Recovering from Social Phobia
Instalment One: Changing Thinking Patterns, Relaxation and Conversational Skills

Point 1: "Before we went, I was anxious for hours about what I'd say to people, since I don't do much with my life."

I was ashamed of looking bad; but on reflection, I didn't have to get so anxious.

In future when a social occasion's coming up, I'll try planning lots of questions I could ask people, so the conversation won't be about me much.

The Reasons Anxiety can Get Worse and Worse On Social Occasions

Also, I know that worrying worked me up into such a state of anxiety that when we got there, I had all the physical feelings I get when I'm anxious, like my heart was beating faster and I was sweating and shaking, and I was so worried about the feelings that it distracted me from thinking of anything worthwhile to say. If I can cut down the amount of worrying I do beforehand, that hopefully won't happen so much in future. So I'll be better at thinking of things. I think the self-help book talks about how to cut down worrying.

It says that it's common for this kind of thing to happen to socially anxious people.

So at least I'm not the only one.

It says that when a socially anxious person goes into a situation that makes them anxious, the first thing that can happen is that we start thinking about our beliefs about it, like that people will be bound to be judging us and making criticisms.
Well, that might be the first thing for me. I know I keep thinking things like that.
It says that when that happens, it'll start us thinking worrying thoughts because we're nervous about being criticized, so we'll think things like, "I'm bound to do something wrong", and "I know I'm not very good at communicating. Everyone's bound to notice", and things like that.
Those thoughts make us have feelings of distress and anxiety, because the body notices we're becoming fearful, and automatically sends out the alarm signals that'll make it easier for us to run away or fight if we need to.
The feelings make us more likely to start shaking and sweating and blushing. So we think we must look even more inadequate and awkward.
We become so worried about what signs of supposed inadequacy we're showing that we can't think so much about what other people are saying to us, so we have to ask them to repeat themselves, or we can't think of anything to say to them or stumble over our words.
That makes us feel even sillier,
so we have even more distressing thoughts about the way we must be coming across,
which makes us even more likely to shake and blush,
which makes us focus even more on our worries that people might criticize and judge us,
so we're concentrating even less on other people,
so we make even more mistakes with them,
which makes our feelings worse;
and it spirals upwards like that, until we bring on ourselves the social disaster we worried would happen when we came in the door and before we got there.

It says that's a common thing among people with social phobia.

Faulty Thinking Patterns and the Way They Can be Changed

It says the way to stop all this happening is to change the way we think about social situations, so our thoughts don't worry us, and so we don't start the process off in the first place.

It says we can change our thoughts if we first recognise that there are several types of faulty thinking we can engage in. It won't be our fault that we do that, but it'll be something to do with the way we've learned to think of things and what we believe about them because of bad experiences we've had, and other people's horrible attitudes towards us in the past. But we can work on changing the way we think about things, because people we mix with now might not have the same attitudes towards us as the people who made us feel bad.

It says that once we recognise that we're thinking something that isn't quite true or that we haven't got enough evidence to be sure of, it can help if we stop ourselves, realise what we're doing, and make a deliberate effort to think something more accurate. It gives a list of common mistakes it says people with social anxiety often make, to help us notice when we're making them so we can put them right:

It calls one type of faulty thinking " predicting the future, or fortune-telling". That's when it's as if we're predicting things before we go somewhere about how we're sure we'll reveal what we think are our inadequacies, or that we're bound to do something wrong. So we can think things like, "I'll never be able to feel comfortable talking to someone attractive", or, "I'll always be on my own", or, "No one will ever invite me back here."

During a social event, the book says we can do "mind reading", imagining we know people are thinking badly of us, without really having any evidence. So we might think things like, "She thinks I'm not talkative enough", or, "He doesn't like people who are shy", or, "They know how hopeless I am at this", when no one's actually said anything like that.
Or we might keep guessing how other people are reacting to us and what they're thinking.

Or we might feel as if little things that we think have gone wrong mean things are much worse for us than they really are, or worry that if what we're about to do goes wrong, they will be. That's called "catastrophising". It's when we think things like, "If this goes badly, I'll never be able to show myself here again", or, "If I put a foot wrong, this relationship is bound to be doomed."

Afterwards, we can go in for doing "post mortems". That's where we keep on dwelling on the way things went, thinking over every little thing, condemning ourselves for what we think we did wrong, and making assumptions about how we came across and how other people reacted.

It says these are all biased ways of thinking, because we can misinterpret things when we're anxious.

It says there are several other styles of biased thinking, like:

Taking things personally: That's when we think things must be to do with us when they might not be. For instance, if someone walks out of a room or looks away when we're talking, we can assume it must be because they don't like us or think we're boring, not thinking of the other reasons why it might have happened.

Taking the blame: That's when we feel sure something was our fault, for no really good reason, like if someone gets angry.

Discounting the positive: That's when we reject memories of good things as if they didn't count, or interpret things in negative ways, like thinking, "She only gave me that compliment to make me feel better", when we don't really know that; or, "I can't be that proud of this achievement; everybody should be able to order a meal in public", not thinking about how much progress in our recovery it means we've made personally since the time we couldn't order one at all, given that unlike most people, we've had to contend with social phobia. Or we might think, "They were only doing that to be polite", again when we don't really know that.

Emotional reasoning: That's when we can mistake feelings for facts. So we might think things like, "I'm so embarrassed, I know everyone's looking at me", when they might not be really; or we might think, "I know I'm inadequate", just because that's the way we feel.

Over-generalising: That's where we assume that just because something's happened once, it will always happen. So we can imagine that just because we've spilled a drink once, we'll always do something clumsy, or because we didn't get a joke, we'll always be bad at getting jokes.

Labelling, or name-calling: That's when we can think things about ourselves or other people that are too extreme to be realistic, like, "I'm useless", or "stupid", or "inadequate", or "inferior". Or we can think things about other people like, "They're unfriendly" or "critical" or "hostile" or "superior", before we've had a chance to really find out for sure.

Wishful thinking: That's when we can imagine things would be better if they were different, like thinking things like, "If only I was cleverer" or "more attractive" or "wittier" or "younger" or "more like others.". That stops us focusing on what we could achieve, because it focuses our minds on things that don't get us anywhere because they make us think we're incapable of helping ourselves, instead of thinking about the things we do have going for us and how to use them best.

Well, all those different names for things sound a bit complicated. It'll be nice if I can remember them all, and it might be worth having a go, but I'm not sure I will. But I don't suppose it really matters if I can't.
I think the main points it's making are that we can easily:

• convince ourselves that bad things have happened or will happen without having enough evidence;
• think the worst about things;
• think things will have much more serious effects than they probably will
• fault ourselves or think other people do, when there might be other explanations for what's happened that we haven't thought about;
• and spend time feeling regretful that things aren't different, instead of trying to make better things happen for ourselves.

The self-help book says that if when we start thinking anxious thoughts, we stop ourselves and can recognise what type of thoughts we're having, it'll stop us being so anxious. So we can think things like, "There I go again, mind reading or guessing what people think", or things like that.

It says that if we're unhappy, discouraged or depressed, we might find it harder to recognise our negative thinking for what it is and challenge it. But we can remind ourselves how we can mistake feelings for facts, so just because we feel something's true, it doesn't make it true. It just makes it harder to see things another way until we focus hard on what happened and try to distinguish facts from the way things have made us feel.

It says that if we doubt whether the suggestions in the book can help us, thinking that our problem's probably too serious, we can challenge that belief in the same way we challenge our other thoughts, and just try the suggestions out to see if they work.

Point 2: "I thought they'd probably all look down on me, since they're probably all doing much better than me."

A Bit of Optimism and Reassurance

I forgot to think that most of them are older than me, so they've had much more time to get into good careers than I have. In five years' time, I might have got over my social phobia and be in a much better job myself. Maybe much sooner. Anyway, there was no way I could really be sure they'd all look down on me. I've never known those people to do that before.

Point 3: "And I was worried that I might do something humiliating like spilling a drink or food down me, especially if my hands were shaking."

How I'm No Worse Than Anyone Else

Thinking about it, if I had, it wouldn't have been as bad as some of the things that went on. Mum got a bit tipsy and accidentally burned the table cloth with a cigarette lighter; Dad had a bit too much to drink and started talking too loud and jokingly chatting up my cousin's new wife's sister; two people knocked into each other while they were dancing and one fell over; someone had to run out to be sick; two people were arguing so loudly that they could be heard above everyone else while people were supposed to be enjoying themselves eating the wedding cake; and at the end of the evening, all the tables and the floor around them were covered in crumbs, and there were a few drink stains on the table cloths.

But sometimes, I myself feel critical of people who do something slightly wrong, I think because I've learned to have this idea that people are supposed to be perfect as far as possible. It might be more healthy if I start thinking that everyone's bound to do silly things from time to time, and it's a fact of life that doesn't necessarily matter too much, depending on what they've done.

Point 4: "And I was worried I might make a mess of things by not doing things in the proper way."

Not Worrying Too Much About Doing Things Wrong

The self-help book suggests that if we're unsure of how to do something, we can sometimes take the advice of the Chinese proverb, "Better to be a fool for five minutes than to be one all your life" and just ask. It says it might be a bit embarrassing to admit to not knowing, but the embarrassment shouldn't last long.

