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The Core of Social Anxiety.

One of the first things I learnt training to be a therapist, was that we all experience social anxiety.  Up until that point I had thought it was just me! 

Looking at it from an evolutionary point of view it makes sense.  For most of our evolutionary history we lived in small familiar groups.  Strangers usually meant danger.  Furthermore, assuming a dominant position over strangers (like we do when public speaking) might usually be expected to lead to death.

For some men, their anxiety of social situations is so strong it actually stops them from doing things.  It stops them from public speaking, going to the pub, playing sport or even chat up women.  Why do some men find social situations so difficult?

To answer this, it’s worth reflecting on what happens in social encounters that are not marked by anxiety.  In the non anxious case, both people pay attention to each other, and concentrate on what each other says.  The conversation moves back and forth, and all of the attention of both people is focussed on the other person.

In social anxiety it’s different.  The socially anxious person is highly concerned about how they are coming across.  They are scared they look anxious, for example, or that they look ridiculous, or are coming across as stupid.  So in addition to paying attention to the other person and what they say, the socially anxious person is also paying attention to themselves, and how they are coming across.  We call this ‘processing yourself as a social object’.

Of course if you are continually monitoring yourself, rather than pay attention to the other person, you’re not going to be as effective at communicating as you would like to be.  There is also a high likelihood you will be processing yourself in critical and negative terms … and if you do that you are going to feel anxious.

What can be done to help people with social anxiety?  Well like all anxiety problems social anxiety responds well to psychological interventions.  In the case of therapy for social anxiety, it can also be fun.  Ultimately the beliefs people have about how they come across need to be tested in the real world.  If the person is scared of looking ridiculous, for example, what, actually, would happen if they went out deliberately looking ridiculous?

One of the things I used to be scared of was looking foolish.  The way I tested this was to start doing stand up comedy.  You can’t do stand up comedy and look cool … it’s just not the way it works.  So I did a course, built up a routine, and launched it on the world (or more precisely a back room in a Manchester pub). 

What did I learn?  Well I won’t be giving up my day job! But I did discover I can make a fool of myself in public and nothing much changes.  It really doesn’t matter.  However, because I learnt I don’t have to be scared of making a fool of myself on stage, I also learnt I don’t have to be scared of making a fool of myself anywhere.  And that meant freedom!

 

 

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Cognitive behavioural therapy (cbt) for men in Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Telephone and Skype counselling for men wherever you live
• Supervision and consultative support for therapists in Manchester
• Mediation for employment disputes in Manchester and the UK

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Are Intrusive Or Weird Thoughts Normal?

There is a myth about the mind which is compelling, repeated often, but also inaccurate.  It is the view that there is an ‘I’ or ‘self’ at the centre of our mental life that is the coordinator and controller par excellence. 

If this view of the mind is correct, what does it mean if we start having ‘intrusive thoughts’ that do not reflect our character?  Well we are compelled to view that if we are in control, then having such thoughts is a bad thing.  It shows we are a bad person.  We are therefore motivated to try and assert control, and either distract ourselves from the thoughts or find other ways of suppressing or neutralising them.

Many men have a daily struggle with these kinds of thoughts, and in the extreme can result in a worse quality of life than someone with schizophrenia.

So what’s going on here?

Let’s start with intrusive thoughts.  The first thing to say is that we all get intrusive thoughts.  What happens is that strange, bizarre and often offensive thoughts just pop into our heads at random.  In one study, 56% of ‘normal’ men had intrusive thoughts about running the car off the road when driving, and 52% of men think about swerving the car into traffic.  Furthermore, 59% of men get intrusive thoughts about insulting strangers, and 69% of men imagine the home is unlocked with an intruder inside.

So if intrusive thoughts are perfectly normal, why do some men get so distressed by them?

Well this brings us back to the view of the mind that, ‘I’ am in control (or should be in control) of what I think.  If we believe this, and start thinking sexual thoughts against our sexual preference, for example, we are naturally going to become very distressed.

But, in reality, are we in control of our mental life in the way we would like to think?

A good way of testing this is to sit quietly and resolve not to think about anything.  If you have ever tried to do that you will have realised that it’s simply impossible to stop the minds relentless chatter.  What we discover is, rather than an esoteric ‘I’ who is thinking our thoughts, it is rather like our thoughts think us!  Rather than be in control of our thoughts, we simply cannot be in control of our thoughts.  In large measure our sense of ‘I’ or ‘self’ is compelling, but illusory.

If we can truly accept this, there is a radical and empowering conclusion to be drawn.  If we are not in control of our intrusive thoughts, then we are not morally responsible for them.  Having ‘bad’ thoughts is not only perfectly normal; it doesn’t make us a bad person either.  And if that is true, there is absolutely no reason at all for trying to control them.

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Cognitive behavioural therapy (cbt) for men in Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Telephone and Skype counselling for men wherever you live
• Supervision and consultative support for therapists in Manchester
• Mediation for employment disputes in Manchester and the UK

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What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is an anxiety disorder effecting about 2% of men.  It’s characteristics are repeated and uncontrollable ‘obsessions’, which are intrusive thoughts that are not consistent with the man’s values, and ‘compulsions’, which are behaviours or thinking patterns that people use to neutralise the impact of the compulsive thought.

