I'm not really doing anything on purpose to treat my SA, except taking anxiety supplements. I'm forced to interact with customers at my job at times, and I'm forced to ask for help/ask questions at work. But I feel like I go in circles with stuff like that, like "exposure therapy" and CBT just do not help me with any of these types of things--it's constantly anxiety about talking to customers-->try to avoid-->forced to talk to customers-->anxiety about talking to customers-->try to avoid-->forced to talk to customers-->anxiety about...and on and on.
Have you done actual therapist-guided exposure therapy?
I seem to recall its success rate being quoted as 65-80%? Something like that. (Whatever "success" is measured as.) Some of it will depend on the quality of treatment being received.
Wow, you're really all in on treating your SA, huh?
Umm, yes. It took bottoming out (twice) before I got to this point, the first time being an involuntary inpatient stay for three weeks last year.
Being in the hospital forcefully exposed me to things that I'd have likely never done otherwise: Therapy sessions with more than one doctor/counselor present, sessions with a medical student present, sessions with a same-aged doctor/counselor, group therapy of any kind...
They set me up with outpatient treatment that started shortly after discharge which, while being very difficult to bring myself to attend, I followed up on. That was 13 months ago.
Earlier this year, I started sliding again and avoiding treatment. What set me straight was (again) bottoming out, this time at a Mexican resort (I was grudgingly there for my sister's destination wedding, and it went very badly for me). When I came home, and with the help of family and my doctor (who, fortunately, takes me very seriously), I got back into it.
Do you think these things are helping so far?
I think for me, just being actively in treatment
(in and of itself) has a 'helping' effect. It's the only environment I feel OK in (where I don't feel I have to suppress myself or 'wear a mask'). It's a positive thing, so every time I attend a session, it's like I'm being given an 'injection of positivity'.
Taking what I learn through treatment and applying it in the real world, though... That's a whole other issue and challenge. My family tells me they've noticed improvements, though, and I have as well in some ways. For me, this has been a problem for 20+ years, so I try to keep in mind that I have to be patient with myself and give myself credit for steps I've made.
If so, which seems to help the most, if you can tell?
The peer support group comes to mind. So far, I think it's helped me stay in 'treatment mode'. Whereas a lot of treatment is time-limited and requires you to sit on wait lists for long periods of time, this group is weekly, ongoing, and always available -- maybe making me less prone to avoidance?
As far as techniques, I go to general pointers that I've learned along the way. Some of them fall under CBT while others I've picked up through advice from counselors or other patients or elsewhere.
Different techniques will work (or not) for different people. These are just some pointers that have helped me at times when facing stressful situations or trying to counter negative thinking:
- "Don't hog the spotlight..." With anxiety, our focus is on ourselves. Put the spotlight on the other person instead, and see what you can learn about them. This doesn't even necessarily entail talking to people. You could be in a group or a crowd and observe other people from a distance. Whether you're in a conversation or just among others, put your focus on someone else (and actively try to learn something about them) as a means to get yourself out of your own mind.
- Our flaws are what make us human. Allow yourself to screw up and make mistakes (even intentionally). There is a vulnerability in that, and it makes us more approachable and 'open' compared to perfection(ism) which can be intimidating and off-putting to others.
- "If only we could see ourselves the way others see us." Have you ever seen or heard someone rail away on themselves and thought, "Dude, there's nothing wrong with you." We are our own worst critics.
- If you're feeling on the outs or like you're getting the cold shoulder from someone, then look at the situation from their perspective. Anxiety can be perceived as guardedness, coldness, an unwillingness to be open with others, lack of interest, etc. Depression can be perceived as disinterest, anger, hate, rejection, a desire to leave the situation, etc. The problem isn't you
; it's your anxiety and low mood, and those things do not define you.
- Appearances don't always represent reality. We can have a way of putting other people on a pedestal, but even people who seem very well connected with others or like they have a great social life, etc. can be struggling with low mood, loneliness, anxiety... Personally, I put on a mask and go through great effort to hide my problems from others. Other people do the same. Everyone is struggling with something
. Take them off the pedestal.
- 'Gathering evidence': Think about positive things people have said or done to you in the past, how others have expressed their support for you or gone out of their way to include you, etc. Think about compliments you've received, or people who have expressed a romantic interest towards you... These things are evidence against
those negative thoughts swirling around in your mind.
- Train yourself to 'be in the moment': 'Mindfulness' - If you've never heard of it, Google it, and find a technique that works for you, even if only for a few seconds at a time.
- If you're faced with a stressor and feel the urge to avoid, then challenge that urge by asking yourself questions like, "What's the worst case scenario here?" "What about the best case scenario?" "What's the most likely outcome of this situation?" "What would I advise a friend if they were faced with this situation?" (stop the self-talk, and talk to 'your friend' instead)