The anxious, mistrustful, emotionally distant spouse
Comprehensive Counseling Services
100 Four Falls Center, Suite 312
W. Conshohocken, PA 19428
Maritalhealing.com
Copyright © 2006 Richard P. Fitzgibbons
Goals
Nature of anxiety and mistrust
Prevalence and Origins
Manifestations
Uncovering
Decision phase of treatment
Work phase - growth in self-giving
Role of faith

Journey of discovery
"Men and women are on a journey of discovery which is humanly unstoppable search
for the truth and a search for a person to whom they might entrust themselves.” John Paul
II, Faith and Reason,n.33,
Most spouses believe they have completed their journey of discovery and found
someone whom they can trust and give themselves to completely for the rest of their
lives..
Unfortunately, for numerous reasons this ability to trust often can be badly damaged
with a resultant loss of a feeling of love.

Incidence anxiety-depression
At least 27 million Americans take antidepressants, nearly double the number that did
in the mid-1990s (13.3 million persons) a study by Columbia University and University
of Pennsylvania
 Olfson, M., et al, 2009. Archives of General Psychiatry
Lifetime Prevalence of Psychiatric Disorders
anxiety disorders 28.8%
impulse-control disorders, 24.8%;
mood disorders20.8%
substance use disorders, 14.6%
 any disorder, 46.4%
Age of onset
anxiety (11 years) and impulse-control (11 years) disorders
substance use (20 years)
mood (30 years) disorders
Half
of all lifetime cases start by age 14 years and three fourths by age 24 years.
Kessler, R.C., et.al. 2005. Lifetime prevalence and age-of-onset distributions of DSM-IV
disorders in the National Co-morbidity Survey, Arch Gen Psychiatry, Jun;62(6): 593-602.
Anxiety
“Anxiety is the greatest evil that can befall a soul, except sin. God commands you to
pray, but He forbids you to worry,” St. Francis de Sales.
Nature of anxiety
A complex and powerful emotion that arises many sources, including the loss of one's
ability to trust or feel safe, intense worries, an excessive sense of responsibility,
weaknesses in confidence guilt, modeling after an insecure or anxious parent, and
biological and moral factors
can create severe marital stress in marriages
Anxiety disorders are serious illnesses that can be as incapacitating as severe arthritis or
other medical illnesses.
Types of anxiety
Healthy anxiety
a warning that something needs to be addressed
Fear of the Lord is the beginning of wisdom
Unhealthy anxiety
Excessive anxiety/mistrust - heightened tension
Damaging to spouses and children & to emotional, physical, mental and spiritual well
being

Nature of anxiety/mistrust
Needs to identified and resolved or it can regularly damage the marital friendship
Marital love and trust are not powerful enough to heal completely the wounds of
mistrust/fear or insecurity from childhood and adolescence or previous adult
relationships.

Journey of Mistrust
Fear enters at one life stage and can emerge strongly years or decades later.
Can damage the ability to feel love toward a trustworthy spouse
Can emerge under various types of stresses
on confidence, new beginnings, birth of a child, financial pressures, criticism, etc.

Generalized anxiety disorder
the most common anxiety disorder with excessive anxiety and worry occurring more
days than not for at least six months with 3 or more of the following for 6 months
restlessness or feeling keyed up or on edge
easily fatigued
difficulty in concentrating or mind going blank
irritability
muscle
tension
sleep disturbance
Anxiety & co-morbidity
Generalized
anxiety disorder (GAD) has a high rate of co-morbidity with other
psychiatric disorders, including major depressive disorder (MDD), substance use
disorders, bipolar disorder, other anxiety disorders. The concurrence of GAD with
another disorder heightens a patient's risk for impairment, disability, and suicidality.
 Simon, NM. (2009) Generalized anxiety disorder and psychiatric co-morbidities. J.
Clin. Psychiatry, 70 Suppl 2:10-14.

