PSYCHOTHERAPY BEYOND THE FRINGE, continued
He consulted psychiatrists who tried more medications and even some ‘exploratory’ psychotherapy to get at the roots of the problem. Finally, one of the psychiatrists accepted Felicity’s suggestion and prescribed Anafronil. Almost all of Nathan’s life changed for him almost at once. He felt calm and happy. He was comfortable at home and found he could tolerate his wife’s ‘peculiarities’ and his son’s ‘odd habits’.
But he still could not, or would not, urinate in public washrooms. What was wrong? In fact, Felicity did not know – or he would have found a way to do something about it. However, it seemed to Felicity that all his efforts and those of others had been in vain due to two things. First, Nathan took his main presenting symptom (and, indeed, his whole life) much too seriously, as though dealing with his ‘problem’ was an urgent and important issue. Felicity’s efforts to get him to ‘lighten up’ were to no avail. Felicity had hoped that the Anafronil would help lighten Nathan up. It did, but apparently not enough. Second, Nathan was almost constantly ‘in his own head’ thinking thoughts and worries which kept him upset. It even occurred to Felicity that Nathan was not really imagining the scenes presented in the desensitization sessions, perhaps because his mind was somewhere else obsessing about something else. Again, Felicity had hoped to diminish Nathan’s obsessive thinking with the help of the Anafronil. It seemed to have that effect, but it did not assist effective desensitization of the anxiety in the crucial washroom setting.
The solution to Nathan’s problem remains undiscovered after five years of sporadic contacts. If Nathan contacts him again, Felicity will try once more to induce Nathan to try a number of options. He could try transcendental meditation (TM) to reduce his thought pressure. Assertive training might help him free himself of some of the ‘buried’ or inhibited resentments he harbours toward both his early and his current life circumstances. Flooding (intense exposure to the essential problem situation during which the person is immobilized and unable to escape) might be tried. In addition to some other procedures which have also been suggested and rejected in the past, covert sensitization (associating the symptomatic avoidance behaviour with a competing and unpleasant experience) might be used. Felicity agrees with Nathan that he’s a ‘hard nut to crack’.