I keep thinking people will think I'm ignorant if I have to ask them about such things, but maybe they wouldn't think that at all. And often, so many things are going on that questions that might seem foolish might be forgotten the next minute anyway. And it might be helpful to ask myself what I'd think if someone asked me such a question. I don't suppose I'd think they were ignorant, so why should everyone else think people are? They're not all like the people at my school. And everyone has to find out these things at some point, not just me, so they will have to have learned themselves first.

Another thing I could do in future is to watch or listen to see how everyone else does things before doing them myself. Like I could listen to how other people start conversations to pick up some tips. And I could look at the way they're dressed and other things about them to find out more about what's socially acceptable in different places.

The self-help book says we shouldn't get upset if we get something wrong, because after all, who'll remember in five years' time whether we sat in someone else's place or said something when we should have kept quiet, whether we looked flushed and distressed for a minute or that we couldn't hide the fact that we were bored or irritated, anything like that? Some of the time, people will have forgotten in five minutes.

And I could make a special point of looking to see if there's any information available on what to do in some places, like notices to caterers to lay out forks in the order they should be used or no smoking signs. The self-help book says that sometimes there is, but anxious people are often too confused to look for it. But we might if we make a special point of looking.

The Error of Making Ourselves Feel More Under Pressure With Inflexible and Extreme Thinking

It says that sometimes, we can make things worse for ourselves by thinking thoughts that put us under pressure to do things "right", when really, there isn't any need to have such high standards at all. They're usually thoughts with the words "'should" or "ought" or "must" in them, like, "I must think of something interesting to say", or "I should be able to like people more", or "I ought to try harder to be amusing and entertaining".

It says that when we put ourselves under pressure like that, it's bound to just make us more anxious and tense, and also, it implies that those things are rules which we have to follow, rather than just traditional ways of behaving that grew up gradually over time, which a lot of them are really, and which lots of people don't follow. It recommends we think of people we know who don't follow them but don't care.

It says that we might feel uncomfortable thinking we don't have to do what we think we ought to do, so it suggests that we just modify things a bit, so instead of thinking we should or we must or we ought to do something, we just think that it would be better if we did but it's not essential.

And it says we should try to avoid words in our thinking that are really too extreme to be realistic, like "always", "never", "totally", "nobody", and so on. So that would mean we should try to catch and correct ourselves when we have thoughts like, "They totally ignored me"; "They never like me"; "I'm always messing things up"; or "Nobody else gets anxious about the things I get anxious about". It says that extreme thoughts like that will very rarely be true. We'll be forgetting all the times when things happened that showed that they weren't true.

It says that sometimes, words that put us under pressure and extreme words might appear together in the same thought, making us feel doubly anxious. So we might think things like, "I should always be polite"; or "I should never show that I'm angry", or "People must always put other people first." The book says that these thoughts are like rules we think we have to follow, and often, they'll make sense, but we shouldn't think we have to obey them rigidly, since everyone is sometimes impolite, or shows anger, or puts their own wishes first no matter what other people want, and there's nothing necessarily wrong with that. It says that every time we catch ourselves thinking any thoughts like that, we should replace them with more moderate ones that don't put us under so much pressure, like, "Things often work out better if you can be polite"; "Everyone gets angry at times, but it does make a difference how you show it"; or "It's perfectly allright for me to come first at times".

Challenging Extreme Thinking

The book says we can help ourselves a lot if we question and examine our thoughts to see how much truth there really is in them, instead of just accepting them as facts. Then we can think about whether they fit with the facts that we definitely know for certain, and we can look for possible alternative ways of thinking. Some of those might make us feel worse, but many will make us feel better.

The book gives an example, saying that if we're eating a meal with a few people, and we feel that everyone else is doing things right but we're doing everything wrong, we can question that thought and ask ourselves what alternative ways of thinking there are, like, "Everyone's probably doing some things right and some things wrong"; "I'm probably the only one thinking in terms of right and wrong anyway, since there are so many different ways of doing things that it doesn't matter which one we choose."; "People are more interested in what other people think than they are in whether we do things the 'right' way"; or "Doing things differently from others might make people curious about me, but probably nothing more than that".

It says that if we did an experiment to make us less worried about doing things wrong where we went to an airport and watched all the people saying goodbye to each other at the departures gate, and lots of other people greeting each other at the arrivals gate, we'd notice that there were lots of different ways of doing those things. There wouldn't be any 'right way' at all. People would do things differently according to their age, how well they knew each other, their nationality, their moods, how long they've been apart or will be apart, who else is with them, and lots of other things. So observing all the different ways of parting and greeting might reassure us that we don't really have to hold rigid ideas about what the 'right way' of doing things is.

But then, the only reason I've got those ideas is because of what people have said to me in the past. Then again, they weren't necessarily right. Just because they may have learned to do things one way, it doesn't necessarily mean it was the 'right way', so maybe they were totally wrong to have thought it was and criticized people for doing things differently. If people can behave so differently from each other when they're only doing a simple thing like saying goodbye or hello, it either means there's a very complex set of rules about who's allowed to do what, or more likely, it doesn't matter as much as I think it does how people do things. So if that's the case, I don't need to be so worried that if I do things a bit differently, it's going to get people's attention and they're going to be critical.

The self-help book says that the way we think about things can have very different impacts on our moods. So if we think we're doing everything wrong but everyone else is doing it right, we might feel so tense and nervous we can't concentrate on eating or talking to anyone; but if we think that no one cares about whether people are doing things the 'right' way, we'll be more relaxed.

The book gives an example of how our thoughts can make a big difference to our moods, saying that if we could see clouds in the sky, we could either be disappointed that it's going to rain, or cheerful because the plants will grow better with the rain, or something totally different.

But it says we can deliberately think thoughts that cheer us up a bit, giving an example of how if we think, "They think I'm peculiar", we're likely to feel rejected or unhappy; but we might feel less upset if we ask ourselves, "How do I know what they're thinking?" and then we answer the question with the new thought, "Maybe I'm just guessing. If I am odd, there might be a lot of people around here who are just as odd as me."

The book asks us to work out what alternative viewpoints we could think of in a situation where we could either make ourselves feel miserable or not, depending on what we thought:
It asks what we'd think if someone we knew well but hadn't seen for some time passed close by us in the street but didn't even smile. It asks if we'd think we must have done something to offend them, or if we'd think that they couldn't really like us. It asks us to think of other possible reasons.

Well, I suppose they might just have so much on their mind that they didn't really notice us, or they were upset so they didn't really feel like talking to anyone.

The book encourages us to think like that about all the interpretations we put on people's behaviour, thinking of possible alternative explanations for any things that make us unhappy because of the conclusions we come to about them.

It says it can be difficult for anxious people to think of alternatives, since we'll so often be worrying about what might happen next, about what else could possibly go wrong, and about how bad it would be if it did. So that'll make it easy to doubt any new perspectives we come up with, and to think sentences that begin with "Yes, ... but ..." like, "Yes, I know they seem to like me, but they don't know what I'm really like", or, "True, I didn't say anything stupid, but then I hardly said anything at all". It says that that's the faulty thinking pattern it mentioned before called discounting the positive, and we should try to pick up on that and examine our anxious thoughts to see if they're really justified. So with the thought about whether people like us, we could think, "But we don't know that they wouldn't like me if they got to know me more. After all, everyone has faults." Or for the thought about appearing to be stupid, we could maybe think, "I don't have to worry about them thinking I'm stupid when I haven't actually got any evidence that they do. Perhaps I'll try talking more, and then examine the evidence for and against the idea."

Point 5: "I was worried about having to talk to people, but at the same time, I was worried I might be sitting on my own feeling stupid and sticking out like a sore thumb because everyone was friendly with other people so no one spoke to me."

Calming Worries With Reassuring Thoughts

OK, I'm going to think about this. I know I was worried about having to talk to people because I didn't think I had anything interesting to say and I was scared it would make me feel a fool in front of them, but what would be so bad about sitting on my own? Would I really be sticking out like a sore thumb when everyone was so busy talking to other people? And even if I did, why would it matter?

So even if the worst came to the worst and they did think I was totally inadequate and boring, I'd know it wasn't really true.

Point 6: "They asked me what job I was doing, but that just made me embarrassed about having to admit to doing such a boring job."

Avoiding the Embarrassment of Admitting to Doing a Boring Job

In future, I could think about what awkward questions people might ask me before I go out anywhere like this, and plan how to answer them in a way that doesn't make me look too bad.

But then, they might not think badly of me for having such a boring job anyway. I'm probably worrying more than I need to. After all, other people have boring jobs too.

Point 7: "I kept blushing, and that made me worry about what they must think of me."

Worries and Reassurances About Blushing

I blushed quite a lot during the day. It did embarrass me. But actually, I have heard people say that other people don't notice blushing as much as we might think. So maybe I was worrying about it more than I needed to. And maybe the more I worry about blushing, the more I'm likely to do it.

I didn't want people to look at me, but actually, I think me having my hair in front of my face and not looking at them meant they had to look closer to see if I was paying attention to them. I thought that keeping my hair in front of my face was keeping me safer from people noticing my blushes. But maybe it wasn't really.

