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Therapy Toolbox

Abby Delouya

Everything is really good,” she took a breath, bracing herself. “But I can’t stay alone.” She slumped back on the couch

Wednesday, November 07, 2018

 Mishpacha image

Goals: To help Ahuva better tolerate anxiety and give her tools to help with her specific fear.


Tools Used: Cognitive Behavioral Therapy, Mindfulness, and Exposure Therapy.


Dark Fears

Ahuva was a charmer, I could tell immediately. Her session was booked for 9:30 a.m.; she arrived at 9:25, notepad in hand. “I’m a good student,” she laughed. Ahuva made herself comfortable quickly, exuding confidence.

“So, I’m not embarrassed because, like, everyone has a therapist, ya know? But it’s so not me.”

“What isn’t ‘you’ about therapy?” I asked.

“The whole exposing myself to a stranger is weird, but I’m pretending we kinda know each other. It’s just that I literally have no issues.”

“Except?” I smiled, taking the bait.

“Except this teeny tiny issue that makes my entire life unmanageable.”

Usually, I do a formal intake: family genogram, psychosocial history, etc., but Ahuva clearly didn’t have patience for that. I waited for her to keep sharing, pen poised.

“I have a great marriage, awesome kids, I’m an event planner, and I have the best family. Everything is really good,” she took a breath, bracing herself. “But I can’t stay alone.” She slumped back on the couch.

“What do you mean, alone? Emotionally?” I asked.

“No! Physically. I am scared, terrified, to stay alone at night. My husband travels for work at least four times a month. I’ve tried everything and it’s only getting worse. It’s embarrassing! I’m 29 years old! I pressure my husband not to leave, and when he does, I’m awake all night in hyper-vigilant terror and then I am super tired and grumpy the next day. I wish there was a pill or something for this.”

I praised Ahuva for her courage to start the process and assured her that practical tools could be effective in controlling her anxiety.


Ahuva’s fears were deep-rooted. She shared her early memories of feeling scared at night: “I remember hearing a train and crying in my bed as a preschooler because I thought it was going off its tracks. I was scared of ‘creatures of the night,’ bears, robbers, the supernatural; scared of earthquake or fire.” For Ahuva, night always felt unsafe.

For years, Ahuva’s phobia lay dormant because of environmental buffers: Growing up, her large family was a hive of activity, in seminary she was surrounded by friends and roommates, and she married Yossi within months of returning from seminary. With Yossi’s kollel schedule, they didn’t travel much. Two years ago, Yossi started working and, with some lucrative promotions came a nonnegotiable travel schedule. Yossi was gone one to two nights a week. That’s when Ahuva decided she needed formal help.

“Even when Yossi’s home, I’m worrying about his next trip. When he’s gone, I’m terrified and barely functional.” (Excerpted from Family First, Issue 616)

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