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Stress
and anxiety
By Karen Gosling, counseling Director |
In this series of real-life case studies, Karen Gosling recounts client
stories compiled from Gosling International's files. The
permission of clients has been obtained to present these case histories. Names
and places used have been changed to protect cilent privacy. |
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| Introduction |
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| Maggie,
34, was referred for counseling by her daughter's doctor, after she
had burst into tears when the astute doctor asked the sick daughter,
aged 11 months, "And how is your mum coping with your move to Singapore?"
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| Maggie
described that she was feeling depressed as well as stressed, and
that these feelings had been mounting over time. The family of 4 had
arrived in Singapore from Australia 8 months earlier, and because
of her husband's work and travel commitments, she now found herself
alone most of the time with a 4 year old and the baby. She was not
unhappy in Singapore, just felt that she had no time or energy to
really enjoy it, nor to meet people who might become friends. |
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| Maggie
and her husband Simon had first known about the move when she was
just pregnant, and she was initially not so keen to come, knowing
that, with a new baby, she would be distant from her family and friends
(and babysitters!) She had suffered chronic anemia throughout her
pregnancy and still often felt weak and fatigued. On their arrival
in Singapore, the family had lived in a serviced apartment, where
she felt like she was camping rather than settling in. There were
no phones and only "snack" meals for them all, with none of her usual
utensils and familiar cooking facilities. She had trouble convincing
herself that she was providing adEQuate nutrition for her children.
During this time, Maggie remembered having strong heart palpitations
on several nights, for which she finally went to the doctor. |
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| Maggie's
husband seemed to be away most of the time (she couldn't relate exactly
how often, as days blurred into weeks). One part of her tried to be
strong so that Simon would not worry about how she was coping when
he was away. Another part of her resented the company for making them
move and now making Simon travel so extensively. In spite of it all,
Maggie described having a message in her head that kept repeating
that she had to cope, had to carry on.
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| Whilst
Maggie felt that she started to feel more settled after about 3 months,
the stresses continued. Mother-in-law stayed on for 3 months. The
maid was helpful, but needed direction and supervision with care of
the baby. Maggie felt trapped and isolated. She started her son in
school in order to be able to get out to meet other mums and start
to make new friends, but this expectation was not met. Her own parents
came to stay for 4 weeks, and needed entertaining. Her mother seemed
very dependant during this time, and unable to do anything on her
own. The children got very sick, first one, then the other, with a
gastro that disturbed their functioning and their sleep. Her daughter
had a high fever for 60 hours which was of such concern Maggie took
her to A and E at a local hospital, where urine and stool samples
were taken to test for serious illnesses. These were suggestive of
kidney troubles, so her daughter was referred on for an ultrasound.
En route, Maggie again became disorientated and lost, and panicked
for her daughter's health, and missed the appointment. She had to
wait 2 hours with a screaming baby to be seen for the ultrasound.
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| A
Christmas trip home to Australia turned out to be another disaster.
Staying in other people's home, the children were sick the entire
time, one with bronchitis and tonsillitis, the other with bronchitis
and a perforated ear drum, an undiagnosed ear infection made worse
by the flight. Maggie made an effort to catch up with friends, but
ended up giving out support rather than obtaining it - her friends
were going through hard times (one had had an infant die, the other
was recovering from her fathers death). On one occasion, her son was
lost in a supermarket for 20 minutes, and on another, her daughter
experienced a choking episode.
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last straw had been the week before, back in Singapore after the dreadful
trip to Australia. Maggie, feeling neglectful when her daughter fell
off the bed and bumped her head, had hurt her own neck trying to attend
to her. She kept a hairdresser appointment nonetheless, and the haircut
was dreadful. Maggie had had enough. |
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| Intervention |
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| The
counselor congratulated Maggie for surviving to this point in time!
She then explained to Maggie that stress accumulates, and that if
a person experiences a series of personal crises without a break (recovery),
that the person can rapidly feel the physical and emotional effects
of severe stress. This includes chest pain, heart palpitations, headaches,
nausea, dizziness, sweating, breathing difficulties and sleep disturbance
(sometimes distressing dreams). Emotionally, the person may feel anxious,
fearful, depressed, isolated, and yet want to hide, and withdraw from
social contact. The person may also notice memory problems, difficulty
concentrating, and poor attention span.
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| The
counselor also explained that if you are experiencing stress, you
will usually find it difficult to make decisions, even about things
about which you are normally quite decisive! This is because the little
voice in your head (the message that Maggie had spoken of) becomes
more vocal and more vociferous, judging and attacking you. This is
the voice of insecurity, of low self-esteem. Every situation seems
a no-win situation. The voice seems to criticize your every move,
and beat you up for things you have already done. It seems to read
the mind of your friends and work colleagues, and lets you know that
they are bored, disappointed or disapproving of you. You feel disappointed
in yourself (for not coping better) and believe that everyone else
is too. This is what causes a person to experience the feeling of
stress - it is stress built up on the inside!
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| Outcome |
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| Maggie
learned strategies from the counselor to manage her little voice (her
internal critic) and effectively reduced her level of stress. She
commented that she felt as though she was getting back control of
her life: the counselor affirmed that this feeling indeed is indicative
of a reduction of stress. Maggie recognized that this strategy was
one she could utilize in many different areas in her life, including
making new friends, parenting, her relationship with Simon, joining
courses, getting back to exercise, dealing with past hurts to do with
her family. |
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| Maggie
experienced no further panic attacks, and when she felt her anxiety
rising, she utilized the strategy of the critic to keep it in check.
Most helpful of all, she said, was the acknowledgement she had received
from the counselor in the first session, when she was told, "Congratulations
for surviving to this point!". This comment made her feel validated,
and gave her the perspective that of course she was allowed to feel
this bad, look what she had been through after all! |
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Karen Gosling is counseling
Director at Gosling International. She is a graduate of the University
of South Australia and holds a Master of Public Health from the
University of Adelaide. Karen is a Registered Social Worker in Singapore
and is a member of the Australian Association of Social Workers
and the Singapore Association of Social Workers.
Gosling International is
a leading emotional leadership consultancy based in Singapore, serving
committed clients worldwide. Goslings mission is one of education
and empowerment; to elevate emotional well-being.
Gosling International
provides face-to-face, telephone and email emotional
leadership consultations for individuals, couples, and family groups.
If you want a professional to help you with behavioural
change or deal with your emotional distress, personal problems,
or are simply troubled by your feelings, phone Karen or Mike
Gosling on (65) 6281-5157.
Consulting
Rooms (by appointment):
21A Serangoon Garden Way, Singapore 556065
Mobile: +65 9816-5651 Email: @goslings.net
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