need advice *trigger?*

[Wuamei]

Thanks Spidey, I like that idea of keywords.

Wuame

 

[zadok1]

i want to thank everyone. you have given me some things to think over.

basicly, i know what i need to do. i know she loves me, and would want to know if i wasn't happy. when i know it is right, why is it so hard to do? i have never been good at talking about this stuff.

i think the world does men a real disservice. they drill into us to be a man, buck up, endure pain, never cry, never let 'em see you sweat. i was a good cyclist, and used to race semi-pro. i can block out pain and suffering and not even realize i am doing it. this being honest with myself is hard stuff. i dont like feeling and owning my emotions very much.

it is funny. i have found controlling my actions is the easy part. dealing with the underlying emotions is the hard part. i can walk away from porn, having affairs, and trying to meet people, but the needs those things were filling are still there. now i am left for find adventure and satisfaction in a long term relationship. there is the hard part.

thanks again,
jeff

 

[New to this]

Lloydy,

Your post made me think. My wife is a self confessed control freak. She only recently used the term, and I had never realized it. She was abused, far more than I ever was. Her need to control has been her motivation for most of her life. She was totally independent at 18. Ive never been independent.

What you made me think about is whether or not Im using her controlling nature as an excuse for my own lack of initiative. Rather than me take some initiative, I focus on her controlling nature. This was never an issue before I remembered the abuse and put the pieces together.

I didnt want to take ownership of this yet.
For an old fart, youre pretty wise.
Thanks.
Devon

 

[Lloydy]

Jeff
how long have we gone without allowing our emotions to show ? I went nearly 35 years - cold and hard, no emotion showing at all. But I would lie awake and cry like a baby.
I didn't know how to deal with emotions at all, anyway they were for "girls and gays" - no offence to either, but that's the way I was.

Therapy works if we allow ourselves to regain those emotions, when I started I was still resisting and it took a long time before I let a tear run down my cheek in front of my therapist, I was still trying to be the hard man.
But eventually they came, and I cried for my lost youth, my fucked up years, and all the other crap.

And eventually I cried in pleasure, the sheer joy of finding out that I was a normal person and not the pervert I thought I was.
It's so liberating to feel emotion - I'm crying now - who cares ? I dont. Why ? because writing this is reminding me of all those emotions I missed and those I now enjoy.

You're absolutely right Jeff, we are programed to be 'the man' and not break down and be emotional. Pain is easy compared to emotion, absolutely.
And it's bullshit.
Let the emotions have their way, if the memory of what happened makes you angry, then throw something, take a hammer and smash something - find something to take your aggression. Also find something worthless if you do.....
If you feel sad, cry, happy, smile.
It's only stuff we were stopped doing, and stuff we deserve to do again.

Devon, there's a common saying that opposites attract. And if we feel weak and usless - as I did - then a strong person to carry us is not a surpising choice.
Luckily my choice wasn't bossy, but I think that as we recover and find our way again we learn so much that we find new ways of dealing with people, even those we love. We have to - the old ways no longer work.

And as a 'wise' man once said to me "stick with me kid, you'll wear diamonds !"

I'm going to scan that stuff on self esteem etc right now.

Lloydy

 

[Lloydy]

Here's that stuff from my course, it's aimed at very new 1st year counselling students, but when I read it I suddenly started to think "ooohhh this makes sense !"
Have a read and see what you think, I'll be interested to read your views as well.

******************************

SELF-CONCEPT

Self-concept may be defined as our perception of personal value, standing and effectiveness in both the immediate and larger environments in which we live. We all have a strong idea of how we fit into our worlds, how other people perceive us, how important or unimportant we are in different areas of our lives, and how acceptable we are to other people at home, socially, and at work. We have fixed notions about what kind of people we are; our strengths and weaknesses, how competent we are, what talents and skills we possess, and what we lack. We also have fixed ideas about how effective we are able to be, how much in control of our situation, and therefore how much we can influence what happens to us, and what happens around us.

The Ideal Self

All of us have taken on board from the earliest age a great deal of information about
a) How we should be if we are to be fully loved and accepted by the people who are most important to us; and
b) What qualities are most admired and approved of in our social circle. Thus we know what we should ideally be like. This information comes to us from the many little messages our parents give us, such as Isnt little Johnny down the road wonderful hes so clever and talented, I wish I had a son like that, or People dont like children who brag about themselves. In many subtle ways we pick up from our parents attitude to us, their passing comments, their praise and their complaints, how much they value us and how they would like us to be.

