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Welcome to the Fair! Setting Treatment Goals

I’m just back in the office after two wonderful weeks of summer vacation with my family in Maine. One day we had a blast at a local agricultural fair. Do you like going to a fair in August? This was in a rural area so there were lots of farm animals: cows, goats, pigs, ducks and chickens. Who knew there were so many types of chickens? Kids could sign up for a pig scramble, or enter to win a bubble-gum blowing contest. Then there was the midway with the rides and plenty of cotton candy and corn dogs.

We all have our different cognitive lenses through which we view life. To me the fair is one of the best ways to see how different the same experience can be for different people. I had a wonderful day with some interesting experiences. For many people with anxiety and OCD, the fair or an amusement park is a high stress experience with plenty of triggers.

There is contamination from animals and people, of course, and for those who worry the scary stories of people injured in rides. There are Port A Potties, and greasy, unhealthy food. Anxiety and OCD want us to be sure, they want us to be safe, and the fair – like so much of the fun in life — is all about the excitement of new and different.

When I set goals with a client, I remind myself that anxiety is very likely to have hit hard in areas of life that are optional — like a day at the fair. I’m sure to ask about fun activities my clients enjoy, and notice with them if there is little in that category. We are likely to start with goals that involve important parts of living life like going to a job or to school. So when we built a hierarchy of goals, I suggest adding activities that might not now seem like fun – after all, if I spent my day at the fair at a 10 anxiety level because I was fearful about contamination, it would have been hard to call it a fun day! Eventually, though, part of living a full life without the limitations of anxiety is to be able to enjoy fun activities, too.

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