Have you ever wondered why you are having a pleasant emotion like happiness or peace? Most have not. We just accept those emotions and move on. But everything changes when we are feeling discouraged, fearful, or angry. I’d like to share with you a CBT strategy that has been helpful to many people who face negative feelings. I call it the STEPP model.

One of the key concepts of cognitive behavioral therapy (CBT) is the idea that our thoughts affect how we feel. Many people struggling with depression or anxiety say that these emotions make them feel stuck. When this happens, they often don’t know what really causes these feelings or what to do about them. The STEPP model is designed to break down your experiences. This will give you a better understanding so you can find ways to help get unstuck in the future.

Emotion – E in STEPP

Let’s start with the orange circle in the middle – the emotion. The question is where does this emotion come from? Many people incorrectly believe their emotions come from a situation, which you see at the far left of the model (the dark rectangle). 

Do you ever ask yourself “Why am I angry right now?” That anger is an emotion. That emotion can be triggered by many different things, such as two co-workers grinning at each other when you walk by. This is known as the situation.  

As you can see from the model, it is more complicated than that. Not every person would have the same emotion in that situation. Some people would feel embarrassed when they saw those co-workers smiling at each other. Others would have no strong emotion. And some might experience the warmth of happiness. 

Thought – T in STEPP

How could the same situation cause such different emotions? Looking at the model, it shows that thought; is in between situation and emotion. These thoughts are often a reminder of a past situation. Or a prediction of things to come.  

If the ‘thought’ was “those two grinning coworkers were laughing at me”, you would clearly feel anger. But if the ‘thought’ was “those smiling coworkers were happy and having a pleasant time,” I might feel my own smile appear. Maybe even feel a bit of happiness. See the difference? 

Developing the STEPP Model

When I developed the STEPP model several years ago, I looked at Albert Ellis’s ABC model, among other models of CBT. The A in the ABC model is for “Antecedent.” Since I am committed to avoiding complex language, antecedent had to go. Other models showed arrows going in both directions between our thoughts and emotions. While there are advantages to these models, I’ve found that with a cleaned up straight model, you can do a lot more. 

Emotion can be broken down into three smaller parts: 

• The name of the emotion 
• The physical sensations 
• The impulses that go with that emotion 

When people have a hard time knowing how to label that emotion they are experiencing, it often helps to first identify the physical sensation and impulse. For example, if my physical sensations are tight muscles and feeling hot, and my impulse is to yell at someone, the emotion is most likely anger. You get the point. 

I wanted to make it easier to identify the thought. Usually, a well-trained CBT therapist would ask individual clients in their office, “What was going through your mind at the time?” Many clinicians can make this kind of questioning work well. However, there is risk of potential confusion. 

The person who walked past the grinning coworkers might say they were thinking “I just wanted to yell at them to go away”. Or maybe they were thinking, “Those two had big grins on their faces.” Those are thoughts, right? They certainly are, but notice that the thought of yelling at them was really an impulse. An impulse is the urge that goes with the emotions–to fight back when angry in this case.

Which Thought Caused My Emotion?

The reference to their big grins was more of a restatement of the situation. This is not a helpful thought that we can later inspect. And certainly not a thought that produced the emotion. To help identify the thought that caused the emotion, I developed something that I call “sentence stems.” 

For each emotion, there are a number of thoughts that are most likely to produce the emotion in question. If I am trying to identify a thought, I can start with the sentence stem. Then personalize it to my situation. Now I have a thought that matches what I was experiencing, that explains my emotion. I will now be able to examine closely in the future.  

Here are a couple examples of sentence stems:  

For anger:

• ____ did it on purpose. 
• ____ should not have done that. 
• ____ did not respect me. 

For anxiety:

• I might not be able to ____ 
• They might think ____
• What if ____

Performance and Precautions – P & P in STEPP

The two Ps in STEPP stand for performance and precaution. Performance are the things I say and do or don’t say and don’t do. Precautions, often called safety behaviors, are the things that I do to try to feel better that ultimately keep me stuck–things like comfort eating, substance use, blocking out my feelings. The fact that my performance does not match my impulses often is evidence that each of us possesses a high level of self-control. Meanwhile our precautions might seem like a way out of our struggles, but they just keep us believing we are unable to take on life’s challenges.

