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By Leo A. Kominek, Ph.D.
Martha is a 45-year-old woman who works in the health care profession as a nurse. She is married and has two adult children. Martha came into therapy because she had difficulty sleeping and felt very tense all the time.
In fact she was so tense that she felt that her insides were trembling all of the time. She said, "It's like someone set off a tuning fork all through my body." She has difficulty concentrating at work and, at times, dreads going home.
Martha has generalized anxiety disorder because she worries about almost everything. She worries about the details of her job, such as, would her reports be clear to her superiors, did she do everything right for her patients, etc. Martha has a very excellent work record, never had a reprimand, and was known as a hard worker. She, more often than not, took paperwork home with her so that she would have time to do it right. Unfortunately, to her "right" meant "perfect."
Martha has significant stressors at home too. She has a spouse who is a spendthrift and a daughter who had once attempted suicide. These were some reasonable concerns for her, but Martha let them drive her to distraction.
She worried constantly about her daughter so that nothing would happen to her.
In fact she felt responsible for the well being of the entire household.
She stated, "I check everyone to make sure they are breathing before I can go to bed myself."
Martha worried constantly about her job, her relationships, and the family's health. In addition, Martha had the belief that she had to be the perfect, mother, wife, and professional. Martha had the belief that she was responsible for everything and everyone.
Martha was aware that many of these worries were unrealistic, but still could not stop the worrying. Martha worried that if she didn't worry something bad was sure to happen.
In fact Martha worried most about those things for which she had very little control. Martha's worries were close to making her incapacitated with regard to her job and her home life.
For Martha to get better, she has to change her habit patterns of thinking and some of her beliefs. She also has to learn to recognize what she can and cannot control and allow this to define her responsibilities.
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