Surviving Anxiety and Shifting Relationships

Francine (pseudonym) is a professional in her early thirties who works in a non-profit that advocates for mental health. She was born and raised in Santa Cruz, California, a small coastal city known for its beach boardwalk, state university, and relaxed attitude. Francine's family background is diverse: Scottish and Israeli roots, including a grandmother who grew up in Morocco. Francine grew up speaking both English and French and was raised in the Jewish faith.

Francine thrived growing up on the UC Santa Cruz campus, where her father taught environmental studies. Surrounded by redwood trees and salty ocean air, Francine felt she was a part of a special little oasis within the already idyllic city of Santa Cruz. Living in faculty housing, Francine befriended other professors and their families. Many of the friends that Francine made there remain her closest friends today. Francine especially loved interacting with the adults on campus who openly invited her into their discussions. Francine was an introverted and artistic child who spent much of her time with her nose in a book or creating something. Francine credits the positive environment of her early childhood with shaping who she is today.

Parental Divorce

However, Francine's early years were not without difficulty. Francine was six years old when her parents announced their plans to divorce. They broke the news at the dinner table. Francine remembers laughing, thinking her parents were telling a joke. She had heard the word "divorce" before, but she figured her parents were simply adults throwing around "big words." Soon, however, it became clear to Francine that the divorce was real, as her parents explained they would no longer be together.

Looking back, Francine was surprised. Unlike some other divorced families, Francine's parents did not openly fight or disagree with each other. In fact, Francine has sparse memories of her parents together; she cannot recall them laughing or talking to each other. Behind the scenes, Francine suspects there was a string of events building up to the separation, but, even as an adult, she is uncertain what they were. At six, Francine was confused and could not understand the ramifications of divorce.

Francine's life quickly changed following the announcement. She began moving between her mother's and father's homes. Francine's father stayed in faculty housing, while her mother found a fixer-upper house right near the beach that was not too far from campus. Francine recalls that it was relatively easy to navigate between both homes in the small town. The parents split custody of Francine fifty-fifty, although Francine initially spent more time with her father due to the ongoing renovations at her mother's beach house. Her parents were successful at remaining cordial towards one another as Francine grew up.

About a year and a half after the divorce, Francine's parents began seeing others. The new partners had already been "in the orbit" of her parents for some time, but Francine had not yet been introduced to them. When Francine finally met her parents' respective "friends," she was perplexed. She wondered, "Who are these people? What are they doing with my parents?" Most difficult of all was vying for her parents' attention. As an only child, Francine was accustomed to always being her parents' main focus. When both her mother and father began paying more attention to their new significant others, Francine felt left out. At this point, Francine did not understand the reality of the new additions to her parents' lives since they had been simply introduced to her as "friends." One day, however, Francine and her mother ran into another mom from her school, and Francine overheard the woman say, "I heard you have a new sweetie." Francine immediately recoiled. It was strange hearing this news from someone else.

Francine was not particularly welcoming to her parents' new life partners. Francine would not make eye contact with her father's girlfriend for the first couple years of their relationship. When Francine's father sat on the couch next to his girlfriend, Francine would try to squeeze in and sit between them. One time, in a fit of resentment and anger, Francine cut the image of her father's girlfriend out of a photograph. Francine resented their new roles in her world and accepting them into her life took time. Just before sixth grade, when Francine was eleven, both of her parents remarried within a few months of each other. Her father and her stepmother were married in July, just as summer was beginning. Her mother and her stepfather married in September. Francine was in both wedding parties.

Along with gaining new stepparents, Francine also gained two stepbrothers from her mother's new partner. The boys were three years apart in age, with Francine right in the middle. Initially Francine and her step siblings were shy and reserved around one another. They came from different backgrounds – for example, the two stepbrothers attended a conservative Christian school, while Francine was raised Jewish. It took a while for them to become comfortable around one another. Once they did, however, Francine loved having "built-in" friends who were all around the same age and shared similar interests and hobbies.

It took a long time for Francine to process her parents' divorce and the changes in her family. Throughout most of this time – from ages eight to thirteen – Francine saw a therapist on a semi-regular basis. By all accounts, Francine was a very well-adjusted child. Although an introvert, she belonged to a small, close-knit group of friends and enjoyed activities like reading, writing, and playing interactive computer games like Sims, Zoo Tycoon, and NeoPets. Francine did not fully understand why she was visiting a therapist. Nevertheless, Francine's parents believed child therapy would help her express her emotions about the divorce as well as the recent passing of her maternal grandparents.