Course of anxiety disorders
Although anxiety disorders resolve in many individuals, studies describe anxiety
disorders in some as insidious, with a chronic clinical course with low rates of recovery,
and relatively high probabilities of recurrence. The presence of particular associated or
co-morbid psychiatric disorders, such as depression, significantly lowered the likelihood
of recovery from anxiety disorders and increased the likelihood of their recurrence.
 Bruce SE, 2005.
Unjust Hurts &Emotional Pain – model from powerpoint
Anger in anxiety disorders
The prevalence of anger attacks in patients with panic disorder was approximately onethird. However, anger attacks were not unique to panic disorder, with similar rates
emerging for patients with other anxiety disorders. Furthermore, patients with depressive
diagnoses had twice the prevalence of anger attacks than did anxiety patients.
Gould, RA, et al. 1996. J. Affect Disorders. Jun 20;39 (1): 31-8

Anger in anxiety disorders
The evaluation of anger in anxious individuals does not receive enough attention even
though many studies demonstrate high levels of anger and anger attacks in anxious
patients. Many anxious spouses simply don’t realize how angry they are with those who
have damaged their confidence or trust.
The presence of anger attacks contributes to a poorer treatment outcome for anxious
patients.
Childhood origins
Parental conflicts - distant, anger, controlling, selfish, insecure
Modeling after fearful, mistrustful, perfectionistic or overly controlling parent
Selfishness/human respect
Strong insecurities
Lack
of family meals
Divorce/separation trauma
Inability to feel safe in school or neighborhood
Absence of a parent in the home after school
Childhood origins of fear
Day care/insensitive caretaker
Lack of balance in family life
Excessive sense of responsibility
Frequent overnight travel by the father
Serious illness in a parent, sibling, or oneself
Alcoholic or narcissistic parent
Origins of childhood fears
Loss of a parent, brother, sister, or close friend
Moral failures/sin
Victimization by the excessive anger of others
Poverty
Out of wedlock birth
Adoption
Weakness in faith
Cognitive distortions in kids
The world is not a safe place.
I need to control or something bad will happen.
Something terrible is going to happen to me.
I am going to be hurt as was a parent.
I cannot trust anyone.
Commitments do not work.
I am my body/appearance/my clothing.
I have to be overly responsible.

Origins of adolescent fears
Same causes as in childhood
Growing trauma from selfish peers
Absence of a birth parent in the home
Lack of trustworthy friendships

Origin
of adolescent fears
Trauma from being treated as a sexual object
Narcissism/human respect
Educators with hostility toward Judeo-Christian morality
Financial worries
Post abortion trauma
Cognitive distortions in teens
As in childhood
I am my clothing, body, appearance
No one can be trusted.
I will be betrayed.
I am not attractive.
I lack goodness.

Anger limits healing – model
Major denial & mistake
I now have a good relationship with my parents. Therefore, what happened in my
childhood no longer has an influence in my life.
I am healed.
My spouse has the all the problems.

Hard work
The resolution of family of origin fears, mistrust and insecurities occurs slowly over the
course of a number of years.

Trust damage in young adults
Mistakenly give themselves to those who are not trustworthy
Give themselves without a basis in true friendship
Result is significant loss of trust with marked increase in anxiety disorders
Modeling after mistrustful parent
Panic, social anxiety, PTSD, substance abuse disorders.
Trust wounds in young adults
Colleges - attempt to undermine teaching on sexual morality
Dorm Brothels at www.catholiceducation.org.
Collapse of commitment employer to worker
greed.
Origins adult fears
Same as in childhood and adolescence
Weaknesses in marital friendship, communication, love
Repetition of the weakness of an anxious parent
Controlling, angry or selfish behaviors in one's spouse
Insensitive treatment by children
Financial concerns
Dictatorship of relativism

Origins of fear and mistrust
Not
feeling respected, protected, etc. by one’s spouse
Lack of balance
Failure to understand the vocation of being a husband or wife
Weakness in faith
dictatorship of relativism
Biological factors
Sin/moral failures

