[Edited 07/12/18 to add]
A special note for any former group members who may stumble upon this series…
Hi there 🙂 If you haven’t read any of the other posts, let me assure you that I have never revealed any personal or confidential information about you or even shared your stories anonymously. I may have made brief references here and there to “group members” as an anonymous whole, but never in specific or revealing detail. This series has been strictly and diligently focused on my own experience and thoughts. I truly hope that in writing it, I did not do anything to make you feel that I breached the trust of our group. Good luck to all of you and thank you so much for being so brave and supportive. xoxoxo
Cognitive behavioural therapy, or CBT, is a type of therapy that focuses on reframing the way you think. You learn to catch those kneejerk negative thoughts and redirect them into a healthier and more positive direction.
CBT is the gold standard for the treatment of anxiety disorders.
And what’s even better than CBT for the treatment of social anxiety (my primary struggle at the moment)? CBT in a group setting.
Yep. Eight to twelve people with severe social anxiety, sitting around a table, participating.
I’ve had two sessions so far. I LOVE IT.
I’m learning so much. And that’s why I wanted to write this post. I want to share some of the take-home messages I’m learning week by week. I can’t share examples from other participants for the sake of confidentiality, but I think I’m safe to share my own thoughts and feelings about the process.
Here are my Session 1 Take-Home Messages:
- The research shows that people with social anxiety disorder (SAD) are more likely to interpret a neutral or ambiguous facial expression as negative. This is completely true for me. I feel very threatened and concerned if someone seems unhappy, uninterested, or upset. This can lead to hypervigilant behaviour, like scanning people’s faces (unconsciously, usually) for the slightest hint of disapproval.
- For the purposes of CBT, the past doesn’t matter as much as the present. The focus is on social anxiety as it affects you NOW, rather than on how it may have affected you in the past or how it may have started in the first place. I found this to be a huge relief, because I really don’t want to delve into the nitty-gritty of the past three decades of my life in front of a bunch of strangers, however supportive they may be.
- I’m not alone. I was stunned by some of the comments made around the table, and some of the physical signs of anxiety the other participants displayed. It was like looking into a mirror, or reading excerpts from my own diary. I’m not crazy. I mean, sure, I’m not healthy from a social anxiety perspective, but I’m not uniquely unhealthy. Other people experience this. Within a few minutes of arriving, I gave a huge inner shout of “THESE ARE MY PEOPLE.”
- If you put me in a group of other people with social anxiety, I become a helper. I am not usually the type of person to speak up in a group, to raise my hand, to talk across the table and give suggestions, or do anything that would mark me as an active participant. But if the people around the table are struggling to speak up, blushing, trembling, crying, or just articulating the painful experiences of living with SAD? Well, apparently that turns me into one of the most active members of the group. I just want to help them. Tell them it’s okay. They’re okay. It will get better, they’ll see. I have to keep reminding myself not to get ahead of myself—I can’t advocate for mental health until I’ve gotten my own issues under control. Or… can I? Can simply commiserating, supporting, and sharing my journey be helpful? I hope so.
Another part of Session 1 was the “Three Components of Anxiety Monitoring Form.” It’s the first step in starting to recognize anxious thoughts, sensations, and behaviours when they occur. You state the situation or trigger, rate how distressing it was, and then write how you felt, what you thought, and what you did. I’ll just share one of my examples here, but if there’s any interest I can go more in-depth in another post!
- Situation: Going to my first CBT session
- Anxiety level (0 to 100): 90
- Physical sensations: Butterflies, nausea, lightheaded, heart racing
- Anxious thoughts:
- They’ll think I’m not anxious enough to deserve a spot in the group
- They’ll think I’m so anxious that I’m beyond help (yes, I had both these contradictory thoughts at the same time)
- They won’t like me
- I’ll cry
- Anxious behaviours:
- Arrived super early (this is called a “safety behaviour”)
- Emotional eating (I can’t remember what but I assume ice cream… the group started at 10 a.m. so that’s early for ice cream in my opinion, or maybe that’s my weird relationship with food telling me it’s too early…)
- Fussed over my appearance countless times (beyond the normal amount of time one might spend fussing)
- Nervous-peed approximately 7,000 times
I think the hardest thing about all those sensations, thoughts, and behaviours is that they are EXHAUSTING. And that’s just one example of how my brain operates ALL DAY, EVERY DAY. I burn through so much of my precious energy just existing. But I feel hopeful that things will get better. It’s already started getting better. I’m having ongoing struggles with medication and other mental health-related challenges (depression, generalized anxiety, perfectionism, skin picking, eating/body image issues, and now all of a sudden anger and poor concentration), but overall I feel more in control of my life. I don’t have the answers yet, and I still have bad days pretty regularly where I withdraw or can’t think through the brain fog and exhaustion, but at least now I feel like I’m pointed in the right direction. It’s a start.
If you’ve had any experience with CBT or anxiety, or just have a thought on this post, I’d love to hear it. The thing about social anxiety is that it’s easy to get tunnel-vision and lose sight of the bigger picture. So please do comment if you’d like to share a thought or encouragement. 🙂
I highly recommend the podcast by The Minimalists, specifically their episode on Anxiety. That’s where I learned the advice that “Busy does not mix with anxiety.” I’m focusing on curating my commitments and goals to help me avoid the perpetual overwhelm that used to just be normal life for me.
What I’ve learned:
Perfect isn’t a place. You can’t get there. The truth is that there is no such thing as perfect. There’s only now. There’s only good enough. And you’re already there.