PhD/PsyD Circumstantiality as avoidance in anxiety?

[Occlumentia]

Hi all, I was wondering if anyone here has any suggestions for readings (or any clinical wisdom you're willing to share) on the issue of circumstantial speech as a form of avoidance in anxiety? I am hypothesising that not getting to the point may mean avoiding really anxiety-provoking content, but I haven't been able to find a lot of info on this. So I'd like to hear if you've encountered this, what you think about it, and you might address this issue if it came up for you. TIA!

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[CheetahGirl]

I bet if you scan the psychoanalytic literature on avoidance as a defense, you may find links to both anger and anxiety. But, I think you would benefit from presenting this information at your program's practicum or bring up specific instances where you experience this clinical phenomenon with a supervisor. Collective groupthink is very insightful.

Good luck!

 

[Occlumentia]

Thanks for the heads-up CheetahGirl - have edited my original post. I didn't think I was asking for supervision as much as for a collegial discussion, but edited all the same.

 

[erg923]

Along with about 2 dozen other things...

I'm not sure what info you might be seeking here? This is going to be your clinical judgment based on the content of the session, the presenting issue and/or the issue you are working on at present. If you think its avoidance, the obvious thing to do is to confront it in a therapeutic way and ask he or she what they think this is about...

 

[AcronymAllergy]

Does it happen? Sure; I've seen folks with PTSD, for example, use it during exposure therapy to avoid/delay getting to the emotionally charged parts of their memories (e.g., by explaining in excruciating detail a mundane and almost-unrelated aspect of the event). But like erg said, at that point it's a matter of clinical judgment and requires that you therapeutically address the issue with the patient. And like Cheetahgirl mentioned, discussing specific instances of it happening (or discussing the general idea of it in preparation for working with patients with anxiety disorders) with supervisors would be a great start.

 

[docma]

Depending on circumstances, it could also be a prodromal sign of thought disorder. This is often missed in adolescents/young adults...so it pays to be curious about other behaviors that may have changed from a prior level of functioning: withdrawal, anhedonia, preoccupation with unusual ideas....Of course these can come with other dx as well...but since we dread identifying this dx in a young person, providers sometimes avoid our own anxiety about seeing the early signs.