Social Anxiety, part 3
The first CBT technique I learned was Worry Record keeping, which I infer is a Cognitive Restructuring technique. It works as follows:
After each experience of social anxiety, fill in a Worry Record form to sort of report the incident to yourself. The purpose is to analyse and expose destructive irrational thinking patterns to take away their power and learn and reinforce new, more constructive cognitive approaches.
Recorded aspects typically include date, duration (when did worrying start and finish in relation to the event), degree of anxiety on a scale, symptoms (tick off from a list), and descriptions of:
- Trigger event
- Worried thoughts
- Anxious behaviours
in relation to each incident of social anxiety.
How it worked for me.
In the Social Anxiety case stories, worries were verbalised along the lines of (for example) ‘He thinks I’m incompetent’. ‘I am sweating and loosing control; people can see how nervous I am and think I’m a looser’. ‘I look like a complete idiot’. So they all evolved around a strong need for social accept and a strong awareness of social competition with other people. Moreover they had clear, consistent triggers.
Social acceptance in the workplace was essential for me too, and especially in focus in the beginning, but the examples didn’t ‘click’ with me. I could identify some thoughts that did fit the formula and I wrote all of them in the forms, but they didn’t seem to me like the drivers of the problems I experienced in my workplace of that era, and the exercises didn’t have any emotional impact at all at the time.
Miscommunication, and shyness as social protection
Initially when I started in the job in question, I was very shy and overwhelmed, and several of my colleagues were incredible supportive. Particularly one of the managers was very friendly and emphatic, and he made me his unofficial part time assistant when my area was quiet so the top boss didn’t get a chance to sack me for redundancy reasons (Top Boss was not a great fan of me).
This very friendly manager, who I was very fond of, often tried to engage me with friendly chat about random topics. He would start a conversation suddenly, usually with a question or remark that sounded like nonsense, but which required an answer nevertheless. I would be baffled for a number of long seconds, stumble through the sudden change of context, and then come up with a confused dorky reply in panic. That was my standard reaction to most friendly chat-attempts in the office.
The office culture was matey and informal. I wasn’t usually part of the casual group banter and couldn’t quite grasp what it was all about. I didn’t advance professionally either. I was just sort of parked in my corner, doing easy stuff.
Also, I was terrified of the Top Boss. His perfume, the way his corporate outfit sat on him, his gait, his standing position, his face expressions, his voice… basically everything about him induced paralysing horror. There was something predatory and stealthy about him, and no instruction manual for staying stay safe in the shadow of his perfectionism, moodiness, sharp intelligence, mind games and socially manipulative manoeuvres.
All in all the workdays were buried under layers of fear, miscommunication and boredom although there were nice aspects too (occasionally).
Over time the anxiety faded, but social miscommunication and boredom remained. I felt misunderstood and under-utilised and increasingly became cranky about the lack of relevant challenges. Basically, people seemed to have concluded that I was a bit slow in the uptake or mentally fucked up somehow, and not really useful in a practical way. I was just ‘the stranger amongst us’ doing my own stuff inside my own little world.
I reasoned that I was deliberately kept out of the loop from any strategic things going on, as if I was a spy or something, and started to become very defensive of the narrow areas of responsibilities that I did have. I had a good degree of autonomy under my direct boss, and that worked. But whenever my direct boss went overseas, a micro-war started up between the replacement manager and me. The other manager wanted to micromanage and change the way things were done to his way, and I fiercely defended my territory against loss of control.
In a sense my social situation became more conflict ridden and complicated once I shed most of the shyness that initially kept me quiet and out of control, but sweet and flexible. I can see how shyness tends to trigger goodwill and helpfulness in people, and in some ways serves as a layer of protection which can cover up more complicated social incompatibilities.
I expect that if I’m blushing, if people can see that I’m nervous and stumble across my words, that they will be gentle; supportive. People tend to be kind to people (and animals) who seem vulnerable. That’s my observation, and that is how I too react to persons whom I perceive to be shy, vulnerable and out of their element. So I don’t understand why the case story characters were so convinced that symptoms of shyness would generally cause people to judge them.
Worry Recording when it works well
However, I later used and still occasionally use the principle of Worry Record keeping (and cognitive restructuring overall) successfully in some situations.
For example, I used to get myself worked up when I drove to meetings with a girl I planned to start small a business with. I was afraid to scare her off because I have a lot of respect for her, and see her as a very socially competent person, so I feared she would pick up on my difficulties and loose confidence in me. I knew she considered me to be assertive, and that was one of the reasons she teamed up with me – that was a trait she needed. So I was afraid to come across as awkward and helpless.
The meetings always went well (albeit were exhausting); we worked well together as a team, and she expressed enthusiasm about the project and the teamwork, so the perceived risk of being ditched was probably ‘just in my head’.