The information also comes to us from a variety of other sources as we are growing up; relatives and friends of the family, teachers and other authority figures, our own friends and peer group, the media (television, magazines, films, newspapers etc.), books we read, the popular culture and so on. When we are grown the messages do not stop; they come from the workplace, aspects of the media become more important, and we may take in messages from partners and their families.

We end up with a very comprehensive picture of how other people think we ought to be, and how we would like to be in order to gain maximum love and acceptance from those around us. In contrast to this, is how we think we really are, how we believe people really view us.

If we are lucky, the messages we have received have been on the whole positive ones, which tell us You are pretty good the way you are. You dont have to do or be anything different for us to love and value you. Then, the gap between who we would like to be and who we think we are is relatively small, and we can be said to have high self-esteem. This means that we have a firm sense that we are acceptable, valuable, lovable people and that we can be effective in our own worlds.

People with high self-esteem (which is not the same thing as arrogance!) have confidence in their ability to deal with all aspects of their lives, and are more likely to be able to judge things realistically. They are also generally able to make and maintain good-quality personal relationships. When unpleasant things happen, they are able to cope with them, and when they suffer failures or other problems they do not automatically blame themselves or feel helpless, they are much more likely to take a positive view and get on with their lives.

If we are less lucky, we learn early on that we are only partially acceptable as we are, and that we do not measure up to the standards that other people have set for us. The gap between who we would like to be and who we think we really are is then much bigger. We can be said to suffer from low self-esteem. This means that we do not think of ourselves as particularly valuable or important, we do not believe we have much to contribute, and we lack faith in our own judgments and opinions, which we often ignore in favour of other peoples. It also means that we are much less likely to believe that we can succeed in life and cope with whatever problems come our way.

Low self-esteem makes people feel that they are able to make very little impact on their world, and that their needs and wishes do not count as much as other peoples. This disempowers them, so that when problems occur they feel unable to cope. As they do not value themselves, they do not expect to be valued or respected by other people, so are more likely to put up with poor-quality relationships, or to fail in relationships altogether. They often spend a lot of time and energy defending themselves from their painful feelings of inadequacy, and view the world negatively rather than realistically.

The Personal World View

Everything we have been taught and everything we have learned through our own experience of life contributes to the way we experience the world, explain our experiences, and respond to the world. Our personalities are made up of a mixture of inborn characteristics and our experiences since birth, and these two elements each affect the other. If we perceive an event in a certain way, we will respond to it accordingly, and that response will create a response in turn from the outside world.

For example, I am a small child with no experience of dogs and I see a large, strange dog coming towards me. I am by nature a timid person, more likely to run away from possible danger than to stick around and risk getting hurt. I decide that the dog looks dangerous, and so I run away. The dog sees me running away, and either thinks Great! a chasing game! or, possibly, thinks If it runs it must be prey. At any rate, it runs after me. It catches me up, knocks me over, and frightens me silly before its owner calls it off. I have now confirmed my original judgement that dogs are dangerous, and from now on I will act on that belief

If, however, I was by nature a bolder, risk-taking person I might hang around to take a look at this fascinating animal. The dog is wagging its tail and does not look ferocious, so I go up to it and touch it. The dog responds by licking my hand, and in no time we are running around playing with each other. My original instinct, to face new experiences head-on, has led to a very different experience of dogs, which will affect how I respond to them in the future.

Of course, if the dog turned out to be vicious after all, the first reaction would have been the sensible one and the second the foolish one. We can only respond according to our natures, and from the results, gradually, we build up a pattern of experiencing, perceiving, responding to, and explaining the outside world. This is our personal world view, and to all intents and purposes our world view is the same thing as our self, or personality. We are our opinions, our attitudes, our beliefs, the way we respond to people and situations. That is how other people experience us and respond to us. If our opinions, attitudes, beliefs and responses were different we would be different people.

CHANGING SELF-CONCEPT AND WORLD VIEW

Carl Rogers (Client-Centred Therapy) believed that the best place to start, when a client comes for help, is with the persons self-concept. How the client sees himself in relation to his world influences how he acts within it. How he acts within it may be effective, constructive and helpful, or it may, in some or many aspects, be ineffective, negative and self-defeating. Helping people to explore their sense of self, and to update, and test against reality, their beliefs about themselves and their world, may enable them to realise that they have all the resources they need to manage their problem situations adequately. Helping them to change the way they view themselves and the world may be the best way of helping them to deal with the problems they arrived with.

