Sunday, February 15, 2009

The Challenge of Overcoming Shyness

Shyness is a problem that I’ve lived with for most of my life, and still live with now, but to a far lesser degree than in the past. I’ve always felt self-conscious and awkward in social situations, but one of the biggest problems for me has been making phone calls. I never had any trouble answering the phone, it was just making calls that terrified me. If I made a call, the first thing I had to do was explain why I was calling. I had to sound calm and professional, and make sense. I found that really hard to achieve when I was sweating profusely, breathing at twice my normal rate, and shaking like a leaf. Fortunately for me, email came into common usage around the time I began my professional career. I found that I could easily substitute email for any phone call. Well, almost any phone call. Every now I then, I had someone coming in with a name and a number on a little slip of paper, saying “I told this person that you would give ‘em a call.” Ughhhh!

The turning point came when I decided to sign up for a research study on social anxiety. Of course to get into the study, I had to make a phone call and set up the initial appointment! (Here’s an important word of advice to anyone out there trying to recruit volunteers for a social anxiety study: USE MAIL-IN CARDS!) Having overcome that one big obstacle, the experience went very smoothly, albeit with lots of paperwork for me to fill out on every visit. I met the diagnostic criteria for social anxiety disorder, which seems to be distinguished from shyness only in that it must have the additional effect of causing a person distress or of being debilitating in some way (so people who are happy with their shyness wouldn’t qualify). The study’s purpose was to investigate whether a combination of medication plus therapy was more effective than medication alone or therapy alone. I was randomly assigned into one of five treatments: fluoxetine alone, therapy alone, fluoxetine with therapy, placebo with therapy, or placebo alone. I received a container of pills, so I immediately knew that I was either in the fluoxetine group or the placebo group. At first I wasn’t sure what I taking, but after about two weeks of pills, I went in for an evaluation. The psychiatrist asked me many questions about whether I detected any difference in my anxiety level, and I could tell by the way she reacted to my answers that she’d concluded that I was in the placebo group.

After several weeks, the study ended and I was officially told that I had been taking a placebo. However, the study stipulated that every participant was entitled to a real treatment, so at that point, I was offered a choice between six weeks of therapy or six weeks of fluoxetine. Since I personally dislike taking any medications, and I wanted a permanent change, I chose therapy.

The cognitive-behavioral therapy had two basic components. One was to examine and counteract my negative self-talk, and the other is to confront my fears in a graduation and controlled way while the therapist provided lots of encouragement and positive reinforcement. I was asked to write down my thoughts when I got anxious. Many people with social anxiety talk to themselves in a negative way: “She’s not going to like me. She thinks I’m an idiot”, and so on. I didn’t have very much of that, although I do tend to assume that people won’t be very interested in what I’m saying. The second component was more useful for me. It consisted of making a list of goals. I had to write out the things I was afraid to do, then rank them in order from easiest to hardest. Then each week, I had to do one or two things from the list, beginning with the easiest, and report back on how it went. So, I began making phone calls. The easiest kind of phone call for me to make is the short business phone call, so I started by replacing some of the interactions I would have normally done by email with the phone call. One really useful thing for me is mental rehearsing. If I was having trouble making the call, I would relax, breath deeply and imagine what I would say in detail. I would also imagine getting a courteous response. After a few iterations, I was able to feel calmer about making the call. I moved from there up to making social calls, but just with the intent of asking a question, not extensive chatting. My therapist and I got along quite well, and she kept asking if I wanted to keep on coming, which evidently wasn’t a problem within the constraints of the study, so I ultimately had about 20 sessions with her.