At some point when I drove to one of our meetings, I got fed up with myself and my destructive nervous tension, so I stopped my car in the roadside and did a simple ‘Worry Record’-like entry in my iPhone notebook:
- How do I feel – which anxious feelings?
- What are my negative assumptions about how I may be perceived by others (her)?
- What can go wrong – What is the worst case scenario?
- What would be the consequences?
- How likely is it? (in %)
It helped! I arrived in a much more relaxed mode than usual and from next time I drove there, the anxiety was totally under control. A surprisingly quick and efficient ‘cure’ against a destructive irrational thinking loop. – I guess that’s a beautiful text-book example of CBT effectiveness.
… and when it doesn’t
Worry Records (and similar methods) can work well when there is a clearly destructive thinking pattern associated with a particular trigger; where the symptom emerges predictably before the trigger situation; and where the thinking pattern is clearly irrational. That criteria doesn’t apply to the majority of my anxiety issues.
For example, I don’t like crowdedness, and a trigger for me is to be stuck with a large unfamiliar group of people in a confined space over many hours (e.g. a large meeting, or air travel). Trigger situations don’t necessarily trigger anxiety, but they may. When they do, the fear isn’t entirely irrational. Panic attacks can cause me to pass out and in a work-related meeting, a workplace, on a plane or when driving a car, passing out can potentially be embarrassing and have severe repercussions.
The potential consequences of passing out is the real trigger. Passing-out incidents can look like epilepsy, last over 20 minutes (so some people have said), cause people to call an ambulance, and I’m pretty sure, could cost me my job (where driving is essential). Traffic safety is obviously a major concern in that regard.
‘How likely is it to happen?’ I have no clue. Passing out happens rarely, but does happen. Panic tends to strike like lightning coming out of a blue sky, rather than build up gradually**. Mild anxiety may linger for a while until suddenly it isn’t mild. I often can’t imagine feelings in advance that I’m likely to feel in the future, like anxiety the next day at a certain event. I often can’t emotionally remember feelings I’ve had in the past either. That makes it hard to prepare mentally for trigger situations and analyse them afterwards.
Out of control panic may suddenly loom when I drive on the motorway to attend a day training session, or after I sit down at the table in a room with 30+ people and know I have to stay there for at least 3 – 4 hours. I am not afraid to talk and participate – on the contrary, I like it: task focus overrides shyness with ease. I am afraid of panic sensations, but only because they could cause me to pass out. I might feel like I’m ‘freaking out’, then half an hour later I’m like a fish in the water, and then a few hours later, someone talks and talks, I’m bored, and suddenly panic sensations loom again.
What’s the ‘worried thoughts’? Restless sensations, frustration that a person keeps talking or talks too slow, an urgent need for physical movement, fear of panic. Not really good record-material.
A similar pattern applies to air travel; another of my triggers. Being strapped in my seat hour after hour, squeezed in between strangers with restricted mobility, can cause intense panic sensations and dizziness (and yes, I have passed out on a plane).
However, I don’t think of that when I plan the travel, buy my ticket or board the plane. I know that I’ll probably feel anxious in the plane but I can’t imagine how it feels like, so I’m unworried. I sort of don’t have empathy with myself! Not even when I strap on the seat belt and when the plane takes off am I worried. But every now and then after some hours and before some more hours, without any obvious trigger, panic strikes and creates what feels like urgent crises with physical impacts.
The only thing that seems to work in that situation is to move, walk around on the plane, stretch, touch different surfaces, touch cold windows, look out, drink water … physical activities and sensory stimulation.
Physical stimulation is my universal anti-anxiety and anti-stress strategy, the only one that seems to work once the ‘thinking’ stage is surpassed and the stress gets physically intense: I try to distract myself, release pressure physically and wait it out.
If I’m driving then I turn on air conditioning to literally cool down. Rhythmic and repetitive activities and familiar pleasant touch sensations are calming. Drive with a hand in the open window, feel the air flow on the skin; sense familiar hard plastic surfaces under the fingers, listen to music or familiar radio hosts, sing, hum, imagine things, plan ideas. I planned how I would rewrite this post last time I experienced a driving-anxiety incident (I wasn’t happy with the draft).
After a while, I notice that the anxiety is gone. It may come back later. Anxiety is an unpredictable energy force.
*This whole series was drafted more than a year ago, and has been ‘stuck in the pipe’ with all the other drafts since then!
**However, passing-out has a reasonable long lead time and only happens under unfortunate circumstances if I have to force myself to remain in a stressful situation for hours or days
Illustrations from OpenClipart.org with Thanks! (except the 2 cartoon figures, which are made by me)