social anxiety disorder

Anxiety Is Like A Metal Detector

By Annabelle Parr

I spend a lot of time reading articles related to enhancing mental health, to highlight and repost relevant pieces, as I value spreading awareness in this area. It’s wonderful that the conversation around mental health and anxiety is more open than it used to be, reminding us that our struggles are deeply human and we are not alone. But one thing I notice is that sometimes the way anxiety is discussed – even with the utmost compassion, can still imply that anxiety is bad. 

Don’t get me wrong; anxiety can lead to problems in our lives. Anxiety can turn into a full blown anxiety disorder, and by definition, anxiety disorders cause significant distress and impairment in a person’s life. And even if we are not in the realm of a full blown anxiety disorder, it can be very uncomfortable. So uncomfortable that sometimes we make choices designed to avoid or get rid of anxiety at the expense of what matters to us.

It’s true that anxiety, and the way that we respond to it, can be a problem.

However, I think when we focus exclusively on the negative parts of anxiety, we are missing a big piece of the picture that can empower us to change how we relate and respond to it. Anxiety – like any feeling – is information. And most of the time, at least part of that information has to do with what is most important to us in our lives.

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For example, if someone experiences a lot of social anxiety and fear of judgement, what might that say about what matters to them? It might mean that they deeply value connection and relationships. Maybe it is really important to them to show up in their relationships as kind, compassionate, engaged and authentic, and maybe the anxiety has to do with worrying that something they could say or do will be incongruent with those values.

The problem with anxiety occurs when we take our anxious thoughts at face value,

and when our behavior is driven not by our values, but by trying to avoid the feared outcomes our minds generate. For example, social anxiety might involve thoughts like “I can’t go to that party. What if I make a fool of myself or say something stupid or am too anxious to even talk, and my friends don’t want to hang out with me anymore?” Such thoughts can feel very real and powerful, and our instinct is not usually to get curious about what they might indicate about what is important to us.

Instead, our instinct is often to think that outcome is likely, and to decide to stay home from the party to avoid anxiety and try to prevent rejection. But if instead, we can notice that thought, get curious about why it is visiting us and what it says about what is matters to us, we might recognize that in fact we deeply value connection. So much so that it feels excruciating to risk the possibility of rejection. And yet, in not going to the party, we are certainly missing an opportunity for the connection we so deeply crave.

When we can identify the values underneath the anxiety, we then get a choice about what to do next.

Getting curious about our values and what is really meaningful to us in our lives then allows us to identify actions that would move us in our valued direction. For example, you could choose to go to the party even though you are feeling anxious in service of your value of connection, or you could choose to stay home in order to experience relief from the anxiety.

From an Acceptance and Commitment Therapy perspective, our pain and our values are like two sides of the same coin: if we flip the pain coin over, we find what means the most to us in our lives. Or, as one of my clients said, anxiety is like a metal detector: when it starts beeping and getting loud, it means there is treasure under the surface, and that treasure is your values.

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Sometimes it can take some curiosity and creativity to get to the core of what the value is, because anxiety can be sneaky and tricky and it’s not always immediately apparent. But if we can look at anxiety as important information, it can help us change how we relate to it. We don’t need to make it go away, we just need to figure out what really matters to us and make choices toward our values.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

What If Everything You Know About Anxiety Is Wrong?

By Annabelle Parr, MA, AMFT

When we experience anxiety, our minds are really good at coming up with all kinds of “what if” thoughts. And those worried thoughts often deal in extremes and absolutes, like the title of this post.  

Good news: it’s unlikely that everything you know about anxiety is wrong.

If you’ve ever experienced anxiety, at the very least you know what it feels like in your mind and your body. But it is possible that some of what you’ve learned about anxiety is not workable (that is, it doesn’t move you toward the kind of life you want to live).

Anxiety in the information age:

These days, the internet is filled with articles and podcasts discussing stress, anxiety, and self-care. It is so important to make information accessible and to talk openly about the difficult and painful parts of being a human. When we are suffering, knowing that we are not alone in our experience can make all the difference.

