Overcoming Separation Anxiety

When most people think about separation anxiety, they think of children having problems separating from their parents.   But separation anxiety can occur at any time in life.  It often has its roots in childhood, but it can continue into adulthood causing panic and shame as well as discord in relationships.

Overcoming Separation Anxiety

Elizabeth Bernstein of the Wall St. Journal online wrote an interesting article called When It Never Gets Easier to Say Goodbye about separation anxiety.  The examples that she gives remind me of many psychotherapy clients that I have treated for separation anxiety over the years.

Case Example
The following vignette illustrates how the separation anxiety affects the person who suffers from it as well as how it can affect a relationship.  As always, this is a composite of many different cases with all identifying information changed to protect confidentiality.

Rose and Mike
Rose and her husband, Mike, were together several years when he started a job where he had to travel at least once a month.  The trips were usually short and not that far from home, but they often involved his staying away at least a couple of nights.

Prior to taking this job, Mike had been out of work for several months.  Both he and Rose were concerned about how his being away from home would affect Rose because she got very anxious whenever Mike was away.  But they both felt that Mike had no choice but to take this job because he was unemployed and he had no other offers.

As soon as Rose heard from Mike that he had an upcoming trip, she would begin to worry immediately.

It could be weeks before Mike had to leave, but she would worry obsessively, asking him countless times if he really needed to go, and talk about all the things she worried about that could go wrong:  What if the plane crashed? What if a burglar broke into the house while he was away?  What if there was some other kind of emergency that she couldn't handle by herself?

Mike did his best each time to reassure Rose, but nothing he said every reassured her.  After a while, inevitably, they would get into an argument about it because Mike would lose his patience.  He felt frustrated and annoyed because nothing he said had any impact on Rose's anxiety.  She, in turn, felt hurt and misunderstood.  She also felt deeply ashamed about her worrying and out of control.

Mike and Rose tried different strategies to help her feel better:  He called her as soon as his flight landed and he would call her a few times during the day to assure her that he was all right.  But these strategies never  helped Rose stop worrying incessantly that something awful might happen to Mike and then she would be alone.

After several of these arguments, he told Rose that she needed to get help because it was affecting their marriage as well as his ability to focus on his work while he was away.   Rose decided, somewhat reluctantly, that Mike was right--she needed to get help.

After a few sessions, it was evident that Rose had separation anxiety that stemmed from a chaotic childhood with parents who were very unpredictable.  They would often leave Rose, as a child of five or six, alone at night while they went out drinking.  Understandably, she was very afraid of being alone and she would beg them each time not to leave, but they told her to "stop being a baby" and they left anyway.  When her baby brother cried at night, she didn't know what to do to soothe him, which made her even more anxious.

Then, one day, when Rose was six, she woke up to find her grandparents and aunts in the living room with her mother.  Everyone was very upset and crying, but they wouldn't tell her what was wrong.  Her father wasn't there, and when Rose asked about him, her mother told her that he was "gone," but she wouldn't give Rose any more information.  Later that day, Rose overheard her aunt talking about a car crash.  She tried to ask her aunt and her mother about it, but they refused to talk about it and sent her to her room.

Rose never saw her father again. No one ever told her, as a child, what happened to her father.  She missed him terribly, but she felt she couldn't ask her mother about it any more because she feared her mother would get angry with her and leave too, and then she'd be all alone.  It wasn't until she was in her early 20s that she heard from an uncle that her father was drunk and had a fatal car accident.

We used EMDR to help Rose to process this earlier loss, as well all the times she felt abandoned by her parents even before her father died.  While we were working on these issues with EMDR, we also worked on Rose developing better coping skills.  She learned to meditate and she also began attending yoga classes.  She also strengthened her emotional support network among her friends.

Once she worked through her earlier losses and experiences of separation anxiety, Rose was no longer anxious about Mike going on business trips.  She and Mike began getting along much better.  They stopped arguing and even planned a romantic getaway, which was something they had not done in a while.

Getting Help in Therapy
If you suffer with separation anxiety, you owe it to yourself and your loved ones to get help from a licensed mental health professional who has experience working with separation anxiety.  Getting help can make all the difference between living a life of constant anxiety and a fulfilling life that you and your loved ones can enjoy.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Overcoming Adult Separation Anxiety Disorder

Up until about 15 years ago, separation anxiety disorder was mostly discussed in psychotherapy literature as it related to children, not as a problem that adults have. And, yet separation anxiety disorder is a phenomenon that has been experienced by adults for hundreds (if not thousands) of years. 

Now that it is more widely recognized and treated by psychotherapists, there is a greater recognition that adult separation anxiety disorder is a problem that exists in about 6-7% of the adult population, which is significant.

Overcoming Adult Separation Anxiety Disorder

Traditionally, separation anxiety has been viewed as a normal development in some infants starting at about the age of seven or eight months when babies begin to become aware that their caregivers are separate from them. 

