Teddy was the gentle giant type: tall and a bit pale, soft all around, though he did play a fairly serious role on the lacrosse team. His curly hair only slightly covered the typical awkward teenage acne. His face generally vacillated between pleasantly cheery and overtly anxious, a brow that furrowed sharply and angularly at any suspicious remark suggesting any danger to the ego that manned it. It was this twitchy disposition that spoiled all of his efforts in athletics, in his social life, and especially in his schoolwork.

Intellect was never the issue: he was certainly clever enough to run with any number of other similar boys at Brunswick who didn’t define themselves as readers or thinkers, but were capable enough in skills to achieve good grades and complete work. He even had a number of specific interests in the arts, namely film study, of which he was a huge buff, and some basic existential philosophy.

His problems occurred with his avoidant behaviors that cropped up at a moment’s notice when he suspected that any peer or teacher ridicule was a threat in any way. Any piece of critical feedback on an essay, for example, any at all, sent him running from the assignment, never to return. As a result, he had to take a medical leave due to the missing work that resulted from this extreme version of nervous avoidance.

I began working with him after he had been in an IOP for a few weeks and frankly, the initiation of the tutoring was quite difficult. We needed to start just through a casual meeting in the halls of The Anxiety Institute as a warmup, then a few days later we scheduled a session. After a few re-schedulings we finally met up. I knew based on the context in setting it up that I was going to need the real slow start with this one.

Opening up with actual school work was going to result in immediate paralysis. So we started with just some conversation about what he was in to, the books, the movies, nothing at all related to the actual work he had outstanding. I discovered the areas he was in to, namely philosophy in modern film, and fully engaged in the conversation with him, throwing in copious, but entirely sincere (which is critical!) praise for his interest and knowledge of the topics we discussed. He began to open up and get more animated in talking about it.

By the end of the first discussion, we had put together a mini-syllabus involving some films and short stories I offered as counter-parts for the films. He was meant to do some work on them, starting off just in sessions and then at home. It wasn’t perfect at first, as these things never are in such severe cases; managing that expectation with him was likewise key. He expected himself to be perfect about completing the things he had pledged, so coaching him down from the ledge of perfection and reframing success was an important measure. After a week or two he gained momentum in completing one or two assignments outside of sessions, which I celebrated heartily with him.

After several weeks, we were able to gradually transition to focusing on his outstanding schoolwork, which likewise took some significant exposure work. It was first a matter of talking about the books, then reading parts of the books or checking notes that were available on them. Finally we turned to the assignments themselves. It took about a month or so, but that type of patience is key in severe cases of what I term a blend of paralytic perfectionism.

Ultimately, he was able to finish the semester, though it took a month into the summer to do so. He went on to return to mainstream attendance the next fall with some tutoring session with me once a week throughout what was his senior year at Brunswick. While he never lost that vacillating disposition of twitchy nervousness, he had built a set of tools to utilize when the impulse to avoid the terrifying occurred. Our relationship had stabilized his sense of self just enough to be able to complete his work for school and complete high school with his peers that spring.