The therapist's office was filled with toys. There were opportunities for Francine to draw and paint and express herself through other creative activities. In one of the first sessions, the therapist instructed her to choose a toy from the office to help build a more comfortable routine. At each session, Francine would return to that toy — it was her "special thing" every time. Sometimes, the sessions were boring, and at other times, they felt helpful.

Immediately following the divorce, Francine attended sessions every week. As she grew older, her parents permitted her to make more of her own decisions. At that time, Francine chose to attend appointments once a month, or once every couple of months, to check in. By age thirteen, Francine felt she had established trust with her therapist. The therapist was kind and caring, and Francine always felt that the therapist meant well, even when the therapist unintentionally patronized her. Sometimes Francine could anticipate what her therapist wanted to hear and would say it in order to appease her questions. Still, Francine felt the sessions did improve her mental health over time. Francine stopped attending therapy at age thirteen. She felt she had outgrown the sessions, and became preoccupied with school and her social life. Upon reflection, Francine believes the most beneficial part of this season of therapy was normalizing the practice early in life and making her feel comfortable with assessing her mental health.

School

In middle school, Francine began experiencing symptoms of anxiety. She would have random stomach aches that she could not attribute to what she ate. Coming to understand that these aches were triggered by stress was how her mother first noticed Francine had anxiety issues. Francine also began to perform small rituals that she would repeat in an effort to control life events.

Another part of Francine's middle school years was a toxic friendship with one of her classmates. This girl had an infectious personality, and "was the opposite of [Francine] in every way." She was an extrovert who hated being alone. Despite their differences, Francine and the girl quickly connected with one another. Her parents were also separated. Unlike Francine, however, her parents were bitter enemies and fostered a dysfunctional family environment. Francine's new friend introduced her to music and pop culture, yet she was manipulative and would convince Francine to behave in ways she was uncomfortable with. In particular, she would pressure Francine to treat other people in a manner Francine herself would not want to be treated. She expected Francine to be everything to her. In eighth grade, at her mother's urging, Francine realized she needed to end this toxic friendship. She was becoming overwhelmed by the pendulum of mood swings and the daily drama. Francine sat down with her and explained she could not continue. It felt like a bad breakup of a romantic relationship.

Near the end of middle school, Francine's father and her stepmother had their first baby. Not long after, when Francine was fifteen, a second joined the family. Francine liked her younger brothers, although it was sometimes overwhelming having two babies in the house just as she was entering high school. Francine's room at her father's house was across from the one her little brothers shared. Their constant crying would wake up Francine in the middle of the night. As an only child for most of her early years, Francine was unaccustomed to living with infants. She thought to herself, "Well, I didn't ask for this," and felt some mild resentment. As a result, Francine decided to stay with her mother for her high school years. Francine describes high school as a completely different world, as she went from a small private school, where most of the students knew one another, to a very large public high school. Looking back, Francine sees this experience as an odd collision of ages that does not normally occur. Navigating her teenage years was hard enough without the added responsibility and distraction of two babies (she frequently babysat her half brothers and pushed them around the neighborhood in a stroller, and when she learned to drive, she took them to activities). Today, however, Francine is "crazy" about her two half brothers, and is eager to spend time with them.

At one point, Francine's parents signed her up for a group therapy session for teens. Francine disliked the sessions and did not feel comfortable sharing her experiences with others. For the most part, they were "just a bunch of teenagers whose parents had made them go." The kids refused to talk and sat awkwardly in a circle. Although the group therapy leader assured them that nothing they shared would leave the room, the sessions felt too vulnerable. Francine lived in a small, close-knit community and knew the idea of her peers maintaining confidentiality was unrealistic.

Francine began planning for college at the start of her senior year. Her father, an experienced professor, helped guide her through the college admissions process. SAT preparation was stressful for Francine – particularly the math component. Nevertheless, she was eager to graduate and to go out-of-state for college. Many of her classmates decided to stay in their hometown, but Francine was desperate to leave. She wanted to follow her own path for the first time.