Well, that's something to bear in mind. Maybe that would happen with me. When I start to get more confident, maybe I'll try it.

Point 8: "I know you're supposed to keep eye contact with people, but I just wanted to look down at the ground."

Thinking About Eye Contact

I thought things might go worse for me if I didn't avoid eye contact with people. But I wonder really. I suppose the trouble with consciously looking down instead is that it made me focus on what I was thinking and feeling, and how important I thought it was to avoid eye contact with people, so I couldn't pay so much attention to what was going on around me. So that meant I didn't have so much brain power available to think about what to say to people. So it made it more likely that my worries about not knowing what to say to people would come true. I think when I look at the ground instead of at people, it just makes me more anxious, because I can't be so sure of what's going on around me, so I don't know when it's safe to look up. So worrying about it just makes me feel worse after a while.

And I know people think it's a bit strange when people don't look at them, so I might be attracting the attention to myself I was trying to avoid. So I worry about that as well. But at the time, it takes a bit more courage to look at people.

The self-help book says everyone gets nervous about eye contact. So we don't have to think it's that much more difficult for us, and chances are, the person looking at us might be a bit nervous too.

Well, once I've started to recover from my phobia and I'm more confident, it should be easier for me. Perhaps I could gradually build up my eye contact with people.

What I Can Do If Someone Suspects I Have Social Phobia

But one thing that scares me is the thought of picking up signs that they know I'm fearful about being there. I just don't know what I'd say if I knew they'd found out and they mentioned it to me! I feel as if it would be horrifying and embarrassing to be discovered.

Or perhaps, if I think they're interested in listening, I could explain a bit about it and about the kinds of things I'm doing to recover. After all, quite a lot of people have phobias of something or other, often spiders. So I don't really need to be ashamed of mine.

Point 9: "Images kept coming into my mind of times on other occasions when I'd blushed and trembled and stuttered, and I felt sure people must have thought there was something wrong with me because of it."

Consolations About Embarrassing Memories

I've actually got no evidence that people really did think there was something wrong with me those times when I blushed and stuttered. The images make me feel as if I know what other people were thinking those times and they were judging me badly, but really, I don't know that they thought something was wrong with me or that I was unacceptable when I did those things at all. I think what makes the memories so bad is thinking that people must have thought something was wrong with me. But what if they didn't? What if they hardly thought anything at all? Then I don't need to be upset and embarrassed about those memories after all. No one since my schooldays has ever said that doing those things makes me look bad, or looked contemptuous or anything. The bullies at school teased me for that kind of thing and several of the teachers thought it meant I was stupid, but maybe a lot of people aren't like those people at all. Bullies bully people for all kinds of stupid reasons, like if their hair's a bit longer than theirs. But in the real world, people have their hair all different lengths. The way the bullies did things wasn't necessarily the right way, even though they seemed to think it was. So I shouldn't let what they thought of me influence the way I think about myself really. As for the teachers who criticized me for stumbling over words, really, I think they were just being bad-tempered and ignorant. I shouldn't let what they thought of me influence me either.

But if I can build up more social skills, then I'll have more successes in social situations, so every time I think of a horrible image, I can reassure myself that there are lots of good ones as well, and even practice replacing the horrible image in my mind with one from a memory of when something went well.

Point 10: "And when they asked me what my interests were, that embarrassed me even more and I just didn't know what to say, because I haven't really got any interests. I'd like to go out and do more things, but I just haven't got the confidence."

Asking More Questions

Now I'm concentrating on what I need to do to recover from my phobia, it might not be long before I do start to build up confidence, and develop more interests.

But one thing I could do is to ask questions that focus people's attention on themselves and their own interests, so they don't have time to ask me so many questions about mine.

One of the magazine articles says that a good conversational technique is to ask people questions that don't just have a yes or no answer, but ones that will need longer answers, ones that begin with the words who, or what, or how, or where, or when, or why.

So maybe I could ask things like, "What have you been doing since I saw you last?" or "How are your children doing nowadays?" or "Where do you like to go out to enjoy yourself?"

I could think up lots of questions like that in the next few days and write them down, so I can refresh my memory with them and it'll be easier to think of questions like them when I next go to a social occasion like that.

It'll be nice if I can find someone beforehand who I'm not anxious about being with who I could practice using them on.

Point 11: "So then I started worrying that they must think I'm really boring, and I felt ashamed of having to admit I lead such a boring life."

Tips on Getting to Sleep More Easily

I'm letting these worries ruin my life. It wasn't just at the wedding reception. I lie awake at night getting more and more miserable thinking about how my life's going nowhere and how people must think I'm boring. When I start to recover and do more things, hopefully that'll change.

But I suffer from insomnia anyway, even when I'm not worrying so much.

One of the magazine articles says that insomnia's common for people with social phobia. It says that when we have a bad night's sleep, are stress hormone levels rise, and that affects our ability to focus our attention well and make decisions the next day, making us anxious about getting enough sleep to be alert during the day. But the more anxious we are, the more likely we are to have insomnia, because we'll be keeping ourselves awake worrying and feeling tense.

The article says there are several things we can do to try to help ourselves. It says they're based on tackling what keeps our insomnia going, rather than what might have started it in the first place. I'll see what I think of them. I think I remember reading somewhere that there are quite a lot of things that can make people sleep better, but that people shouldn't get too worried about remembering or doing them all, since then, their anxiety about whether they're doing everything right will stop them getting to sleep! So I'll think of these as just tips, not rules.

• It says we should keep regular sleeping hours, going to bed and getting up at the same time every day.
• It recommends we go to bed earlier rather than later so we don't get over-tired.
• It says that if we get to bed late one night, we shouldn't try to make up for it the next day. We should keep to a strict schedule, so the body knows when it's supposed to be sleeping and when it's supposed to be awake and is less likely to get out of rhythm.
• It says that if we start thinking anxious thoughts in bed, we should either make a quick note of them so we can put off thinking about them till the next day knowing we won't forget them, or if they're unreasonably negative thoughts, we can challenge them with more realistic ones. It recommends we keep a notebook by our bed to write thoughts in if we want to.
• It says we should go to bed only when it's time to sleep. It says we shouldn't read or watch television in bed, since that could distract us from sleep, or make us associate being in bed with things we normally do while we're awake, so we might think of them more instead of concentrating on sleep there. It recommends we watch TV or read sitting in a chair rather than in bed if we really want to do those things in the bedroom, or that we do them in another room.
• It says we should try not to take naps or allow ourselves to doze off earlier than our scheduled sleep time. It says we can help ourselves to do this by staying reasonably active throughout the evening if possible. It says that if it's possible and necessary, we could ask a friend or family member to help us keep awake.
• It says that if it's possible, we should start each day with at least 20 minutes of sunshine. It says it helps wake us up, energizes us, and tells our internal body clock that it's daytime.
  Well, that might be possible in the summer!
• It says it can help to take a light amount of carbohydrates before bedtime, like a biscuit or piece of toast, because that can release calming chemicals in the brain. But it says we should avoid eating heavy meals during the four or five hours before bedtime.
• It says that late in the day, we should limit our intake or use of caffeine, nicotine, alcohol, and foods containing monosodium glutamate, because they're stimulants. It says avoiding caffeine means avoiding coffee, tea, cocoa, chocolate, some soft drinks, and some over-the-counter medications. It says that we should avoid those things if possible, or at least most of them, because caffeine takes six hours to leave the system.
• It says that while alcohol can make it easier for us to drift off to sleep, it tends to make it harder for us to stay asleep, because we can get slight withdrawal effects when it starts to leave the bloodstream during the night.
• It says it can help if we don't have all that much of anything to drink after 6 PM, especially people who often need to get up during the night to use the toilet.
• It recommends we exercise every day, and says it's best to do at least 30 minutes a day, preferably in the late afternoon or early evening, but not within three hours of bedtime, since exercise releases chemicals in the body that make us feel more alive and active. It says that being inactive is considered one of the worst things that someone with insomnia can do.
  Oh, perhaps I'll have to think of exercises to do then.
• It says we can prepare our minds and bodies for sleep by doing relaxation exercises, taking hot baths, listening to soothing music before bedtime, or doing anything else of our choice that helps us unwind.
• It says we should make our bedrooms very dark, not allowing moonlight, light from other rooms of the house or outside to get in.
• It says we should sleep at a comfortable temperature, trying to keep the temperature in the room the same from night to night.
  Oh, who's going to be able to do that! I mean, for one thing, it gets colder in the middle of the night and then warms up in the early morning while people are still asleep; and it warms up more and more as the weather gets warmer throughout the year! Still, not being too hot or cold when trying to sleep is obviously a good idea.
• It says we should be careful about taking non-prescription sleeping aids, since most of them contain antihistamines as their main ingredient, which are slow to take effect and slow to leave the body. It says they may leave us feeling drowsy the next day.
• It says that if we wake up during the night and can't get back to sleep, instead of just lying there tossing and turning, it can help if we get up and go to another room to read, watch television, or do some work around the house until we feel sleepy again, then go back to bed.
• But it does say that we ought to see our doctors about insomnia if it doesn't clear up, because there can be medical causes. It says that often, medication can affect the quality or quantity of our sleep, medication like antidepressants, anti-anxiety medication, anti-inflammatories, high blood pressure medication, and alcohol. So it says we ought to see our doctors to ask them whether any drugs we're taking could be causing it.
  Actually, I don't take medication, so it can't be the cause of mine, but I do sometimes drink too much.