It All Comes Together

When we understand how all these pieces fit together, we can gather strength to handle those troubling emotions. When we look into the thoughts, we can often see that there are more accurate and helpful thoughts that could replace them, so have the opportunity to feel better. On the other hand, we can choose to form a new relationship with those troubling thoughts and learn to let them come and go. 

I hope that you have plenty of pleasant experiences to enjoy freely today. But any of us with strong troubling emotions might see a warm light of hope appear when we see that it was just a thought that was driving those troubling emotions. Sometimes, that is all it takes. 

In the face of a challenging situation such as COVID-19, how can we be resilient? In other words, how can we make adjustments for the difficult conditions without putting our lives on hold? Here are a few suggestions for handling the stress from the current situation.

• Listen to reliable sources. Social media is a better source of entertainment than a source of truth. We are more likely to find reliable information and keep our stress down by seeking advice from medical professionals and organizations such as the Center for Disease Control (CDC).
• Make the best of things. Once you know your options and adopt a plan, it’s time to settle in and do life. Choose to make the best of things and accept that there is uncertainty in all times.
• Resist predicting the future. We all have to live with uncertainty at times because we simply cannot predict the future with full accuracy. Try challenging fortune-telling thoughts by asking, “Do I know for sure that this is true?” And consider what other outcomes could occur. The future is full of possibilities, but our mind often gets stuck on one particular idea.
• Acknowledge the worries, but don’t let them overtake you. It can be hard to accomplish our greater life goals when we’re constantly distracted by worry.
  • Step 1: Recognize your fearful or anxious thoughts and feelings.
  • Step 2: Allow the fear and anxiety to come and go without seeking to change or even act on them.
  • Step 3: Revisit your worries later when you can address them. Try talking to a friend, journaling about your concerns, or even creating an action plan.
• Keep doing rewarding activities. In times of high anxiety, we’re more likely to avoid doing things that would otherwise boost our mood. Resilient people take reasonable precautions, but they also accept risks that are out of their control and engage actively in the world as much as they can.

No one wants to get sick or face a challenging recovery—with COVID-19 or any other illness. But worrying about the unknown is not helpful either. Give these strategies a try. They may help you find peace, and maybe even growth, in a time of great uncertainty.

The four most commonly recognized communication styles are:

1. Passive
2. Passive-Aggressive
3. Aggressive
4. Assertive

Passive communication often comes from a place of low self-esteem. Passive communicators frequently don’t speak up for themselves or assert their wants or needs. They may feel as if their feelings and opinions don’t matter, may not look people in the eye, and may even apologize for speaking up. Over time, being passive may lead to built up frustration or anger.

An example of Passive communication:
Sarah disagrees with Mark, but doesn’t want to speak up because she doesn’t like conflict. She looks down and nods her head in agreement, even though inside she dislikes how he is always getting to state his opinion.

Passive-Aggressive communication involves expressing negative feelings in a hidden, or indirect way. The person is still trying to avoid conflict, but the feelings come out in a roundabout way.

An example of Passive-Aggressive communication:
Sarah asks Mark, “Are you wearing that to the party?” triggering hurt and embarrassment for Mark. But rather than tell Sarah that he was bothered by the comment, Mark retaliates by slowing his efforts to get ready for the party, knowing it is important to Sarah that they get there quickly.

Aggressive communication has unfortunately impacted most people at times. The person who has been aggressive often expresses him or herself in a way that hurts others, often in response to their own anger or drivenness. Can you think of such an interaction? You probably ended up feeling hurt or insulted.

An example of Aggressive Communication:
Sarah is upset with Mark’s choice of restaurant for the night: “I can’t believe you chose this place again. You have the worst taste! How could you be so stupid? Why would I want to go here?”

Assertive communication is often the most effective and kind way to communicate. You are able to express your feelings and opinions directly, without deliberately offending or hurting others. This type of communication can be challenging, because you often must be brave (you are sharing your own wishes) and honest (sharing your true feelings can be hard). If you practice, communicating assertively typically becomes easier over time.