Francine attended a college in Seattle, Washington, where she ended up staying for the next ten years of her life. She immediately fell in love with the city's atmosphere and enjoyed her college courses. Her freshman year was a wonderful experience; she was so happy to be charting her own course. In the summer before her sophomore year, Francine underwent a major back surgery and spent the entire summer recovering at home. When she returned to school in the fall, she was ready to live her "college life" and enjoy being a normal twenty-year-old.

Falling In Love

Part of that typical college experience was falling in love. Francine met a man who, like herself, was a native French speaker (he came from an African country formerly colonized by France). They would speak French with one another, and one day he asked Francine out. When he slept through their first date, Francine was prepared to write him off, but he was persistent in winning a second chance. Over time, their relationship deepened and Francine believed she was truly falling for him.

About a year into their relationship, Francine began to notice some concerning discrepancies. When she and her boyfriend first met in class, he told Francine that he was twenty-eight years old. This age gap was already pretty substantial for Francine. However, one day, he left out his ID by accident, and she discovered he was actually thirty-five. Feeling shocked and betrayed, Francine confronted him. He admitted he had lied and apologized, promising there would be no more deception. Francine anxiously worried about what she would tell her parents. They had met him before and were already concerned when they learned he was twenty-eight. Although she was dismayed, Francine was too invested in the relationship to break it off. She also believed her boyfriend's assurance that there would be no more lies.

Six months later, Francine was checking her email on her boyfriend's computer after he had fallen asleep. She opened up Gmail, and saw several photos of a little girl on his account. Francine could not help herself and started looking through the photos. She wondered if this could be his daughter. She jolted her boyfriend out of his sleep and pointedly asked him who the little girl was. Initially, he attempted to convince Francine that the girl was not related to him, before finally confessing that the little girl was indeed his three-year-old daughter. Their entire eighteen-month relationship came crashing down. Francine's mental health worsened as she came to terms with this new reality. However, she was still not yet ready to give up on the relationship. As she was about to leave for a six-month program abroad in France, she decided to stay with her boyfriend in a long-distance relationship. She believed that the space between them might repair the broken trust.

Francine believes this was the worst decision they could have made at that juncture. The distance only added to the problems in their relationship. At one point, her boyfriend came to France to visit his family, and he and Francine planned to meet up in Paris to talk things through. Francine took the train to the airport in Paris and texted him over WhatsApp, waiting for him to respond with his arrival time. She waited at the airport for hours. Eventually, her messages stopped going through and she realized that he had blocked her. She had been ghosted. She could not call him, could not text him, and could not get in touch with him at all. She did not hear from him for two years following this incident.

Looking back, it is difficult for Francine to rationalize why she decided to stay with this boyfriend for so long. She believes she saw his personal failings as obstacles they could overcome together. After finding out about his daughter, she even had a vague vision of going back with him to his West African country and making a life there together. A thought even crossed Francine's mind that she could likely be a good stepparent to his daughter, given her experience with her half brothers. Francine is glad the relationship ended so abruptly because she could not end it herself, even after uncovering her boyfriend's repeated lies. Instead, she focused her energy on trying to navigate France and her exchange program.

Therapy

Francine had enjoyed being in a relationship and all that accompanied it. She wanted to be one half of a couple, and the end of this relationship devastated her. After returning from her exchange program, Francine sought mental health therapy through her school. In addition to the emotional toll of the breakup, Francine also dealt with stress from school and grieved the passing of her aunt. Unfortunately, the pool of therapists at her school never had any openings. It wasn't until after graduation, when Francine had a job with benefits, that she was able to resume therapy.

Before meeting with a therapist, Francine was instructed to fill out a questionnaire to assess her emotions, mental state, and levels of anxiety and stress. She was also asked about her ability to focus and the frequency of her anxiety. Through this questionnaire, as well as conversations with her therapist, Francine received a diagnosis of general anxiety disorder (GAD). This confirmed what Francine had long known about herself and her anxiety, going all the way back to her stomach aches when she was in middle school. Francine attended sessions with this therapist for about a year, but ended up moving too far away to continue visiting regularly. Overall, Francine liked this therapist; she appreciated her compassion and non-judgemental attitude. However, she also felt the therapist was not quite in touch with where Francine was at in her life due to their significant age difference. This therapist was in her fifties or sixties and at times, Francine felt they could not relate to one other. Eventually, Francine decided to switch to a therapist closer to her new home.