Resisting Change

However, it is not a simple matter to change our self-concept or our world-view. We have a great deal invested in them both. They are the sum of our experiences and they shape our personality, that most precious, personal and irreplaceable aspect of ourselves, the only thing in life we have any sense of certainty about. Take away a mans personality and what is left? Thus the idea of change is very threatening, because we risk losing our sense of self, our sense of our own identity. If we change any important part of our thinking about ourselves or the world, the knock-on effect is enormous, because we are in effect saying, I myself and the world, are not as I believed in this particular respect. How much else have I got wrong? Where does that leave me? It is easier and safer to go on thinking the same things, even if they are painful and unhelpful, than to risk losing our sense of who and what we are.

Therefore, even when a client comes knowing with one part of herself that all is not well, and that something needs to change, another part of her will resist change vigorously.

Pain and Fear in Changes to Self-Esteem

Once our level of self-esteem is established, we guard it carefully. Very small changes in self-esteem can be tolerated, but large ones cannot - and it does not matter whether such changes are positive or negative. If something happens to knock our self-esteem, the painfulness of the experience depends on how bad the knock is. A small knock we can cope with - it may well simply confirm what we have always believed, that we are second-rate, or unlucky, or both. A major blow to our self-esteem leads to that most painful of feelings, shame. We will generally do almost anything to avoid that, and it takes a long time for us to recover from a shaming event when it happens.

You might think that anything which raises our self esteem will be welcome, but that is not necessarily so. Firstly, any change to self - concept is hard to accept and feels threatening. Secondly, if we allow our self - esteem to be raised, we take the risk that we will be knocked back again. That would be much more painful than if our self-esteem had never been raised in the first place. Thus, it is useless to offer big compliments or statements about value to anyone who suffers from low self-esteem. They wont be accepted. Small compliments may be. For example, telling someone who believes that she is fat and ugly that she is in fact stunningly beautiful (even if it is absolutely true) is no use. Telling her on one occasion that her hair looks nice, commenting on another that the colour she is wearing really suits her, and so on -gradually, through tiny steps, building up for her the idea that someone else rates her as attractive, may enable her to risk the possibility that she is not quite as much of a lost cause as she believed.

Equally, a person who comes for counselling because he is failing to cope with a situation needs to have his confidence in his coping abilities developed gradually, in small steps. It is not enough to state what may be obvious to the counsellor, that he is in fact a perfectly competent human being who has everything he needs to cope adequately with the situation. She will help him more successfully if she provides him with small opportunities for experiencing genuine success for himself For example; he believes he lacks the courage to tackle difficult situations. But look at the courage he has shown by coming for counselling, and talking about things which are very difficult. He believes that he cannot communicate successfully with his wife. But he is communicating successfully with his counsellor. What can he learn from that? Using role-play to work through a scenario he finds moderately difficult may give him confidence to tackle the situation in real life. Then he might graduate successfully onto more difficult scenarios. In this way his view of himself and his personal effectiveness would undergo progressive, manageable degrees of change.

 

[zadok1]

Lloydy,

i have been running this text through my mind every since i read it. i feel as though i am on the verge of some great revelation, but am not there just yet.

so much has been playing on my mind. before getting help, i was addicted to sex with all the negative esteem issues, but i also thought of my self in possitive ways as well. when i started reviewing my life, i lost myself for a time. i think many of my current struggles are because i am emerging as a new person. your post has given me a lot to consider, and has made me feel a lot more in control, and a lot more powerful.

thank you,
jeff

 

[Lloydy]

Jeff
that's the big fright, changing.

We move through recovery and are forced to change drastically, we can't do it any other way.
We learn new things to help us overcome our pasts, and - more importantly - we learn all about ourselves.

And it scares the crap out of us, so we revert to our natural defences against change ( I'll post the handout about that as well ) and resist the changes.

So there's a whole pile of other stuff to deal with, and eventually we do.
Part of the handout describes a 'filter' that lets stuff in and out of our minds, and that filter ahs been set under the influence of the abuse we suffered. Figure out how to make the filter bigger and the crap flows out and the good flows in.

Over the last couple of years I have been told by a few people that I know but don't often see "I don't know what's different about you Dave, but you've changed" thankfully they say for the better as well ! Things aren't perfect, far from it, but I have made the most progress since I stopped resisting change.

