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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I am afraid of being out in public with my wife and small children. I am always nervous a

Customer Question

I am afraid of being out in public with my wife and small children. I am always nervous and can't relax. But when I am out by myself I am not afraid as much. Please help.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help you.

Elliott, LPCC, NCC :

When did this start?

Elliott, LPCC, NCC :

Are you concerned for their safety

Elliott, LPCC, NCC :

Do you not enjoy being seen as a married man with children?

Elliott, LPCC, NCC :

You understand that I can best help you by having a back and forth conversation with you, but you seemed to have stepped away from your computer.

Elliott, LPCC, NCC :

I can give you the best service if we are exchanging information.

Elliott, LPCC, NCC :

If you are not with me in a few minutes, then I will save and exit from this chat and we can resume when we are both on line.

Elliott, LPCC, NCC :

Ahh. I see you here.

Customer:

Yes, I am concerned for their safety. I am always worried about someone bothering us or being placed in a dangerous situation. I just can't relax and this has been for years.

Elliott, LPCC, NCC :

Have you ever been in a threatening situation at any time in your life?

Customer:

A couple of times. But I was alone.

Elliott, LPCC, NCC :

What kind of situations? War, childhood abuse, witness to horror, neglect, in an accident, and so forth?

Customer:

Altercations with people in public.

Elliott, LPCC, NCC :

Do you get into fights when you are on your own and when you are with your family do you feel vulnerable?

Customer:

Here is an example of something. I would be very uncomfortable in a restaurant with them if we would be seated next to a table with let's say a group of loud college kids in there 20's. I would always be anticipating something to happen. The worry drives me nuts.

Elliott, LPCC, NCC :

If you were by yourself in that same situation in the restaurant, what would happen?

Customer:

I would probably still feel anxious and not enjoy the meal. But it would be less overwhelming.

Elliott, LPCC, NCC :

Would you say something to the group

Elliott, LPCC, NCC :

Might there be an altercation?

Customer:

No, I probably wouldn't say anything. I would just ignore it and avoid conflict. It is just the anticipation that wears on me, I think the worst and nothing happens. This has been life for years and years.

Elliott, LPCC, NCC :

What do you do to soothe yourself, if not get into an argument or start a fight? Any reaction or do you just kind of smolder?

Customer:

I guess smolder, butterflies in the stomach, increased heart rate, nervousness. Afraid and I don't know why when nothing has even happened.

Elliott, LPCC, NCC :

This is high anxiety, almost a panic attack with the butterflies and increased heart rate. Have you ever had a full-blown panic attack?

Customer:

Numerous times, to the point that I have to leave for a moment to recollect myself (to the restroom or isolated spot). Then I go back and again it builds.

Elliott, LPCC, NCC :

Has your family witnessed this?

Customer:

No, because sadly we don't go out much. I fear even taking my 4 year old son to the park. I have to take him to a school yard that is isolated, no one around. And even then I start to panic that maybe someone will show up with other kids. I am there with extreme worry and once we get in the car and go home, I feel this adrenaline type flush and calm comes to again when I am in my house.

Elliott, LPCC, NCC :

Were you ever bullied in any way by friends or family members?

Customer:

When I was younger I was bullied from time to time, but I think it was just the normal bullying that kids in grade school and jr high would experience, nothing extreme. Talking to you makes remember that even growing up from the age of 4-5 I would always in the morning when getting ready for school be extremely nervous with butterflies in my stomach and afraid. This was even before times when I was bullied.

Elliott, LPCC, NCC :

Were there issues at home that made you feel insecure or worried or afraid?

Customer:

My parents would sometimes fight, loud shouting and numerous times as a young child we would hear physical contact to my mother and shouting and crying. Myself and my siblings would all be afraid and it was the same adrenaline flush after things were quiet.

Elliott, LPCC, NCC :

Are you easily startled?

Customer:

I was young exposed to this at about 3 thru 11 years old on and off. Through out my childhood.

Customer:

Please elaborate on easily startled.

Elliott, LPCC, NCC :

Jumpy. React to certain situations as if they startle you (like a jack-in-the-box could startle a little kid, for example)?

Customer:

Not to that extreme, but its as everything when I am in public makes me nervous. Example, if I am in line at the supermarket and someone gets behind me. I get nervous and began to anticipate the worst. I start to think about not making a mistake or taking to long to check out my groceries because I don't want to have conflict with the person. male or female. But even more extreme with male.