Origin adult fears
Excessive sense of responsibility/lack of balance
Lack of faith
Unjust treatment at work
Loss of job
Loss of health
Post abortion trauma
Post divorce mistrust
Cognitive Distortions
I need to control to prevent something bad from happening.
My spouse is not trustworthy and will betray me as did a parent.
Others will hurt or control me.
Something terrible is going to happen.
I will be betrayed as a parent was.
 If I don’t show love, I won’t be hurt.
I’m safer being independent.
Uncovering & Self-knowledge
An awareness of the ability to establish secure attachment relationships with one’s
spouse, with each parent, same sex friendships, other friends,etc
Identify relationship in which love/attachment may have been “wounded”
Mistrust checklist
Confidence checklist
Symptoms of mistrust
Emotionally distant behaviors
Controlling and irritable
Critical, negative communicator
restless, moody, obsessional thinking, compulsive behaviors, catastrophic thinking,
insomnia, nightmares, phobias.
Lightheaded, dizzy, rapid heart beat
Panic attacks
Goals in Work phase
Deepen understanding
Resolve anger
Build trust, not control
Enhance confidence
Strengthen marital friendship
Seek a balance life with healthy priorities
Faith
Medication as a chemical crutch

Work phase - FOO
Based on the spouse’s history of their anxiety or emotionally distant behaviors,
forgiveness exercises are often used to uncover anger during this period. The spouse is
asked to focus on the desire to understand and forgive an insensitive parent,spouse or
employer who hurt them. This exercise can lead to the emergence into consciousness of
significant emotional pain from past

Past forgiveness exercise
Picture oneself as a child or teenager thinking, “Dad, Mom I want to understand and
forgive you for
Being emotionally distant
Being too anxious
Being too controlling, critical and angry
Not building my confidence
Not protecting me adequately
Being selfish
Abandoning me

Past forgiveness exercises
“Dad, Mom I want to understand and forgive you for
Being emotionally distant
Not being a good role model as a spouse
Forgiveness process
Such strong anger and hurt can emerge that a person cannot forgive.
In such cases spiritual forgiveness is effective and can include giving the anger to God
or thinking that I am powerless over may anger and want to turn it over to God.

Anger limits healing – model from powerpoint
Benefits of forgiveness
Increased ability to see the goodness in one’s spouse
Improved marital trust
Strong feelings of love for one’s spouse
Increased ability to receive the spouse and marriage as gift
Diminished level of anxiety and fear
Enhanced
self-esteem
Less irritable

Benefits
As anger from past hurts decreases, past fears and mistrust seem to have less influence
over the present. In fact, the healing of anger appears to facilitate a growth in trust or a
safe feeling and in confidence.

Excessive sense of responsibility
Take steps to protect oneself from the unreasonable and damaging demands of others.
Assertiveness may be needed with an employer, customer, relative, etc. who has
unreasonable expectations or children who demand participation in numerous sports
activities to the detriment of a balanced family life.
Assertiveness
Assertiveness is employed with forgiveness in these cases so that one will learn to
express anger in a healthy way, minimizing the possibility of overreacting. Here the
spouse works at first forgiving and then, as the anger diminishes, gives a correction. to a
spouse, child, colleague, etc. in a gentle manner.

Confidence
Many men with anxiety disorder related to their work identify a lack of confidence as a
major factor in their vulnerability to excessive anxiety. Often a conflict with a father is
identified who failed to build male confidence.
As their understanding of their father’s childhood experiences grow, they are usually
able to recognize that their fathers modeled their behavior after their own fathers and they
realize that the hurts

Work phase - challenges
Denial of anger
Resistance to forgiving offenders
Perfectionistic thinking contributes to denial
Need daily commitment to forgive
Struggle to give up obsessional thoughts of control
Control compulsions
Emotionally distant behaviors
Common marital complaint
Husbands most frequently at fault as a result of modeling after an emotionally distant
father.
Forgive the father.
Commit to be loyal to his goodness but not his weakness
Try to be a more cheerful giver
Offer 5 positive comments for each negative comment
God help me to give myself more.

