Posts Tagged ‘cognitive-behavioralism’

What if I can’t?

September 17, 2010 1 comment

The further I get into my therapy, the more hopeless I feel. I want to get past this horrible fear that’s dominated so much of my life. But I can’t do it. The things that my therapist is asking me to do are so simple, so trivial – and yet, I’m absolutely paralyzed at the thought of doing them.

It’s not that she’s pushing me too hard. We spent a total of a couple of hours over the span of multiple sessions working out a ladder – that is, a list, from easy to hard, of the different kinds of situation that trigger my fears. And we’re starting with the easiest one that I could come up with. There’s no easier first step. And yet, I can’t do it.

In my last post, one commenter asked something about what kind of example I’d be setting for my children if I give up.

I don’t know. I don’t want to teach my kids to give up when things get hard. But I also really believe that there are some things that we can change, and some things that we can’t. No matter what happens with my therapy, I’m never going to stop being shy or introverted. Those are just basic parts of how I’m put together as a person. I can’t decide to stop being introverted. It’s a fact, not a choice.

I want my children to understand that we don’t get everything we want. That to got through life, you need to be able to be realistic, set realistic goals, and be happy with what you can achieve.

I’m not arguing against being ambitious. But we don’t always get to decide how things will turn out. We don’t gain anything by denying the existence of the limits that reality puts on us. If my son were to decide that he wants to be a professional linebacker in the NFL, he’s going to be disappointed. It doesn’t matter how much he wants to do it – he doesn’t have the right sort of body for it.

I don’t want to teach my children that they need to aspire to some kind of arbitrary goal, and torture themselves if they can’t get there.

All that my therapist is asking me to do is to find an excuse to walk into a couple of stores on my way to work, and ask someone who works there a question. Just a simple question, like “where can I find the toothpaste?”

And I’m absolutely sick at the thought of doing that every day. I can’t face it. It’s pathetic, but I can’t. And when I say sick, I’m not being figurative. I’m giving myself migraines every day from the stress of it.

And if I can’t even do something that small, that simple – how is it remotely possible that I’ll ever defeat this wretched anxiety?

Is this just an inescapable part of who I am? How long do I keep doing this to myself before I can conclude that it’s not going to work?


A Subway Thought Study

August 24, 2010 1 comment
One of the main things that I’m doing as a part of my therapy right now is an exercise. I’m learning to analyze my own reactions to the social situations that make me uncomfortable. My doctor has a worksheet that I’m supposed to fill out as soon as possible after an incident. I don’t try to do it every time I feel any kind of anxiety; I’d be spending all of my time doing nothing but filling them out! But I try to do at least one each day.
The form has four sections:
A set of checkboxes. I’m supposed to say what
I’m feeling (anxious, sad, guilty, angry, …), and how intensely I feel it.
A quick in-the-moment description of the situation. No judgements here:
just the facts.
Automatic Thought
Exactly what was I thinking? Here I’m supposed to start by just
writing, in the moment, what I was feeling. Then I’m supposed to pick
it apart: how much did I really believe what I was thinking at the time,
and now, looking back at it after, how much do I believe it?
What did I do? What were the results of what I did?
We’re very early in the process, so that’s all we’re doing now. I assume that we’ll eventually get into something like attempting to think about alternative things I could have done, or something like that.

For example, yesterday, I was riding the subway on my way home from work. I was wearing a very geeky shirt. It said /(bb|[^b]^{2})/. That’s a geek joke; it’s “To be or not to be” written in a programming language. Some guy on the subway saw my shirt, and complimented me on the shirt, and said something about “I bet not many people outside of your office understand that!” He was being friendly. There was nothing mocking about it – just another geek sharing the joke.