Things to Consider When Deciding Whether to Take Medication for the Anxiety

The self-help book says that some people wonder if they should take medication for their anxiety.

I was wondering if I should start doing that, or at least take a tranquilliser before I went to the wedding reception, but I was embarrassed about going to the doctor to ask.

The book says that medication could be helpful, since there are many drugs that treat the symptoms of anxiety and depression, and new ones are coming out all the time, but there are quite a few things we should consider before we decide to take it.

It says that drugs don't solve anxiety problems in the long term, and some drugs become less effective if we take them regularly, so we'll need more to get the same effect.

And it says that if we come to rely on them, they can make us feel less confident about handling situations without them, and so we'll be much less confident in our own ability to get over the problem ourselves, and it might come back when we stop taking them.

So it says people who want to take medication should discuss it with their doctor.

It says that whatever people decide, it's still worth working through the self-help book, because it'll help us develop the skills to deal with the problems ourselves, and that'll give us more confidence in the long run. It says that anyone already taking medication doesn't need to stop doing that to find the book beneficial. But it says that starting to use two things together will mean we don't know which of them is working, the self-help book or the medication, so it'll be better to start one thing at a time.

It says that if people have other problems besides social anxiety, like alcoholism, depression or panic attacks unrelated to social phobia, the book will still be useful for the social anxiety, but it might mean deciding which problem to work at overcoming first, since it's best to work with one important life change at a time.

Well, I haven't got any severe problems apart from social phobia, so I'll carry on with this for now.

Point 12: "So I got more and more anxious and my mind started going blank, so I couldn't think of anything to say. I suppose that must have made them think I was boring then if they didn't think it before."

Practising Replacing Negative Thoughts With More Positive Ones

I think part of the problem is that if I keep thinking negative things like, "I'm boring" or "I'm stupid", that just makes me more anxious, and then I'll be too fearful to think of anything to say, so I will come across as those things, whereas I might not have done if I hadn't thought those things in the first place. After all, if I'd asked lots of questions, the conversation would have been mainly about the person I was talking to and not me anyway.

One of the magazine articles says that when we catch ourselves thinking a negative thought, one technique is to say "Stop!" to ourselves, and then replace it immediately with a little positive thought. It gives examples of the kinds of positive thoughts we could substitute for the negative ones. So we might think things like:

• I'm boring.
  But I'm going to plan to start doing more things, and my life could take off especially when I start to recover from social phobia, and then I'll be more interesting.
• I'm a failure.
  But I can be a success, at least in the things I know I'm good at.
• I'm stupid.
  No, there are things I've done in life that prove I'm not, and I'm going to start doing more things that will prove to myself that I'm not really.
• I'm inadequate.
  Just because I did one thing wrong, it doesn't mean I'm inadequate, and certainly not in every area of life; and anyway, I can learn how to do these things better.

It says that another technique is called the "empty chair technique", where we sit where there are two chairs, (or at least two) and we sit in one chair saying the bad things about ourselves that we normally think, and then sit in the other chair and pretend that we're a defence lawyer speaking for ourselves. So it might go like:

• Us as the self-critic: I can't do anything well in life because I just don't have what it takes.
  Us as the defense lawyer: That's not true. I do lots of things right.
• Us as the self-Critic: Everyone's going to think I'm a loser.
  Us as the defense lawyer: I'm not going to be able to tell what they're thinking of me. It's very unlikely that everybody would think I'm a loser. And if some people do, well, what do they know? They probably won't be taking my social phobia into account, for a start.
• Us as the self-critic: I'm stupid.
  Us as the defence lawyer: I'm not stupid. I might do stupid things from time to time, but that doesn't mean I'm a stupid person. Everyone probably does stupid things sometimes. And some of the times when I feel stupid, I'm just anxious, and once I can cut that down, I'll do things better.

It says we can pretend we're a good friend or supportive family member instead of a defence lawyer if we like, imagining what they'd say to us.

Point 13: "When I did say something, I got distracted by how anxious I felt, because I was sure they'd be judging me, wondering what was wrong with me because I got my words mixed up. Then I started thinking they must think I'm stupid for finding it so difficult to say things."

Learning to be Less Self-Conscious

The self-help book says that the more self-conscious we are, the worse we'll feel about ourselves, because we'll be focusing our attention on our anxious feelings and any outward signs we're worried there are of them, and be feeling sure that other people are noticing them as much as we are and judging us for them. And then the more we worry about that, the less we'll be observing things around us, so we're more likely to do clumsy things like putting our elbow in the butter or spilling things. And we're more likely to get our words mixed up, because we won't be able to concentrate properly on what we're saying.

It says the way we can stop ourselves becoming more and more distressed by our self-consciousness till more and more things go wrong is to focus outwards onto other people instead of focusing on our feelings and worries. It says we might even be able to get so absorbed in what people are saying or what's going on around us that we forget our feelings altogether if we try.

It says we can become less focused on ourselves by developing an attitude of curiosity about what's going on around us, imagining we're like a scientist observing people for the purposes of collecting information in an experiment to analyse human behaviour or something. So we'll listen to what they say and look at what they do before we make a judgment about how they're reacting. That'll be different from what we usually do when we can jump to conclusions about what they must think about us. And when we do make a judgment, it should be one that an unbiased fellow scientist would also agree with.

We should make sure we rely on facts and not guesswork, since our guesses will have just made us anxious in the past because they're usually based on what we expect to happen and the way we imagine people will be feeling, which might be completely wrong.

When we stop focusing on our feelings and worries and give more attention to people around us, we'll be able to interact with them more naturally. And because our worries aren't making us anxious anymore, we'll stop doing the things we do when we're anxious like getting our words mixed up, and so we'll be much less likely to end up feeling stupid and as if we made a mess of things.

It says it's bound to be difficult to focus attention away from ourselves at first, since our anxiety symptoms are likely to distress us so much. So to make it easier, we can practice in two stages, the first being to make a conscious decision not to focus on our worries and feelings and other anxiety symptoms, and the second one to make efforts to fill our minds with what's going on around us.

It says that when we're deciding not to focus on our anxiety symptoms, it can help us take our attention off them if we first consider that though they'd be useful in getting our attention if we were in real danger, we won't be in real danger just from a social occasion. If we think we are, it'll probably be the way we've just learned to think about being with other people over the years, but the people we're with now might not behave anything like people we had bad experiences with in the past.

Then we can ask ourselves if there's anything to be gained from dwelling on our thoughts and feelings, like if we think they might help prepare us for the worst, or allow us to escape before the thing we dread actually happens. It says thoughts like this are common for people with social phobia, but really, focusing our attention on ourselves has far more disadvantages than advantages.

It suggests we write down a list of all the advantages we can think of of not focusing our attention on ourselves, so we can read it every now and then to remind ourselves.

Well, perhaps it would mean that the less I thought about my anxiety symptoms, the less I'd be likely to do things wrong because I wasn't concentrating properly on observing things around me, so the more confident I'd become, so the better impression I'd make. And then, I might make more friends. And the more confident I became, the more I'd be able to do.

The self-help book says that the aim isn't that we focus all our attention on the other person, but that we achieve a good balance of focusing it on them and us. So it says we wouldn't aim to maintain eye contact with someone all the time, but to look at a person and look away like we would if we weren't anxious.

It says that one way to make focusing on others easier is to give ourselves something to do at the same time, like the task of finding out something about the other person or people we're talking to or who are sitting around us, such as asking ourselves what we like about the way they dress, or how we can work out what they're feeling, or if we can guess what jobs they do. We can search for things about them that interest us, or imagine we're going to describe them to someone else and make a particular mental note of characteristics about them so we could do that.

It says that if our attention wanders back to our worries, which it probably will, since everyone's attention keeps shifting to other things even when they've decided to only concentrate on one thing, we shouldn't be frustrated with ourselves, but should just make the decision again to focus on other things, and then deliberately take the focus of attention off ourselves and put it somewhere else, choosing something specific to focus on to make it easier.

Point 14: "And there were people from another part of the country there, and I felt really self-conscious about speaking to them, because I worried that they would look down on me for having the accent I've got. So that made me even more anxious."

Coping With Anxious Thoughts Caused By Past Experiences and Bad Memories

I think when people get older, maybe they've got more to think about, so they don't think so much about little things like whether people have the same accent as them. And thinking about it, I could stand up for myself now if someone criticized my accent. I wouldn't just believe what they were saying like I did when I didn't know any better because I was only a child. I could ask them why the way people speak is so important to them.

The self-help book says that people who've been bullied will have sometimes taken in the horrible things the bullies said as if they believed them, but whereas they might have had a grain of truth in them, often they will have been exaggerated, and sometimes they won't be true at all.

I know the bullies and the teachers said all sorts of horrible things about me, like that I was stupid and I couldn't even do simple things right, and that I didn't belong there.

