“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:

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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.

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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.

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.

For people with social anxiety, dating is often one of the biggest areas of challenge and difficulty. Either it’s something that’s avoided entirely or they suffer through it. So when someone comes to me and they have social anxiety and we address the the dating-related questions, [there are] a few basic recommendations I’ll make:

1) Reduce the expectations you put on yourself

A big part social anxiety is the feeling or idea that “I need to be perfect,” “I need to say just the right things,” “I need to do just the right things.” These thoughts and feelings create unrealistic expectations.

2) Don’t expect the other person to be such a critic

People with social anxiety problems are thinking that whoever they are with is ready and poised to criticize them when they do anything imperfect. It’s helpful for the social anxiety sufferer to say, “I’m not gonna expect that person to be quite as critical as I anticipate they will be.”

Learn more about setting expectations in our blog post and video on dealing with social anxiety during holidays, birthdays & social gatherings and our 5 tips for dealing with social anxiety during the holidays.

3) It’s not the end of the world if something goes wrong on your date

My third recommendation is for people to tell themselves, “even if I do something imperfect, and even frankly if the other person does criticize me or think less of me because what I did or didn’t do (and this probably won’t happen), I can bounce back from that – that isn’t the end of the world. I don’t have to treat this situation like if it doesn’t go well then it’s game over.” So we really encourage people to look at the big picture and put a little less pressure on themselves.

Every day I work with people who have no interest in pretending that the world is perfect, that everything is great. They tell me about past tragedies or fear of adversity. Many of them have already experienced great pain. They say that positive thinking offers them nothing, that pretending it’s going to be great is not helpful. I agree with them. We don’t subscribe to positive thinking at Learn to Live.

Thought Inspection is realistic thinking, not positive thinking. Bad things might happen, some already have. If a person is anxious, the first step is to consider whether our worries are likely to come true. With Social Anxiety Disorder, the thoughts are often about being watched and judged by others, predictions that are often far less likely to come true than we fear. Thought Inspection is not about inventing some new reality but rather about identifying and accepting reality as it exists. People are often too busy to pay attention to our mistakes and imperfections, or they don’t notice them if they do look. When that realization sinks in, people often feel relieved.

Still, I often see the gnawing sense that something more is needed. So we look at another question—if the bad thing did somehow happen, how could I then cope? How could I talk myself through it? These are not easy discussions, but they are often part of Thought Inspection. We don’t like imagining the bad things long enough to consider how we might deal with them. But I have seen brave people do it time and time again and soberly consider how they would cope if they were judged or criticized or fired. We don’t need to be anxious or live in such great fear if we see that we could find a way through even if the bad thing happened.

I find it helps to share stories of those who make it through real adversity and suffering. We find inspiration in those who struggle through successfully. Here’s how one young woman coped with profound emotional pain and humiliation. Very inspiring.

CBT is an approach that helps people cope with and work through the worst of their fears, whether they happen or not.