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As much as it is wonderful that these topics are getting so much air time, the way we talk about them matters.

As anxiety is a rather hot topic these days, we decided to bust some of the common myths that, though well intentioned, can actually keep us stuck.

Myth #1: You can self-care your way out of anxiety.

There is a fair amount of content out there that sends the message that if you just take enough bubble baths, do enough yoga, or drink enough herbal tea, your anxiety will finally go away. Or that if you’re ever going to get a handle on your anxiety, you have to eat healthy, get good sleep, and exercise regularly. None of those activities are bad or wrong, and they can help us feel good.

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But when we engage in a behavior (ANY behavior – even “healthy” behaviors) where the purpose is to control or avoid our internal experience, we may paradoxically find ourselves even more stuck. Our anxiety might go away momentarily, but we may find that in the long term (or even in the middle of downward dog) our anxiety actually gets more powerful. And then when anxiety doesn’t go away, we think that we are doing self-care wrong, or worse, that there is something wrong with us since it’s not working. Cue cycle of chugging herbal tea and feeling anxious about the fact that we are still feeling anxious. 

Myth #2: If you just got the hang of positive thinking, you’d be anxiety-free.

If positive thinking works for you, helps you cope, and allows you to be the person you most want to be, carry on. But if it doesn’t, you are not alone. When I am at my most anxious or upset, trying to convince myself to believe a more positive thought often makes me feel worse. I might be able to come up with a more positive thought, but then I just feel frustrated that I can’t make myself believe it. Research supports that trying to suppress our thoughts can actually increase the frequency and intensity of the very thought we are trying to avoid.  

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While traditional Cognitive Behavioral Therapy works on helping people to engage in more balanced thinking (NOT unrealistically optimistic positive thinking), Acceptance and Commitment Therapy can help us change our relationship to our thoughts. Our thoughts, after all, are just words. Sometimes they have helpful information to share, but they aren’t always great at communicating it to us. 

Myth #3: You need your anxiety to go away before you can do the things that matter to you.

Anxiety is good at convincing us that we can’t or shouldn’t do things that matter to us until we feel less anxious. But the best antidote to anxiety is doing what matters to you even when anxiety is at its loudest. Because here’s the thing: anxiety typically shows up around the things that you care most about. So if you wait for anxiety to go away before you go after the life you want or before you show up as the kind of person you want to be, you may end up waiting forever.

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So is your anxiety coping skills toolkit workable?

Workable simply means: does this behavior help you move in the direction of your values (who and how you want to be in the world) and does it have a cost to you? So if you have a stellar self-care routine that helps you feel more present, engaged and able to show up in your life as the person you want to be, keep doing your thing. And if positive thinking has helped you live a more meaningful, fulfilling life, keep it up.

But if you find that you are trying to control your anxiety and make it go away, and instead it just keeps getting more powerful, more intense, and more uncomfortable as your life gets smaller and more restricted, Acceptance and Commitment Therapy (ACT) may help. ACT is designed to help you change your relationship to anxiety and help you develop psychological flexibility: the ability to do what matters to you no matter what.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, MINDFULNESS, AND TELEMENTAL HEALTH SERVICES. SAN DIEGO PSYCHOTHERAPY CAN HELP. WE CAN BE CONTACTED AT 619-269-2377.

I Get Nervous in Social Situations…Do I Have Social Anxiety Disorder?

By Annabelle Parr

Most of us probably know what it’s like to feel nervous about public speaking or before going on a first date. We might feel anxious before a job interview, or find our palms get sweaty right before we shake hands with someone we’ve just met. But for the 7 percent of US adults that experience social anxiety disorder in a given year, the fear of humiliation and embarrassment can be debilitating (National Institute of Mental Health, 2017).

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What is social anxiety disorder?