Protector of female genius
“Woman can find herself only by giving love to others.”
Mulieris dignitatem, 15. John Paul II. 1988
Special capacity to show love
Delicate sensitivity to the needs of others.
Understanding of inner conflicts in others.
Special capacity for the other.
Ratzinger, Cardinal Joseph. (2004) The Collaboration of Men and Women in the
Church and in the World.
Male genius and strength
Greater distance from process of gestation and birth enables him to act more calmly on
behalf of life.
He acts to protect life and guarantee its future.
He is a father in a physical and spiritual sense.
He is called to be strong, firm, reliable and trustworthy.
The Collaboration of Men and Women in the Church and in the World2004.

Emotionally distant spouses
 Can lack of understanding of the calling to self-giving and to true friendship
“The fundamental and innate vocation of every human being is to love.” CCC, n. 1604
“The Lord loves a cheerful giver,” 2 Cor 9:7.
Often fears being controlled
Selfishness is a major factor as it turns one in.
Other causes in EDBs
Conflicts need to be uncovered & addressed
Excessive marital conflict with loss of trust
Controlling, angry, critical spousal behaviors
Lack of respect
Excessive worries
Inability to let go
Lack of balance
Emotionally distant spouses
Resistance - “Don’t say, ‘That’s the way I am - it’s my character.’ It’s your lack of
character. Esto Vir! - Be a Man!” The Way #4 St. Josemaria Escriva
“Man cannot find himself except through a sincere gift of himself.” Gaudium et Spes
24:3.
Try to understand that happiness and fulfillment will be found in self-giving

Healing
Let go of worries before dinner
Try to be giving on returning home
Communicate positive experiences, emotional, spiritual, thinking
Set aside time to talk in the evening or to share a reading
Go to bed at the same time
Faith - greater love and trust with worries

Healing
give to more to the marital friendship aspect of marriage
pursue balance in one’s life
try to relax in the PM and not work･
set aside date night regularly
keep angry, controlling, critical people at a distance
be careful whom one trusts
try not to be obsessed with material possessions
pursue the virtue of temperance
Faith
“Man cannot always give, he must also receive. Anyone who wishes to give love must
also receive love as a gift. Certainly, as the Lord tells us, one can become a source from
which rivers of living water flow (cf. Jn. 7:37-38). Yet to become such a source, one must
constantly drink anew from the original source, which is Jesus Christ, from whose
pierced heart flow the love of God (cf. Jn 19:34).” DCE, n. 7
Improve communication
A problem shared is halved.
Don’t let the sun go down on your worries.
Write a list of fears/worries and entrust them to God
Common cognitive distortions
I have to maintain control.
I need to limit my vulnerability in order to feel safe.
My spouse wants to control me.
I could not trust my parents to be sensitive and I cannot trust my spouse.

Cognitive distortions
My spouse is not trustworthy.
I will be betrayed and mistreated as my mother or father was.
Our marital friendship will be as unhappy as was my parents.
Responses to CDs
There is much goodness in my spouse & he/she is basically trustworthy.
My childhood pain is not going to control my adult life, especially my ability to trust.
I will not be betrayed as I was in my childhood.
I will be happier by respecting and not trying to control.
My spouse loves me and wishes the best for me.

The control delusion
False assumption that everything is in my control.
Trap - gives one an early sense of increased confidence and less anxiety
However,
it takes a terrible toll on the individual and the marriage.
Struggle to let go of this conflict
Effective meditations - “The Lord is in control - not me.” “Lord help me to trust you
more this day and also my spouse.”