An example of Assertive communication:
Sarah wishes that Mark would put down his phone when they are having an in-person conversation: “Mark, I would really appreciate if you would put your phone down when we’re having a discussion. When you are looking at your phone, I have a hard time knowing if you’re listening to what I’m saying, and I wonder if what I’m telling you just isn’t important to you.”

Sarah probably felt a little nervous telling Mark how she felt, but she expressed herself honestly and in a respectful way. Hopefully, Mark will put down his phone and listen to Sarah during their next conversation and they will both feel better about how they are communicating.

Being assertive doesn’t come naturally to everyone. Sometimes it seems easier to give in to others, or more natural to get what you want by ordering people around. If your parents communicated this way, then it may seem normal to you. These types of behaviors are learned. The good news is that we can unlearn unhelpful behaviors. Persisting in problematic communication strategies—communicating passively, passive-aggressively, or aggressively–often leads to feelings of anger, resentment, irritation or isolation. Assertiveness can be learned through repeated use. There’s always time to change…here are some things to think about when you are interacting with someone with whom you have a relatively good relationship:

• Tell the other person what they’re doing.
• Tell them how it’s affecting you.
• Tell them how you feel about it. (Try to use “I” and express feelings rather than thoughts)
• Respectfully, tell them what you’d like them to change.

Each time you’re assertive, it will likely become a little bit easier. Gradually, you may start to notice that you feel better about yourself, and the relationships you have with others will be more satisfying. Change isn’t easy, but being assertive is worth it.

“It’s not that I was no longer afraid, but as it turns out, you can practice being afraid. The more you do it, the less daunting scary things feel. Also, I learned that nothing is as scary in reality as it is in your head.”

Below is an excerpt from her blog post, Psychologist Dr. Russell Morfitt on How to Deal with Social Anxiety:

______________________________________________________

What can a Learn to Live member expect from the program? How long does it last? What’s the commitment like?

Dr. Russ: Structurally, the Learn to Live Social Anxiety Program consists of eight interactive, multimedia lessons with practice exercises to complete in between. We recommend completing about one lesson per week. Periodic assessments help members to set goals and track their progress along the way.

Members quickly learn that they are not alone, which is very powerful. Throughout the program, they learn the key tools of CBT and how to apply them in their personal situation. Members also learn how to build up their social support network, a trusted group of friends or family that may support and encourage them throughout the program.

And it’s not just thought-challenges and fear-facing exercises. These are important, no doubt. But sometimes it’s the small things in our lives, the tiny avoidant habits that add up to unhelpful thoughts and behaviors. Members learn to identify these habits and work toward changing them. The overall process involves learning online, then applying that learning to one’s life. It’s really the real-world practice that creates results.

______________________________________________________

If you want to find out more about CBT, the Learn to Live story, and social anxiety, here’s the full interview – Psychologist Dr. Russell Morfitt on How to Deal with Social Anxiety.

Molly has done a great job of connecting with other people who have faced their fears, like Jaimal Yogis of The Fear Project, and has even started her own #HeyEleanorChallenge, “a weekly email encouraging you guys to take itty-bitty steps (and the occasional big leap) outside of your comfort zone.” Sign up for the email list here. You can also like “Hey Eleanor” on Facebook or follow along with Molly on Twitter.

CBT stands for Cognitive Behavioral Therapy and is a form of psychotherapy that has been around since the early 1960’s. (There’s an interesting story about how the two most prominent founders of the model, Aaron Beck and Albert Ellis published their seminal books about the same time in the same year – so there has been some dispute over who was the first to formally present some of the key ideas.) CBT takes into account a person’s thoughts or perceptions, and how those thoughts or perceptions affect emotions and actions. We learn to identify our automatic thoughts or distorted thinking, after which we are better able to change those thoughts to something more logical or more useful. We can then begin changing our patterns of behavior, facing fears and eliminating unnecessary precautions, getting more active, or applying new alternative behaviors in place of the old actions that kept us stuck.

