Thursday, July 19, 2007

The Cure for Self-Consciousness

Cham says, "Read this Mom," and tosses me the July copy of O, the Oprah Magazine.

"No time, Cham."

"But we'll be on an airplane forever. What are you talking about? You'll have plenty of time, Mom."

I've got nothing but time. She's marked the article, The Cure for Self-Consciousness. If Cham says Read it, of course I'm going to read it. She represents the younger smarter people out there. (Like you, right?)

Martha Beck starts us out at a cocktail party. (Already you like it, I know) She tells us to picture ourselves in a bad dress or something we think looks or fits badly.

So I'm supposed to think I look like a whale and I'm positive that everyone is staring and laughing at me at this party. And I'm embarrassed and ashamed. Not hard to do this visual exercise, is it?

But because we're logical thinkers and entertain a cognitive therapy, we know that the feeling of exposure is irrational and rooted in some kind of early childhood narcissistic injury.

Like maybe your mom said, You're not going to wear THAT are you?

And you say to yourself, It's not all about me. It's unlikely that most people are really looking at me or noticing me or even caring I exist.

But O is talking to readers who obsess anyway, who might know that but can't stop worrying about how they look and sound, or if they're dead silent in social situations, what people must think of that. And they have nightmares, like those we've discussed earlier in the fear of exposure post, dreams about being the only naked person in the room.

I'd say, by the way, that if you might be sensitive to a full page photo of a naked woman desperately trying to cover up, definitely don't buy the July issue of O. (Why is this necessary, someone tell me. Is it art?)

The problem here, according to Ms. Beck, who makes no claim to a relationship with the famous cognitive theraps, is that we're so worried about appearances and what other people think that we don't do the good things we want to do. We box ourselves into very boring lives.

She's right.

I remember my mom at that Gater Park in Florida just last winter. She didn't want to do the Everglade speed boats (there's a special name for them, I can't remember it) and her "better" judgment years ago would have held her back. But with only a little encouragement (she's with me, FD and my father, after all) she got on that boat. And her hair blew in the wind like crazy and none of us have ever, ever seen her laugh so much in our lives. It was wonderful.

Beck calls that fear of being judged negatively performance anxiety. I also see it associated with not so simple social phobias and anticipatory anxiety, worrying about worrying. Call it what you will, Ms. Beck brings up a study about the "spotlight effect."

I didn't see the study but I think that we can talk about the results anyway. Keep in mind that all we're doing here is passing on a few cognitive tools and the language we therapy docs tend to use at breakfast. (My kids tried to be polite about it unless I talked about sex and then it was, Shut up, Mom). Anyway, we haven't critically examined research on this blog and I don't intend to do that here. It's a blog.

So three psychologists, Glilovich, Medvec, and Savitsky coined the phrase Spotlight Effect and suggest that we must develop a "mental dimmer switch."

I love the metaphor, even if I doubt the outcome of their work. The study and supposedly other similar studies finds that the spotlight effect makes most of us think that we're getting twice the attention we actually get. We overestimate how much people are staring at us. If we realized nobody cared we'd worry less, but instead we magnify how much people care by two.

These social experiments bear repeating, as all experiments do. It's all about the way variables are measured and if the measures measure what they should. If I had to guess, I'd bet people quadruple the number of people they imagine are noticing that stain on the tie, that bad hair day. I'd even double quadruple it.

I suspect we only get a tenth of the spotlight we think we get, if that.

It really isn't about us. There's so much more for life to be about.

But many people have disabling anxiety and it's no laughing matter. Perfectly normal looking people come to therapy and say that they look in the mirror and see Frankenstein.

And I tell them: Even people with fairly good self-esteem see Frank in the mirror.

We're all a little paranoid is the truth, some of us much more so than others, and yes, social context makes all the difference. Why we are this way? I used to blame Madison Avenue. But I know it's probably a mix of genetics and the way we grow up. And Madison Avenue (environment).

Cognitively we can trace this anxiety to fear of exposure. Although the O article doesn't use this language, it's possible the therapy docs who did the research do.

The journalist is totally right when she tells us that reluctance to take risks socially limits what we do. We grow with new experiences. I'm pretty sure our brains get bigger as they forge new cellular pathways. It's mind-expanding, so to speak, when the roads not taken, those neural highways in the gray matter, are taken.

She's also right when she says that people who feel they're in the spotlight exaggerate their mistakes and under-emphasize their accomplishments. They also tend to under function: they don't shout out good ideas; they dress too conservatively; and they rarely sing or dance in public.

Don't tell me that can be a good thing sometimes. I personally like it when it's off-key but happy. (Remind me to tell you about that choir I was in 10 years ago.)

The docs who did the research also say that people regret it when they fail to try new things. We should go ahead and try things even when we doubt ourselves. We should take a risk or we'll regret not having worn that red dress, never having skied.

For sure on that dress.

And there's MORE! Remember, O has promised to pass on the CURE for this problem, so there has to be more, and it's all good, if not the cure for everyone. As I've indicated, if you've had a traumatic history advice won't make much difference. You need to be in a place to take advice. To make bread you don't just need yeast. To make a person rise, having advice is like having a little flour and water, a good start, but not enough to make bread happen any day soon.

The cure:

(1) We need to recognize that social fear is universal.

So I worry that I might be wearing two different socks, which can happen if you're me, but tell myself that everyone else is worried about how they look, too. If a patient isn't worried about socks, there's cellulite.

We should only care what the good guys say, by the way, and they won't care what we're wearing.

(2) We're supposed to double everything.

We docs are always going to tell you to exaggerate something, so doubling is a nice start. I prefer to think of it as over-shooting because you probably won't really over-shoot, so if you at least try to over-shoot you'll shoot. We learn this from the great 12th century Jewish thinker, by the way, the Rambam.

