Nobody Cares: An Existential Approach to Anxiety
In October of 2017, I was sitting in my professors office mid-panic attack, when she leaned over and said to me, “Rachel, nobody cares.”
I was a year and a half into my masters program at Eastern Washington University (EWU), where I was on track to graduate with a degree in Mental Health Counseling. I was in the middle of my six month internship at Frontier Behavioral Health (FBH), where I was providing therapy to clients with Borderline Personality Disorder (BPD).
In September of 2017, I had started having panic attacks at my internship. I would notice myself getting fearful and afraid to go into the office. I would sit in my car giving myself pep talks about how it was a safe place to be, that nothing bad was going to happen to me, and my life wasn’t in danger. The moment I would enter my office, though, I would feel a surge of panic flood my body. I’d grow teary and shaky, and the minutes leading up to a client’s arrival usually consisted of having a full blown panic attack in my office.
I talked regularly with my supervisor about these instances. She was graceful and supportive. She gave me ice packs and tissues, and reassured me this job is hard and it’s normal to feel paralyzed. I couldn’t imagine how anyone did this work.
My clients told me traumatic stories so horrific—terrors I couldn’t have fathomed if I tried. I couldn’t stop thinking about my clients at home each night. About how I couldn’t possibly have the skills to help them. About how I couldn’t relate to their struggles so how dare I even pretend to empathize. About how I was an inferior counselor and shouldn’t be allowed to help anyone. About their traumas and stories, and the pain and suffering they feel, and how awful a place the world is.
My anxiety escalated so severely that at one point I actually believed one of my clients might shoot me in my office.
I didn’t know this then, buy my anxiety had developed into paranoia. A small comment this client had made in previous sessions about the right to bear arms stuck with me, and I created a story in my head that she wanted to have a gun, and that she wanted to hurt people who she didn’t trust, and that since she probably didn’t trust me, she was going to bring a gun into FBH and shoot me in my office.
It was at this point I knew I should no longer be providing therapy.
My mental health was compromised, and it wouldn’t be ethical for me to sit with clients. I asked for a two week break, and my supervisor understandably obliged.
I still attended my regular courses during this break, and while I did, I met with my professors outside of class hours to discuss my condition. I kept them abreast of my panic attacks, paranoia, and how I felt about taking a break from internship.
Paired with my anxiety of being an inefficient counselor was the anxiety of being an imperfect student. I was constantly concerned with getting good grades, and entirely fearful of being poorly reviewed by my professors.
In one of my meetings with a professor (who, by the way, I idealized), I started to have a panic attack. I didn’t fight it, as I felt her office was a safe space to sob, blurt irrational words, and blow snot into her plethora of tissues. She was after all, also a licensed, renowned therapist.
“I just don’t think I can do this...I think I have to leave the program. But I don’t think I can do that either—I can’t quit—I can’t not be able to finish another thing in my life because of my mental health. I have to finish something in my life, I just have to.”
She let me sob for a few minutes. We sat there in silence together, me bent over in shame and embarrassment, her bent over in compassion and interest. Leaning towards me, her hands clasped over her clipboard on her lap, my professor—the therapist—looked at me with a gentle smile and said,
“Rachel, nobody cares.”
I was dumbfounded.
I left that meeting filled with rage. How could my professor, a licensed counselor with over a decade of experience, tell a person who is in the middle of a panic attack, worried about her mental health and fucking future, that NOBODY CARES? I fumed over this all night long. I rattled my brain for reasons she would say something so hurtful.
It wasn’t until I lay down that night, after hours of stewing, that I understood what she meant.
Holy shit. Nobody cares…Nobody CARES. Nobody gives ZERO FUCKS if I don’t finish this program. Everyone is living in their own movie where they are the protagonist, and I’m just an extra.
That was the moment I made the decision to leave my graduate program.
So what’s this existential approach hum drum?
Nobody cares—a very existential approach to anxiety—is a statement that freed me from the burden of continuing on a path that was killing me. So what is an existential approach? And why was it ok that my therapist said this to me, or how is it different than if someone says nobody cares and means it?
