The Case of the Shaking Hands: Phobia Counselling
Updated: Nov 27, 2018
Wee Geordie is suddenly petrified of ants for no apparent reason. It is time again to do detective work with Mr Jenkins to examine the trigger and then find the cause.
Robert Davies © 2018
“Wee Geordie won’t stop shaking his hands. The only time he stops is when he has to hold a pencil, but then his other hand shakes twice as fast,” explained Geordie’s mother.
Mr. Jenkins had noticed Geordie that morning for the first time. He’d seen Geordie somewhere near the rear of a line of grade 2’s. who had lined up for gym class. Mr. Jenkins had halted to let them pass. He noticed Geordie way at the end of the line-up. He was shaking his hands as if to flick the remaining bit of water off them. The problem was his hands weren’t wet and yet, Geordie hadn’t ceased shaking both his hands the entire time he’d made his way down the fairly long corridor. His hands were all a blur.
“When did it start?” asked Mr. Jenkins of Geordie’s mother.
“It seems to have started with the ants when they started turning up in his classroom.”
“Yes, it’s been a problem and not just for Geordie. The janitor has ant traps everywhere. But, thank goodness, we’re seeing less and less of them.”
“That is good. Maybe, Geordie will stop his hand-shaking soon. What do you think, Mr. Jenkins?”
“Well, Geordie and I have already met as you know, and his anxiety is really extreme.” “Really extreme? Poor Geordie! That’s what I thought. But why this strong reaction to ants?”
“Well, for one thing anxiety can cause all sorts of physical symptoms on top the negative emotions and thoughts.”
“I don’t understand?”
“Well, our thoughts cause emotions which determine our behaviour. This means that Geordie is holding a thought in his head. It is that thought that is driving all these emotions and this behaviour. Our thoughts cause our emotions which determine our behaviour.”
“Why is he shaking his hands.”
“Well, there are many physical symptoms to anxiety such as a racing heart beat, pain in the chest, butterflies in the stomach, constipation, jumpiness, lump in the throat, jelly legs, headaches, feeling tired and feeling dizzy. There are others, but that’s a quick summary.
“And Geordie’s hands?” “Yes, another symptom is tingling or numbness in the fingers or toes. I guess Geordie is finding the sensation of tingling strange and bothersome. You know that ‘needles and pins’ feeling and is shaking his hands to get rid of it.
“So, Mr. Jenkins, my wee Geordie feels threatened. You are suggesting that it could be the ants. He is thinking some thought which gives him his anxiety and then the symptoms?”
“Yes and No.”
“Yes and No?”
“The ants could be the trigger. They triggered something in his memory.” “Can you help him, Mr. Jenkins?”
“I think so. Geordie and I will meet again and do the detective work. It is not always easy to find the cause. Geordie might not want to talk about it. He might not even be aware of it. He might have it hidden in his memory.” “So, it’s not the ants?” “As I said, I am guessing the ants are a trigger for something in his past, something that was traumatic. Anyway, Geordie and I will try to solve the problem. Anything else you might want to ask?”
“No, thank you for explaining anxiety.”
The next day, Geordie and Mr. Jenkins worked together. The only way to get rid of anxiety is exposure, to face the fear. First, though, Mr. Jenkis had to find out what it was that was bothering Geordie?
Mr. Jenkins was sitting with wee Geordie. Mr. Jenkins had just finished doing the brief mood survey.
“Geordie, you are still really anxious.”
“I know. I can’t stop shaking my hands.”
“I am thinking that we have tried the ant angle. We looked at photographs of ants. We used the internet to watch different kinds of ants.”
“But, I am still anxious!”
“Yes, we even talked to about 10 people about ants. You see, Geordie, the only way to get rid of anxiety is to face what we fear. It seems as if we have had you look at ant photographs, watch ant life films. That is called exposure work. We have talked about them and went to catch a few in your classroom when the students were out.”
Geordie was listening closely, but still shaking his hands while nodding his head.
“You see, Geordie, I am thinking that it is not the ants, but the ants remind you of something that you found really scary.”
“Something really scary?” “Yep, something really scary.”
“I’ll come and get you from class tomorrow, Geordie. Meanwhile, think of something probably to do with insects that really bothered you. OK, let’s walk back to class.”
The next morning Geordie returned. Immediately, he blurted out, “I think it was the bees.”
“Yes, when I was in kindergarten we went camping at a provincial park. My Dad, me and my older brother went for a hike through the woods. Dad started pushing over old, rotten trees. My brother and me would help. It was fun to see the old trees come crashing down.”