One the most valuable things I gained from the therapy experience was getting reassurance that my social skills are actually pretty good. I had this lingering fear in the back of my mind that maybe I grated on people somehow, that it might actually be unpleasant for them to talk with me. But I asked my therapist that, and we had practice conversations, which both of us seemed to enjoy greatly, and she told me that my social skills are fine. Knowing that it’s someone’s job to tell you the truth means that you can have total confidence in her answers. My hangup is just fear really, and the only way I’ve found to diminish fear is to do the thing I fear and see that it’s not so scary after all. It was really helpful to me to go through the experience, and to learn that my fear really doesn’t know best. The fear was telling me that something bad might happen, but when I pressed on through the fear, the bad thing never came. I learned to challenge my fears and not be ruled by them. I’ve also come to distrust strong emotion in generally. I find if I’m feeling calm and relaxed, my intellect and my intuition work pretty well and can be relied on, however, if I’m upset, fearful, angry, or even highly elated, then my judgment needs to be questioned much more carefully.

What’s been really helpful to you in overcoming a fear or negative experience in your life?

3 comments:

  1. Clarissa - I have this to the nth degree, and have had since I was teeny. Before I even started school. School was excruciating, and I developed selective mutism (which I keep misspelling as MUST-ism: that surely means something! LOL!). Which of course developed into worsening anxiety & travel phobia (I still deal with that one today) & full blown horrible, miserable (did I mention horrible?) panic attacks. All of this was just called "shyness" or "homesickness" when I was a child, but as an adult, I finally sought therapy for it all. I've been in that therapy for years & years - at least once a month, and I take medication. It took a long time to stop feeling ashamed of relying on meds, but I now accept it, which, oddly (or maybe not) allows me to treat myself more kindly, to stop thinking there's something wrong with me because I need meds to combat panic attacks. About 18 months ago, I bought a CD from Healing Journeys - a CD that literally changed my life. It is designed specifically for panic attacks - not just a relaxation CD (although those are quite helpful) & contained a specific exercise that just opened me up. Literally. All those years of therapy had NEVER touched that spot. Very weird - maybe all those years of therapy had prepared me for that moment, but who knows? THAT experience, in turn, led me to begin blogging, which has, in turn, led me to now see my counselor on an as-needed basis (only once since last April: I began blogging at the end of last February). YAY!!

    As I mentioned, I still experience travel anxiety/phobia, and that's a toughie, because I get physically sick, and trust me, you don't want to get that sick in the middle of traffic. And I would feel so sorry for whoever was sitting next to me on a airplane if I became sick. Sometimes I call my panic attacks "sick attacks" since my belly is so involved. ANYWAY (sorry!) I have a plan for this. it's one that makes me sad & breaks my heart, but I feel you must find the hidden gifts in heartbreaks. I have a 16 year old cat who is ailing, who requires a 6-day a week fluid injection, who is my heart, the light of my life. We have been together forever. She has been dealing with this condition since last spring & doing quite well & I am in no hurry to see her go. But when she does, I am allowing her to give me the gift of travel. I will no longer worry about her being at home alone - as I always did - and so I will take that opportunity to teach myself to move out into the world. Slowly, I know, at first, but it is the gift I will take from her, whether she knows it or not. I like to think she does.

    Whew! I'm sure you're sorry you asked! Forgive this long, long response, but it truly felt as if I'd been directed here. I found you via San @ Life with a View. I'll be back & I promise to not be so long-winded!

    :) Debi

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  2. Thanks Debi—I really appreciate your “long, long” comment. I can see that you too know the difficulties of being terrified by something that most everyone else considers ordinary, and I love finding a kindred spirit in that. I am thrilled to hear about your progress and your positive attitude. I love your blog too—I’m putting it on my list. I can see it will take a while for me to work back through all your older posts--you’re very prolific.

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  3. That I am. LOL! I am at this very moment agonizing about this upcoming Monday's blog - it will be my one-year blogiversary (shh - don't tell anyone!), so, of course, I think it must be perfect. :) The cool thing is that this past year has taught me that it really DOESN'T have to be perfect, that it will be fine however it evolves. I will add YOU to my list, and we can keep a hand out for each other, if needed. Thank you!

    :) Debi

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