into it, breathe into it, and many times the emotion will go away.
I am learning to do the same thing with negative thoughts, even when I am not meditating. When a thought comes into my mind that I have had before, and I know where it will lead, I try to dismiss it. I categorize it as “worrying,” perhaps, and it almost always goes away. Before I met Dr. Kimmel, I had no idea I could choose do that.
During our time together, Dr. Kimmel listened to me try to figure out how to connect the dots. He pointed out where many of the things I was learning from meditation were also common to psychological therapies, such as “name it to tame it,” the same concept being used in both. And he applauded the use of religious thinking to aid my recovery.
I haven’t had a pill in two weeks and I feel fine. I recently said thank you and goodbye to Dr. Kimmel, and he promised to be there for me if I need him in the future. I asked him if my malady has a name, and he told me that it is called generalized anxiety disorder. The National Institute of Mental Health website says that 6.8 million American adults suffer from it. And as far as I know it doesn’t go away entirely.
I still go into the same bathroom at about the same time in the early mornings. Most times I am not aware of what used to happen in there, but sometimes I start to remember and simply choose not to allow those former demons to enter my mind.
J.L. Cowles is a writer in the Los Angeles area.