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Fundamentals_of_Abnormal_Psychology_6e_Ch04 -...

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ComFun6e_Ch04_C!.indd 94 12/10/09 11:15:56 AM
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B ob Donaldson was a 22-year-old carpenter referred to the psychiatric outpatient depart- ment of a community hospital. . . . During the initial interview Bob was visibly distressed. He appeared tense, worried, and frightened. He sat on the edge of his chair, tapping his foot and fidgeting with a pencil on the psychiatrist’s desk. He sighed frequently, took deep breaths between sentences, and periodically exhaled audibly and changed his position as he attempted to relate his story: Bob: It’s been an awful month. I can’t seem to do anything. I don’t know whether I’m coming or going. I’m afraid I’m going crazy or something. Doctor: What makes you think that? Bob: I can’t concentrate. My boss tells me to do something and I start to do it, but before I’ve taken five steps I don’t know what I started out to do. I get dizzy and I can feel my heart beating and everything looks like it’s shim- mering or far away from me or something—it’s unbelievable. Doctor: What thoughts come to mind when you’re feeling like this? Bob: I just think, “Oh, Christ, my heart is really beating, my head is swimming, my ears are ringing—I’m either going to die or go crazy.” Doctor: What happens then? Bob: Well, it doesn’t last more than a few seconds, I mean that intense feeling. I come back down to earth, but then I’m worrying what’s the matter with me all the time, or checking my pulse to see how fast it’s going, or feeling my palms to see if they’re sweating. Doctor: Can others see what you’re going through? Bob: You know, I doubt it. I hide it. I haven’t been seeing my friends. You know, they say “Let’s stop for a beer” or something after work and I give them some excuse—you know, like I have to do something around the house or with my car. I’m not with them when I’m with them anyway—I’m just sitting there worrying. My friend Pat said I was frowning all the time. So, anyway, I just go home and turn on the TV or pick up the sports page, but I can’t really get into that either. Bob went on to say that he had stopped playing softball because of fatigability and trouble concentrating. On several occasions during the past two weeks he was unable to go to work because he was “too nervous.” (Spitzer et al., 1983, pp. 11–12) You don’t need to be as troubled as Bob Donaldson to experience fear and anxiety. Think about a time when your breathing quickened, your muscles tensed, and your heart pounded with a sudden sense of dread. Was it when your car almost skidded off the road in the rain? When your professor announced a pop quiz? What about when the person you were in love with went out with someone else, or your boss suggested that your job performance ought to improve? Any time you face what seems to be a serious threat to your well-being, you may react with the state of immediate alarm known as fear (Garrett, 2009). Sometimes you cannot pinpoint a specific cause for your alarm, but still you feel tense and edgy, ANXIETY DISORDERS C H A P T E R : 4
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