Dear Robert Saltzman,

I have a question that regards what one can "normally" expect from a therapist (and if what some people have told me about is typical), and it regards an issue that is a bit complicated and hard to explain. I'm 34 years old and live in rural Oregon.

Basically this story consists of two key threads. One is that I've been I've bothered by war and by that I mean A LOT since I was about eight years old or so. The other point is that I was diagnosed with mild dyspraxia and severe auditory processing disorder at the age of 31 and have been fortunate enough to find European and British style treatments (physical and auditory therapies mostly) for these problems that are based on neuroplasticity as a means of mitigating the problems rather than the dominant American model where you basically try to learn how to compensate for them. The latter is the reason I might need to find a therapist, but the former sort of complicates the matter.

Let me explain.

Obviously both those things have been key issues pretty much all my life and both tied together in a number of ways.

As for being bothered by war, I don't think that is pathological but in my case it probably is a bit extreme. Partly it was the sort of moral/existential questioning of why people would do such things and why so many adults around me accepted and glorified war. Why so many of my friends (girls as well as boys since so many assume otherwise) thought it would be cool to be in a war, and so on. The other part was a great deal of fear of nuclear war. As a child of the 80's, I was really really frightened by all the 1980's "First Strike" talk, by Reagan's saber rattling, and by portraits such as "The Day After" and that British import "Threads". Only years later would I learn that many others my age had a similar experience. I lived in a very conservative community in Arizona (although my parents were/are liberals) and the overwhelming majority of my peers and my only sibling (13 month younger brother) were basically Reaganite pups who just LOOOVED their Rambo movies, their Top Gun, Iron Eagle, and all the other 80's militaristic youth culture. Many of them read "Platoon" as a pro-war film without irony. The other part of involved the fact that I always had a very strong sense that the Vietnam War had cast a very, very dark shadow over American society. Very strong. So much so that on a typical day walking to school as a nine year old (this was before Platoon came out and before I had heard much on the topic except offhand references and vague comments), I was more aware of it than I was aware of the fact that Missy-a girl who was much bigger than me-would considered me her favorite punching bag. And as an adult, I feel more marked by far, by a sort of sense of Vietnam as a cloud hanging over everything than the fact my own father (who is not a Vietnam Vet and neither is my mother) was/is an alcoholic-albeit a functional non-violent and non-abusive one. While that may sound kind of odd, I suspect it isn't as left-field as some people might. Doris Lessing wrote of having a very similar sort of reaction to having been born right after WWI as I was born just after the Vietnam War. While Doris Lessing actually had a father who was a vet, I suspect that a lot more people have this sort of experience than will admit it.

As a girl, when I tried to tell my mother of this she told me that these fears were simply "transference" and that I was really worried about things like boobs, periods, and boys because "that's what girls worry about". When I was a teenager, school counselors really tried to get me to stop thinking about war, famine, and environmental destruction, to stop saying the Vietnam War and Desert Storm were wrong, and to stop writing disrespectful essays about President Bush (Bush Sr. that is) and Senator John McCain. Instead they wanted me to focus on hair, make-up, prom dates, and boys. I honestly think some of the school brass were more offended by my behavior than the fact that many of my peers getting pregnant and driving drunk.

Early in the Iraq War, I went to a massive funk. I was an anti-war protester even though I was poor, without medical insurance or health care, and suffering from undiagnosed hypothyroid. It was actually more devastating by the Iraq War, than my own crummy health and dismal economic situation. I was just really, really pissed that Bush would do this and so many people backed him. All the while, people were always telling me I had "no reason" to be that upset about the war because none my immediate friends or family were fighting in Iraq. While I discounted all the nuts who called protesters "unpatriotic" and such, I was amazed how many people in the anti-war movement considered it taboo to be truly upset about the war, or to express any concern for people in Iraq rather than exclusively talking about American soldiers. I was told by many people that the VVAW types had a "right" to be severely upset about another war, but I did not-although the VVAW types themselves-at least those who picked up on it-didn't seem offended.

In the past couple years I decided that this sort of upset over war, while not necessarily "typical" isn't immoral or pathological. But I learned from experience that people will often want to dismiss such things as being "really about" something else ranging from PMS to my father's drinking.

And I don't know how I'd work with a therapist who would take this tack.

As for the dyspraxia and APD, that is the main reason I would consider working with a therapist.