Examples of Obsessions include:

• Thoughts that things are unclean or contaminated.
• Thoughts of having sex with your mother or other inappropriate people.
• Imagining your children being hurt by a stranger.
• Thinking ‘gay thoughts’ even though you are straight.
• Thinking you have knocked someone down in the car.

Examples of Compulsions include:

• Repeated washing.
• Repeated checking.
• Doing things in even or odd multiples.
• Performing rituals.
• Excessive prayer.
• Excessive hoarding.

Of course OCD is just an extreme form of what we all are capable of doing.  We are all familiar with the idea of setting off for the airport and getting anxious about whether we have locked the door or turned the gas off.  In OCD though, this feeling permeates all areas of the person’s life, and can be deeply disabling.  People can be in an anxiety state almost all the time.

We all tend to experience anxiety in different ways.  If you tend to experience anxiety with obsessions and/or compulsions, what can be done about it?

Well understanding your difficulty is a start.  You can get detailed information about OCD and hoarding at Everydayhealth.com.

Treatment from a psychotherapist involves understanding what triggers your obsessions and compulsions, and learning new patterns of behaviour which means you can tolerate intrusive thoughts more easily, and are therefore less likely to get caught up in them and indulge in neutralising compulsions.  Understanding your OCD is important because it will not go away on its own, and may well get worse. 

Drug treatments are also available for OCD which may suit some people.  Drug treatment should be combined with psychotherapy to get the best results.

 

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Cognitive behavioural therapy (cbt) for men in Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Telephone and online counselling for men wherever you live
• Supervision and consultative support for therapists in Manchester
• Mediation for employment disputes in Manchester and the UK

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About This Blog

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The Anatomy of Worry.

All of us, from time to time, get caught up in worries.  Usually something serious and life changing is about to happen.  A loved one may be seriously ill, or our job is under threat.  For about 1 in 20 people, worry can become a serious mental health issue.  Understanding why can help us with our normal, but serious worries.

Generalised anxiety disorder (GAD) is the term given to people whose worry has got out of control.  Typically GAD patients worry about a range of different, often inconsequential, things, and their worry can be characterised as excessive and out of control.  Consumed with worrying thoughts, work output is compromised, and the patient can often withdraw from their social life, and even take to their bed.  Consumed with such excessive and uncontrollable worry, GAD patients understandably feel anxious and down, but also experience other symptoms like tension in the neck and shoulders, trouble sleeping and poor concentration. Typically GAD starts in the early teens and patients suffer typically for 25 years before seeking help!

According to the cognitive behavioural therapy approach to GAD worry can be characterised as having four components.

1.  Positive Beliefs About Worry.

People who worry a lot tend to believe worrying is a good thing.  For example I have worked with worriers who believe that worrying shows they care about people and that worrying can avert a future disaster.  Clearly if you believe worry is an effective strategy, for whatever reason, then you are more likely to do it.  Worrying, of course, is different to problem solving.  It is unlikely that worrying can ever be a useful strategy to solving life’s problems so changing patients positive beliefs about worry is a central part of CBT.

2.  Intolerance of Uncertainty.

A further central feature of people who worry is the inability to tolerate uncertainty.  In many situations in life certainty is neither possible or, arguably, desirable.  Worry tends to rush in leaving the worrier hypothesising endless scenarios in a search to close the uncertainty.  Learning to tolerate greater levels of uncertainty has been found to be essential to help people worry less.

3. Negative Problem Orientation.

When faced with a problem, we can either face it in full confidence of our ability to solve it, or else feel defeated by the problem before we even begin.  The latter is known as a negative problem orientation and is characteristic of many chronic worriers.  Fortunately the attitudes we have towards our life’s problems can be changed.

4.   Avoidance of Upsetting Scenarios.

At the heart of many worries are upsetting situations.  Rather than face these problems head on, worry acts as a kind of distraction which, paradoxically, traps us in the anxiety from which we are trying to escape.  As Tao Te Ching suggested, “Because the sage always confronts difficulties, He never experiences them”. Similarly in CBT of worry, helping patients face their difficulties rather than getting caught up in worrying about them is extremely helpful.

So how does this help us understand normal worries?  Well take the scenario of a loved one seriously ill in hospital.  In this situation we have a realistic possibility that the loved one will die, which is a painful idea.  Worry acts as a distraction from this idea by giving us something to do in the face of the uncertainty.  There is also probably nothing we can usefully do for the person as they are in the hands of the medics. If we also believe that worrying about the person shows evidence we care about them, then we have all the ingredients we need to get caught up in worry.

Fortunately for most of us most of the time, periods of worry are short and transient.  For those who worry constantly, and it is excessive and debilitating, you need to know that it is a recognised mental health problem and professionals will take it seriously.  Perhaps most important of all, there are lots of things that can be done to help you understand and change your worrying.

 

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Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK.  He offers:

• Group therapy weekends for men in London and Manchester
• Beginners meditation weekend retreats for men in London and Manchester
• Counselling for men in Manchester
• Psychotherapy for men in Manchester
• Cognitive behavioural therapy (cbt) for men in Manchester
• Telephone and online counselling for men wherever you live
• Supervision and consultative support for therapists in Manchester

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About This Blog

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