A Self-Study on Conquering Social Anxiety

This blog post is dedicated to the sweetheart who took it upon herself to reach out to me for my experience with social phobia disorder. You took the very first step by overcoming your fear of being a burden to other people by contacting someone for their help. From what I have seen, you are a wonderful person and you are on the right path to 'getting better'. I know that it may not be possible for everyone to attend therapy, but I believe in your determination to help yourself. You are all that you will ever need, but I am always available if you need someone to help you with your goals.

The thing about social anxiety is that you have to constantly put yourself in uncomfortable situations in order to conquer it. It's pretty tough to do without a therapist around to guide you, but it is actually conceivable for you to put yourself through the rigors of mind re-training that a therapist would normally help you with. It’s just that it will be harder to do, obviously, because you do not have that safety net there to reassure you of any failures you may face and help you get back on track from that. Before I go any further, I just want to note that I don’t have any qualifications other than great personal experience when it comes to this. I’m just trying to do my best to explain a type of therapy that I had gone through to mostly conquer my crippling anxiety. I went through what is called ‘Cognitive Behavioural Therapy’ (CBT) for about three months, about two years ago. That being said, I’m just going on by what I remember. I will do my absolute best to remember everything in order to make this as useful as possible to others who are experiencing this devastating disorder, but I’m going to forget a few things.

What is Social Anxiety?

I’ll keep this short; anyone who is truly interested in this read will likely already know if they have social anxiety. I’m including this for someone who may suspect they have this disorder but may not be entirely sure, so feel free to skip ahead of this paragraph if you don’t need the whole run-down. ‘Social Phobia Disorder’ or ‘Social Anxiety’ is essentially, as the name states, a branch of a specific anxiety that relates to social situations. If you have symptoms of anxiety when in situations relating to people as a whole, you may have social anxiety. I will not know all the examples one may have of social anxiety, for there are many different manifestations of the disorder, but I can include some of my own personal examples that I will later touch upon. Phone calls, taking the bus, walking down the street, walking down a busy corridor, being in a public place such as the mall, communication difficulties, asking for help, ordering food at a restaurant/fast food joint, purchasing items from a store. The list of social anxiety blankets over any conceivable situation in which the person with the disorder may confront another human being. Symptoms of anxiety and anxiety/panic attacks can include (but are not limited to): hyper-vigilance, rapid breathing, rapid heart-rate, nausea, tenseness in the muscles/jaw, teeth grinding, dizziness, fainting, vomiting, weakness, symptoms of shock, and bouts of crying. The symptoms can range from ‘mild’ (former symptoms) to ‘extreme’ (later symptoms, indicating an anxiety/panic attack). Why are all these day-to-day actions so tough for people who live with social anxiety?

There could be many reasons why a person has social anxiety. From what I have seen, the most common reasons for social anxiety is a person’s fear of judgment and criticism and confrontation based on their appearance, personality, beliefs, and actions. Hyper-vigilance is the number one symptom for all social anxiety sufferers, as these people are hyper-aware of the world around them as well as themselves and their own behaviour in an effort to appear ‘normal’ and ‘unnoticeable’. These people are afraid of what they perceive to be as ‘being a burden’, or ‘being a nuisance’ or ‘being offensive to other people’s senses’. People with social anxiety typically have low self-esteem issues where they perceive themselves to be beneath much of the population and their daily routine. Social anxiety, if left unchecked, can be crippling to sufferers as it can result in total isolation of their world. The world of a social phobia sufferer will gradually become smaller and smaller as they avoid the necessary routines of life that enables them to go to school, commit to plans with friends, maintaining friendships/relationships, keeping or getting a job. Even leaving the house can become difficult for a social anxiety sufferer. In most extreme cases, social phobia sufferers will isolate themselves into their home, either emerging only when ‘they have to’ (for me, I got to the point where I would only leave my house for my therapy sessions) or just not at all. It is a very sad and very lonely way to live. Social anxiety disorder is shyness taken to a whole new level; to others, some social anxiety sufferers may appear ‘unnaturally quiet’, ‘un-opinionated’, ‘extremely agreeable’, ‘flaky’, ‘hesitant’, ‘noncommittal’, as the sufferer makes their greatest effort into appearing unobtrusive and unremarkable to everyone else around them. They will keep their opinions to themselves so as to avoid confrontation/disagreement, and may tend to avoid or ‘flake out’ on commitments to family members and friends.

