Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for August 18th, 2011

Afraid of the World

Posted by Dr. Vollmer on August 18, 2011

   Rikki, twenty-two, female, has struggled over the fifteen years that I have worked with her. First, she had no friends; the Asperger’s label was thrown around. I did not think it fit. Rikki always appeared to me to be painfully afraid of taking chances: social or academic. She wanted friends, but she was too afraid to approach people. She wanted to do well in school, but sometimes she did not persevere with her studies. She was inhibited, terrified of moving forward, terrified of developing into an adult. High school years were miserable. She was teased mercilessly. College got a lot better. She made friends: weak ties, though. She did well in school, but she was still anxious and afraid. Graduating college was like falling off a cliff. Her weak-tie friends stopped calling and texting. She made a résumé, but she was too afraid to send it out. She now lives in her room, plays video games endlessly, and sees me consistently twice a week. “What do you think you are afraid of?” I ask her. “Well, my mom and dad need me around the house. If I move out, who is going to make sure that the dog gets fed, the garbage gets taken out, the computers work properly.” Rikki responds quickly, as if she has thought a lot about this question. “I know you are very important to your family, but I think you need to focus on moving forward with your goals. I think your parents will figure out how to keep their lives going after you leave.” I say, helping her to see that she needs to focus on growing up and out of the nest, rather than worrying how the nest will be when she is gone. “I know all that,” Rikki says to me impatiently, “but I can’t stop worrying about how things will be if I find a job.” “That is interesting. Maybe you can’t stop worrying because you are afraid to get a job, and so worrying about your parents, keeps things as they are.” I say, realizing that Rikki is using her worry about her parents as a protection from her worrying about her own development.

  Despite Rikki’s painful paralysis, Rikki has come a long way. Many professionals thought she would always be a loner, but her college years proved that friendships, although not strong friendships, were fulfilling and rewarding for her. She met people she really cared about. Predictably, it was hard for her to keep up the ties, when the structure of college went away, but she did prove that her social skills were good enough to create a network of people who cared about each other. At the same time, in the absence of college, Rikki has returned to a very lonely and isolated existence. If she could magically be placed in a good work environment, Rikki would be a diligent and loyal employee. The problem is that Rikki is too frightened to seek employment, even though she has a good skill set. My job is to help her, slowly and with patience, to take the baby steps towards financial and emotional independence from her parents. Fear is a powerful inhibitor. Hope is a powerful motivator. The tension is quite strong. Rikki and I are not giving up.

Posted in Anxiety Disorders, Psychotherapy | 4 Comments »

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