Laura set off for work early. The day before her boss had raised questions about her performance and she wanted to have a meeting with him to put her point of view. Yesterday she had been too upset but she had thought about it and made a list of the points she wanted to raise.

She accepted she hadn’t been herself for the last eighteen months, but she knew she was good at her role as a manager and felt she’d not let her difficulties interfere with her work.

As she walked to work she clutched her mobile in her hand as usual. She’d bought herself a new phone with an alarm button and a watch with GPs and alarm button. She took care to walk as far as she could away from the kerb. As usual she was feeling tense and jumpy. Over recent months she sometimes had to stop if someone walked past too close or too fast on her right. She knew she had even been jumpy in the office and wondered if her manager, who was new, had picked up on this. She’d been avoiding people and become withdrawn socially. She avoided shops when they were busy and hadn’t been to a supermarket in months. She’d been unable to go the gym or exercise which she used to do every day. As a consequence, she had put on weight. She hated this and had become more self-conscious as a result. She’d also put her studying on hold as she couldn’t concentrate enough. She was sleeping badly and had occasional nightmares. All in all life had become a drag.

From the outside this can look a bit strange. Friends and relatives might be puzzled by the changes. Bosses might not stop to think what has been going on in the background. Even the individual might be confused by how they have changed and worried where it will end..

A common response is to see some of the changes as odd and think of them as symptoms of some supposed condition or disorder. However, if we put the person back at the centre of their experience we can ask whether anything significant has happened and more importantly how the person has reacted.

18 MONTHS AGO
Laura was feeling more optimistic. She was still recovering from her operation and the stitches had not yet been removed. The whole episode had been a bit scary, but she felt she had been lucky and was doing well. It was her fourth day back at work and she was determined to get back to her role. Her team had managed reasonably well while she was in hospital, but it was a busy role and she had only been with the company for two months and was still on probation.

As usual she wanted to take her two-year-old dog for a walk before work. Dolly was a rescue dog from Spain. Unfortunately, Dolly had major kidney problems, but despite this she was very lively and a great companion. Laura took the usual route around the local streets. She did not take her mobile as it was too big for her pocket.

Suddenly, out of the blue, a car mounted the pavement. Laura just saw it coming over her right shoulder, but she had no time to get out of the way. The car hit her knocking Laura into the air and crashing into a wall. People came to help, and an ambulance was called. She was in a lot of pain and there was concern she might have broken her pelvis and collar bone. For her part Laura was worried about not being able to contact anyone and about Dolly who had to be looked after by a stranger. She was also mortified by having her clothes cut off in the ambulance with the door open.

THE PRESENT
Most of us would find what happened to Laura challenging, especially against the background of her operation and her concern for her poorly dog. Many of the changes Laura made were more instinctive than well-thought-out deliberate actions. They were driven by the feeling she could be in danger at any time. This is how we tend to react. It is understandable and has a strong internal logic. However, it is important to see that in many ways it can be unhelpful.

In particular, if Laura carries her phone, takes her new watch and walks away from the kerb she is actively reminding herself that “something might happen” and that she could be “in danger”. She didn’t do these things before the accident and all the time she does them she is unwittingly putting herself on edge. We can’t walk to work like this and feel calm. Importantly, It is likely that thinking and behaving like this in the daytime feeds into her disturbed sleep and occasional nightmares. While the way she walks to work is only a small part of her difficulties it can feed into and keep alive other aspects.

Laura knows she needs to go back to walking to work like she used to; she is trying to deal with the difference between knowing what to do and doing it.