First and foremost, the most important thing that one can do when living with social anxiety is to train yourself to recognise when you are having an ‘attack’ and why. You must essentially ‘reprogram’ your brain and your body to react differently to the situations that you may experience anxiety in. This is a very difficult process, and such a feat will not happen overnight. Instead, there are small ways that you can gradually shift your way of thinking into a more positive and healthy mindset. It is not an impossible task to undertake, for after all, people with social anxiety managed to ‘retrain’ their brain towards the opposite end of the spectrum of positivity to where they are now. This is just a matter of training your mind to shift back into positivity. Easier said than done, of course, but doable.

How to Recognise and Analyse Your Anxiety – Cognitive Behavioural Therapy

Cognitive Behavioural Therapy: “A psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systematic process.”

When experiencing ‘hyper-vigilance’ in a social setting, it is important to familiarise yourself with your own personal set of anxiety symptoms. These symptoms will vary for person to person, and may not necessarily be any of the ones that were listed under ‘What is Social Anxiety’, which are my own personal symptoms that I have experienced. It is important to realise when your body is in ‘fight or flight’ mode, basically poised and tensed for survival, but also equally important to take great care to note the situation that you are in that is making you feel so anxious. In my group CBT, the therapist gave us a bit of ‘homework’. We were given a chart that had to be filled out by the time we got together again every week, and it is a chart that will ensure organisation in your thoughts so I highly recommend that any person seeking to put an end to their own torment to make their own. In the following text, I’ll reveal the headers of the chart along with some personal examples that I go through, and then I will pick through the examples a little more finely.

What is the situation that is making you anxious?
Public transportation – buses; was being crowded in a moving vehicle with people with no escape route.

From a scale of 1 to 10, 1 being the least and 10 being greatest, what level does your anxiety rank?
4.5.

What are the symptoms of your anxiety specific to this situation?
Faster heart rate/breathing, hyper-awareness, tenseness in the shoulders and jaw

What do you fear?
People looking at me; judging me for appearance; people speaking to me; and confrontation.

Is this a rational belief?
No.

What steps were taken to bring your anxiety levels down?
Breathing exercises, muscle relaxing techniques, and analysing the irrationality of my reaction.

Did you succeed in bringing your anxiety down from your original number? What would you rank your anxiety as now?
Yes. 3.5.

What is the situation that is making you anxious?
It is important to be able to identify the situation that you are anxious in. If possible, it is always good to include a brief note in this section of the social aspect of this specific situation. Try to note down as much as possible for yourself (though still keep it brief) as the situation just being “on the bus” is a little vague.

From a scale of 1 to 10…
Being able to rate your anxiety is a very helpful part of the process. This step allows you to objectify your anxiety a little bit, being able to step away from how you are feeling to analyse it a little more clearly. Depending on your level of anxiety, your range will differ from any other person’s. Think of one of the more distressing moments in your life related to your anxiety, and apply that as a 10. 1 can either be no anxiety at all, or a minor faster heart-rate. For myself, my 10 would be a full-blown hysterical panic attack, likely considered to be a ‘scene’ if I were in public, and my 1 would likely be aware of a situation with the potential for discomfort, but really feeling pretty comfortable in it regardless with little to no symptoms. Always be very honest in this section. Do not exaggerate too much; be realistic with yourself on what your 10 is, and what the situation you’re currently in is in relation to that.