Lloydy

 

[Lloydy]

Here's the second handout about resistance to change.
Please remember these have been written for first year trainee counsellors, so the perspective is from the 'other' chair.
But I found them extremely interesting and relevent, I hope they give you something to think about.
Lloydy

DEFENCES AGAINST CHANGE

All human beings develop ways of protecting themselves from pain, fear, shame and grief. When someone is confronted by the need to explore or face up to painful feelings, memories and situations, habitual defences come into play. This tendency is made stronger when the person is threatened with changes to self-concept and world - view.
The familiar, however unpleasant and uncomfortable, is safer than the risky unknown. It must be remembered that defences have, or had, survival value, and as such have positive characteristics as well as negative ones. If a persons defences are battered down before he is ready and able to deal with whatever is being defended, enormous damage can be done. Thus it is vital that people are given the time and space to tackle their problems at their own pace. Then, even if the defences do not fall of their own accord, recognising and acknowledging them with the counsellors help and support becomes a positive move towards growth and health. Otherwise, whatever defences are made useless by the counsellor, will be replaced by other, more desperate defences - or the client will simply stop coming for counselling.

Everyone has their own way of defending themselves, but there are some common forms of defence and resistance to change.

1) Denial

Sometimes the only way to deal with something is to deny that it exists. If certain aspects of life are associated with overwhelming pain, the mind has a way of closing off that area, allowing the person to behave as if it did not exist or had never happened. This is a largely unconscious process.
A form of denial can be used more consciously by people who have to live with the unthinkable - for example, the progressive illness and certain death of a loved one. Such people may deliberately set that knowledge aside in order to get on with their lives. This is a helpful mechanism, as long as the reality can be acknowledged and accepted at least from time to time.
True denial, the refusal to accept the reality of a situation or feeling, is fine as a temporary measure (it is a common short-term reaction to sudden death, for instance) but has harmful consequences as a long-term strategy.
Unresolved issues, which have been banished from consciousness, inevitably turn up in some disguised form, such as psychosomatic symptoms, phobias, neurosis, or simply high levels of stress. It takes energy to keep the unacceptable at bay, energy, which could be used more constructively to live a fuller and more effective life.
The counsellor builds up a picture of what is being denied from hints and clues dropped by the client during counselling. Only when a client feels sufficiently secure in the relationship, and has maybe worked through other, related issues, may the mind release its grip on the banned material and allow him to tackle it. The counsellor can help by creating a safe place for this to happen, and by offering the client opportunities for getting closer and closer to the crucial issues.

2) Withdrawal

Some people react to stress or pain by withdrawing into themselves, and cutting themselves off emotionally (and sometimes physically) from those close to them. It is the equivalent of pulling up the drawbridge and dropping the portcullis.
This may have been an effective defence in an environment where positive support was hard to find, but it prevents the person from asking for, or being able to accept, help in the present. Generally, people who come for counselling have already made a move outward, but withdrawal may be used frequently during the counselling process when the person is confronting difficult issues. It is both a warning to the counsellor to back off, and evidence of the importance of that particular issue.

3) Displacement activities

Displacement activities are patterns of behaviour which people show when they feel threatened or uncomfortable. They are recognisable because they always happen at certain kinds of moment, and they have the effect of distracting attention from the issue at hand. Smoking can be a displacement activity as well as a way of calming nerves; the actions of handling a cigarette packet or filling a pipe, finding a match or lighter, lighting up etc. give the person a breathing space and allow him to shift the spotlight away from the dangerous area.
At the right time, the clients attention can be drawn to the displacement activity, and he can be asked to sit with what is happening inside him at that point. In future sessions, the appearance of the activity then becomes a signal to the client as well as the counsellor that something important is happening inside the client.

4) Talking as a Defence

A common defence in articulate people is talking at a great rate and with few pauses. Talking is a specific form of displacement activity. It allows the person to avoid feeling the feelings associated with what he is talking about.
When such people are made to stop, and experience the feelings which go along with the subject matter, the effect can be dramatic.
The feelings are happening underneath the talk, but the person is successfully masking them from consciousness by concentrating on head stuff.
The counsellor needs at some point to stem the flow and persuade the client to risk
staying with the feelings in order to gain insight into what those feelings really are. Then the feelings can be explored and dealt with.
Talkers are notoriously difficult to counsel as they are usually experts in the avoidance of painful feelings and slide back up into their heads at the first opportunity. Just keeping track of what they are saying taxes the counsellors concentration. Firmness and confidence on the part of the counsellor are needed in order to work effectively with this defence.

