DISCLAIMER: I am not a psychiatric professional nor am I capable of diagnosing or treating mental health problems. If you have a mental health emergency please contact a professional.
For reasons that I won’t go into here, I ended up in a therapist’s office in 2017.
I had been very depressed and I wanted to rectify the situation post-haste. I was referred to this therapist and I went to see him for a diagnostics session, to see if it was a good fit and if really he could help me in the end anyway.
A diagnostic session is pretty simple to explain. Your mental health professional will ask you a variety of questions (that you should answer honestly) that will help determine the course of your treatment should you need any.
I did mine, and what the therapist determined was that I was really depressed (“Not the worst I’ve seen, but bad”) and that the situation was being compounded by a social anxiety disorder that was going untreated.
I always knew that I really cared about what other people were thinking but I didn’t think this was irregular. The therapist pointed out to me that in fact most people are not wound up in the goings on of other people’s thoughts and feelings.
We decided that the depression might be alleviated if I treated what could be the root cause, and that was my social anxiety.
So we agreed to do a course of therapy and there it was, I was committed to treatment.
Creating a fear hierarchy
The first thing we did was come up with a list of social situations that made me nervous just talking about. It included everything from talking on the phone, to job interviews, to chatting with an attractive woman.
You may not be like me, and find that your nerves are more aroused in other situations. So for my example today, I’m going to choose ‘going to a party’ as the social situation that brings up nerves.
It’s kind of a broad example as going to a party can be broken down into various social situations, but I’m going to address it as a whole experience.
So let’s just say, you are in treatment for social anxiety and you put ‘going to a party’ as the number one on your fear hierarchy.
You should come up with a bunch of experiences, starting small, and getting more nerve racking, that will expose you to your fear of going to a party.
For this example, we are just going to say, you’ve done a number of small exposures (perhaps socializing with friends, family get together), and now it’s your time to attend a party.
Preparing for the exposure
Now, this stage is not as simple as it sounds. It’s not as straight forward as showering, putting on your clothes, and heading off to the party. You need to analyze your thoughts and feelings before the situation arises and come up with some coping mechanisms if your nerves become too much to handle.
Identifying automatic thoughts/feelings
Imagine you are in the party. What is going through your mind? Are you afraid you will be awkward, do you think people will notice, will your shyness affect your ability to hold a conversation? It can be anything that pops into your head before you actually do the exposure.
Anyway, write down these thoughts.
Now Identify the feelings you had when you had these thoughts and write them down. You can feel anything, but you might feel…
A lot of learning to manage your social anxiety is about stopping your automatic thoughts and feelings in their tracks before you become too frazzled.
Identify your thinking errors
Depending on your automatic thoughts, they will fall under certain categories of thinking errors (ways of thinking that do not serve you). They include…
- All or nothing thinking
- Fortune telling or catastrophizing
- Disqualifying the positive
- Emotional reasoning
- Mind reading
- Should statements
- Unhelpful thoughts
Let’s say for our example your automatic thoughts about going to party include being afraid people can tell how nervous you are.
Identify the thinking errors within that thought (in this case fortune telling, emotional reasoning, mind reading, and unhelpful thoughts).
Now it is time to move onto the next step!
Challenge your automatic thoughts!
This does take some practice since you probably are used to letting your thoughts and feelings override your decisions. But asking the right questions really takes the wind out of the sails of bad and persistent automatic thoughts.
You should ask yourself…
- Do I know for certain that __ (e.g. people can tell how nervous I am)?
- Am I 100% sure that __?
- What evidence do I have that __?
- What is the worst that could happen? How bad is that?
- Do I have a crystal ball? Is there another explanation for __?
- Does __ have to lead to or equal__?
- Is there another point of view?
- What does __mean?
Answer as many questions as you feel are relevant to your situation. Then carry on to the next step.
Create a rational response to your automatic thoughts
Make a list of key points (these will be the answers to the above questions). For our example let’s say that you wrote down -1) I might come off as a shy, but that is the worst that can happen 2) Feeling awkward doesn’t mean I’m being awkward.
Then summarize your key points into a rational response that you will use later when you are actually doing the exposure (or attending a party). For our example we’ll say that the rational response is : Feeling a certain way doesn’t mean I can’t do this (party).
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Achieving behavioural goals
One thing you should do is set a real quantifiable goal for your exposure. In this instance you are going to a party, but your goal should be more than just walking through the door and then walking home.
For this example, let’s say you have to have a conversation with at least 5 people, and those conversations have to cover at least 3 topics each.
That’s not to say you should pull the cord on the conversation if you reach your quota. But setting goals like this let’s you see how easy it is to actually accomplish what you set out to. Side note – you’d be surprised by how many topics are broached in a a regular every day conversation.
It’s the day of the party and you are nervous, but that is okay because you have your rational response ready to go.
You make your way to the party, and walk in, some of your friends are there and there are also people you do not know.
Go up to someone you don’t know and introduce yourself…and it could end there.
One might take this moment to feel like a failure, but relax you have your rational response. So just repeat it to yourself in your mind while you navigate through the party.
The next conversation you start goes much better and some dialogue gets going. While concentrating on the conversation you are mindful of your thoughts and feelings and are using your rational response to keep going.
Success! You had one conversation that covered three topics and it ended normally without someone calling you out for being awkward. Great Job.
The night goes on and you have all your conversations, next thing you know you’ve blown past your original quota and are now just mixing it up.
Write down in a journal or something what you learned from your experience and where going to party now ranks on your fear hierarchy. Depending on how easy you found the exposure you could even take it off the list completely. But chances are you’ll need more practice before that happens.
For our example of going to a party, you might have learned that 1) no one can tell how nervous you are 2) Meeting new people is no big deal.
Congratulate yourself, you are now the life of the party!
For more information about social anxiety check out the resources right here.
Have you overcame some social anxiety? If you are comfortable sharing, please let us know your experience in the comments.