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:

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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.

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.

This old saying of unknown origin speaks to the incredible impact of even the smallest insects, over time, on the hardest surface. The constant grinding of small feet wears away even the most solid rock. Sadly, this is also true of our ANTs, those Automatic Negative Thoughts that constantly wear away at even the most confident self and contribute to challenges such as depression, social anxiety, and stress, anxiety and worry.

ANTs are not our personal automatic thoughts, but really types of thinking patterns that may be hidden in our private automatic thoughts. Over the years they’ve been called cognitive errors, thinking errors, cognitive distortions, or “stinkin’ thinkin’, though the latter term has been applied in various ways to various experiences (and why not?) Still, at the risk of confusing a few temporarily, I’m going to use the term ANTs because it sticks in our minds.

We discussed several types of ANTs last month in our blog post on mental health and the holidays. Here are more ANTs that you may recognize in your own life:

Fortune Telling – You possess a crystal ball, but unfortunately it only predicts negative things for you.
– If I go to a party, everyone will ignore me, just like what seemed to happen last time.

Labeling – Instead of calling a failure or unusual behavior a one-time incident, you generalize, and attach a sweeping, permanent label, whether this is about yourself or someone else. When you label, you don’t just observe your shortcoming, you draw general, negative conclusions from them.
– I couldn’t think of anything to say to a couple of people at the party. I’m such a social failure. I’m so awkward. (In truth, you probably do just fine in many other situations)
See also: How Heidi Overcame Her Social Anxiety with Online Cognitive Behavioral Therapy

Focus Only On the Bad – This is exactly what it sounds like. If four out of five people compliment the cake you made, you’ll focus on the fifth, turning a non-comment into a criticism. When you anticipate others opening gifts you’ve given them, for example, you might selectively recall only the image of the one dissatisfied gift opener and predict the same negative response with each gift you give in the future.

Feelings Make Fact – Feelings are complicated. Sometimes they are related to experiences or memories that you have from the past. Feelings are not necessarily truth – they are feelings.
– I am so uncomfortable at this family gathering, and I feel unattractive in this outfit. They must all think I am fat and ugly and unlovable. (Feeling unlovable does NOT mean you are.)

Not Helpful Thoughts – These are thoughts that may or may not be true, but dwelling on them does not serve a positive purpose.
– I’m not as physically fit as I used to be. I’ve gained weight, and I’m getting wrinkles. It’s hard getting older.
These statements may be true, but choosing to dwell on them won’t help you feel good and be in a state of mind where you can easily observe the pleasant things around you.
See also: The Relationship Between Depression and Social Anxiety

I hope these examples help you to better understand the thinking patterns (cognitive distortions, stinkin thinkin, cognitive errors) we refer to as ANTs. It’s a new year – what better time to work on new thought patterns? Get ready to squash those ANTs before they wear you down! Check back soon for a lesson on Data Collection – you’ll learn how to be a super sleuth of your own social situations which may help you address mental health challenges, including social anxiety, depression, or stress, anxiety and worry.

• Travel – Thanksgiving crowds at the airport or on a bus, train or subway are larger than usual. The possibility for social interactions (making eye contact, talking to the person next to you) increases.
• Preparation – Holiday preparation can be stressful for anyone. Throw in the added anxiety about going to the store or having a group of people in your home, and the stress level increases.
• Eating with others – Many people think of dining with others as a fun, social event. For someone with social anxiety, it may be seen as more of a hurdle or something to suffer through. The expectation of dinner table discussion and the simple act of others watching you eat may cause the social anxiety sufferer to lose their appetite.

See also: Overcoming Social Anxiety was HARD, but it changed my life…

• “Public” speaking – In some homes, Grandma always says the prayer before the meal. In others, the act of saying grace or going around the table and sharing what you are thankful for is the norm. Speaking out loud can be hard enough if you have social anxiety, but being asked for a spontaneous prayer or to share what you are personally grateful for may initiate panic mode.
• Socializing – As if the travel, preparation, eating and possibility of impromptu public speaking weren’t enough, the whole POINT of Thanksgiving (besides food and gratitude) is usually socializing with family and friends. While small gatherings of familiar people may be more comfortable, sometimes holiday gatherings mean new people, distant relatives, and large groups.