Basically when I was almost 32, I totally lucked out and found all these therapies that could do so much more for me than the American "compensation based" systems-most of which were made for people who are much lower functioning than I am anyway. Much of the difficulty I've had socially and with finding a job at my education level (I have an MS in environmental toxicology.), was related to the fact that I had these learning issues. As a student I got good grades and managed to hide these problems very well. And as long as that was the case, everything that was noticeable (except my politics) was pretty much put down to quirkiness, nerdiness, shyness, bright kid's boredom in school, "poor choices", late blooming, social immaturity, lack of self confidence, awkwardness, and other relatively pat things that I was presumably going to outgrow. When I got to be an adult I was accused of having everything from a "Cinderella Complex" and various Nancy Fridayesque sort of psychological issues, to a hidden drug problem, to being torn up with Catholic guilt, to just a serious attitude problem.

But when I found out what was wrong I was very, very lucky to find a more progressive approach to these issues than the dreary USian "you can only compensate for it" model. I started out finding and using this British system of neurodevelopmental therapy.

And I found it to be an excellent system that really works and really did dramatically lesson my problems with coordination and auditory processing. But the INPP strongly recommends that adult who used their system also spend some time in therapy, because. I wasn't able to find a therapist at the time, because of geographic, financial and work barriers. But I did find that doing the INPP system while it helped enormously in many areas, also seemed to make my susceptibility to anxiety increase drastically. Also when I did a sort of auditory therapy called "The Listening Program" I developed among other things the ability to read people's facial expressions much more accurately. And while, this is a useful skill, I find it hard to get used to. I find that since I notice when other people are nervous or upset much more easily, that it makes me paranoid that they are mad or that I'm offending them. In fact, even walking down the street noticing the nervous looks on people's faces makes me wonder if something bad has happened and I haven't seen the news yet, or if there is a bad accident down the street. It really spooks me at times, because I'm so unused to having such easy access to people's facial expression and I have a lot of anxiety because my brain has gone through a lot of funny changes. My OT thinks that anxiety is a major barrier to my improving function.

So for these issues, it's likely that I do need to see a therapist.

But I've heard stories about therapists labeling concern over things like war and such, as being the result of say something going on in your sex life or in your relationship with your Mom. One friend of mine says that's just a stereotype, and that modern therapists wouldn't do that the way that old school Freudians did. But I also know some people who say that during the 80's, they had therapists who wrote off their adult fears of nuclear war as hidden sexual abuse, their outrage over El Salvador as repressed sexuality, or their anger at Ronald Reagan as hatred of their own father.

So I basically have a situation where my lifelong fears and upsets over the matter of war, is pretty major factor in my life, but really not a major reason that I would seek therapy. I can accept that one has to be honest with a therapist. And if I was to not admit that I spent much of my childhood terrified of nuclear war, troubled by the "shadow" of Vietnam, and alienated from the sea of Reaganite puppies, I was living in at the time I really don't know how I can be honest about my childhood of the therapist asks. I'm also prepared to be honest about the fact my Dad was an alcoholic. But what I don't want to deal with a therapist who would try to write off my concerns, upsets, and fears regarding war as somehow not valid, irrational or a case of "transference" of some kind.

How can I find a therapist who probably wouldn't do this, but would have a good chance of treating anxiety? What type of therapy would make the most sense?

Thank you for being willing to answer questions. You keep a very well written blog.

Sincerely,

Amy Reynolds

Amy--

Sometimes a person in need of help will have to try more than one therapist before finding a good fit. With this in mind, you should consider an initial therapy appointment to be a kind of job interview in which you evaluate your potential therapist to see if he or she has the capacity to provide the kind of environment—the container, so to speak--into which you will be putting your personal history, present concerns, fears, and hopes, all of it. For example, you might begin telling your new therapist about your attitudes towards war, and then ask him or her whether your fears "make sense." If the therapist says yes, then ask, "Well, what do you make of my fears about war?" If you get a "Freudian" style of reply, it is time to look elsewhere, since that is not the kind of interpretation which you think will help you.

In my view, a good therapist, regardless of theoretical orientation, will be one who allows you to feel seen, heard, and understood. If that does not happen, even in the first session, just move on until you find the right person to provide your therapy. Since your concerns about war were dismissed and belittled by your mother (which must have made you feel unseen, unheard, and misunderstood), you certainly should not be spending any time with a therapist who will do the same, thereby aggravating all the old wounds.

I would suggest that you begin with a therapist who works along the lines called "self psychology," a method of treatment devised by psychologist Heinz Kohut in the 1970s. I could be wrong, but based on what you have written, I think such a person might be a good fit for you, and possibly could help you greatly.

Be well.