The skills of CBT can be applied immediately to problems we are suffering from in the present. And these skills become a helpful set of tools that can be applied to new situations as the challenges of life arise. CBT can be applied to work, school, relationships, and social situations – almost anything!

Among the most common reasons someone may seek out CBT are depression, anxiety, obsessive-compulsive disorder, social anxiety, and post-traumatic stress disorder (PTSD). What many people don’t realize is that CBT can be applied to a whole host of issues we face in our daily lives: pain conditions, sleep disorders, life stress, eating disorders…the list goes on.

In recent years, we have learned that CBT has another asset – learning how to change our thoughts and behaviors can be done from the privacy of our own homes. Internet-Delivered Cognitive Behavioral Therapy, (iCBT) has been demonstrated to be as effective as face-to-face therapy. The iCBT option means that those of us who may not otherwise choose face-to-face therapy – because of cost, stigma, or lack of options nearby – can still get the benefits of CBT.

CBT may sound like just another acronym in a world full of TLAs (three-letter acronyms). But really, it’s shorthand for a proven strategy for reshaping our unhelpful thinking and changing our unhealthy behaviors. Whether you need help with the stress of a new job, handling college life, or speaking in front of a group, CBT is a tool that can help you change your thoughts, your behaviors, and your life!

It’s a staggering statistic: 1 in 4 adults living in America have a mental health problem, such as anxiety, social anxiety, or depression. Given this, it would be natural to expect that it would be relatively easy to get help for these mental health challenges. But, curiously, it’s not. Here are a few reasons I have observed that help explain why:

1. Stigma or the fear of stigma. Despite the progress made through the #stopthestigma campaign, stigma has been a strong force over the years. Mental health problems have, at times, not been viewed as the real, treatable, health problems they often are. Talking about them has not been the norm. Whispers, awkward glances, and hushed conversations about something “not being right” have historically been commonplace.

We frequently fear being stigmatized when, in truth, we don’t really know if others will accept us or not. None of us wants to be labeled, but sometimes the fear itself—of being judged or labeled—is our biggest foe. Often, the best step we can take is to reach out and get the help we need, regardless of what others think. Often people find that others are compassionate when they learn of these struggles.

2. Cost. Mental health care, like any health care, costs money. Whether it means an office visit and the cost of a monthly prescription or 3 months of face-to-face Cognitive Behavioral Therapy (CBT), mental health care is not cheap. For many years, stigma and cost have prevented a large number of people from seeking help. With the enactment of the Affordable Care Act (ACA), cost has become less of an issue. The ACA has expanded mental health and substance use disorder benefits for 62 million Americans. Most health plans must now cover depression screening and behavioral health assessments at no cost, and plans are no longer able to deny coverage based on a pre-existing mental health condition.

Not all providers participate in insurance plans, but many do, so it is definitely worth looking into.

3. A shortage of mental health professionals. For many people choosing to seek care, distance and waiting lists pose an additional hurdle. While some areas may have a sufficient number of providers, there are many mental health provider shortage areas that continue to face growing needs, especially with the expansion of coverage under the ACA.

Sadly, even when therapists are accessible, they often fail to provide evidence-based care so the impact of the treatment is disappointing.

4. Fear is a pervasive obstacle. Fear of being labeled. Fear of therapists or therapy. Fear of admitting the problem itself.

Fear is a normal emotion with any challenge in life, but in many cases, working through that fear is a step in the right direction, a step toward help and healing. Many people have found that, if they can just take that first step, the fear becomes more manageable.

5. The nature of the beast. Anxiety and depression are, by their very nature, obstacles to finding a solution. In severe instances, many sufferers can hardly get out of the house or even out of bed. Other times people rationalize their thoughts and behaviors as “just my personality.” Coming to a point of acceptance about needing help and having the energy and courage to take a first step of asking for help are all part of the picture.

These factors are complicated and often compound one another. But our hope is that through awareness, accessibility, innovation, and courage, we can start to roll back this beast. Our #mentalhealthmatters.