The self-help book says we should try to think of all the horrible things we tend to think about ourselves when we go out, so if when we spill something, or can't think of anything to say to people, or feel anxious when we know we shouldn't really and no one else seems to, and we think it means we're stupid or incompetent, we can try to work out how much of that was caused by what the bullies or other people said to us. And when we've worked it out, we should ask ourselves whether what they said was really justified, or whether they were exaggerating, or making judgments unfairly, like if they didn't take into account that we were really anxious when we stumbled over our words in class or something, so they thought it meant we were stupid when it really meant that they'd verbally abused us so much that we were really anxious about making more mistakes so we weren't calm enough to do things properly.

It says that bullies often bully for reasons that really have far more to do with their own inadequacies than ours, like if they feel scared that we'll show them up as not very clever if we're cleverer than them. Or they're worried about being bullied themselves, so they pick on other people so people will think they're tough and not mess with them; or they'll do it to make themselves feel tougher. Or they get a selfish thrill out of seeing people's reactions when they bully them, and they enjoy it so much that they don't want to stop.

The book says that when we do do something wrong, we should remember to just think of it as one thing we did wrong, or one wrong behaviour, rather than something that means our whole character is faulty.

It says that all kinds of things might bring back memories of the bullying that might give us anxious feelings and make us start thinking the way the bullying made us think again. Examples could be a certain way that someone behaves, or even little things like being spoken to in the tone of voice someone spoke to us in when they were being nasty, a physical similarity someone has to a bully we once knew, being around controlling people or those with authority over us, sights, sounds or smells that remind us of those times, and so on. It says that memories can be triggered off easily, bringing strong feelings with them, that make us more likely to think the horrible thoughts we do.

It says that sometimes, we might not know why anxiety suddenly comes over us, or feelings of dread or vulnerability or inferiority or something like that, but it's because something that triggered off a memory happened, but it happened so briefly we hardly noticed it with our conscious minds; or it's something where we don't make the connection at first, like if one of the bullies often used to eat chewing gum and someone else comes close to us a few years later who does that. It says the brain matches the two things up and sends out danger signals before we've had time to think about it consciously.

It says there are ways we can help ourselves get over painful memories, or nightmares about what happened.

One thing it says can help is if we express what happened to us, either by telling other people about it, or even just by writing it down or putting it onto a tape recorder. That way, we can get our feelings out of our systems.

It says that another thing that can be helpful is if we think of our painful memories and invent an image that symbolises a happier outcome than the one that happened in reality.
So for my memory of being teased about not belonging, I could have a day-dream where I imagine feeling confident and telling them it's silly to bully people just because they're new. I could try turning that into an image in my mind of me standing there with a bold posture talking, and imagine that could symbolise hope for the future. And then whenever a bad memory comes into my mind in future, I could try thinking of the strong image.

Point 15: "I know I started speaking too quickly and quietly and mumbling after that because I felt so anxious, and so they must have thought I was even more stupid."

The Importance of Doing Things to Increase Self-Worth

Speaking too quickly and quietly didn't mean I'm stupid, only that I was anxious and worried I wouldn't have anything decent to say. As soon as I get more confident, that should stop happening.

And people might not have thought I was stupid at all. I think I'm really the one who thinks these things mean I'm stupid, not other people, because I started believing what the bullies said.

So once I'm more confident, I'll be able to do better.

There are probably things I could do to prove to myself that I'm not really stupid, like learning something maybe. I'll think about things I know I'm already good at, and things I'd like to find out more about, and think about what I could do to learn more about them. If I can do that, then I'll know I'm not stupid, so I'll stop feeling as if I must be and doing things more badly than I would if I felt more confident.

Point 16: "I hardly ate or drank anything, because I was worried about getting something wrong or spilling things so people would think I looked like a fool."

Getting Over the Fear of Doing Things Wrong by Deliberately Doing Things Wrong

Thinking about it, if someone next to me spilled their food or drink, would I think they were a fool? I don't suppose so. I think I imagine I've got to do things perfectly because of the criticisms I got from a few people in the past. But thinking about it, It was only a few people compared to all the people I've ever known, and I don't really know that everyone else thinks about things the same way. In fact, when I have spilled things in the past few years, no one's treated me like that.

One of the magazine articles says we can get over our fear of not doing things perfectly if we practice doing little things wrong, like forgetting someone's name or dropping some papers, and finding out what happens.

It says we can do that in our imaginations first, working out how we'd respond if someone commented, rehearsing it in our minds several times, imagining handling the situation well, and then doing it for real.

Since we'll be in control of doing whatever we've chosen to do wrong, it won't be so likely to make us feel incompetent. That will hopefully mean we're calmer, so we've got more of a chance of taking in people's responses. And if they don't react nearly as badly as we've always worried they would, we'll know there isn't much to worry about after all when we do little things wrong.

We can think up several things to do that are slightly strange or wrong, imagine doing them first till we feel comfortable with the idea, and then do them for real, so we get lots of opportunities to find out how people respond.

So maybe most people don't disapprove of this kind of thing nearly as much as I think.

How Certain Foods, Alcohol and Other Substances Can Make Anxiety Worse

Thinking of food, I'd love to have been able to enjoy lots of food at the wedding.

But it's interesting that one of the magazine articles says that certain types of food and drink and other substances can make anxiety worse.

It says that caffeine and nicotine can release a chemical called norepinephrine that can do it, and even that they can deplete B vitamins, which are essential for a healthy nervous system. And it says they interfere with sleep.

I'll have to look into that.

It says alcohol can also deplete B vitamins and vitamin C, and cause anxiety symptoms if taken in large amounts.

It says that eating a lot of sugary foods can make us feel anxious. That's because they stimulate the hormone insulin that breaks down sugars and starches in the digestive system, and too much sugar makes the levels of insulin rise to unhealthy levels because more is needed to deal with it. And that can make us feel irritable, jumpy, weak, and hot and sweaty, so it makes us feel as if we're anxious.

But it does say that sugary foods in moderation can make us feel good sometimes.

It says there are other things that can mimic anxiety symptoms. It says that some allergic reactions can, and some diseases, and some types of medication. So it recommends anxious people see a doctor about the symptoms as part of their attempts to get over them.

Point 17: "Afterwards, I kept criticizing myself about how badly I must have come across."

The Importance of Distraction from Worrying Thoughts After the Event

I think dwelling on events afterwards might do more harm than good, actually. I'll have to find a way to stop myself doing it, because thinking about how badly I think things went just makes me more anxious about going into situations like that again.

The self-help book says that it's common for people to dwell on what happened afterwards, working themselves up into a state where they're really upset, thinking over who said what and what happened when, but not coming to any conclusions about how to do things better next time. So it says there's no point in doing it. It says it'll just make things worse, because we'll just bring to our minds all our biased ways of thinking again, all the beliefs we have that might be exaggerated or mistaken, that just confirm in our minds that things really were as bad as we thought, or even worse. It says that the longer people worry, the worse it makes us feel, and the more convinced we are that things were really bad, even though it usually means we drift further and further from reality in our thinking, because of the faulty ways we're interpreting things.

I suppose the book could be right, thinking about it.

It says that although some people assume that dwelling on things like that must be helpful because it might mean we come up with ways to solve our problems, people usually don't, and so it's best to stop ourselves thinking over things as soon as we notice we are, and distract ourselves by doing something more interesting instead.

It recommends we make a list of interesting things to do beforehand, so we can just pick one after we've been out somewhere, rather than trying to plan what to do when we're in a state of anxiety.

Point 18: "All the horrible feelings I felt at the time came back."

Having Reassuring Thoughts, and Making Reassuring Discoveries

I think the horrible feelings came back because I was thinking the same things that I'd thought when I had the anxiety symptoms before. I was thinking about how bad people must have thought I looked when I was blushing and trembling and couldn't get my words out. That embarrassed me, so I started blushing again. And I started feeling humiliated that I could have behaved in a way that would make people think I looked so awful.

I'm going to try to reassure myself with thoughts like that whenever it happens again.

The self-help book says that people with social anxiety have made some reassuring discoveries when they've been pretending they're scientists observing what's going on around them. It says some have found out that people don't take nearly as much notice of them as they assumed they would when they blush. And it says people have found out that others often don't notice when they're shaking or looking nervous, or do but hardly pay any attention, maybe because they're too preoccupied with what they're doing themselves, or it doesn't have any significance for them. It says that people often look calm even when they don't feel calm.

It says that most people don't spend much time judging or criticizing other people. And almost no one is entirely happy with the way they are, or the way they manage to get on with other people.

The book suggests we try finding out for ourselves that people don't notice our anxiety symptoms as much as we assume they do, by that technique of pretending to be like a scientist observing what's going on around us.

I'll think about that, but I'd be worried I'd find out the opposite.

But it says that it's common for people with social anxiety to be reluctant to focus on what other people are doing, in case they pick up critical signals.

I'd be especially worried about looking at people if I thought they were going to see me making a fool of myself, like if I felt sure I was just about to blush when there wasn't any good reason. I'd be scared of finding out what they thought.

But it says that avoiding eye contact with people for reasons like that can just make the fear worse, because we never find out information that reassures us that things aren't as bad as we think, and so we can worry that much worse things are going to happen than are really likely.

And I must stop thinking that blushing makes me look like a fool. As that self-help book says, maybe people hardly notice it, or forget it the next minute a lot of the time.