With all of these opportunities for stress, someone with social anxiety may just decide to skip Thanksgiving a la John Grisham’s book, “Skipping Christmas.” The characters in that book didn’t actually end up skipping Christmas, and you don’t need to skip Thanksgiving. There are ways to handle the stress and anxiety of the holiday:

• If you plan to travel, try to travel with someone you trust. Let them encourage you during moments of anxiety. If you decide to travel alone, prepare well to reduce the unnecessarily stressful moments. Arrive early for your flight/bus/train. Find your gate. Try to spend some of your waiting time doing deep breathing and relaxing with a book or listening to music. As you travel, remind yourself that some anxiety is expected, and that you can just sit with the anxiety until it passes.
• If you are hosting the celebration, do what you can before the actual day to reduce demands on you. Set the table the day before. Splurge and have your groceries delivered via an online service. Enlist help – make the main dish and have family and friends bring the sides, or order a Thanksgiving meal from a local grocery store or restaurant. If you have time, try to exercise that day, even if it’s a short walk or jog. This may reduce your stress by increasing your endorphins (happy brain chemicals) and giving you an extra boost for the day.
• Do an “eating in front of people” trial run. Go out for coffee, or invite 1 or 2 close friends over for dinner. Challenge your anxious thoughts about eating in front of others. Chances are, people are so into their own food, they aren’t taking the time to focus on how you look/what you’re eating/if you are or aren’t contributing to the conversation.
• If you are hosting, you can ask someone else in advance to say the before-meal prayer or lead other religious or non-religious traditions. If you are heading to grandma’s house, call her before to let her know that while you love her and love her food, you just don’t feel comfortable speaking in front of everyone. If you’re feeling brave, go for it. Practice out loud for your spouse. Read the script to yourself in the bathroom mirror. You may just surprise yourself. The “I will never be able to speak out loud in front of people,” may change to “ I can do it imperfectly in front of my close family and friends.”
• The actual socializing may be the most anxiety provoking, but it doesn’t have to be. Most likely, these are people who know and love you. You can sometimes choose to be with a smaller group, or if you feel better on your turf, offer to host. If you find yourself at a large gathering and you have challenged thoughts for similar situations in the past, take time to review them before the event. Though you likely want to reconnect with relatives you see seldom see, it’s okay to spend plenty of time with your support people – spouse, children, parents or best friend. If you need a break from the chaos, find a place to do some breathing exercises, go for a short walk, or talk to someone you trust. If you’re keeping a journal, bring it with you and look back at previous entries.  See how you successfully handled group gatherings in the past. You can do it!

By changing your thoughts and behaviors, even in the smallest of ways, you can change your life.

I’m Heidi. I’m 24 and I live in Milwaukee. I’ve dealt with social anxiety my entire life. I can’t remember a time when I didn’t feel nervous about something. My anxiety has focused around food mostly; whether people were monitoring what I was eating, whether people would judge me for what I ordered, whether something would be too expensive, you get the idea. It was so bad that I even started to struggle eating at my own dinner table as a kid because it reminded me of the feeling of being in a restaurant and all the formality that goes with it.

I finally started seeking help for my anxiety my freshman year of college by seeing a counselor. It was really helpful, but mostly in sifting through family issues that had caused my anxiety. By the time college was over, I had successfully sorted through all of my baggage as to why my anxiety existed, but I somehow was missing the whole “what to do about it” part. That’s when I found out about the Learn to Live online social anxiety program. I heard about it through a friend, and I decided to give it a try. I was a little skeptical at first, especially considering my anxiety was so specific to eating in restaurants, but I figured it couldn’t hurt to try!

I began the social anxiety program and finished it in under 3 months. I appreciated that I could go through the program at my own pace, especially since the fear-facing stuff was pretty hard. I felt like this was the first time someone was telling me practical things to do to actually deal with my anxiety in the moment besides “just breathe.” The program took me through my thinking process and showed me how to negate my automatic negative thoughts. The homework really helped, but I’m not going to lie, it was tough! No one wants to go into their most anxious places on purpose!! It was truly worth it though, as my life is totally different now that I’ve completed the Learn to Live program.