“You name it – I can worry about it. My mother would tell you I “came out worrying.” For most of my life I accepted the worrying as part of who I am, much like my short stature or brown eyes. It’s just the way I was made! Sure, sometimes I couldn’t sleep or worried myself sick (literally – like urgent bathroom trip sick) before tests or important events, but for the most part I didn’t let on to anyone other than family or close friends that I was worrying or anxious. I could put on my game face and power through a speech, playing sports or performing in front of someone.

After college, I moved to a small town and began working as a medical professional. I didn’t know anyone there and I began to worry more and more about everything in my life- not just specific things like public speaking, but “How am I going to do this job? Am I ever going to meet anyone in this small town? How do I manage all these new bills and responsibilities of being an official adult?” One night as I was driving home from working at the local hospital, my worrying spiraled. I began having what I can now identify as a panic attack. I was breathing fast and felt light-headed. That episode was different for me, more intense. It led me to seek help.

I found a local psychologist who did individual therapy, but also recommended I join a group of other young women with similar experiences and feelings. The therapist and the women helped me immensely. I didn’t know it at the time, but she practiced cognitive behavioral therapy (CBT). I made lists of my thoughts and then examined them rationally. I learned how to stop my “stinkin thinkin” (her words, not mine). The group of women became my community. We supported one another, laughed, cried, and gave each other reality checks. Gradually, I learned to stop the anxious feelings and worry before they gained any momentum. I was able to take away tools that have helped me in almost every situation in life: a new job, a new relationship, waiting for medical test results, even exciting (but potentially anxiety provoking) events like getting married or going on a vacation. I’ve learned that I can’t control the situation, but I can control my thoughts, attitudes and actions. There isn’t much that makes me anxious these days…well, there is one thing: swimsuit season.

The last time I was excited to wear a swimsuit I was 12. It was red and had “Coca-Cola” written all over it. It was cool. I was cool. The next summer, something changed. I noticed my body in ways I hadn’t before. I became acutely aware of a birthmark on my leg, and felt my larger thigh (yes, I actually measured them to determine that one was indeed slightly larger than the other!) jiggle conspicuously. Everyone was looking, right?!? I must have the strangest birthmark, weirdest shaped leg and wobbliest bits of anyone at the pool. Walking in front of people was a chore that I avoided at all costs without a large towel or cover-up. My swimsuit-body-anxiety was only amplified by magazines showing only “perfect” airbrushed bodies (I didn’t know that at the time) that were nothing like mine.

Oh, hindsight. Had I known the tools of CBT  that I know now, I would have used them in the dressing room under the fluorescent lights as I dissected my body or before I walked in front of the “crowd” at the pool. I would have made myself examine my thoughts:

• “Is everyone really looking at you?” No – they are too worried about themselves or have fallen asleep in the sun or are chatting with friends.
• “Is your birthmark really that bad?” No – it’s unique and in a strange spot, but most people probably don’t even notice. Remember that one person who actually told you it was cute?
• “Can everyone tell that your one thigh is larger than the other?” No – not unless they take a tape measure and wrap it around your leg. Are you kidding me?

I would have encouraged myself to look around, engage with people, splash and play, have fun! I don’t have the same swimsuit anxiety that I did when I was younger, but each year I still feel some negative thoughts creeping in as I try on swimsuits or anticipate being in front of others in a suit. A few weeks ago I had a wonderful swimsuit shopping experience. Yes, you heard me correctly! I took my 7-yr-old daughter to pick out a suit. She tried on 10 suits, and with EVERY SINGLE ONE of them she said, “Oh! This is my favorite! Don’t I look great in this? I can’t wait to play on the beach in this!” Wow. If I could bottle that and pass it around… she taught me a lesson: Love yourself. Be excited for new experiences. Rock those wobbly bits and birthmarks and whatever you have that may be “different.” Life is too short to let those negative thoughts creep in. Get out there and enjoy it! Happy Summer…”

Summer is here! The warm sun of summer often encourages us to engage in new commitments and patterns as we look ahead with hope, making, for some, new seasonal resolutions. Often, those of us hoping for change are facing some kind of fear, whether it’s fear-of-the-new or fear-of-changing-the-old. One of the most important tools in the Cognitive Behavioral Therapy (CBT) toolbox for anxiety and social anxiety is fear facing. It’s an idea that belongs at the center of our new commitments, given the role it can play in helping us actually achieve our goals.