What are your symptoms of anxiety?
This is an important aspect in being able to understand how your body reacts to certain situations. This is also helpful in being able to determine where you are on your ‘scale’ range. The more symptoms you notice, the higher up in your scale you are likely to be. If you are hyper-alert with a faster heart rate in one situation, and hyper-alert with a faster heart rate and trembling in your limbs in another, it gives you a good idea on what level your anxiety is at, and makes it easier for you to put your anxiety in perspective.

What do you fear?
Be very honest with this section, no matter how ‘irrational’ it may seem. A huge majority of your social anxiety is actually irrational fear, which is why it is something that you are struggling with while other people may not be. This is why it is a disorder; it is a dysfunctional thought process that is interfering with your quality life. This is why you are working on getting yourself help for this. So no matter how irrational you realise you seem to see yourself as, jot down anything you feel like you legitimately have concerns over. For some who have social anxiety disorder, you will find that a lot of your ‘fears’ stem from your fears of how other people perceive you. I do not know the exact term for this, but there is one, and it is essentially what is known as the socially anxious person believing that they have a capability of ‘reading’ people and delving into their inner thoughts; essentially mind-reading. A socially anxious person is concerned about other people’s opinions to the point of obsession. They are hyper-vigilant because they believe that they can see judgment in other people’s eyes, their expressions, and the way they move their hands. You are hyper-alert because you are tuned in to the people around you and how they are acting, and trying to pick up on anything that you think you could justify as them judging you.

Is this a rational belief?
Now you get to do a little more thinking about the previous question and express honestly if you believe your fear to be rational or not. It is, again, putting your anxiety in perspective and scrutinizing it a little more closely from the outside looking in, which is a very useful tool to develop in your fight against social anxiety. Being in immediate physical danger that could actually result in your own bodily harm is a legitimate and rational response for anxiety and the 'fight or flight' adrenaline rush. If you are being cornered by a mob of hungry zombies, drop the journal and run. You don't really have to do any more analysis at that point. People looking at me/people judging me: this is an irrational fear, because yes, people will look at you, but that does not necessarily mean that any judgment is going to take place. People will look at other people all the time, and most of it is completely absent-minded. You are, by being hyper-vigilant, looking very closely at the other people around you for ‘signs’ of their dislike. By doing this, you yourself are making the very judgment on others that you are so afraid of yourself. This does NOT make you a bad person. It makes you a normal person in partaking in normal, judgmental thought processes. Being completely realistic on normal human behaviour is crucial in this section. Being able to recognise that most of the beliefs that your anxiety stems from are irrational is absolutely a key step towards success in being able to shake your dysfunctional thought process. Recognition is the first step towards the retraining of your brain. Without recognition, you will not be able to tell where your problems lie.

What steps were taken to bringing your anxiety levels down?
If you have discovered that one of your symptoms is difficulty breathing/rapid breathing, taking this opportunity to try some breathing exercises is crucial. If you find your body very tense, relaxation techniques (slowly relax from your toes and upwards) are in order. The internet is a plethora of information on these types of relaxation techniques, so I will not touch upon them here. I will leave that up to the reader as a bit of extra homework to seek out such information.

What is your number now?
Now that you have analysed your situation, recognised any irrationalities, and have taken steps towards relieving your physical symptoms, it’s time to re-evaluate your anxiety rating. Even if your number is only a smidge lower, it’s a start that will only be setting up for success. If your anxiety is still the same or perhaps higher, the most important thing you can do is continue to stick with the situation as long as no immediate (and actually rational) dangers are present. If your anxiety is higher and you leave the situation at that peak, your body/mind will further associate this situation with the need to be anxious, and so the next time this situation is confronted, you may find it a little more difficult. This is exactly the sort of cycle that allows social anxiety to get worse, and the only way to truly battle this cycle is to break it by sticking with the situation until your anxiety has come down some. (That being said, it is best to start off with small things at first to make this final step easier. If you immediately try to tackle something that you have rated as an 8, it may be too overwhelming.)