The book recommends we plan when we're going to do the experiments where we imagine we're like scientists observing people, and plan who we're going to do them on in advance. Otherwise, we might not get the courage when we're in the situations.

It says we can work out a system of doing fairly easy things first, and then building up to doing more difficult ones.

I'll give this some thought. I could start off by being bolder at looking at people who I'm fairly sure will be friendly; and once I've been reassured about them, it'll make me more confident about observing more about the way other people are reacting.

Another thing that made me get feelings of humiliation again was thinking that people must think I was totally responsible for the way the conversations went badly, so when they did, it was my fault. I always think that. I always think that if there's a silence in a conversation and no one can think what to say, it must be my fault for being such a bad communicator.
But really, the other person's just as responsible for making a conversation go well as I am. And if it goes badly, it might be because they couldn't think of what to say either. Or it might be because they think I feel unfriendly towards them and don't want to speak to them, when really, I'd like to, but my anxiety stops me thinking of things to say. So once I stop being so anxious, that should stop happening. I shouldn't think that when a conversation goes badly, they're bound to blame me. They might even be blaming themselves.

Point 19: "I feel angry and frustrated with myself for being so stupid that these things get to me so much, and that everyone can enjoy themselves so much more than me."

I shouldn't allow myself to keep feeling stupid because I'm the way I am. After all, if other people had had the life circumstances I have, maybe they'd be like it.

Bad and Good Ways of Expressing Anger

I know I get in an irritable mood sometimes because I think I'm missing out on things.

Or sometimes, I behave in a hostile way to other people, which hides my anxiety. I wonder if that's what some of the school bullies were doing to me. Interesting. So instead of really thinking I was all that bad, they might just have been a bit scared of me, fear of the unknown.

One of the magazine articles says that we should be careful not to take anger out on people who don't deserve it, anger they might have done nothing to provoke, that we've got because we're really angry with ourselves or a situation, or something else that was nothing to do with them.

Yes, I suppose I do do that sometimes. But then they get annoyed, and I end up feeling worse.

But it says that anger can actually be useful, because if we're angry, we might be bold enough to do things we wouldn't do if we were feeling fearful, so we can use anger at a situation to motivate us to face it. So, for instance, if we had a panic attack somewhere we enjoyed going, and we feel as if we made a fool of ourselves, but we get angry because of what happened the next time we want to go rather than fearful that we might have a panic attack again, and we think something like, "Why should that panic attack ruin my enjoyment of this?! Why should it stop me going back?! I'm not going to let it spoil my fun!" our anger might make us bold enough to go back. And then we might notice that no one seems to be remembering what happened before, so that might reassure us, and we might not feel panicky this time, and our anger should go away again.

Thinking of Ways to Bring Enjoyment Into Life

The self-help book says we don't have to miss out on as much enjoyment of life as we might think. It recommends we make ourselves more cheerful by getting involved in activities that have nothing to do with social anxiety.

It suggests we could do physical activities like gardening or physical exercise; recreational activities like reading good books and listening to music; learning new things, like how to cook appetising-sounding new food, watching good things on television, or doing things on the computer; and creative activities, like painting, drawing, playing a musical instrument, doing some kind of craft like learning how to make useful or pretty things, creative writing, and things like that.

Yes, maybe there are things I could do for enjoyment that I didn't think of before. Some of those sound nice.

And it recommends we try to think of everything we can think of that we could do without anxiety that we'd enjoy, thinking back over the past to see if there's something we used to do that we liked doing but gave up, but that we could start up again, and new things we might like if we took up, perhaps things we're curious about learning about. It recommends we write a list of activities we might enjoy, trying to get ideas by thinking about anything we've done before, and what anyone in the family does.

The book says that even if we're lonely, doing more activities we enjoy on our own will stop the feelings getting to us so much, until we're confident enough to be with other people more. Then we can do more things with them as well as carrying on the activities we enjoy doing on our own.

Physical Exercises

I've heard they recommend physical exercise for people with anxiety, since we can work off nervous energy with it, and it can also help get rid of the energy from angry feelings.

The thing is, I'd risk meeting people if I went to sports centres and things.
Then again, if I went swimming more, I wouldn't have to talk to them.
If I bought some keep fit tapes, I can exercise at home more till I get more confident.
I could do brisk walks around the park. I've heard that's supposed to be good for us and can make us feel more energetic and less tired, as well as relieving tension.

When I do get more confident, I'll be able to start enjoying more of the things that other people do as well.

One of the magazine articles says that exercise has been found to be a powerful antidote to anxiety and depression.

It says that sometimes, if we stay still for too long when we're anxious, our muscles can tense up so much they start causing us pain. Exercise can relieve the tension in them.

It says that a lot of people don't like exercise because it feels too much like work. But since it can help us so much, it's worthwhile making it a part of our daily routine. It says it might be difficult to get around to it until it becomes a habit, which might take about a month, but it says that once it's a habit, we'll just do it as a matter of course, without really thinking about whether to or not.

It says it's best to set a time to do the exercise and stick to that every day, so we don't keep thinking we'll get around to it later and never bother.

It says that if we know of any reason why exercise might not be a good idea for us, we should see our doctor before deciding to do any.

It says we should try to find several types of exercise to do, so we can have a bit of variety so we won't get bored doing the same thing over and over again. It says it'll help us much more if we find it psychologically rewarding, rather than just thinking it's our duty or that it's boring or a burden. So it says we should search out things we enjoy. And it says it can be easier for us if we have some variety in the exercises we do during the week, like doing one fast exercise and one slow one, or one team one and one alone.

It recommends we do stretching exercises, besides the exercises that we choose ourselves. It gives instructions on how to do them.

It says we should never force or strain any of our muscles in doing the exercises.
Well, I think if I do them, I won't do them too vigorously, in case I stretch something a bit too far and pull a muscle or dislocate something.

It says that caution and correct breathing are important. It says we should breathe slowly and deeply, and breathe out fully. It says if we can stay aware of our breathing, it'll help us reduce stress.

Instructions For Some Exercises

It says that one type of exercise is called shoulder rolling. That's where we slowly move our shoulders around. We let our arms hang loosely, and pull our shoulders down a bit, move them forward, upwards and back around, and continue the process slowly several times, and then do that in the other direction instead for a while.

It says another exercise is called a shoulder stretch, where we lay our forearms on top of our head, and grasp our right elbow with our left hand, slowly pulling it behind our head. We should do it quite gently, not forcing it. Then we should hold it for several seconds, notice how it feels, and then let go and repeat the same thing with the left elbow being grasped by our right hand.

It says another exercise is called arm shakes, where we let our arms hang by our sides, and then we lightly shake our right hand and wrist. Then we slowly increase the movement to include the forearm and elbow more. Then we start to shake our arm with more energy, and shake the whole arm for one minute. Then we swing the whole arm back and forward from the shoulder while still shaking it. It doesn't say how long for. Then it says we should just let it hang by our side, feeling the sensation in it. Then it says we should do the same with the other arm.

It says another type of exercise is called leg shakes, where we balance ourselves with a hand on a table or something, and then lift the right leg a bit and begin to rotate the foot and ankle. Then we start shaking the foot, ankle and lower leg. Then we include the leg up to the knee, then the whole leg. Then we shake it more quickly. Then we swing it as we shake it. Then we stop and notice how it feels. Then we do the same with the other leg.

It says another exercise is called sitting toe touches, where we sit on the floor with our legs together straight out in front of us, and we try to reach down to touch our toes with both hands, slowly, gently trying to bring our foreheads down to touch our knees. It says that when we feel the resistance, we should hold the position for a moment.

It says another exercise is called a side stretch. That's where we stand with our legs shoulder-width apart and straight, and then put our right hand on our right hip and hold our left arm above our head, slowly bending to the right. It says we should hold it for a moment, feeling the resistance, and then do the same on the other side.

It says another exercise is called a back stretch, where we first stand straight with our feet shoulder-width apart, and then bend over forwards from the waist with our shoulders, neck and arms relaxed, until we feel a stretching in the back of our legs. Then it says we should hold the position for a moment, then bend our knees to take any strain off our back before standing up straight again.

Well, I'll try those a bit to see how they make me feel, and if I like them, I'll do them some more.

The last exercise it mentions is called scalp massage, where we put our arms up and our elbows out, and move our fingers in small circles, pressing gently all around our head, and around our face.

Well, that sounds as if it could be fun.

Point 20: "I feel as if I'm different from other people, as if I just don't belong, as if everyone else is much more competent than me. I thought they must all think I'm weird."

Conversational Skills

Really, they were probably too busy thinking about other things to think much about me. But I think I might be confident that I can fit in more if I felt happier having conversations with people.

One of the magazine articles talks about conversational skills. It says that most people have been in situations where they were stuck for things to say and the conversations were full of awkward pauses while they tried to think of things, and not being able to made them anxious, and then they thought things were worse than they really were.

It says that asking questions is often the best technique of starting or keeping a conversation going, and the purpose is often to find out about things that we and the other person are both interested in and would like to find out about more.

It says there are two types of questions, closed questions and open-ended ones. It says closed ones are likely to get short answers, like yes or no. But open-ended ones might get longer answers, so they'll be the best ones to use if we want to find out the most about someone.