Anxiety sufferers who have never deliberately faced their fears understandably shudder at the idea of moving closer to the things they have always tried to avoid. But continued avoidance ignores a powerful tool called habituation. Habituation is the process of decreasing a physical or emotional response to a trigger or stimulus by repeatedly undergoing the stimulus. Think of it as a kind of tolerance built up as we deliberately spend more and more time in the situation we fear. Over time, we don’t respond in the same way through anxiety – a rapid heartbeat or sweating – because we become more used to the situation, or habituated. The stimulus simply doesn’t bother us in the same way it used to. If we’ve consistently escaped or avoided difficult social anxiety situations, we miss out on an important lesson. When we deliberately move closer to the situations we fear without using special precautions to feel safer, our fear will typically drop. Odd as that may sound, it’s a result supported by years of experience. To demonstrate, I usually recommend purposely putting yourself in a situation that triggers your anxiety. This is called a “Fear-Facing Trial,” a situation during which you can watch what happens to your level of fear over an extended time, say 30 or 45 minutes.

One tool I’ve found useful for measuring fear in the moment is the “Fearometer.” Think of it as a pressure gauge for your fear. Here’s what it might look like:

0: Peaceful State of Mind
25: Mild Anxiety
50: Moderate Anxiety and Nervousness
75: Animal Impulse to Escape or Avoid is Getting Strong
100: Most Anxiety I Have Ever Felt

Once you understand the Fearometer, it’s time to try a Fear-Facing Trial. To do this, you will want to:

1. Find a situation that triggers mild to moderate anxiety
2. Try to practice habituation. To do this, you must allow yourself enough time – this is not something you can rush. New research has shown that, for some, decreasing anxiety with habituation equals success. For others, success may mean not giving in to escape tactics or unnecessary precautions. You won’t know until you try, but even if you aren’t able to “habituate,” you may still be able to overcome your fear.
3. Be deliberate – do this on purpose
4. Set aside any self-defense tactics (unnecessary precautions like avoiding eye contact, censoring your words, blending into the woodwork, etc.)

Try picking something that may be a fairly common situation for you, like asking a question in class, or speaking to someone at the grocery store. Assign a Fearometer number to your fear, like:

Speaking to someone at the grocery store = 50.

You might then head to the grocery store and ask someone in every aisle for something (easier), or ask for products that are usually in a different type of store (harder). Each time you ask a question, take note – did your Fearometer increase, stay the same, or decrease? A general goal would be to reduce your Fearometer number to one half of the original level during your trial.

After you finish your trial, take time to evaluate the situation.

• How did it go?
• Did your fear and anxiety decrease?
• What, if any, physical sensations did you notice?
• Was your heart racing?
• Did it decrease by the final interactions?
• Were you kind to yourself?

You can’t expect perfection on the first try! If you did allow fear or avoidance behaviors to control the trial, take note of how you might change your thoughts and interactions during your next trial. It often helps to have a “battle cry,” like, “I’m taking back my island!” or anything that is empowering to you. (I have a friend who says “Shazam!”) Finally, reward yourself for your efforts and success.

One final note: recent research has been demonstrating that we can still experience long term success even if the habituation is less obvious, as is sometimes the case. The best predictor of long-term success is whether or not we face our fears in a sustained way and refuse to give in to unnecessary precautions. Know that with time, patience and practice you can take back your island and your life.

1. Telling your story draws us together. Whether you are struggling with depression, anxiety, stress, divorce, or another issue, telling your story can help connect you with others who are experiencing the same thing. Just hearing someone else say, “Me too,” can break down feelings of isolation and loneliness. Having one other person, or even a whole community who believes you, understands you and can serve as a support system can be extremely empowering. When you share your story with trusted others, you create a small world around you of openness that could potentially become contagious, spreading in a way that makes all of us grow closer in more authentic relationships.