The research gurus are totally right. If we successfully rouse up the courage to put ourselves out there socially with gusto, then it is likely we'll be be appreciated for at least having some guts. Then there's always appreciation for providing comic relief and permission for others to chime in on a conversation, too.

(3) Think through your limits--not to them (I'd say, not about them).

A sensei taught Ms. Beck how to break a board with her hand. She had to pretend that the board didn't even exist and was told to aim ten inches behind it. Apparently you're not supposed to even be thinking about hitting the board itself. The focus is beyond the board, it's what's beyond the feared stimulus that matters.

Now this is great stuff. We see a situation as potentially very embarrassing so we're focused on the embarrassing moment, but we shouldn't. A person who is less anxiety-ridden still might see a possible negative experience, but keeps eyes on the prize, drives in the rain, so to speak, to get where he's going.

No pain no gain.

(3) Finally, there's the Universal Question, and Beck does a great job with this, by the way, her build up is really cute. The Universal Question is:


I personally go with So what?

Beck: If I do that I'll look like a clutz. So?

Beck: I say that, people will disagree. So?

Therapydoc: They'll think I'm nuts. Yes! So What? Who doesn't need therapy?


1. You want to worry? Worry about something that's already happening, not something that might happen. Like child abuse, for example, or the exploitation of women. Racism. Genocide. Then go to work on eliminating those things.

2. What we've talked about is all cognitive-behavioral therapy. Do you see how?

When you use your logic and imagination, it's cognitive. But the idea that you should make the spotlight less intense by subjecting yourself more to the source of anxiety is behavioral. It's an exposure therapy.

3. To make the spotlight feel less intense, you push yourself into it and find out what confident people already know:

The spotlight's not so bad, and someone else is going to take it from you anyway. In a nanosecond.

Copyright 2007, therapydoc


Jasia said...

The other cure for social phobia is turning 50... it's what the Red Hat society is all about. What is it about turning 50 that so often makes people (in this case women) no longer care what people think about them? I don't know but it sure happens a lot. I've experienced it myself and the best explanation I can come up with is that a certain self confidence comes from simply having a 50-year span of your own life experiences. You can truly say "I've been there, done that" to so many things by the time you're 50 you begin to feel like an expert at life, your own life. And what "expert" worries about being challenged by those with less knowledge in the field? Not many, because they are confident in what they know. Who knows me better than me? No one. So I should care about what others think of me why?

Anonymous said...

Nice post! I'm starting a graduate program in the fall at a school with only twenty five students in the program, and I'm a little nervous! This post definitely helps to keep things in perspective.

Tiffanie said...

I like Martha Beck. I go to Oprah's magazine just for her common sense articls.

I also like your blog. I've learned alot here.

Heidi said...

I swear some of these social phobias are contagious. But as part of the still-a-tad-younger and not-as-smart representative of the generation X, I want to say... thanks.

therapydoc said...

JASIA, this is such a great comment and I have so much to say on it that I'm just going to wait and write about it. I'll quote you though, you can be sure, if that's okay.

therapydoc said...

Thanks TIFFANIE and CURIOSITY KILLER (obviously very bright, both of you) for the chizuk (pat on the back, rhymes me ME-TOOK)

And JULIE, we're going to need your help coming up. So enjoy school and help us out often!

Jasia said...

Quote away... I'm honored! I'm also confident enough in what I've spoken of to not feel threatened about what you might say ;-)

therapydoc said...

Not to worry, I totally agree with you.

Anonymous said...

Thank you for sharing this with the Carnival Against Child Abuse

April_optimist said...

I'd also suggest another factor: the friends with whom we surround ourselves. Are they people who support us "going for the gusto" and doing new things or are they people who are only too happy to point out our (perceived) flaws to us? I suspect many people with social phobias tend to have the latter kind of friends who reinforce these fears. It may be very helpful to step back and ask ourselves if these are the friends we really want to have or if maybe it's time to get new ones.

Anonymous said...

Your post is excellent.
Social phobias have reached epidemic proportions. They're out of control and we're all caught in their vicelike grip. Few of us escape them.
We're brain washed by the media, into believing that what we look like to others,is of utmost importance in life.

therapydoc said...

Exactly, pastfirst. Thanks for writing.

rainah said...

I've only just come to this after Google-searching "curing self-consciousness." It's all very true! My therapist puts the "so" question gently to me quite often, yet the thoughts sort of get caught in a repetitive cycle of 'anxiety-ridden negative thought/feeling', 'rational voice interjecting logic', and back to the beginning. I tried CBT and it didn't work out, and EMDR for a moment, also not for me. Now we're doing DNMS therapy. Hopefully I'll be better soon! Thanks for your blog, belated as this comment is!

therapydoc said...

Thanks for stopping by!

yogatherapy said...

I like your post...! we don't have to care too much of people who not support us, we can ignore them to keep our mind positively. However, try to keep the faith to another as a humanity so we can feel much better.

SEH said...

Oh, I know I'm writing a lot today, but I'm reading a lot of your blog on this rainy Friday!

I just wanted to comment that Buddhism says that it IS all about us. In that, it's what we allow our heads to be full of.

The cure, in Buddhism, is to focus on what actually IS, instead of thinking about what might be, whether it's a fear we have, or even wishes for our future. That's what makes us miserable and unable to enjoy this moment right now.

I think your conclusions mirrored these ideas, so just thought I would write to add that. great common sense advice!

therapydoc said...

To behave in ways that aren't completely irrational, "being here now" as opposed to the past or the future, helps quite a bit. Not easy, of course, and for someone suffering from mental illness, it isn't even necessarily the answer.

Better Things-- Seeing Ghosts