  • So how did I feel?
The main thing? fear; not terribly severe fear, but definitely frightened. On a 1-100 scale, probably between 30 and 40. After the fact, sadness; again, somewhere in the mid thirties in intensity. After all, this guy was trying to be friendly, and I didn’t know how to respond in a way that would show that I appreciated the gesture.
  • What was I thinking?
How am I supposed to answer? What am I supposed to say? What does he expect from me? Should I just say “yeah, true”? Is that enough? If I say the wrong thing, what will he think of me? If I say anything, I <em>know</em> it will be the wrong thing. Anything I do is going to be the wrong thing. I’m absolutely, 100% sure that I’m going to do the wrong thing.
  • What did I do?
Initially, I froze. All of those thoughts were running through my head, and that took up pretty much all of my brainpower at the time. So I froze, with a blank stare on my face for a couple of seconds. He definitely noticed that weird blank stare – he had a sort-of concerned look on his face. And then I sort of nodded my head and smiled, said I was OK, and then turned away in embarrassment. Basically, I made myself look like an idiot. Not really because of anything I actually chose to do, but because of the way that I didn’t react because my mind was so busy racing with panic about needing to decide how to react. I created a self-fulfilling prediction about my own behavior.

First Steps – what am I so afraid of?

August 8, 2010 3 comments

When I talk about the things that I have trouble with, it sounds silly, even to me.

The way that I’m fighting my social anxiety is through work with a cognitive-behavioralist therapist. C-B is a method that tries to get at a problem by doing a couple of things.

  1. It tries to help you analyze and understand your reactions, so that instead of just feeling blind fear in a situation, you develop the ability to see what it is that you’re so afraid of. By doing that, you’re supposed to develop the ability to at least intellectually understand that what you’re really afraid of just isn’t so bad.
  2. It tries to develop your ability to accept the fear. Once you understand it, you can start trying to do things that you’re afraid of. You’ve analyzed them to death, so that you understand what you’re afraid of, what the worst outcome could be. The fear is real, it’s a part of you. But it doesn’t have to control you. Right now, when I walk into a crowd of people, I’m absolutely paralyzed with terror. The only thing I’m able to do is, basically, find a nice dark corner to hide in. But – again, in theory – the idea is that by understanding what you’re afraid of, and accepting that the fear is real, you can learn how to act in spite of the unreasonable fear.
  3. It tries to get you to confront the fear. This is the thing that totally freaks the living crap out of me. You deliberately go into situations where what you’re afraid of is going to happen. And from that, you’re supposed to learn that it’s just not that bad.

I’m sure that I’m doing a lousy job of explaining it. But the idea is to understand not just your behavior, but the subconscious thought process that underlies it; and then to try to change that thought process. By changing the way you think about it – both on a conscious level, and on a subconscious level – you can change the way you feel about it, and change the way that you react to it.

That all sounds very nice intellectually. But what it means in practice is that you need to confront the things that scare you.

What I’m supposed to be doing every day now is taking the situation that was hardest for me that day, and piecing it apart. Looking at exactly what happened. Working through what about it made me so anxious. What did I think was going to happen? How much did I believe the worst outcome? What did I do? What else could I have done? What do I think would have happened had I handled it differently?

It sounds so damned benign when it’s phrased like that.

But what it means, really, is facing just how much of a freak I really am. Because the things that totally freak me out are so damned simple, so totally trivial. It’s just pathetic to realize that something so simple can cause such an intense, painful reaction. That I’m so sure that even the simplest thing is going to go so horribly wrong. That I can’t handle something that’s just easy, normal, and painless for most people.

An example. A couple of weeks ago, I picked my daughter up from camp. We got there, and they had breakfast for the parents under a tent. I walked into the tent – and there were about a dozen people there, milling around, picking up food.

To me, that was awful.

I went to grab a seat out of the way in a corner. And someone who worked there came up to ask if they could get me a cup of coffee. I couldn’t even answer them. My voice was just gone. All I could do was nod my head, because I couldn’t get myself to make a sound.

Such a simple situation. Such a simple interaction! But I couldn’t do it. And it probably left the person who offered me coffee with the impression that I’m a stuck-up jerk who wouldn’t lower himself to talk to the hired help. But that’s not it at all. The reality is that I’m just a pathetically broken person.