2. You become an advocate. You don’t need to have a fancy degree, years of experience or other qualifications to be a mental health advocate. By telling your story, you become a supporter and source of encouragement for all those who are going through the same thing and are not yet ready to reach out. In addition to your becoming an advocate, you in turn become eligible for the encouragement they can provide.

3. When you share your story with trusted others, you grow closer to them, having taken a risk. Think of it as a sort of a behavioral experiment in which you hopefully learn that they care and honor that trust. Can you think of a time when you shared something with a friend or family member and ultimately ended up feeling closer to them because of how they responded to you taking a risk and sharing?

4. One of the “tasks” in cognitive behavioral therapy is “facing your fears.” When you share your story with trusted others, you face your fears in a very direct way, often experiencing the fear of rejection or ridicule. Facing those fears is an important part of getting past your anxiety and urge to avoid. Through that process, you may also discover that others have helpful and useful ideas for you as you continue to share your story with others.

It may sound like one of the scariest things you could do, but maybe it’s worth a try. Sharing your story may end up being one of the most important things you could do for yourself. You may end up with a new (or closer) group of supporters, and the satisfaction of facing your fears, taking a risk and coming out of the other side can be exhilarating.

Each day, our bodies and minds are collecting data automatically. We sense that the water is too hot to touch, smell rotten food and know it’s time to take the garbage out, or notice the car merging and move over before we collide. I’d like to challenge you to consciously collect data about your social situation, i.e. the people around you and your own actions. You may think, “Why do I need to collect data? What kind of information would I collect, anyway?”

Cognitive Behavioral Therapy (CBT) uses data collection in a unique way. You will be collecting information about what REALLY happens in a difficult social situation. For example, a trip to a restaurant may involve you thinking SO much about talking to the server, making dinner conversation, or wondering what others think of you, that you don’t actually notice the interactions. Was the server actually rude to you? Did people find you interesting? Were people staring at you, or were they involved with their own conversation, enjoying their food or texting on their smart phone?  These are the interesting and useful data points for a social anxiety sufferer.

Collecting this data can actually be fun. Think of yourself as Ethan Hunt from Mission Impossible: this is your mission should you choose to accept it:

1. Take a notecard, or use our “Find Out for Myself” worksheet, and write down what you predict will happen.
2. Observe everything: Where are other people looking?  Are they staring at you?  If so, ALL of them or just a few?  Do they seem happy, sad or indifferent? What they are saying?  Is someone clearly judging you? Is anything terrible happening?  And how about you, are you able to speak, to make a bit of eye contact, to survive?
3. Focus on THEM especially, without doing the things that block the experience and keep you from really observing how things would go if you let go of control of the situation–not concentrating on your thoughts, covering up your shaky hands, drinking alcohol,  or trying to conceal your nervousness in other ways. Really engage. Observe where they are looking. Hear what they are saying. Try not to think about what you will say next.*
4. Review your notes once you return home. Did your automatic thoughts come true, or did things turn out better than expected? Maybe you realized that few people looked at you for any length of time, and no one glared or that people actually smiled at you. People may have been so engaged in their activities that they didn’t have time to notice if you were blushing.  And maybe your fear of being unable to function did not entirely come true, though you may have been imperfect, as we humans so often are.

Mission accomplished!  The more you are able to take a step back and collect information about your surroundings, the more you may find that most of the time, your dire predictions do not come true. You are taking steps to improve your life, learning to live again.

* But here’s the thing—people who have no anxiety problem tend to assume that things in life are just fine unless there is compelling evidence that something will go wrong, or has already.  The opposite is true for those of us with problem anxiety, who automatically predict that bad things will happen (or assume that have happened already) unless we see compelling evidence to the contrary.  So, as we collect these data, we want to be aware of this unfair bias we make, and try to think more like less-anxious people.  We want to be looking for COMPELLING evidence that we are being judged, gossiped about, stared are, or viewed as boring.  Time to bring a high standard for evidence here—we have not found compelling evidence that someone is judging us if they simply don’t smile at us enough, or evidence that they are bored with us, simply because they go talk to another. Most of us think we can read others’ minds, but we can’t. So we need hard evidence here.