A 27-year-old man sent for therapy by his family conveyed that he would prefer discussing anxiety related to work.

As a teenager diagnosed with OCD, he had done some counselling sessions before. In our initial sessions, he focussed on the nature of his work, his challenges and deliverables, and it became apparent that he suffered from performance anxiety. Throughout his academic and professional journey there had been severe anxiety. His body reacted with head jerking and shoulder shrugging, which had colleagues teasing him almost daily at his school and workplace. 

He repeatedly spoke of his motor and verbal tics and how they intensified under pressure. During an anxiety related episode, he repeated himself constantly, even when family and friends would tell him that they could hear and understand what he was saying. 

We did psychoeducational work to help him understand the nature of his issues. He was sent for an evaluation to a psychiatrist and started on medication. 

In one of the regular therapy-sessions, he opened up about feeling sad and lonely and confided that he often felt misunderstood. During this session, he was overwhelmed by a strong wave of emotions. Later he identified that he had felt a similar feeling 9 years ago, when he was going through a breakup. In matter of seconds, he symptomized verbal tics and kept repeating himself many times, “…But I have moved on”. A short while later, in brief silence the tics had stopped, his body visibly relaxed as he regained his composure. His voice had reached his ears and he had really heard what he ‘said’.  

An unanticipated and wonderful moment in therapy where a deliberate silence communicated safety. It opened the door for the client to let in his thoughts and feelings and allow himself a true emotional experience.