Dr. Wolf, With patients such as Gary, I am always struck by their need for affirmation from a self-object that doesn't provide it. In this case Gary's parents. In his case he remains with his parents instead of with his girlfriend who does give him self-confidence. He probably also gets positive feedback from colleagues, teachers, etc. But I have found that it won't be as satifactory as his parents approval
With patients such as Gary I tend to bring this seemingly paradoxical state to their awareness. As we explore this, the anxiety seems to dissipate. I base this intervention on the psychoanalytic view of anxiety occurring when the ego detects conditions that are not safe.
I am not an analyst. I learned this technique during my own analysis when my analyst had me ponder why my father's approval, and not others, had such importance. My analyst was a classical analyst, by the way.
I am interested in your comments on this type of intervention.
Norm - a former Gary complete with IBS(now gone).