One of the most frightening things about having a mental health problem is how crazy it can all seem. Panic attacks in which your body seizes up; depressed moods that make the world look like a place of devastation; obsessions that keep you doing the same damned thing hour after hour. Too often, the client ends up worrying about where it is all going to end. The anxiety that results creates a spiral of worry that compounds the original issue. The burning question many clients have is: what the hell is happening to me? Why this? Why now? Clients naturally seek answers, and failure to address this may block people from taking that first step towards resolution.
Related to these questions is another concern: will this psychotherapist be able to help me? Does he know what he is doing? Can I trust him? This concern is especially salient if the visitor has never been inside a consultation room before. It’s even more pressing if she has and been turned off by the vague, or disturbing, answers so far received from other professionals.
In framing the answer the therapist is not simply offering re-assurance. She is also providing a route map. One that takes in the reasons for the problem, and indicates what the solution might be. Along the way, she normalises the predicament the client is in.
Normalising is the art of reframing the problem from ‘weird’ and ‘alarming’ to ‘expectable’ and ‘soluble’. Expectable in terms of the cognitive and emotional characteristics of the client, the life problems that triggered the disorder, and the physical result (the anxious state). Soluble in terms of addressing, one by one, his thoughts and emotional judgments, his physical state, and his difficulties in life.