Getting anxious in a social situation does not mean that you have social anxiety disorder. In order to receive this diagnosis (American Psychiatric Association, 2013), you must experience persistent fear or anxiety about one or more social situations, causing you to either avoid or suffer through the feared situation. In addition, you must also fear that your behavior will reflect your anxiety and that this will lead to negative social repercussions, like humiliation or rejection. Finally, the anxiety must be out of proportion to what might be expected in that context. This fear, anxiety, or avoidance around social situations must last for at least 6 months and it must make it difficult to function in important areas of life, such as work, school, or relationships. 

What are some examples of situations that trigger social anxiety?

Individuals experiencing social anxiety might find themselves feeling anxious about any number of situations, including making small talk with coworkers, interacting with the cashier at the grocery store, ordering a latte, going on dates, attending parties, eating in public, giving a speech or presentation, or performing in front of an audience. The main fear underlying social anxiety is experiencing rejection or humiliation.

Social anxiety isn’t all bad.

Like all anxiety disorders, social anxiety disorder is an adaptive response gone awry. The reason we all know that heart pounding, cheeks flushing, palms sweating reaction to a nerve-wracking social situation is that we have evolved physiologically to avoid any trace of rejection. Humans are inherently social animals, and our survival has depended upon our ability to function in the context of relationships. Beyond basic survival, relationships also add joy and meaning to our lives. As a result, we are literally neurologically wired to connect with one another. We achieve that social connection by concerning ourselves with what those around us think, need, and feel. Imagine a world where everyone only cared about themselves and paid no attention to the impact they had on others…yikes! So a little anxiety around situations that might result in rejection can be a really healthy, adaptive response. However, if you find yourself so afraid of rejection that you can’t be vulnerable enough to engage in necessary or meaningful social interactions, that’s when social anxiety can become problematic.

Risking rejection is part of the process of having deeper connections.

The paradox here is that in order to seek connection, you are also automatically risking rejection. You cannot get the joy and reward of interacting and bonding with others if you are not also willing to accept that this will sometimes result in pain, embarrassment, or rejection. Social anxiety disorder – unlike manageable anxiety that shows up in any number of vulnerable situations – hinders connection because the desire to avoid rejection overwhelms the impulse to seek connection. In other words, you miss out on both the risks and the rewards.

What are the consequences of social anxiety disorder?

When social anxiety reaches disordered levels, it can make it impossible to focus on anything but anxiety, so you are unable to be truly present in the situation and you white-knuckle your way through. Or it is so overwhelming that you avoid the situation entirely, and life becomes restricted by fear. It can result in isolation, loneliness, and underperformance in areas which you might otherwise excel. The catch is that the anxiety is so strong that it prevents you from learning that a positive outcome is possible. In Acceptance and Commitment Therapy (ACT), this is called experiential avoidance.

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Does social anxiety have to rule my life?

No! The good news is that social anxiety is highly treatable. With Cognitive Behavioral Therapy (CBT), clients can learn to reframe their anxious thoughts to be more realistic, as opposed to catastrophic. They can learn that anxiety is not all bad, but how we view it drastically affects how it impacts us. And with the help of a therapist, they can learn to slowly face the things that have come to feel impossible. ACT, the third wave of CBT, can also help clients to get in touch with their values and act in ways that bring meaning to their lives, even when they are experiencing something difficult, like anxiety or fear.

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Getting anxious in social situations is a pretty universal experience. It’s hard to find someone who has never been nervous about some kind of vulnerable, human-to-human experience. But when it becomes something that is making it difficult to engage in life in the ways that bring you purpose and joy, it might be worth reaching out for some help.

IF YOU FIND YOURSELF STRUGGLING, FEELING STUCK, AND/OR COULD USE SOME HELP NAVIGATING YOUR FEELINGS, YOU COULD BENEFIT FROM COGNITIVE BEHAVIORAL THERAPY, ACCEPTANCE AND COMMITMENT THERAPY, AND MINDFULNESS. DR. SHOSHANA SHEA CAN HELP. SHE CAN BE CONTACTED AT 619-269-2377.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

National Institute of Mental Health. (2017). Social anxiety disorder: Statistics [Webpage]. Retrieved from https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder.shtml