Existential psychotherapy originated in the mid 20th century, when psychologists like Rollo May and Irvin Yalom started incorporating existential thought and philosophy into their work. These therapists, along with others, developed a therapeutic approach that “confronts life’s ‘ultimate concerns,’ including loneliness, suffering, and meaninglessness” (Psychology Today).
At the core, existential psychotherapists believe that anxiety is a part of the human condition, and that we come in contact with anxiety when we face these “ultimate concerns.” According to existential theory, those of us who experience anxiety are likely constantly facing existential questions of meaning, purpose, and connection.
So what is the solution, according to an existentialist? How do we deal with the anxiety of finding a reason for living?
“Part of the existential is just acknowledging That ship has sailed…A lot of it is mourning. You mourn these realities so that you can move toward relinquishing them” (Hill, 2019).
I came across an article written in The Atlantic that sounded all too familiar to some of my conversations with my professor. In the article, the author describes her experience in therapy with an existential therapist. She wrote how the therapist responded to her paralyzing anxiety with, “No, there is no objective meaning, and yes, we will all fail at times to create it. Yes, you will die” (Hill, 2019).
LOL. Yes, you will die. This sounded an awful lot like the nihilistic comment my professor made to me.
This is one of many seemingly nihilistic phrases that existential therapists might use. Nobody cares was another. I started looking into other common existential phrases, and some that initially shocked me included “nothing exists” and “there is no meaning to life.” Jeez, guys, pretty dark.
But when I truly learned to appreciate the existential approach, I realized statements like these were only temporarily nihilistic. I adopted an existential lens. I tried to focus on what these statements really were. What doors could they open in my mind? If I started to fully acknowledge these statements as being true—if I really adopted an existential approach and accepted its philosophy as gospel?
I realized that all of these statements had one thing in common: They were opportunities to free myself from the notion that I have any control over anything whatsoever.
Nobody cares became an opportunity to live my movie without worrying about what everyone else might think.
Yes you will die became an opportunity to explore, experiment, and try everything.
Nothing exists became an opportunity to free myself from the fear of permanence.
There is no meaning to life became an opportunity to make my own meaning, rather than trying to figure out a meaning that something or someone else has set for me.
With this lens, life became less serious. Less consequential. More experimental, free, and full of discovery. A journey with twists and turns, but one without so much fear of retribution or failure. And, if you’re a true existentialist, a little humor.
“Existentialism can be so much fun, especially when you let yourself laugh…we go through all this agony, just to die at the end!” (Hill, 2019).
Ok—so existentialism might not be for you. That’s ok. It takes a certain kind of person to appreciate, let alone choose to implement an existential approach to life. Especially to mental health. And, it begs being mentioned that if a schoolyard bully or your friend from work says “nobody cares” to you when you’re having a shit time, it’s highly unlikely they mean it in the existentially provocative way that my professor did. That really is just plain cruel.
But it wasn’t until I understood what my professor meant by “nobody cares” that I was able to free myself from the suffering in my life.
Because in reality, it’s not that nobody cares. Of course people care: my parents, friends, husband, family members...these people care. But they care about me. Not whether I do or don’t finish my graduate program. They care that I’m happy, healthy, and thriving.
If I had forced myself to finish that program, I likely would have spiraled much further than panic attacks and paranoia—my eating disorder would likely have re-emerged in full force (she was already taking a seat at the table), I may have developed more delusional thinking than being shot by my clients, and it’s possible I would have gone down a path of mental illness that I have never experienced before.
Nobody cares gave me permission to acknowledge that something wasn’t working and to ask for something better for myself. To free myself from guilt and shame. To honor my needs and my experience. To trust that, this too would pass, and one day I would look back on that part of my life without shame anxiety.
It did pass. And now, three years later, I do look back and think I made the right decision. It was hard as hell, but I did what was really important in that moment for my movie: I survived.
References
Sussex Publishers. (n.d.). Existential Therapy. Retrieved from https://www.psychologytoday.com/us/therapy-types/existential-therapy
Hill, F. (2019, January 18). What It's Like to Visit an Existential Therapist. Retrieved from https://www.theatlantic.com/health/archive/2019/01/existential-therapy-you-can-ask-big-questions/579292/