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High Anxiety By David B. Martin This case happened while I was at work and the setting was in an emergency type condition. The subject was a para-mutual teller at a local thoroughbred race track. She was white, in her early 30's, and had one child, a daughter. The day was an extremely hard and exhausting day both physically and mentally. It was a big stakes race day that was leading to the Triple Crown Races, and here in the state of Kentucky, in the heart of thoroughbred country, we take these races seriously. At the end of the day she discovered that she was over $100 short. She literally became an emotional mess. She was highly upset because she could not believe she was $100 short and stated that she had no means of covering the loss, which is the responsibility of para-mutual tellers to do. I believed that she was on the verge of a nervous breakdown. I ascertained this by her uncontrolled ranting and raving, by her tone of voice, her entire body shaking, and unable to remain calm and controlled in trying to determine a logical reason or cause. Seeing this situation generated before me and its continued escalation to unhealthy levels, I immediately determined that my first response was to get the lady to regain control of herself. This was done by using myself as a pillar of support, by my action of placing my arm around her shoulders, and with verbal suggestions that everything would be alright. Using this physical and oral anchoring technique, I made further suggestions of reassurance, followed by deep breathing, and relaxation. This allowed me to begin pacing her which further lead to me leading her into a calmer state. Slowly she began to regain control, both physically and emotionally. This I determined by the change in her voice, the cessation of crying, the lack of ranting and raving, reduced shaking of her body, and her ability to listen, hear, and understand. By pacing her, I believe that I was able to use my control to lead her into a more controlled state, which allowed her to gain some composure of herself. I followed this by diverting her attention away from the event into re-framing of the current situation. With my arm still around her shoulders, I was able to tell that she was accepting the guided imagery by feeling and seeing the muscles beginning to relax. Peace and calm seemed to be setting in. Once she was under control, or had reached a state of control that I felt she could handle, I was faced with another thought. In her condition, the best thing that I could do was try to reestablish her self-esteem. I believed that she was so mentally and emotionally exhausted that it would be the wisest thing to do. If I didn't, she may enter or re-enter into a suicidal state, or have extreme problems coping. This was when I started to do a re-framing of the days events, anchoring them to the future thoughts,through the suggestions that she in the future would not just learn a valuable lesson from this even, but that she would even laugh, make fun of it, and enjoy the humor in it. I further suggested that this was just a part of life and that it would pass, and make her a better person. RESULTS OF THE CRISIS: It turned out that shehad mistakenly done a money return as a money draw, so she wasn't $100 short but actually $50 over in her money box. That's money that is now hers to keep. Now she can look back and laugh about what happened, as well as learn a valuable lesson to be more careful with the money that she is entrusted with.
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