It gives some examples of closed and open-ended questions. First it gives examples of closed ones and likely brief answers:

• "Do you work in this building too?"
  "Yes."
• "Do you like it?"
  "It's allright."
• "Have you worked here long?"
  "Three years."
• "Do you live around here?"
  "Yes, just around the corner."
• "Do you go to parties very often?"
  "Sometimes."
• "It's a bit hot in here, isn't it?"
  "Yes."
• "Are you as bored as I am?"
  "Probably."

Then it gives a list of open-ended questions, that often give people room for giving longer answers:

• "Where do you work?"
  "At the hospital."
• "What do you do there?"
  "I'm a children's nurse."
• "Oh! What kind of ward do you work in?"
  "I work on a specialist liver ward, where children come in to have liver transplants, and treatment for liver complications that aren't quite bad enough to need liver transplants. But I don't work with the children themselves, but educating their parents about how to look after them when they go home, and how their conditions will affect them."
• "From your tone of voice, you sound as if you enjoy it. What do you like about it so much?"
  "I really enjoy working with people, and it gives me a sense of achievement when I've been able to give the parents the information they need and reassure them about the problems they're facing. Some of the parents are really nice, and since I spent so long looking after the children, some of whom are in there for ages, I got attached to them, so it's nice to think I'm contributing to their welfare by teaching the parents how to care for them better."
• "Why did you leave the wards to educate the parents?"
  "Well, I'd been working on the wards for some time and I fancied something new. I knew I enjoyed educating the parents, since I was doing some of that anyway. So when a full-time job came up where I could be doing that, I went for it. I do go back to the wards sometimes and help out, and it's nice to see the children again and give them a cuddle from time to time."

The magazine article says that the examples illustrate that a lot more information can be given if we ask questions that begin with "What" and "How", than from questions that begin "Do you" or "Are you".

It says that people won't always be interested in talking about what we've specifically asked them about, but still, open-ended questions do give them more room to talk about what does interest them.

And it says another reason they're better is that since they keep conversations going longer, we won't have to work nearly so hard thinking up new questions to ask.

It says we don't need to get anxious if we're not very good at thinking up open-ended questions at first, because we'll get better with practice.

It says that if we haven't got an open-ended question in mind to ask them but we are interested in what they're saying, and we don't feel like telling them anything about ourselves because we want to hear more about them, a good technique is to paraphrase something they've just said back to them, or highlight something, to indicate to them that we'd like to hear more about it. So a conversation could go:

• Stranger: "I'm a teacher at a primary school. Young children are often fun to work with. They're so open to new ideas and so curious."
  Us, highlighting something: "You really like working with these kids?"
• Stranger: "Yes, they want to know everything. I'm always on the go."
  Us, highlighting: "They obviously keep you very busy."

It says that as it shows, when we highlight things, it means we have to be listening carefully to what the other person says, and thinking about what they're saying about their feelings and preferences. It says that as well as encouraging them to expand on what they're saying, highlighting lets them know we've been listening, and everyone likes to think they're being listened to, so they'll probably be pleased.

It says that if we're talking to someone we want to be with but we want to change the conversation, there are ways of changing the subject. It says that being direct and honest can be the best way. It says that people will naturally pause for breath, so it can be best to wait till then, or more considerately, till they've finished the point they're making or the story they're telling, and then say we'd rather be talking about something else, if possible giving a reason, like, "I'd like to hear more about how you're getting on", or, "I'd rather we didn't talk about this person, because they're not here to defend themselves", or whatever, and then ask them a question about something unrelated to what they were just talking about.

It says that if we want to end a conversation with someone, because we're not interested in what they're saying or we're running out of things to discuss, there are things we can do. It says that knowing we have the ability to end a conversation before we quite run out of things to say will help us relax and give us more of a sense of control. It says that signals we can use are moving away slightly, and reducing eye contact and the amount we nod. It says that then, we can tell them we'd like to end the conversation by saying something like, "I'm going to get a drink and circulate a bit. It's been nice talking to you." Or we could say something like, "Oh, Becky's over there. Excuse me; I'd like to go and see how she's getting on."

It says that if the person we're ending the conversation with is someone we like and we'd like to talk to them again sometime, we could say something in a friendly way like, "See you again later". It says that a lot of what we convey is communicated non-verbally, so if we use a dull tone of voice, look bored, or show signs of irritation, it can leave them feeling as if we don't like them. So it's best to let them know we're ending the conversation in a pleasant informative way that doesn't put them down and make them think we want to hurt their feelings.

Feeling Scared to Go and See the Neighbours

Better a diamond with a flaw than a pebble without.
--Confucius, (Analects)

Try as hard as we may for perfection, the net result of our labors is an amazing variety of imperfectness. We are surprised at our own versatility in being able to fail in so many different ways.
--Samuel McChord Crothers

Mistakes are part of the dues one pays for a full life.
--Sophia Loren

The Story Itself

Relaxation Exercises

First the magazine suggests a breathing exercise we can do, and then it suggests one or two relaxing day-dreams we could have.

A Breathing Exercise

As for the breathing exercise: It says that at least when we do the breathing technique the first few times, we should find a comfortable position to sit or lie in, where we'll be resting our back, head and shoulders.

It says we can close our eyes, and then breathe slowly in through our nose with our mouth shut to the count of six, or we can try four if we can't manage six. We can imagine we're gently trying to get the breath right into our stomach. Then we can hold it for two or three seconds, and then we can breathe out slowly to the count of six, or four if we can't make six, imagining we're gently trying to push air up from our stomach to get it out. It says it's best to breathe slowly and effortlessly.

It says some people gasp air in quickly all at once and then hold it for all the time they count, and then let it go again quickly. But that doesn't help them relax. That's not much better than what the body's doing anyway, breathing too fast. We need to breathe slowly and evenly for the technique to work.

It says that if we put a hand on our stomach while we're doing the breathing, we'll be able to tell if we're breathing far enough into our lungs, because if we are, our stomach will inflate like a balloon when we inhale, and fall when we exhale. If we're not doing it right, our chest will move more.

It says it's good to take about 15-20 breaths. That might well relax us. It says the exercise might take five minutes.

It says that when we've practiced the exercise a few times, we can use it in any situation where we feel a bit tense. We won't have to go and lie down or sit somewhere comfortable or have our eyes closed. We can do the breathing technique whatever position we're in. So if we knocked on someone's door, we could do the slow breathing for a minute or two while we waited for them to answer it. Or just before we went out, we could do it for a few minutes. Or even sitting down with other people, like at a wedding reception, we could do the breathing while we're not talking to anyone.

I'm going to try this. If it works, I'm going to try it in all these situations in the future, when I'm out, or when I'm getting a bit worried about going out, or whatever.

It says that anyone with asthma or another lung disease should see a doctor before doing the breathing exercise.

Day-Dreaming About Nice Things

The magazine article says that when we've relaxed the body, it can also help calm us if we relax the mind. It says one way of doing this is if we close our eyes and try to imagine ourselves somewhere where we really enjoy being, either an imaginary place or a real one we like, like a place of natural beauty perhaps, or somewhere we once enjoyed going on holiday. It's best to try to imagine every detail we can about the place to make it as realistic as possible, to give us more of a chance of getting engrossed in it and forgetting our anxiety. So if we can, we should even imagine details like colour, subtle shadings, amount of daylight and sunshine, temperature, types of sounds, their volume, the time of day, the movement of objects and other things, what the objects around us are like to feel, what smells we can smell, and how we feel about being there.

While we're doing that, it says we should remind ourselves how peaceful and relaxing it is there, and how calm and secure it's making us feel. It can be a day-dream we can choose to have any time we want to relax and calm our minds down.

We can imagine gradually drifting into it if that makes it easier for us to get our imaginations going, like imagining walking down a long flight of steps onto a beach, with everything gradually coming into view and hearing, such as children playing, the waves lapping the shore, and so on; or walking into a wood, gradually seeing and hearing more and more things.

It says that when we do this, it's best if we find somewhere comfortable and quiet to sit where we're not going to be distracted.

It says that making the images as clear, detailed and convincing as possible might take time and practice.

It says that we can say things to ourselves while we're imagining ourselves in the nice scene, like, "I'm letting go of all the tension", or "I'm becoming calm and relaxed".

It says that when we've finished, we can guide ourselves back to an alert state of mind if we think we need to by telling ourselves a few times that we're becoming more and more alert.

It says that it might help us to imagine a scene in great detail if we think about what would be nice, and record our description of it onto a tape, describing what we'd like to do there; and then when we want to day-dream about it in the future, at least at first when we haven't practiced much, we can play the tape back to ourselves, to prompt our minds each step of the way on what to think of while we're day-dreaming.

It says it's best to write a script to read onto the tape if we do that, and then to read it slowly. We can get an idea of how slowly to read it if we run through the day-dream in our heads while we're rehearsing reading it before we record it.

So maybe it could say something like:

"You walk into a wood. You go slowly down the path smelling the nice tree scents as you go, listening to the sounds of fallen leaves crunching under your feet, seeing the sunlight through the trees, and listening to the sounds of birds. After a while, you come to a clearing. You sit on a rock to listen to the birds ..." etc.