5) Anger

Anger is used as a defence in many different ways. Anger is a powerful and active emotion, unlike grief, and fear, and shame, which disempower people. Anger is therefore frequently used as a mask for other, more painful or less acceptable feelings. Counsellors need to learn to distinguish between genuine anger, which is an appropriate reaction to a particular situation, and false anger, which is being used defensively. Anger can also be used as a defence against depression. Some habitually angry people are in fact suffering from masked depression. In other words, their chronic anger enables them to keep active in the face of the disempowering force of their depression. Once the source of the depression is understood and dealt with, the anger is no longer needed to keep them going.

6) Blaming

One way in which a person can deflect bad feelings about himself is to blame others, or Fate, for his troubles. Such a person may talk of being unlucky, of receiving unfair treatment from other people, of being picked on and discriminated against, of not having had a chance.
Much of what he says may have its roots in fact, but until he is able to accept responsibility for himself in the here-and-now, and look at the ways in which he himself may be contributing to the situation through his negative self-concept and / or distorted world view, he is not likely to make any progress. Before people can make positive improvements to their lives, they need to take full responsibility for themselves in the present.
Exploring and understanding how past experiences have shaped their lives then becomes a positive move towards psychological health, rather than a justification and an excuse for continuing to feel helpless and inadequate.

7) Lying

People do not always tell the truth to their counsellors. Clients who lie are indulging in severely self-defeating behaviour, but lying is, after all, one of the most obvious and successful defences against punishment.
A client who lies believes that the truth will alienate the counsellor, or that the counsellor will be disapproving and judgemental if they learn the truth.
The only way to disarm a liar is to make it clear to him that the truth will not have the negative effect he fears; to make him feel sufficiently valued and respected to risk telling the truth.
He may test the counsellors non-judgementalism by trying out a little bit of the truth. If the counsellor passes the test, more of the truth may emerge bit by bit.
Some people have become habitual liars and find it very difficult to break the habit, even when they know that it is neither necessary nor useful.
Into this category come people who have developed the habit of fantasising about themselves, spinning stories about their background, their exploits and their experiences. Extracting the facts from the fiction is a time-consuming process and not always a successful one. However, even the fiction has its uses in that it offers evidence of the persons needs and fears.
Habitual liars and fantasisers are likely (though there are other, less sympathetic reasons for people to become so) to have such low self-esteem that they do not believe their true selves to be in any way acceptable. They may also have been reared in an environment so hostile to their personal development that lying became a necessary tool for survival.
Counselling of people in this state is usually a long-term process. Counsellors need to be very alert to inconsistencies in what the client says and to the clients body-language. It is also important to be able to challenge the client firmly but acceptingly.

8) Shock Tactics

The client who sets out to shock the counsellor is most probably trying to defend the indefensible. It is an aggressive defence in that the person seeks to establish or maintain a dominant position by throwing the counsellor off-balance. There are many reasons for someone to use shock tactics. One is that he may be saying, in effect, I know how bad I am, you dont have to tell me. He is assuming that the counsellor will pass negative judgement on him. Another is that he is desperately trying to justify actions which are important to him whilst defending himself against his own secret knowledge that what he is doing is wrong. Substance abusers or sex offenders may use this type of defence for example.
A third is that he is only able to maintain a bearable level of self-esteem by pretending to be hard, and the evidence for his hardness is his ability to say and do things which other people would not dare to do.

If the counsellor falls into the trap of being shocked, or expressing a negative judgement, they may as well end the counselling then and there.
However, such tactics can make counsellors feel very uncomfortable, especially if they are women counselling men who use sexual shock tactics. Support from a colleague or supervisor may help the counsellor to deal with personal feelings.
Clients who use shock tactics need to learn, firstly that they are not going to work, and secondly that they are not necessary. It may take a great deal of perseverance, and consistent accepting behaviour, on the part of the counsellor before such a client feels able to risk showing bits of his true self.

9) Humour

People sometimes hide their hurt and their low self-esteem behind a mask of humour. This includes the jokers, who have so often been laughed at that they now deliberately set out to make people laugh (Ill do it before you can do it to me); the people who are always putting themselves down, but in a funny way to hide how much it hurts (they are also testing all the time the truth of what they are saying, so every time you laugh, you are confirming their poor view of themselves); people who make light of the impact on them of serious problems or events, because they cannot allow others to see how devastated they really are; and people who, in the counselling room, turn away any comment from the counsellor which gets a bit close to the mark, with a flip comment or a joke. The counsellor needs to challenge the joker client, to point out lack of congruence, both between what is being talked about and how it is being talked about, and between the humorous language and the not-at-all humorous body-language.
Humour is often a very courageous defence, indicating someone who has managed to find a way of protecting himself or herself without cutting off from other people or being aggressive towards them. It is usually very moving for a counsellor to deal with someone whose apparently upbeat and perky attitude hides a great deal of pain or grief.

