The”Passengers on the Bus”go round and round.

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In acceptance and commitment therapy(ACT) they sometimes talk about the passenger on the bus metaphor and this role play supposedly illustrates how your negative thoughts influence your mind.etc etc.  Look at how enthusiastic every body is! Look at the positive comments on Youtube! Yet it makes me feel like vomiting and would certainly put me off doing this kind of therapy even if it was free and available tomorrow. Is this even any good for people with anxiety and especially social anxiety?

I cant imagine doing any role plays or exposures in my present state of mind.  I would just follow him around sort of mumbling and looking awkward as a passenger and giving no feedback whatsoever as I would not care or notice.  They might as well ask me to do a song and dance routine although considering some of the crap I have read about social mishaps I would not put that past them. Its as if in every one of these kind of videos the people say exactly what they want to hear instead of what would really happen as they are all hyper motivated. Would meds change my motivation? Perhaps a lobotomy would be better then at least I would not care any more.. I think this is why 9 out of 10 people with social anxiety dont go for help unless they are forced to and why they think CBT and other sorts of therapy are quite successful as only the motivated and enthusiastic people even do it. What therapy is there for negative, depressed and unmotivated people with social anxiety?

 

If you feel the way I feel

How self help sites and therapists seem to expect you to feel when looking for or doing things to fight your anxiety.

How you really feel.

“Oh I must go out and smile at total strangers on the street, engage in witty banter with shop assistants on the weather every single day without sounding mad or boring and approach attractive women and ask them out even though I have not worked in 28 years and make strange squeaking noises when I speak. That’ll cure me!”

Reality Check

“A common approach shy individuals will take to overcome their anxiousness is take on some big social challenge like going to a single’s bar or walking up to a model-esque woman and striking up a conversation. The problem with this approach is that if you fail to smoothly socialize, you just reinforce the narrative in your head that you’re shy and awkward, that you can’t change, that socializing is threatening, and that the only way to get rid of those threatening feelings is to avoid socializing altogether.”

Yes, now imagine getting that reaction when just trying to speak to a cashier at Tesco or even ordering food or a drink at a cafe and then hearing that these events are supposed to be the easy ones on a hierarchy list.  Thats why everything I do has reinforced my negativity and pessimism even more. I am still trying to find things that I would or could do that would be easy. Remember very shy people dont even get invited to parties so we dont get to choose. Shy, very shy or painfully shy? There seems to be a huge difference which is totally ignored. Then also add depression into the mix.  Perhaps they need different types of treatment for different levels of anxiety. Some hope.  The NHS often shoves people with different types of anxiety into the same group therapy regardless as its cheaper.

“At least once a day I want you to do something on purpose that is just outside your comfort zone. Things that count as being just outside your comfort zone are usually things like: saying one “small talk” sentence to a cashier, calling a relative, inviting a friend to a movie, putting a status update up on Facebook, saying the word “hello” as you walk by a stranger on the street.”

You see here we go again. Speaking to a cashier is 10/10 for avoidance for me. They also always ignore etiquette as if it is obvious what to say when speaking to different people such as male or female, young or older and what is appropriate to say to each may not be the same to the other.  And the most obvious one of all. If I am nervous I COME ACROSS AS A TOTAL MORON. People often dont understand me, I say inappropriate things or  my voice is so weak they cant hear me. All common for shy people and yet all ignored totally on self help sites.

I also dont have any relatives I know at all, my one and only friend lives in another city, I dont use Facebook as I have no friends and would not want people I used to know from work to contact me as I have been unemployed for many years and saying hello to strangers on the street I still find absolutely ridiculous as strangers dont speak in city centres.

PAINFULLY shy!

So here is a video from the private therapy clinic in London on social anxiety I saw on YouTube. I know its on about avoidance strategies but I think its interesting that at one point she brings in another person and says “Talk for 2 minutes!”  Of course she does fine and that’s the point but it also begs the question that do some therapists and so called experts have any understanding of crippling social anxiety at all?

I say this because I have seen videos on group therapy and they just expect people to speak on random subject for so long or for homework approach strangers and make random conversation as supposedly easy tasks. As said previously perhaps only motivated people who have recovered to a certain point are even able to go to therapy and in which case why would I go to the doctor for help if the therapy demands a certain level of recovery before you are even able to try doing it.

You see, just bringing in a stranger and demanding conversion on a random subject may even now have me completely struck dumb and my brain freeze up entirely. This often then creates the classic nightmare of blushing and sweating and a full on anxiety attack.  The thing is I am better now than I used to be. When I was in my twenties I blushed, stammered and had anxiety attacks almost uncontrollably and especially around attractive girls so even the most basics of simple conversation were excruciatingly awkward and any coherent sentences close to impossible due to the physical manifestations of shyness. Speaking to a girl I liked and assuming I would really be OK or that no one would notice(IF ONLY THAT WERE TRUE!)was not even close to my reality.

