Now there’s sleep..…and there’s sleep”. (Continuation of previous blog).

By this time I had come to know my patient pretty well and clearly she felt comfortable with me and trusted my judgment. Moreover, she was at her wits end and urgently required help if things were ever to improve. To begin with, together, we ‘rehearsed’ certain simple but important points about the function of worry with which we were both by this time familiar. Incidentally, to say, as sometimes people do that “worry is useless and pointless” is not entirely true. Rather is it a strategy evolved by the brain for weighing the options when faced with issues and consequent choices. Indeed – and just like stress – some concerns (which induce stress) are as appropriate as they are good for us. (This is very different to “worrying about anything and everything”). Furthermore – and again, just as it is when faced by and dealing with stress – we need, wherever possible, to worry on our own terms and thus to build in that essential “recovery time”. So this is what I suggested to her.

“The moment you awake and become aware that worry is creeping up on you, rise from your bed and leave the bedroom. Forget the sowing or ironing, lest you adversely tinge (associate) them also with your ‘welter of worry’. Make straight for the most uncomfortable chair in the house. You really need” (so I insisted) “the kind of chair which is reserved for that caller or visitor who you desperately wish to discourage; the kind of chair with uneven legs, broken springs and which the cat or dog (preferably both) have frequently used for repose”. I further assured, her lest any doubt should remain, that I was deadly serious, advising that if she didn’t possess such a chair then she must acquire or ‘invent’ one. “There do your worrying” I insisted, “agreeing deciding to return to the warmth and comfort of the bedroom and bed, only when you feel you have done sufficient worrying for that night and are now ready to enter the recovery phase; e.g. a relaxing scene on a sunny river bank some spring afternoon or whatever”. “Do that”, I continued, “every time you wake up in this manner and I assure you, your nights of worry will swiftly come to an end”.

Ere she left my clinic room and in order to dispel any remaining doubt, I assured her that I had seldom been more serious about anything. (Much later on, my patient told me of the response of an accompanying friend that day, as they discussed matters on their way home together; “didn’t he even suggest giving you some pills to take?”) Two weeks later my patient returned in triumph. Apparently she had actually acquired an appropriate chair from a neighbour and after about the fourth night had, so she assured me “Slept right through”, continuing to do so ever since”.(SB).

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