The characters in the following vignette are fictitious. They were derived from a composite of people and events for the purpose of representing real-life situations and psychological dilemmas which occur in families.
This story is about a teenager who undergoes a crisis of confidence, after her identity was challenged by a sports injury. Her resulting difficulties challenged the well-being and stability of the whole family.
Madison was in 9th grade. She had been a star soccer player in middle school and was now on the varsity team.
Madison had been known for being unstoppable and fearless when it came to sports. Last spring she was injured and unable to play for several months, and was on the mend as she entered high school in the fall. Over the summer, her parents noticed that she seemed “off” and unhappy.
Madison’s injury created a crisis of confidence for her, since her identity was built around being a soccer player and being able to do whatever she set out to do, particularly in sports.
Madison was always a good kid. She was an only child and came across as older than her age – reserved and self-contained. Though she resumed playing sports once school started, she was not back to “herself.” She had difficulty adjusting to the workload and new environment at school, feeling pressured and unmotivated to persevere in her schoolwork when she didn’t feel sure of herself.
In the fall she became symptomatic, ruminating obsessively to the point of distraction about getting hurt or injured. This anxiety escalated into periodic panic attacks. During these episodes she became convinced she was having a heart attack. Madison also started having fights with her dad, feeling pressured by him around her school performance and his worry about whether she would get into college. She tried to avoid him because she felt he didn’t understand or trust her, and he made her feel worse. Madison’s relationship with her mom was relatively stable, and better than with her dad.
The Parents’ Perspective
Why was Madison’s dad so anxious and scared for his daughter?
Mom and dad were both concerned about Madison. Her mom, Brooke, seemed calm and confident, low-key. She clearly had faith that Madison would be all right. Her dad Nick, on the other hand, seemed anxious and scared for his daughter. Private sessions with Nick showed him to be self-aware. He was able to recognize that he was vulnerable to reacting out of his own anxieties rather than in a way that would help to Madison.
Nick revealed a childhood history of trauma. When he was a boy, his mother — a vibrant, athletic woman with whom he had been very close — died suddenly. Nick was committed to working hard to be a better dad, and was impressive in his ability to take responsibility when it was warranted. However, in therapy sessions with Brooke, Nick’s sense of perspective was overshadowed. He reverted to his position that that Madison wasn’t really trying and focused on the legitimacy of his concern about the risk that she may not get into college.
The tension between Brooke and Nick was palpable. When they argued, they became notably polarized in how they viewed Madison, though in actuality their views were not that far apart. When Nick was confronted about his more rigid and different perspective around his wife, he explained that around her, he felt he was a failure as a dad and husband, and needed to prove his credibility. He felt constantly criticized by his wife, about his eating habits and lack of exercise, and in general. He said that she assumed she was always “right”, and acted as if she knew more than he did about everything.
Psychologically Speaking: What’s Really Going On?
Madison’s athletic ability had always provided her a sense of mastery, confidence and certainty about her identity. She often felt invincible, especially on the field, and learned to believe that if she tried hard enough at most anything she could succeed. Though she was aware of some anxiety at times even before having been injured, especially when faced with change, training and playing soccer channeled and contained the anxiety. Her anxieties at that time were primarily centered around underlying self-doubt around performance, and always alleviated by relentless practice and training.
Madison’s injuries shattered her sense of invincibility and left her with a sense of being helpless. At the same time, not being able to play temporarily took away her major mode of coping with self-doubt and anxiety. Even when she resumed playing soccer, Madison’s defenses did not work as well as before at managing her anxiety because of her newfound awareness of vulnerability. On top of that, her usual mode of coping was overpowered by the increased academic demands, changes and pressure of high school.