“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.

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.

School was the hardest in terms of dealing with social anxiety. I was much taller than the other kids and this made me self-conscious. My peers would often bully or taunt me for my height, and I would take these remarks to heart and it would make me withdraw and fear people and social settings even more.

In high school my anxiety remained the same. I’d fear everything involving people; including catching public transport, eating in front of others, attending birthdays or places where there’d be heaps of people, talking to my peers (especially boys!), giving presentations, going to a grocery store, walking along the street, talking on the phone, and even sending an email!

All these situations ignited great fear within me and I would become overly conscious of myself and my behaviour in social interactions, the classic ‘spotlight effect’.

It wasn’t until graduating from high school and starting university that I began to acknowledge my behaviours and the thoughts which may have been contributing to my anxiety. I began seeking self-help books which dealt with social anxiety and CBT, and worked on myself to counteract the negative automatic thoughts I’d have.

From this, my anxiety relieved enormously. However it wasn’t until I begun the Learn to Live online program in conjunction with daily meditation that I saw tremendous results.

I finished the Learn to Live program within 3 months, and in this short time I found my whole mindset and approach to social anxiety change for the better. Through the online coursework I was able to adapt the new knowledge and coping strategies and use them in social settings which would usually cause me great anxiety.

This program is different to others I have tried in terms of its format and its use of tailored CBT strategies for social anxiety sufferers. It gave me a challenge; something to work towards and commit to. I would start a new module each week and commit myself to doing the activities outlined.

Obviously it wasn’t an easy process. Essentially I was training myself to do the absolute opposite of what I’d usually do in situations which caused me fear. Instead of avoiding situations like I usually would, I would make myself confront them and stick to them until the initial fear all but disappeared. From talking to a stranger on the street, to striking up a conversation with a store person, or calling and making my own appointments.

By exposing myself to fearful situations and reminding myself of the practical strategies outlined on the program, I was able to overcome my fears and realize that I have much more inner strength than I realized.

One of the turning points was when I decided to attend a big event by myself. It included meeting and talking to a celebrity. I was so anxious beforehand, but because I was aware of these thoughts I knew how to counteract them and relax.

Not only did I make new friends, I also managed to hold a conversation with the celebrity and ask for a picture!

From this event I’ve continued to improve in leaps and bounds. I can happily walk down a street or go shopping without feeling that crushing sense of self-consciousness and fear of what people think of me. I have no qualms about picking up a phone and talking to a stranger. I initiate 90% of my conversations with strangers, friends, and family.

Rather than fearing social settings, I now look at them as ‘challenges’ and find I actually end up enjoying being in these situations.

One of my favorite things to do now is to sit and eat at a café in the city – by myself. I also feel calm and confident in my social interactions, to the point that now talking casually to a stranger in passing or with a co-worker is second nature.

Of course there have been times where I’ve felt my old feelings of crippling fear and anxiety. Sometimes it has been a case of 3 steps forward and 5 steps back. The difference now though is that I am now aware of the reasons behind my behaviors and am able to effectively deal with the anxiety as soon as it arises.

Through continued training with CBT and the modules on Learn to Live, these positive coping strategies are starting to become – and will end up – being my normal way of behaving.

Dealing with social anxiety is extremely prohibiting. It can make you feel alienated, alone, and like there’s something wrong with you. In my experience, the worst part was having others think that you were arrogant or rude or disinterested in them, when in fact, the opposite was true!

Such behaviors which I used as coping strategies included avoiding eye contact, pretending to not ‘see’ someone as to avoid conversation, covering my mouth while I ate, letting others do the talking in groups, and completely withdrawing from people, to name a few.

I can never thank Dr. Russ and the team at Learn to Live enough for helping me to realise that social anxiety is not who I am and that essentially, I am in control of how I choose to let this fear dictate me.

Social anxiety is not a sign of weakness, moreover it is a heightened sense of awareness of your own thoughts and behaviors in social settings. Once you begin to learn this, it becomes easy to begin changing these negative and prohibiting thoughts and behaviors and to start accepting yourself for who you are and learn to live as the interesting, confident, and fun person you really are!

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.

Just this week in California, 2,600 Kaiser Permanente clinicians announced an upcoming Kaiser Permanente mental health clinician strike. The clinicians plan to strike to “protest Kaiser’s chronic failure to provide its members with timely, quality mental health care.” Under question are Kaiser’s alleged failures to appropriately fund and staff their psychiatry department, leading to understaffed clinics and hospitals, unacceptable appointment wait times, and adverse outcomes related to not having access to care. They have been fined $4 million for “failure to provide mental health treatment in a timely manner.” The demand is simply too high and the resources too scarce.

As large and profitable as the Kaiser organization is ($3 billion in profits in 2014), it is not immune to the burden of increased mental health demand. Decreased money being allocated toward mental health, a shortage of trained mental health providers in certain areas, and a very large demand for services pose significant challenges, not only in California, but all across America. We can expect to see more tension in the healthcare sphere, and especially in the mental health space, as more people are given access to covered services through programs like the ACA.

The hope is that difficult situations like this one in California will get us thinking more broadly about innovative solutions in our search for affordable and effective options to meet the pressing needs. Creative solutions like Internet delivered Cognitive Behavioral Therapy, for example have been proven through years of research but remain underutilized. Any solution that addresses the major barriers to treatment to like stigma, cost, and accessibility should be considered.

See also: PsychCentral: Dr. Russell Morfitt Discusses Online Counseling for Anxiety

2,600 clinicians will be striking in order to raise awareness about the situation in California. Let’s hope the strike creates a dialogue about other treatment options as well.

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.

The good news is that psychological treatment for social anxiety – namely Cognitive Behavioral Therapy (CBT) – has the benefit of addressing not only the primary diagnoses, but the comorbid conditions as well. The tools and fundamentals of CBT, including Thought Inspection, identifying Automatic Negative Thoughts (ANTS), Fear-Facing and others, teach sufferers to identify and change the problem thoughts and behavior patterns that perpetuate the anxiety. These techniques, which focus on behavior, have the potential to address underlying behavior and root causes of other, physical and mental health problems as well.

Some of the most common comorbidities experienced by social anxiety sufferers include depression, bipolar disorder, panic disorder, conduct disorder, avoidant personality disorder, and the use of alcohol and illicit drugs to relieve symptoms.
This is something to keep in mind if you’re feeling overwhelmed by overlapping issues. The tools and fundamentals of CBT can be used to address a broad array of disorders by targeting those thoughts and behaviors at the root of them all.

Read the transcript of this video below:
Social anxiety involves making predictions for the future, predictions about the future, dreading things and then developing patterns of avoidance. And really that’s true for other anxiety problems as well – I dread something, I fear something about the future and then I develop behavioral patterns that keep me stuck.

Usually they’re about avoidance or escape, and so for that reason there is a great deal of comorbidity – that means overlap. If I have social anxiety disorder, I have a 50% chance of having another anxiety problem or depression. And depression is especially likely because when I have social anxiety disorder I’m tempted to avoid meeting new people and going out. And I avoid doing some other things that might give me meaningful significant relationships with other people and important experiences that I could have and enjoy. I start missing out on those experiences because of that avoidance. Then I’m at greater risk above becoming really depressed when I have some kind of setback happen in my life.

So, I’m not out there in the kind of environments that would give me positives, or that would help me bounce back from the setbacks and negative things that might happen to me. So I’m at greater risk of getting really quite depressed.