This form serves to not only allow you to better understand yourself, but I have found the entire thought and analysis process to be extremely useful in taking my mind off of my anxious moment. It is channeling your hyper-sensitivity from the outside in your vigilance of other people to the inside of yourself. It is fascinating thing to see and understand you for having irrational fears, and taking the steps to correct that; it also serves to momentarily distract you from the situation at hand, which can, in turn, help bring your anxiety ‘rating’ down by the time you wrap up your analysis of the self.

Applying To Your Life – Goal-Oriented Aspect of CBT

Cognitive Behavioural Therapy: “A psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systematic process.”

If you are someone with social anxiety disorder and you are planning on taking this advice, it is advised that you keep writing supplies available if possible wherever you go. If it is not possible, try to remember as much information as you can, but even buying a small notebook and pen and using that specifically to track your anxiety will be very helpful for you. After you have filled out this form, it is recommended that you review these on a daily basis while in a safety zone. This enables you to reflect back on the situation while completely comfortable, and also enables you to further rationalise your reaction to the situation that you went through. If you succeeded in lowering your anxiety, this note-keeping may serve as a confidence journal. If you failed in lowering your anxiety, it is important that you take the time to reflect on that as well and think about how you will conquer the situation the next time you need to handle it. Please just remember that you may and probably will fail. This is not a reflection on your abilities to fight your disorder. You may have simply bitten off a little more than you can chew, which is fine, because it may be hard to determine exactly how anxious you may be before setting out to be in a certain situation. Or you may have chosen a legitimately safe rung on the ladder, and met with unexpected obstacles that you simply were not ready for. This is just the nature of daily life, and it is okay to fail in this exercise every once in a while. If you are actively failing quite often, simply re-evaluate what situations may be too tough for you, and back-track a bit to a safer level of comfort that still poses discomfort to you, but not in any extreme amounts. The important thing is to not allow failure to erode your confidence away. Take everything in baby steps, and allow yourself to be immersed in confidence whenever you do succeed.

Now that you have means to keep track of your anxiety, it is time to discuss how to apply this to your everyday life through personal goals. Unfortunately, there is no magical cure-all for social anxiety disorder (much like with any disorder) and it will take a lot of hard-work, perseverance, and perhaps even tears and much disappointment to be able to live a semblance of a normal quality of life. The issue with social phobia disorder is the gradual isolation and narrowing of the sufferer’s personal world, as they gradually keep avoiding situations until they are effectively too anxious to have a good quality of life. In order to fight this, the sufferer must gradually regain portions of their world back, starting with the smaller and more manageable things first. The theory is that in conquering the very small things, the broken self-esteem of the sufferer will gradually piece itself together again as they gain confidence from their success, enabling them to face the next step of their ‘anxiety ladder’ and gradually climb to their ‘ultimate goal’.

The first step of this goal-oriented process is to create your own ‘anxiety ladder’. The first thing to do is to set your ‘ultimate goal’; goals that you would truly love to see yourself at later down the road with a healthier frame of mind. You can always go back and change these goals if you later find that you set your ‘ultimate goal’ to be a little easy, because you did not have the confidence at the start to look at a bigger picture. For now, just choose one thing that you would love to be able to do and set that as a beacon for yourself, and then keep traveling down your list of goals, trying to list them all in order of manageability. Mine was as follows:

Move out
Maintain a job
Go through the interview process for a job
Apply for jobs
Complete high school
Register for final course for school
Asking for directions
Phone calls
Initiate hang-out invitation with a friend
Being able to shop at a mall
Initiate conversation first with a friend
Take the bus often
Be able to walk on the street with other pedestrians