Right after I finished the program, I met Jon, a guy who went to my college, and we really hit it off. In the past, I purposely avoided first dates because they would inevitably be in a restaurant, which I knew would just tank the relationship when he saw me freaking out. First dates were pretty much a worst-case scenario for my anxiety besides thinking of my wedding day (everyone staring at you while you eat? NO THANKS!). I figured it was worth a shot to go on a real date considering I had all of these new anxiety-fighting tools to try out. I was absolutely freaking out before he came to pick me up, and I literally had the Learn to Live resources and tools out to help me talk through my anxiety before the date. Once he got to my house, I started using the techniques in my head, and the anxiety started to disappear. The date was awesome, and I was so proud that I wanted to jump up and down (of course, that was probably not the best idea in the parking lot of a bar and grill with a guy I just met!). Jon and I continued dating, and we got engaged in January.

Remember when I said worst-case scenario would be a first date or my wedding? I wasn’t lying. I thought of a million ways to try and avoid having a dinner in order to not subject myself to that caliber of anxiety. Alas, social norms always seem to win, and we decided a dinner would be best. I began to brace myself for this day of anxiety. Then I remembered that I still had the homework assignments from the Learn to Live program, so I took them out and started to review. We had a beautiful wedding day. Everything seemed to be going perfectly, until we got into our reception. It turned out that all of the table numbers were wrong, and the head table was in a place that I hadn’t expected: at the very end of the buffet line. That meant that every person who grabbed food would then stop directly in front of my new husband and me, chat about the food and take a good look at what I was eating… AKA my worst nightmare come true. Then other things started to go wrong, like the sound system was glitchy and my dinner music wasn’t working right, and the projector wasn’t working. I started to get really anxious. Really anxious. I took a deep breath, and I started to negate my automatic negative thoughts as they clouded my mind. Slowly but surely, the anxiety subsided. I ended up having a really great rest of my night. I’m so glad I didn’t let my anxiety ruin my wedding reception! I have taken back my island!!

So a new question came to my mind: Does this mean that I’m a failure and that I’ll have anxiety forever? Absolutely not. Anxiety is not going to define me. Will I have relapses when there are certain circumstances that are the perfect storm? Yeah, maybe. But it’s what I do with those circumstances that makes all the difference. If I wallow in how anxious I am, of course I’ll have anxiety forever. I’m giving it power in my life. But if I actively work to wear away at those thoughts as Dr. Russ and the social anxiety program taught me, they’re less likely to come to the surface, and if they do, I can get rid of them much more quickly.

If you would have told me three years ago that I would be anxiety free and eating in restaurants like everyone else, I would have laughed and thought you were making a cruel joke. I had nearly accepted that this was my lot in life, but it’s certainly not true. Take the Learn to Live social anxiety program seriously, and your life will change seriously. It did for me!

Best wishes, and keep fighting!!
Heidi

For that reason, I wanted to let you know about an important development at Learn to Live, that we believe will help many with expanding their social network.   We are launching our new Social Anxiety Community Forum, where people can go to connect with other sufferers who’ve “been there” and to get information to help them overcome their social anxiety. Our goal at Learn to Live has always been to provide the tools and resources to help people in their battle against social anxiety. One of those tools is a network of support that extends beyond what we offer through our Program and in our materials.

We’ve created our Community Forum in order to foster the sorts of relationships that grow organically from one person helping another. We’ve integrated the forum into our website in order to facilitate its use for those going through our Program, but we’ve opened it to the public so that we can all benefit from the lessons learned by those who’ve experienced social anxiety. The forum is divided into three broad categories:

1) Social Anxiety Situations is a category in which people share their personal experience with social anxiety, the way it affects their work, their play, and their relationships.

2) Social Anxiety Tools is a place to discuss the different tools associated with Cognitive Behavioral Therapy. What works for them. What doesn’t. It’s where old members mentor new members on best practices around the various CBT tools. Got a question? Pose it. Got an answer? Share it.

3) My Progress is a broad category of  topics giving voice to the personal experiences of social anxiety sufferers. Need encouragement? Ask for it. Need to vent? You’re among friends. Got a recent success to share? You’ll find others to celebrate with you.

See also: Take a Free Test for Social Anxiety Online

Remember, this is your story. Your life story can get better and better, and a whole group of people who have “walked in your shoes” may be ready to help you on your way. So whether you’ve just figured out there’s a thing called social anxiety or you’ve been battling it for years, I hope you share your questions and your wisdom on the Community Forum. Let’s help each other.

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.