As most children develop over time, they realize that even though their caregivers might leave the room, they still exist and will come back. For most children, this resolves separation anxiety, unless they have anxious caregivers, there are problems with bonding with their caregivers, or there is some other disorder or problem that causes them to feel anxious when their caregivers leave them.

Episodic Separation Anxiety vs. Separation Anxiety Disorder:
It's not unusual to have some degree of separation anxiety as an adult at certain points in your life (e.g., after the death of someone close to you or when experiencing other losses). This would be considered episodic separation anxiety. However, adult separation anxiety disorder is a recurrent and persistent problem that is not linked to anything objective that is going on in a person's life at the time.

Typical symptoms of adult separation anxiety disorder are:

• Recurrent excessive worry about separating from a place or a person that you are close to (like a spouse)
• Persistent and recurring fear about losing people close to you or that something bad will happen to them (when there is no objective reason for feeling this way)
• Recurrent reluctance to go to school or work or go elsewhere due to fear of separating from someone close
• Persistent and excessive fear of being alone
• Persistent and excessive fear or reluctance of going to sleep without having someone who is close to you in the house or nearby
• Repeated complaints about headaches and other physical symptoms when you are separated from the person or people that you are close to
• Recurrent nightmares about separation
• This anxiety causes significant impairment in one or more major areas of your life (e.g., your relationships, work life or in other significant areas).
• These symptoms last a month or more, and they are not attributable to any other physical or emotional causes.

The following fictionalized scenario is an example of adult separation anxiety disorder:
Maureen was a married woman in her mid-30s when she started psychotherapy to deal with separation anxiety disorder. She had gone to her primary care doctor, at the insistence of her husband, because she would become extremely anxious and worried whenever her husband wanted to do anything on his own or when he was not around her for even a short period of time.

Overcoming Adult Separation Anxiety Disorder

It didn't matter if they had spent the entire day together and he wanted to go out for a short walk on his own to clear his mind. Maureen would become extremely anxious and worried at just the thought of her husband being away from her. She would become upset, tearful and angry if he told her that he preferred to go out on his own for his walk and not with her. She was convinced that something awful would happen to him (e.g., he would get hit by a car or someone would kill him or kidnap him) and she would never see him again.

At work, she would call him several times a day to "check in" and if she couldn't reach him, she would panic: What if something happened to him and no one knew how to contact her? When she finally reached him, she was a nervous wreck and this would anger him. He felt that she was too "clingy," "needy" and "insecure," and he told her that if she didn't get help, he didn't know how much longer he could deal with this.

Maureen's primary care doctor recognized the symptoms of adult separation anxiety disorder. He told her that he was not qualified to treat her, and he advised Maureen to see a licensed psychotherapist. Maureen's therapist took a detailed psychosocial history and provided Maureen with psychoeducational material about adult separation anxiety disorder.

They also began using clinical hypnosis to help Maureen to calm herself and to internalize a felt sense of a loving, caring figure in her life (in this case, it was her grandmother) that she could call on in her mind when she felt extremely anxious. After a while, she was able to mentally call on this loving person in her mind with ease and feel a secure attachment to her.

Overcoming Adult Separation Anxiety Disorder

Maureen worked hard in therapy and attended her sessions regularly. She learned that there would be no quick fix for her problem. However, over time, with the help of her therapist, Maureen's separation anxiety dissipated and her relationship with her husband improved.

Why Clinical Hypnosis?
There are many ways to treat adult separation anxiety. Clinical hypnosis is a safe and effective form of therapy. It allows you to relax enough to get to the unconscious causes of the problem. You maintain a dual awareness of the here-and-now as well as whatever comes up in the clinical hypnosis session. It also allows you to discover if you are being triggered by other prior events in your life.

Clinical hypnosis is usually faster than regular talk therapy--although, for adult separation anxiety disorder, it's important to understand that this is not a 3-5 session treatment. Separation anxiety disorder is a complex problem and requires a lengthier treatment, even with clinical hypnosis, than some of the other problems that lend themselves to short-term hypnosis treatment, like smoking cessation.

When seeking clinical hypnosis treatment, always make sure that the person you plan to see is a licensed mental health practitioner and not a lay "hypnotist." As I've mentioned in prior blog posts about clinical hypnosis (also known as hypnotherapy), there is a big difference with regard to the education, clinical expertise and skills between a hypnotherapist and a lay "hypnotist."

If You Suffer with Adult Separation Anxiety, Seek Help from a Licensed Psychotherapist:
If you suffer from adult separation anxiety, the people around you might not understand what is happening to you. They might tell you that you're being dramatic or immature. They might also tell you that you "just need to get over it." But for you, the symptoms are very real and painful. Rather than suffering alone, you could benefit from seeing a licensed psychotherapist who has experience working with clients who suffer with adult separation anxiety disorder.

There are many ways in psychotherapy to work with clients who have separation anxiety, including a combination of cognitive behavioral treatment, psychodynamic psychotherapy, EMDR and clinical hypnosis. You want to find a therapist who tailors treatment to the individual client's needs.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

I have helped many clients overcome adult separation anxiety.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.