This list can be more extensive than mine, and I’m only really remembering what I had set for myself a couple years ago. We can see through my first entry that I just seriously needed to be able to get a job to support myself, and my list travels all the way down to being able to be comfortable with walking on a street. Obviously, we can kind of see the extremity of my own situation through these goals: I had essentially isolated myself to the point where I did not leave my house unless it was to attend my therapy sessions, so even walking down the street on a nice day with other people around was very tough for me. I am very proud to say that after much dedication, I was able to complete every single thing on this list and more. Not only have I maintained my job for nearly two years now, but I have been promoted to supervisor and I am well respected within the workplace by my coworkers and customers. I was able to go out by myself apartment shopping, apartment negotiating, and I have been living on my own for nearly two years as well. Not only did I finish high school, but I have been accepted into college for the fall term after many miscommunication errors by the college when it came to my application that I had to hound them over. This has all been achieved by someone who originally could not leave their house to walk on the sidewalk with other pedestrians. I realise that my own story is exceptionally successful, but I was exceptionally dedicated at working towards meeting my goals on a daily basis. With every single one of these steps, I also had a wonderful therapist behind me who worked tirelessly at helping me meet my goals and discussing my failures with me when I was unsuccessful. If you are reading this as more of a self-study, it may be difficult without such a support system. Make yourself to be your best support system, and perhaps make it one of your goals to ask a friend or family member to be part of your support system as well.

Through the use of the journal form and your goals, every day should be an opportunity to place yourself in discomfort. As stated before, you should always start off with the smallest things on your list and gradually make your way up. Pay attention to your manageability. If you are going through your goals quickly at first but then reach a set of goals that are a little more difficult, definitely slow your pace down a bit and take your time climbing the next step. It is important to try and do the same things on a daily basis to try and build that confidence in the situation up. Take a walk every day, and extend that walk every time you go out. Take the bus every day or as often as you’re able to afford. The idea is that once you have reached that ‘peak’ in anxiety, your anxiety level should drop off. As you continue going back to that situation to repeat the process, after a while you should find that you have fewer symptoms and your initial ‘rating’ for the situation when you are at your ‘peak’ is lower than it originally was when you first began. As you continue being successful, your confidence level should build that stepping stone that will enable you to climb towards your next goal. It’s a slow process and requires much, much patience. It is very hard for someone with social anxiety disorder to have patience with themselves, as they perceive themselves to be on the lower end of the social ladder; they truly believe that they are not good enough, not worthy, that there is something wrong with them to justify and invite other people to share in their loathing for themselves. It’s a lonely way to live, and it no longer has to be that way.

This treatment will not work for everyone, even with a therapist to guide you through the steps of CBT. If you’re able to attend a CBT session, I believe that they are generally cheaper than regular talk-therapy, sometimes even offered for free (as mine was). Really, though, it all comes down to you: Do you want it badly enough? Do you want a world with opportunities that you have the self-made tools to take advantage of?

If you want your world back badly enough, you will succeed. You need to believe that for yourself. The first step in regaining that belief in you back is braving through the discomfort. It’ll be a tough go, especially at first where you just may be completely unaware of your limits. This is fine. I failed too. I lost some struggles. But ultimately, in the end, now, I’ve won. I still struggle from time to time; I avoid making phone calls, I will cross the street to the opposite sidewalk if I see someone walking towards me and I do still have some difficulty getting together with my friends (very blessed that I have patient friends); I indulge, shamefully, a little bit in my disorder. It just goes to show that it just may never go away… But you can definitely conquer most of it, and gain the strength and tools to bull through those situations that are waiting to spring upon you in life. In committing yourself to getting better, mostly, you are equipping yourself with a skill set useful and unique to yourself.

I’m going to begin wrapping up this lengthy blog post. Exposure treatment of CBT may not be for everyone, but CBT has been proven to be an incredibly effective form of therapy that has helped so many suffering from a variety of disorders, including myself. My apologies for the lengthy post, but it’s actually a subject and experience of mine that has, for once, been a really positive aspect of my life that has changed me for the better. CBT was the turning point for me in turning my life around from the 'dark age' I experienced over 2 years ago after my rape. While talk-therapy and Prozac helped jump-start things, it was ultimately CBT that began my trek to moving on with my life. CBT and my therapist saved my life.

As a side note, further apologies for neglecting my blog for the last couple of months. Life took over, but I have some things bottled up, so I would expect there to be more posts soon to come.