Excessive responsibility
Focus excessively upon meeting other peoples’ expectations
People expect to be able to reach anyone at anytime
JP II and worry
Hiking story
Moral failures/sin
Consider with excessive anxiety and irritability
Can result in obsessional self-critical thinking
Identify failure
Grow in virtue
For Catholics - Sacrament of reconciliation
Consult with clergy
Correction and fear
“You never want to get to the heart of the matter. Sometimes, through politeness.
Other times, through fear of hurting yourself. Sometimes again, through fear of hurting
others. And always, through fear!”, St. JoseMaria Escriva,The Way, n. 33).
Adult Children of Divorce
Recognize need for more trust
Past forgiveness exercise - parent(s)
Admit powerless over mistrust and turn it over to God
Meditate upon the Holy Family as another loving family.
Healing the trust wound
Recognize the need to trust in order to give oneself and to receive
Make a commitment to try to trust more…first the Lord and then others
See the trustworthy qualities in one’s spouse
Uncover and resolve guilt
Healing anxiety
Work on maintaining good friendships
“A brother strengthened by a brother is like a fortified city,” Prov. 18:19
Keep untrustworthy, controlling people at a distance
Be careful whom you trust
“Perfect love casts out fear.”
Medication as a chemical crutch while building trust and confidence.
Role of medication
Due
to the high co-morbidity of anxiety with depression and excessive anger, the
serotonin reuptake inhibitors are very effective because they are proven to diminish each
of these emotions.
Ideally, medication should be used in conjunction with a treatment plan that attempts to
uncover and address the origins of the anxiety.
When the numerous origins of anxiety are being successfully treated, it is then possible
to decrease and later taper many individuals off medication.

Going off meds
The medication is often prescribed for serious anxiety disorders without proper effort
being made to attempt to identify and to resolve the causes of the anxiety.
As a result, when people treated in this manner want to go off their medications, they
regularly experience the re-emergence of symptoms of anxiety including dizziness,
insomnia, irritability, lightheadedness, difficulty in concentrating and memory, fatigue,
weakness, etc.

Going off meds
These symptoms are often incorrectly viewed as withdrawal symptoms from antianxiety medication when, in fact, they develop often because the basic conflicts have not
been adequately treated, particularly difficulties in trusting, an obsession with controlling
others, and weaknesses with confidence and loneliness. These unresolved emotional
wounds can intensify when medication is withdrawn resulting in a excessive anxiety.

Going off meds
A number of individuals need to use medication for an indefinite period of time in order
to function effectively as do those with chronic medical conditions such as diabetes and
arthritis.
Faith & anxiety
In a survey of 37,000 men and women those who attend church, synagogue or other
religious services, the higher the worship frequency, the lower the prevalence of
depression, mania and panic disorder.
Baetz, M., et al. (2006)

Faith and panic disorders
Researcher Marilyn Baetz, MD, of the University of Saskatchewan in Canada, stated,
"The higher the worship frequency, the lower the odds of depression, panic disorders and
mania.”
How spiritual values and worship attendance relate to psychiatric disorders in the
Canadian population. Can J Psychiatry 51:654-61.

Faith and anxiety
The importance of religion was a predictor of improvement in panic disorder after one
year. Over time, the improvement was seen for the religion was very important.
Bowen, R, et al. (2006) Self-rated importance of religion predicts one year outcome of
patients with panic disorder. Depress Anxiety 23:266-73.
Faith and mental health
In a systematic review of 850 studies the majority of well-conducted studies found that
higher levels of religious involvement are positively associated with indicators of
psychological well-being, life satisfaction, happiness, positive affect, and with less
depression, suicidal thoughts and behavior, drug/alcohol abuse.
Moreira-Almeida, A., Neto, F., Koenig, H.G. (2006) Religiousness and mental health: a
review. Rev Bras Psiquiatr.28:242-50.)

Faith and anxiety
"But he who fears God feels interiorly the security of a child in the arms of his mother:
He who fears God is calm even in the midst of storms, because God, as Jesus has
revealed to us, is a Father who is full of mercy and goodness. He who loves God is not
afraid." 6/22/2008