SERIOUS AND POTENTIALLY DANGEROUS
DEFENCES

For some people, their lives have contained so much that is bad and harmful that they have had to adopt the most extreme defences just to keep living. These range from partial or mild to bordering on, or even becoming, psychiatric conditions. The four main types are:

a) Depressive

Such people retreat into depression. It is an extreme form of withdrawal, a closing-down of the personality. It is a passive defence, and more women than men use it.

It is extremely difficult to counsel someone effectively while she is in this state. It is quite common for anti-depressants to be used to lift the person sufficiently to make more normal mental functioning possible.
However, with a great deal of time and patience, it is possible to encourage a depressive client to take very small, gradual steps towards re-assessing her negative self-concept and world view.

b) Schizoid

This has nothing to do with schizophrenia. It means that someone has completely shut off his feelings and, in effect, lost the ability to feel and to name those feelings accurately. Some schizoid people learn to mimic acceptable feeling reactions to people and events in order to pass muster socially, but these are not genuine, and are not good enough to sustain in-depth personal relationships. Schizoid people are therefore almost invariably isolated people who are often experienced as cold and distant by others. The extreme schizoid personality is the psychopath. Men use this type of defence more often than women.

By the nature of the defence, the schizoid person defeats the counsellors attempts at building rapport and developing empathy, and can therefore be extremely frustrating and unrewarding to work with.
Bearing in mind that this is an extreme defence, it follows that whatever has caused the person to cut off so completely from his emotional side must have been very traumatic indeed. In extreme cases, a judgement has to be made as to whether this is merely a defence, or whether it is a more pathological condition. Also, some people are born lacking in emotional responsiveness. However, setting aside these instances, if with perseverance, and consistent respect and acceptance, the counsellor is able to made a break-through, the rewards are immense. It is often emotionally sensitive and vulnerable people who have been driven to this extreme, and it can be like witnessing a statue coming to life.

c) Paranoid

This is an attitude of permanent suspiciousness and cynicism about the intentions of other people. Paranoid people have had such uniformly negative experiences of other people that they cannot afford to expect or hope for anything good from personal or social relationships. This needs to be distinguished from psychiatric paranoia, which may have a physical basis rather than being based on negative experiences. Paranoid people always interpret other peoples words and actions in the worst possible light.

Challenging these perceptions, helping the client to re-assess their negative expectations of others, and enabling them to experience a positive, caring and helpful relationship, will give them the opportunity to experiment with a different way of interacting with the world.
As with all extreme forms of defensiveness, this is a time-consuming business needing much patience and consistency from the counsellor.

d) Obsessive

Some people deal with high levels of stress and anxiety by developing repetitive patterns of behaviour and an obsession with certain aspects of their lives.
This can vary from mild, occasional behaviours to obsessive- compulsive disorders, where the repetitive behaviour comes to dominate the life of the person and, often, the lives of those close to him.
These obsessive behaviours are a way of controlling aspects of the environment, and thus of damping down unbearable anxiety.

The obsessive type of personality is shown in the kind of person who pays minute attention to detail, and is very fussy about how things are done, an over-conscientious person who takes responsibilities too seriously, a perfectionist to the point of irritating and boring all those around him. More serious examples include people who check over and over that certain things have been done, like switching off electrical appliances, locking doors etc.; who have fixations about germs and cleanliness, and cannot tolerate the slightest bit of dirt or disorder in their houses; who feel an overwhelming need to perform certain ritual actions at certain times or in certain situations, such as never leaving the house without touching all the ornaments in the living room, or counting to one hundred every time a cat crosses their path.

Counselling people with high levels of anxiety, and obsessive defences against it, usually takes the form of a mixture of cognitive and behavioural counselling. The cognitive part involves helping them to understand how they contribute to their anxiety by the way they think. Helping them to make changes to their self-concept and world view are important. The behavioural aspect involves gradually weaning them off the obsessive behaviour patterns and helping them to develop better anxiety management strategies.
Medication is often genuinely helpful in these cases, and such clients should be encouraged to visit their doctors