Abstract
This chapter deals with client’s experiences of anxiety. The perspective of the inner worlds sheds light on the pathogenesis of anxiety-related conditions, as we first show in detail in relation to phobias. Then, we consider other anxiety and obsessive-compulsive conditions and show that a cognitive-psychodynamic approach is able to describe the rich variety of these client issues in a unified framework. In particular, the symptoms appear to have a metaphorical value with regard to the dimensions of vulnerability of the inner world, which provides powerful therapeutic levers to work with in therapy. Finally, we specify how cognitive psychodynamics can contribute to the treatment of these conditions by adapting it to the individual needs of the client.
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Notes
- 1.
We are grateful to Dr Mirabel-Sarron and the review Annales Médico-Psychologiques for accepting that the study of Mr K’s case, presented in the article cited in reference, can be widely reused here. Mr K was a client of Dr Mirabel-Sarron. Some points of this article are also mentioned in this chapter.
- 2.
For an example, see Mirabel-Sarron et al. (2018, pp. 73–74).
- 3.
Even if the interruption of symbolic treatment is not as premature as in the re-experiencing syndrome of the traumatic event that define PTSD (see Chapter 7).
- 4.
See the definitions of “symbolic web” and “conflict” in Chapter 7, Sects. 4.1 and 4.2.
- 5.
See Chapter 7, Sect. 4.3.2, for the definition of the Ideal of the Home.
- 6.
- 7.
- 8.
The dimensions of vulnerability of the inner world can be rigorously defined within the conceptual framework of representational spaces (see Plagnol, 2004).
- 9.
The Kafka Burrow stops on the dreadful hypothesis of another living agent who enters the territory and turns out to be as cunning as the inhabitant whose own tricks he predicts.
- 10.
For example, the encounter of an iceberg is likely to cause a breach such that water invades the ship and eventually sinks it, despite attempts of compartmentalization, just as in post-traumatic stress disorder, as we have seen in Chapter 7, the encounter of a life-threatening experience opens a breach in ordinary space that eventually absorbs all mental life despite dissociative defences.
- 11.
- 12.
Recall that the tension exerted on a (zone of) a representational space mirrors its complexity, i.e. it is inversely proportional to its degree of unification/consistency (see Chapter 7, Sect. 4.1).
- 13.
A traumatic factor that contributes to a phobic syndrome can be compared to the presence of a wreck that induces vortices.
- 14.
When an anxiety episode appears to be triggered by a purely internal circumstance, that is by an intrusive thought (e.g. a fantasy), clinical analysis generally finds an external circumstance that has activated the intrusive thought.
- 15.
- 16.
It contrasts with the very premature inhibition of the symbolic work in post-traumatic stress disorders (see Chapter 7).
- 17.
Formally, it is the same problem as a water leak whose source is hidden, revealed by stains of humidity on the ceiling, stains that one would try indefinitely to erase by a paint coat, without daring to probe the walls of the home to find the source of the leak.
- 18.
Thus the Officer of The Penal Colony devoted himself to the absolute respect of the mechanical protocol of execution, but his fidelity to this protocol is itself a passion, and he finally throws himself into the cogs of the machine (with the words “Be Just” to be written on him)—which moreover horribly disrupts the machine.
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Ward, T., Plagnol, A. (2019). Invaded by Threat: Anxiety and Obsessive-Compulsive Thoughts. In: Cognitive Psychodynamics as an Integrative Framework in Counselling Psychology and Psychotherapy. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-25823-8_8
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