Francine began seeing the new therapist (who was in her thirties) in March of 2020, just before COVID overtook the United States. After meeting just once in person, they switched to virtual therapy sessions. Francine spoke with her therapist over Zoom through the clinic's platform, which was designed to preserve confidentiality. While she appreciated the convenience of not having to commute, Francine found that virtual sessions were less personal. As COVID dragged on, her therapist agreed to speak over the phone so that Francine could talk with her therapist while walking around her neighborhood. However, Francine then missed not being able to see her therapist.

A couple of months into COVID, a discussion with her therapist and another questionnaire led Francine to be diagnosed with obsessive-compulsive disorder (OCD). Francine knew she had issues with anxiety, but her more recent diagnosis came as a surprise. She was astonished to realize that others with OCD had some of the same habits she did. Francine's earlier tendency to perform rituals resurfaced, particularly in the early stages of COVID and the pandemic lockdowns. For example, while worrying about her mother's health, Francine would turn light switches off and on. Her mother was high-risk, being in her sixties and having had pneumonia before. In Francine's mind, turning the light switch on and off would somehow prevent her mother from falling ill with COVID. Additionally, Francine would also walk the same path in and out of rooms in repeated sequences. She believed following the same path seven times in a row might prevent something else negative from occurring. Francine recognizes that when she explains these behaviors out loud, they sound strange. However, in the moment, Francine gave in to these urges. She figured they were similar to an indulgence — she knew the practices held no real power, but did not see the harm in performing the actions. They felt like an added layer of safety.

Through therapy, Francine was able to self-manage her anxiety and OCD. She has never taken any medications for her disorders, but has a keen awareness of when her symptoms flare up and what coping strategies she needs to employ to address them. Francine's therapist taught her how to check in with herself by asking, "How are you feeling in your body today?" and "What's coming up for you physically?" Francine learned how to become more in tune with her nervous system and the physical manifestations of her anxiety. Therapy also taught her how to navigate interpersonal situations. Francine's therapist would instruct her to state what she would like to say to someone and they would then discuss those sentiments. Francine requested the therapist assign homework, as she knew she responded well to activities. Her therapist also helped her minimize her urges to click light switches or other anxious habits that Francine had developed (such as standing on one leg for a certain amount of time) by having her visualize approaching waves. The first wave would make Francine uncomfortable. However, if she holds on, and overcomes several more waves, resisting would become easier and easier. Eventually, Francine would not have to climb the waves at all.

Following COVID, Francine moved back to her home state of California. Unfortunately, her therapist did not possess formal licensure yet in California so Francine planned to look for a new mental health provider that she can see in person.

Thoughts on Mental Health

Francine believes that mental health is just as important as physical health. She emphasizes that people should not be afraid to seek therapy and to find a therapist that is right for them. If a therapist is not a good "mutual match," people should not lose hope. Therapy is a process that can require time and patience. Reflecting on her own experiences, Francine acknowledges that individuals may "not see the results [they're] expecting right away." Moreover, assessing the social landscape, Francine states that "self-care has become […] almost glamorous" and awareness of therapy is widespread. The downside of the proliferation of self-care and therapy is that people may expect therapy to be a "quick fix" for serious mental health issues.

Additionally, Francine notes that initial therapy sessions can be challenging. In particular, she struggled with the urge to ask about her therapist as if they were having a normal conversation. She has since grown more comfortable with focusing on herself during her sessions.

In terms of finding a therapist, one obstacle is the cost of treatment. Francine noted that therapy "can be really expensive" and she prefers finding a provider whose fees are covered by her insurance. Next, when looking for a therapist, she researches reviews that others have left for the mental health therapy provider. If the reviews are positive, Francine may schedule a consultation and an intake, where she can describe exactly what she wants to be seen for. Francine also looks out for therapists who specialize in certain mental health issues, like anxiety or PTSD (post-traumatic stress disorder). With all other factors being equal, Francine favors therapists who offer in-person appointments rather than remote or "telehealth" sessions.

Coda

A few years after her boyfriend deserted her, he reached out to explain that he had stopped communicating with Francine because he knew she was "too good for him." She would not break up with him, so he decided to break up with her instead. As traumatic as the breakup was for Francine, something positive came out of the aftermath. Reeling from the relationship drama, Francine ended up confiding in a fellow student enrolled in the same exchange program. Their close friendship continued after they returned to the United States. A year later, they became "more than friends" and have stayed together since then, marrying a few years later.