It says there may be times when we want to do a little day-dream like that to calm ourselves down, but we haven't got time for anything too detailed; so at times like that, we can just picture ourselves luxuriating in the shower, perhaps, or enjoying soaking in the bath, anything we'll enjoy imagining. We can still imagine some details, like the warmth of the water, the feel of it on us, and how that makes us feel. We can breathe slowly and evenly all the while if it helps, and if it works for us, we can imagine that with every breath we breathe out, anxious thoughts are being breathed out with it and blowing away, leaving us feeling relaxed in the warmth of the water.

It says that another type of image that it can be useful for us to bring to mind is one of us wearing something we wore when we did something successful, and we can imagine ourselves being successful again. We can imagine we're confident, knowing we can succeed, experiencing again all the good feelings we had when we were successful last time.

Another suggestion is that we can imagine ourselves surrounded by an imaginary shield that no one else can see, but it protects us from harmful words, so criticisms and judgments just bounce off it before they reach us, so they can't hurt us. We can imagine it goes wherever we go.

It says it's best if we do relaxation exercises often, and they're best done before and after we go into an anxiety-provoking situation. It says that during an event that makes us anxious, it's best just to do the breathing exercises.

Point 2: "I do that when I want to get something from the shops sometimes - waiting till they're less crowded before going, so I won't risk meeting so many people."

I expect I worry far more than I need to really. After all, thinking about it, I think people probably are too busy to be noticing too much about what I do.

Using Laughter to Release Tension

One thing one of these magazine articles says can help us is if we build up a collection of humorous things and think of things that can give us a good laugh before we go to places, to release our tension, perhaps some comedy sketches on tape or something.

But it says it's best not to come to rely on things like that in case we run out of them.

It also says that it can be good to think of funny things to say in case we do things we think are clumsy or below standard while we're out. For instance, if we go somewhere where we have to sign our name at the check-out, and we're usually really self-conscious because we think our signature's bad, especially if our hand's shaking while we write it, it can help if we think of a joke to make about it, like, "Oh dear, that's not very good. Aren't you glad I'm not your doctor!"

Then people might laugh at the joke, and then get on with what they're doing, so we won't have to worry about them looking down on us.

It says that laughter's good for us anyway. It says it boosts the immune system, lowers the blood pressure, increases the disease-fighting T-cells, and makes us feel better.

It suggests other ways we can get ourselves laughing more, like finding ways to be more playful; trying to surround ourselves with playful or humorous other people; making a point of doing one playful thing a day at least; watching children and/or animals playing; collecting cartoons and jokes to post to or share with other people; looking for humour in what happens to us and in life in general; and watching comedy programmes or videos we like.

It does warn us not to use humour as an outlet for anger or aggression though, hurting people's feelings by being sarcastic or making horrible jokes about them.

Point 3: "I expect they don't like me. After all, I'm not really any fun to be around. They probably don't want me with them."

Not Reading Too Much Into Things

Well, they've never said they don't want me with them, actually. I think I just think I'm such a failure that I can't believe they do. Sometimes, I've been talking to them and they've seen a friend and ended the conversation quite abruptly and gone off to talk to them, but thinking about it, that's probably much more to do with their liking for their friend and desire to meet them before they walk away than it is to do with their feelings towards me. I think I'm maybe too suspicious sometimes.

Anyway, I'm going to take up as many of those suggestions as I can about how to bring more humour into my life. I'm going to start collecting jokes and thinking of funny things to say if I do think I've done something badly. Then I will be more fun to be around, so whether I needed to worry about that before or not, I won't have to worry about it any more.

Point 4: "I expect they wonder why I haven't left home yet."

Raising Low Self-Esteem

Thinking about it, I've got no evidence that they do. I suppose I just assume they must, because I'm ashamed of not having left home yet.

The self-help book says that thinking like that might mean we have low self-esteem, which means we don't think we live up to the standards we consider we should, and we don't accept ourselves if we think we don't, and we don't believe other people accept us whether we do or not, even if they do really.

It says that when self-esteem is low and people feel worthless or as if they haven't got anything useful to contribute to society, they don't feel confident enough to try things, and so they can contribute even less, so they just end up feeling worse.

It says the cure for it is to do things that will make us feel valued, like finding ways of helping other people. Then even if people do think badly of us, like wondering why we haven't left home, we'll at least still feel like worthwhile people, so it shouldn't matter to us so much.

But it says that sometimes, people can think highly of us even if we don't ourselves.

Actually, the neighbours might think some good things about me. I'll try and remember things I've done in the past that might have made them think well of me.

Notes and Links

The Backstory

The Distressing Way Things Are Before They Begin to Improve

Louise has developed a social phobia. Her fear seemed to get much worse when she was in her mid teens. Now, at the age of 23, she still lives with her parents, even though her father criticizes her for still living at home, saying they wish she'd move out. He just doesn't seem to understand her fears. It isn't as if 23's all that old anyway, but she still feels inadequate because of his unreasonable criticisms.

Her mother was always over-protective of her, constantly warning her not to stay out after dark or go out without a coat when the weather got colder, or go near her schoolmates when they developed coughs and colds. Her mother's very anxious herself. Louise thinks this might have contributed to her social phobia.

But also, her father was in the army for most of her life, and they had to move from place to place, which meant she didn't have much of a chance to develop new friendships and learn good communication skills by interacting with familiar friends.

Worse, she was bullied at every new school she went to. People made fun of her because her accent wasn't like theirs, because it was like the one in the place she'd just left. And they called her ugly and fat, even though she wasn't really, or other unkind things.

Because of her anxiety about being at school, Louise began to stutter and her mind would go blank whenever teachers would ask her to say something, which gave them the impression that she was stupid, so they often criticized her unkindly. So she became more and more anxious, thinking she just wasn't acceptable to people and was inferior and stupid.

When she did do a good piece of work and took it home, sometimes she'd be praised, but sometimes she'd be criticized for not doing even better, so she could never be sure what was going to happen. The uncertainty made her more anxious.

She felt a lot of uncertainty in other ways also, since sometimes when she went to her mother about a problem, her mother would sympathise, but sometimes, she'd shout at her for being a nuisance while she was busy, or for not being able to cope with it herself; and it took a while for Louise to work out how to predict when she was likely to get what reaction and only go to her mother when she knew she was in a good mood. So she felt insecure.

Because Louise never got the opportunity to develop good friendships with people and improve her communication skills, she began to feel inadequate in company where she felt she wasn't as witty and good at conversation as everyone else. She thought there must be something odd about her and that no one could like her.

However, she wasn't nearly as bad at communicating as she thought. The problem was that the more anxious she became, the more she focused on her supposed inadequacies, and so the less she concentrated on taking part in conversation, so she never got the chance to become confident in her conversational skills. Her growing anxiety turned into a phobia.

Now, she thinks she's a hopeless communicator, and thinks she must be fat and unattractive. She's sure no one will want to know her once they start speaking to her. She's got no confidence. She has got a job, but it's boring and repetitive, not at all what she'd like to have done. But she doesn't feel she's got the confidence to go for anything better, because it would mean having to meet more people and be trained, and if she found it difficult to do something she was being trained to do, she feels it would show up her inadequacies and make her look bad and feel worse, because people would judge her and criticize her.

She's become scared to converse with people in public, worrying that she'll make a fool of herself or they'll think she's boring or silly or unintelligent, or she won't be able to think of anything to say.

She gets panicky at the thought of eating in public or of doing anything where she's likely to be the focus of attention or might do something wrong, in case she looks bad.

She stays in a lot of the time, because going out where she might meet people frightens her so much.

When she does go out to social occasions, she does things to try to limit her anxiety, like turning away when she sees someone coming who she worries about talking to, so they'll think she isn't interested and hopefully go away. She doesn't like to walk into a room alone, so she waits for someone else to go in and then creeps in behind them, hoping they'll get all the attention.

For hours before she goes to a social occasion, she worries about what might happen - whether she'll make a fool of herself by not being able to think of what to say, or by not being able to hide her trembling and blushing, or whether people will ask her to talk about things she doesn't know about.

Afterwards, she thinks through what happened, criticizing herself for every tiny little thing she feels she did wrong, like if she didn't look at someone enough, or was too anxious to concentrate on what she was saying properly so she got her words mixed up. She feels sure people must think she's stupid because of it, so she feels stupid herself, and can criticize herself for it for ages.

A lot of the time though, she doesn't dare go out at all. So her life's boring, because she doesn't develop new interests. And she sometimes feels lonely, but she doesn't know how she can feel comfortable meeting more people. She feels as if she's a failure, and that everyone seems to be more capable than her. She knows her fear's way out of proportion to the real risks, but she feels as if she just can't help it, and this makes her feel even more inadequate and inferior.

Sometimes, when she does meet people, she accidentally puts them off her by being aggressive towards them, because she expects them to be hostile towards her, and so she behaves defensively.

She gets depressed at the thought that she could have the anxiety disorder for years and years. She worries that it'll mean she'll never achieve anything in life.

When Positive Change Begins to Happen

One day, her mother buys her a self-help book, and gives her a few articles on social phobia she's found in magazines, in the hope that she'll get over her anxiety problem and become more confident. Louise finds them interesting, and starts to put what they teach into operation.

Over the coming weeks, there's a big improvement in her mental health.