Elliott, LPCC, NCC :

That is called hypervigilant and was to be my next question.

Elliott, LPCC, NCC :

Do you get bad dreams or ever get flashbacks to the bad times of childhood?

Customer:

Please elaborate and I appreciate this session by the way. Thank you.

Elliott, LPCC, NCC :

You have described the state of being overly, nervously watchful, which is called not just vigilance, but extreme vigilance.

Customer:

No bad dreams or flashbacks to childhood, that I recall. But you are correct I am super aware of my surroundings when in public at all times. I just can't relax.

Elliott, LPCC, NCC :

You have have the symptoms of Posttraumatic Stress Disorder (PTSD) It is a complex form anxiety caused by various types of trauma, including the many years of abuse that you witnessed, an perhaps endured yourself.

Elliott, LPCC, NCC :

You get these attacks of panic sometimes, and you fear going out in public, especially with the family because you don't want to have a public attack. This kind of fear is called Agoraphobia and often goes with panic attack.

Elliott, LPCC, NCC :

Let me give you the criteria for PTSD directly from the psychiatric "bible" of diagnoses, know as the DSM-IV.

Elliott, LPCC, NCC :

You will look at it and see that a lot applies to you:

Elliott, LPCC, NCC :

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

Elliott, LPCC, NCC :

PTSD DSM-IV


309.81 DSM-IV Criteria for Posttraumatic Stress Disorder


A. The person has been exposed to a traumatic event in which both of the following have been present:


(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.


B. The traumatic event is persistently reexperienced in one (or more) of the following ways:


(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.


(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.


(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.


(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.


C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:


(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma


(2) efforts to avoid activities, places, or people that arouse recollections of the trauma


(3) inability to recall an important aspect of the trauma


(4) markedly diminished interest or participation in significant activities


(5) feeling of detachment or estrangement from others


(6) restricted range of affect (e.g., unable to have loving feelings)


(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)


D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:


(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response


E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.


F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.


Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more


Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor


Elliott, LPCC, NCC :

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

Customer:

I can't believe that it could be this. PTSD. I have experienced this my entire life pretty much, but I still have been able to persist and go to college, graduate and have a career.

Customer:

It's all there in what you sent me to review.

Elliott, LPCC, NCC :

That is what every mental health professional uses to diagnose

Elliott, LPCC, NCC :

You can be helped with therapy and not drugs.

Elliott, LPCC, NCC :

It is like somebody has been in an accident or beaten up an has been physically injured.

Elliott, LPCC, NCC :

If they keep experienced the events that injured them (still falling off horses or getting tackled in football) then the injuries persist. They can heal.

Customer:

Can this be inherited, so to speak.

Elliott, LPCC, NCC :

You an heal. You were emotionally beaten up. You are not psychotic and don't have a mood disorder. You have been emotionally hurt.

Elliott, LPCC, NCC :

Not really. Can you inherit a broken arm?

Elliott, LPCC, NCC :

Let me recommend a great book for you.

Customer:

Good point. I have a lot of grey hair for a 34 year old.

Elliott, LPCC, NCC :

There are several out there that will help you on the road recovery.

Elliott, LPCC, NCC :

You are lucky. At least you have a lot of hair. :)

Elliott, LPCC, NCC :

Here is one good book:

Elliott, LPCC, NCC :

There is a new book that I have only glanced at but it looks great and shows three different approaches to healing.

Customer:

Thank you for the recommendation. I will definitely pick this book up and order.

Elliott, LPCC, NCC :

There are both self-help books and they are a start.

Elliott, LPCC, NCC :

You will recover now that you have an idea of what this about.

Customer:

Thanks again, before I go. Could you please give me your thoughts on forcefully putting myself in the situations that fear me to desensitize??

Elliott, LPCC, NCC :

Go to dinner with your family and pick a happy family place and be determined to have a great time.

Elliott, LPCC, NCC :

You need to expand the envelope at a comfortable pace.

Customer:

Elliott, in my 34 years of life I have never spoken to anyone about this. Thank you so much for your help.

Elliott, LPCC, NCC :

Get the books and follow the suggestions and exercises. The are guides.

Elliott, LPCC, NCC :

Thank you so much I am so honored to have your trust. I shall hold you in my prayers.

Customer:

Thank you, XXXXX XXXXX now sign off and rate. Very valuable insight and advice.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and 2 other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Thank you so much. May God bless you and your family.
Elliott

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Elliott, LPCC, NCC
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35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.