“Well, then on our very last rotten tree, as soon as it fell, out flew about a dozen bees. I guess there was a nest.”
“That must have been scary!”
“Yes, Dad yelled, ‘RUN! But before I could even move, two bees landed on my hands. One stung my left hand and flew off. The other went up my sleeve and stung me under the arm and in the ribs before I shook him out and he flew away.”
“Ouch! I know what that feels like.”
“It really, really hurt. I guess I was pretty scared because I was always nervous about bees after that.”
“Okay, Geordie. What we have to do with the bees is what we did with the ants. Let’s go talk to people around the school about their experiences.”
Twenty minutes late, Mr. Jenkins were back in the counseling room.
“So, you see, Geordie, lots of people have been stung by bees, and everyone agrees that it really hurts. Now as bad as the bees are with their sting, what is good about them? Wouldn’t the world be better off without them?”
“No way!” Mr. Jenkins, “we also found out that by flying here and there, they help the flowers of all the food plants start growing their tomatoes, and apples and a bunch of other things. If we had no bees, we would starve to death.” “Well, what about the hornets? Aren’t they useless, too?”
“Nope, they do the same thing plus they kill lots of insects that cause problems.”
“So, what I am hearing is that as much as bees are a misery, we need them to live.”
“Is that it?” “Yep.”
“So, Geordie, are bees good or bad?”
“Good! But they sure have bad stings.”
“Okay, let us finish our mood log. You wrote:
THERE SHOULDN’T BE ANY DARN BEES BECAUSE THEY STING PEOPLE.
“But now what are you telling yourself?”
WE NEED BEES TO HELP US GROW FOOD. THEY ARE GOOD, BUT THEY HAVE A BAD STING.
“What about that sting? Is it really bad?”
“I know what you mean. I guess it is like a protection. Bees are important so God gave them this protection so people would leave them alone.”
“Why is that important?”
“Because bees are good and they are really important, and they sting to protect themselves.”
“Write that down Geordie.”
BEES ARE GOOD, AND THEY ARE REALLY IMPORTANT, AND THEY STING TO PROTECT THEMSELVES
Geordie wrote it down in the mood log.
“How true is that, Geordie, between 0% and 100% between not true and totally true?” “I don’t know what a percent is, Mr. Jenkins. But, saying ‘bees are important’ is totally true. “
“How true is your first thought that they shouldn’t exist and that they are bad?”
“Not true at all.” “So, now that you are thinking about bees differently. What about all those strong, negative emotions you had such as unhappy, panicky, pessimistic, angry? How strong are they now?”
“They are not strong, at all.”
“Okay, write in 0%”.
Geordie wrote in 0 after each negative emotion that before had been between 80% and 100%.
“Geordie. I think you have conquered your phobia about bees. I will meet up with you in a couple of weeks because the fear will come back at least once. We will use your same new positive thoughts about bees to chase that fear away. Okay?”
“Let me walk you back to class. I think you are in music now.”
Mr. Jenkins was once again amazed at how exposure to the things that we fear allows us to conquer that fear.
That afternoon, Mr. Jenkins, was thinking about avoidance. Mr. Jenkins was thinking about the new principal who was a challenge. “I will have to face my fears about this person, who seems to have a penchant for finding something negative about everything I do!”
Already the negative comments were building up. There was a steady list growing.
“I guess the new administrator has stung me on a few occasions already this year,” thought Mr. Jenkins. “I best conquer my fear of this person, or my anxiety will grow out of control, too!”
Mr. Jenkins knew that everyone has their fears. Sometimes we can avoid them such as skydiving.
“Yes, we don’t have to skydive; we can avoid that. That is okay. But administrators, we have to get along! At the same time, who says we have to get along! It might not be possible. But then again, it might be time to change schools," thought Mr. Jenkins, who gave out a long sigh.
“It is not always an easy decision to ‘face or avoid our fears'. What would wee Geordie say?”
Most people like stories, and therapy is all about stories. Telling stories about powerful techniques used in TEAM CBT therapy demystify this therapy one story at a time.
Yet, confidentiality is a cornerstone of all counselling. Without confidentiality, clients wouldn’t feel safe going to therapy to divulge the most painful areas of their lives. To safeguard clients while illustrating TEAM CBT techniques, confidentiality is kept by either having the client’s consent or by distorting the facts, making the client unrecognizable .