Of course I was F**king avoidant! The humiliation was so intense I was contemplating suicide and punching myself in the head while sitting in the toilets! Can you imagine the embarrassment of acting like that in front of girls and other people ridiculing me which as I was in a crap manual job full of blokey ignorant young men was a common event for anyone even slightly different. What the flying F**K is is about intense humiliation that therapist dont get? Is it just because they have never experienced it themselves? You would do ABSOLUTELY ANYTHING to avoid it.  So the idea you go to a therapist and deliberately make a list of your most anxiety inducing situations and then agree to go and do them is not even a remote possibility for many people.

And then if you do go and force yourself to speak to people they assume things are usually much better than you imagine is yet more absolute lies.  Avoidance may not be the answer but neither is extreme humiliation which traumatises you for years. When I watch all these experts and read the self help books they never seem to even consider that anxiety can be this bad and that exposure therapy is a straightforward task to recover from if you just practice hard enough. I wonder if they have ever even treated somebody who is really cripplingly shy.

 

 

 

 

 

A million to one he said

I actually got to the stage where I was about to visit my GP for the first time ever about my anxiety. This  apparently often happens  because of something else which in my case is depression which has meant that I have become so avoidant I am only leaving the house to shop at Tesco and have given up doing everything else. However I made the mistake of looking online at all the types of treatment available.  Sounds reasonable? However realistically many GP’s dont even offer therapy for older people with anxiety and depression and just hand you a leaflet. Great, that will cure me!  Then there is about a year, yes one year sometimes even 18 months to wait to get therapy on the NHS. And finally……….. I have read the UK anxiety forum and lots and lots of people who took therapy for social anxiety said their therapist was a complete moron and it actually made them worse or no different at best. Yes, there is loads of help for social anxiety! Online advice anyway, in real life its almost non existent.

Getting help for anxiety or depression in the UK reminds me of the Drake’s equation for the chances of finding intelligent life on another planet. Several million to one or more.There are just so many factors to be taken into account before anything gets done. The next problem is that I have read countless CBT manuals for anxiety online and self help books and they all pretty much say go out and EXPOSE yourself!  No not in a naked kind of way but expose yourself to fear inducing social situations so you get used to them and get better. Then do more harder ones for ever and ever and ever!

I cant even think of easy ones I feel I could try to start of with.

Just Smile!

I walked down the street the other day wearing dark glasses and a peaked baseball style cap as normal. It was at least sunny and warm. As I live in a busy city there were lots of people coming my way, many making their way home from work or studies as there is a university not far away and it was past 4PM.

All I could kept thinking about was is it normal to make eye contact with strangers or even smile at them on the street? I say this because its yet another of the so called simple exposure tasks for social anxiety I have read about online. What is the etiquette considering I am single man in my forties?  There was absolutely no explanation about the rules of engagement. Some men are aggressive and in gangs and would see eye contact as a challenge.  Smiling at young people sounds a bit creepy to me like you are after something or fancy them especially younger women.  Do strangers really smile at other people on the street in a busy city at all and why the F**k would I want to. How many would smile back or even think I was insane?

Its yet another moronically stupid peace of advice for anxiety which would claim to be quite a normal thing to do and see me as highly negative or irrational for daring to object and yet in reality could get me attacked, abused or thought of as being even stranger than I am already. Perhaps the therapists who invent this crap all live in peaceful idyllic towns in fantasy land where everyone is friendly and kind. Perhaps they think everyone with anxiety is 23 and attractive also.

To make me feel even more negative I also read this on a forum from someone with social anxiety this morning on CBT therapy.

Professionals often set a very high bar for you, then really do lay into you when you can’t reach it – blaming you for everything and then in the next breath genuinely wonder why you lack confidence.

It sounds staggering doesn’t it? Kind and supportive environment my arse! There are just so many people online who claim to have had terrible experiences with NHS therapists and also their doctors who appear to think its their God given right to get annoyed and irritated with patients who dont recover with therapy or dare to go back for more help. Someone only last week said their doctor was looking up social anxiety on Wikipedia as they had never even heard of it.  Yet every single website and doctor on TV tells you to see your GP immediately as if there is fantastic help available and almost immediately.  Don’t suffer alone! Go to your GP and get told off like you are a small child!

Is CBT a scam?

‘Extensive evidence’ shows that two years on, depressed or anxious people who had CBT were no more likely to have recovered than those who had no treatment, said Oliver James, chartered psychologist.

After 5 to 20 sessions those with anxiety or depression appear to recover, 2 years later they are no different to those who had no treatment, he said. ‘As a treatment, rafts of studies have shown it to be ineffective in delivering long-term therapeutic benefits to patients with anxiety and depression.

So I am still trying to convince myself if going to the doctor would actually be a good idea. After all will it really help me find a job when I have so many other problems?  Putting yourself through up to 20(much less on the NHS) weeks of intensive exposure with resulting stress and then when you are on your own again it all goes out the window is not great to hear. I just read someone had to wait 18 months for CBT for depression on the NHS so it can take ages to even get started.

In the short-term, 40 per cent of those who complete a course of CBT, typically five to 20 sessions of up to an hour, are said to have recovered. CBT appeals to politicians and NICE because it is quick and cheap

Only 40%. I thought it was 75%.  Less than half is an appalling success rate. But dont forget some people say “There is loads of help out there, dont suffer alone!” There isn’t. Its a lie and in reality a tremendous struggle to even get the right help or find anyone. Time to start praying to God again.