128: Intense Social Anxiety–I’m Losing Control! What Can I Do? Part 1.

128: Intense Social Anxiety–I’m Losing Control! What Can I Do? Part 1.

Feedback from last week’s workshop from the woman who provided the example of a political conflict with her mother:

Hi David and Fabrice,

I listened to the podcast on the way to work today, I loved it! Felt honored by the kind attention David and Fabrice gave to this.

Using the 5 secrets has led to a much healthier and loving relationship with my  mom, and her Xmas visit was so much nicer than others have been, because I understood so much more about what her political stance means to her. I think it is a way for her to stay connected to my dad, who died 5 years ago–they loved to talk about politics together, though he was as brainwashed as she is. 😉

That allowed me to realize that her vote for Trump, and her failure to understand how horrifying he is, wasn’t a personal swipe at me. It was about longing and connection, and although it seems twisted to me, her Faux news/Alex Jones/Sean Hannity group on TV is a reliable community for her.

Anyway, I think she felt more loved and accepted and valued when she stayed with us this year, and I feel really great about that. Thank you all for the guidance and great teaching!

Eileen

Thanks so much for that wonderful note, Eileen! . . . And now for today’s show!

You CAN Defeat Shyness!

Lately, I’ve gotten lots of emails from podcast fans who struggle with shyness, which is categorized in DSM5 (The Diagnostic and Statistical Manual of Mental Disorders) as “Social Anxiety Disorder.” This is one of my favorite things to treat, since I struggled with practically EVERY type of social anxiety early in my life, so I really know how it feels and how to defeat it. It’s incredibly common. In fact, when I give workshops for mental health professionals, I sometimes ask how many of them have struggled with shyness or public speaking anxiety, and nearly all the hands go up.

This podcast will be the first of several on this topic, because it’s so common and relatively easy to overcome–IF you have the courage!

Here the are several different “flavors” of social anxiety recognized by the American Psychiatric Association, including:

  1. Shyness
  2. Public Speaking Anxiety
  3. Performance Anxiety (such as intense anxiety during a musical or athletic performance)
  4. Shy Bladder (or Bowel) Syndrome. This is the fear of peeing or pooing in a public restroom, for fear you’ll freeze up or make too much noise and others will notice.
  5. Test Anxiety

One common theme is the fear that others will notice your anxiety or poor performance and judge you. Another common source of suffering is shame of feeling like you are inherently flawed and will be seen as defective or even as insane by others. Sometimes, these fears become so extreme that they can significantly interfere with relationships and leisure-time activities as well as work.

Dan is a podcast fan who courageously immigrated to the United States from Iran as a young man. When he arrived in America, he had little education and almost no knowledge of English. He also suffered from an extreme case of acne, which eventually cleared up, but left him with severe social anxiety.

In spite of these problems, Dan worked hard, learned English, and became a top student in college and in graduate school as well, and went on to develop an excellent career. But in certain performance situations, such as public speaking or interacting with strangers, he panics and trembles and his heart races; his mouth twitches and his voice gets shaky, and he has thoughts like these:

  1. I’m about to lose control over myself.
  2. Others will see my symptoms and think I’m mentally insane.
  3. In spite of making Herculean efforts to control these symptoms, I have failed.
  4. I will never overcome this.
  5. I am defective for life.
  6. I will lose my job.

David and Fabrice remind listeners that they cannot treat anyone through a podcast, and that there are large numbers of treatment techniques that can be extremely helpful in the context of a compassionate and skillful therapeutic relationship. Since Dan is seeing an excellent therapist, they suggest and illustrate five powerful Interpersonal Exposure Techniques that Dan might want to do under the supervision of his therapist, including:

  1. The Survey Technique
  2. Self-Disclosure
  3. The Experimental Technique
  4. Shame Attacking Exercises
  5. The Feared Fantasy Technique

David and Fabrice also discuss how to address patient and therapist fears of using powerful exposure techniques, and how the avoidance of exposure can sabotage the treatment. They describe four techniques David as developed to help therapists with this, including:

  • Dangling the Carrot
  • The Gentle Ultimatum
  • Sitting with Open Hands
  • Fallback Position

David describes “Reverse Hypnosis.” This is where the patient hypnotizes the therapist into giving up on exposure thinking that it is “too dangerous,” or that the patient isn’t “ready” or is “too fragile.”

