Saturday, November 3, 2007

a little too close to home

Part 1: Anxiety and Parenting Practice

I got hit with a double whammy: a mother AND a father with an anxiety disorder. This had interesting consequences for me, because I had the definite genetic input, but I also had the environmental factors beating me over the head constantly. My mom still sends me articles clipped from the local newspaper about women being raped and murdered, along with advice about how not to have the same thing happen to me. Just last week she sent me a little internet film about kitchen grease fires, narrated by a woman who had had her face burned off: an awesome thing to find in one's inbox first thing in the morning. Don't get me wrong, I love my family, but we're also a nice little self-reinforcing kettle of neuroticism.

When you grow up in an anxious family, you get the genetic predisposition, but you also get the constant message that the world is Out to Get You (see also maternal lecture #347, "There Is Not a Man in the World Who Doesn't Want to Dismember You and Shove You in the Trunk of His Car"). I was consequently interested in Minecka & Zinbarg's suggestions (2006) for reducing the likelihood that children of anxious parents would grow up to have anxiety disorders themselves.

While I thought their suggestions were sensible, I felt that they would be almost impossible to implement without managing the parent's anxiety first. Particularly, Minecka & Zinbarg suggest that children be provided with experiences that "facilitate the development of mastery and a nonavoidant coping style" (p. 23). One might also infer from evidence cited earlier in the article that they might suggest that parents redirect or refrain from discussion of possibly dangerous or threatening events, as this may reinforce children's avoidant responding. These are all excellent, evidence-based suggestions; however, I wonder if Minecka & Zinbarg considered just how difficult it may be to get a parent with an anxiety disorder to avoid verbal instruction and rumination about threat with their children, and furthermore, to allow the child sufficient control over their choices and environment to develop a sense of mastery. All parents worry about the welfare of their children, but anxious parents may be more likely than others to experience
uncontrollable worry leading to a restriction of their child's environment. This is a kind of avoidance-by-proxy, in which the parent prevents the child from engaging in more independent behaviors that cause the parent worry. Subsequently, the child both learns the parent's fears vicariously and loses the opportunity to engage in behaviors that would instill a sense of control--and immunize them against vicarious learning of the parent's fears and avoidant style. Therefore, I see addressing the parent's anxieties and fears as absolutely necessary to the implementation of prophylactic childrearing practices.

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Part 2: The Problem with "Pathology"

I went to see Autism: The Musical and afterwards there was a Q & A session. One of the panelists was a 12-yr-old boy with autism. The moderator asked him, "what does it feel like to have autism?" The boy responded, "I never know how to answer that. It would be like asking someone who doesn't have autism, 'What's it like to not have autism?' A person with autism can't tell you what it's like to not have autism and a person without autism can't tell you what it's like to have autism. It's part of me, I don't know what it's like."

That's the problem with talking about these conditions exclusively as pathology. My anxiety is part of me and it would be silly even to consider who I would be without it. I want to manage it, so that I can function, but I don't actually want to erase it. It's helpful to a certain extent--it's part of the reason that I'm so perfectionistic about my work, and I like that. I like focusing on details and making my work beautiful, whether it's a knitted lace shawl or a sonnet or a term paper. That's the flip side of my anxiety. I don't want to be "cured." I don't want some tumor excised. I like who I am. It doesn't really feel like a disorder as much as a complex and integral part of my make-up, some parts of which I want to dampen and some parts of which I want to highlight. Lexapro helps me do that to a certain extent, but so does choosing environments in which I know I'm going to function better and avoiding environments (like big, loud, crowded parties) in which I know I'm going to function worse. And so does gently putting myself into situations within my proximal zone of development (like, say, calling up someone I don't know and asking them to let me come observe at their facility) and letting myself find out that I didn't die. And so does taking time to meditate and go hiking. We shouldn't focus so much on eliminating the disorder as on shaping the life.

So there.

4 comments:

Thrasher said...

What a beautifully self-disclosing post! And hilarious! I think we have the same mother...do you look into the back of your car when you're finished at the gas station to make sure a creepy man hasn't crawled in the back?

Joanna said...

All three if us must have the same Mother...not only do I look in the back of my car before I get into it but I've now become extrememly afraid of getting pulled over by a police car at night because my Mom has passed on SEVERAL stories about women who get abducted by people who pretend to be police officers. I also get lots of forwarded emails from my mom about refraining from flashing my lights at other cars whose lights are off and about people stealing my identity by calling and asking me to press *70 or something...okay, just thought I'd share how neurotic my mother is as well!

jcoan said...

What an excellent post. Thanks so much for this. There is a literature on treating the parents of kids who are experiencing all manner of emotional difficulties, and for some disorders (particularly oppositional-defiant things like I had when I was a kid [note self-disclosure]) treating the parents--and leaving the kid entirely out of it--may work better than doing anything with the kid at all.

Shari said...

my mom recently forwarded me the following emails:
-if you hear a baby crying outside your house, a man is probably waiting for you to go outside so he can rape or rob you.
-if someone offers to let you smell perfume, it's probably ether and the person wants to rape or rob you.
-if you get pulled over by a police man, it's probably a person who actually wants to rape or rob you.

i also get phone calls telling me how dangerous it is for me to walk home from class after dark and how dangerous it is for me to be in the psych buildings on the weekends....

i'm glad i'm not the only one with a mom like this!!

(and people wonder why i am often nervous...)