And speaking of anxiety, listeners might want to consider the upcoming workshop by David and his colleague, Dr. Jill Levitt, on the treatment of anxiety disorders on May 19, 2019. Check it out below!

Also, I promised to post my list of 100 Shame Attacking Exercises, so here it is! It’s not perfect, so please have low expectations. It does have some value.

Thanks. Stay tuned for more on Social Anxiety in future podcasts!

David

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Dr. Fabrice Nye currently practices in Redwood City, California and treats individuals throughout the world (but not across U.S. state lines) via teletherapy. You can reach him at fabrice@life.net. You can reach Dr. Burns at david@feelinggood.com. If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

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THREE COOL UPCOMING WORKSHOPS FOR YOU

TEAM-CBT Methods for Anxiety Disorders–

Step-by-Step Training for Therapists

by David D. Burns, MD and Jill Levitt, PhD

May 19, 2019

You can attend in person or from home via Live Streaming

Check it out now!

THERE WILL BE MANY EXPERT TRAINERS TO GUIDE
THE ONLINE PARTICIPANTS IN THE SMALL GROUP EXERCISES

Coming Soon!

Act fast if you want to attend! The February 10 workshop habits and addictions sold out early.

And there will be two awesome summer intensives for you this year!

THE INTENSIVES ARE ALMOST ALWAYS
THE BEST WORKSHOPS OF THE YEAR!

July 15 – 18, 2019
Calgary four-day intensive
Sponsored by Jack Hirose & Assoc.

July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis

042: Shame-Attacking Exercises

042: Shame-Attacking Exercises

Picture 9Making a Fool of Yourself — On Purpose!

In this podcast, David and Fabrice discuss a mind-blowing technique developed by the late Dr. Albert Ellis to help individuals struggling with shyness. It’s called Shame-Attacking Exercises. Essentially, you do something bizarre in public to overcome your fear of making a fool of yourself; and you will probably discover that the world doesn’t come to end. When used skillfully, this method can be incredibly liberating.

However, there are several ethical considerations. First, before therapists can ask their patients to do Shame Attacking Exercises, therapists have to do Shame-Attacking Exercises themselves! David explains his first, terrifying Shame-Attacking Exercise in a Chinese restaurant in New York after giving a talk at a workshop sponsored by Dr. Ellis.

In addition, therapists have to be careful in the way they use Shame Attacking Exercises, and who they use them with. You have to have an excellent therapeutic alliance with your patient, and the patient has to trust you. In addition, the exercises have to be in an appropriate location—for example, it would be disrespectful to do them in a hospital. And you have to be careful that the Shame Attacking Exercises is not aggressive or frightening to other people.

He also describes how Shame-Attacking Exercises helped a man and a woman he treated who were both afraid to flirt with people they were attracted to, and in both cases, he had to push fairly hard since the patients put up stiff resistance to the idea.

TEAM-CBT includes many powerful techniques, and while they have the potential to bring about rapid and often fantastic change, they also have the potential to hurt if not used skillfully and appropriately. Any listeners who are interested in using these techniques should first consult with a mental health professional to make sure the techniques are appropriate and likely to be helpful to you.

All that being said, you will (we hope) LOVE this podcast!

In upcoming podcasts, David and Fabrice will address questions on OCD (Obsessive-Compulsive Disorder) submitted by several listeners. Is OCD an organic illness? Are drugs necessary in the treatment? What’s the prognosis? David will describe powerful, drug-free treatment methods based on the four models he uses to treat all anxiety disorders: the Motivational, Cognitive, Exposure, and Hidden Emotion Models.

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