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From the January 1999 issue

         This weekend, I sat in our boat and watched my eleven year old son water ski and ride the “tube.” It was one of the most wonderful days of my life!
 I’m sure you are thinking “big deal, people do that all the time.” But most people do not have an eleven year old son that was so scared of life, that he could not spend a full day at school. A year ago, I was afraid for my son’s mental health. He could not sleep in his own bedroom and he would NEVER try anything that could result in injury.
         I began to realize we needed help when my son came into our bedroom every night. We would have terrible arguments in the middle of the night. We thought we could get him to stay in his room if we left the lights on. That did not help. We got a dog and trained her to sleep at the foot of his bed. That did not help. I sat on his bed with him and then tried to sneak out once he was asleep. NOTHING WORKED! He would lay in bed and think things like “What if the house catches on fire?” “What if someone breaks into the house?” “What if we have a tornado in the middle of the night?” “What if my parents die in the middle of the night?” and on and on. No matter what we told him, he would always think of another “what if.”
         We decided he needed professional help. Much to our dismay, it took several weeks to see a doctor. In those weeks, he began to have panic attacks, stomach cramps, vomiting almost every night and could not go to school. If I left the room to take a shower, he would sit outside the bathroom and bang on the door, begging me to hurry and come out. This affected the whole family. My husband and I began to argue. We could not agree on how to handle the situation. My other two children were angry about all the attention my son demanded. I was beginning to feel hopeless.
         The day we finally got into see a doctor, my son sat between my husband and me in a curled up fetal position, playing with his ear and looking only at the floor. The therapy was strange at first. My husband and I met with the psychologist on the first visit without our son. We explained the situation and talked about our son’s general health and school background. The next visit was with our son alone. I was worried that he would clam up and not talk. He did not like new people or new things. To my surprise my son came out of the office with a smile on his face. I asked him if he talked with the doctor and he said “yeah, a little bit. But mostly we played cards. He taught me a great game called Kings on the Corner.” My first reaction was “you mean all you did was play cards?!” In time, I realized this was a way to help my son relax and I later found there was a lot of conversation during those card games.
         My son learned different relaxation techniques during therapy. For example, he was VERY afraid of thunderstorms. So we got a tape of thunderstorms and he listened to it every day. At first, he listened to it in the day light with his bedroom door and window shades open, but eventually he listened at night in the dark.  This helped him get used to the sounds and if he felt anxious, he practiced his deep breathing and relaxation techniques.
         There were some days my son did not come out of the office with a smile on his face. But these were usually the times when the doctor was asking him to try something new or perhaps the topic of the day was a little too intense.
         In less than a year, with the help of a medication called Zoloft, and a lot of therapy, my son is enjoying life. He is pitching for his baseball team, water skiing, riding bikes and he started middle school and really likes it! Most of all, he is being a normal eleven year old boy. We still have a long road ahead, but with the help of family, friends, and professionals, the read doesn’t seem as scary.

                                                                                    --Amy Whitney and son Lee

From Summer 1998:

Mani: How has social anxiety affected your life?
Dinah: My anxiety is about how am I being evaluated…and my assumption that it’s probably negative. I would burn up if someone looked at me, wondering what the person is thinking that could embarrass me. I couldn’t eat out in public, or go to a movie unless it was really empty and I could sit on an aisle seat. Because of my fear of humiliation, I’ve hibernated and pulled away from the world.

What has helped you?
Reading your book, then taking Dr. Howard Liebgold’s phobia class, I began to understand my anxiety and learn some tools to change it. The first thing we were told to do in the class was list our phobias. I had sixteen social phobias, and my concern about being looked at seemed to underlie them all. The beautiful thing is that as you work on one anxiety-producing situation, several others fall away because they are so interconnected.

What tools did you learn?
We learned about the effects of adrenaline. We compared the brain to a computer that has been programmed to believe that certain situations are life-threatening. Whenever the computer sees a situation as dangerous, it will trigger a dose of adrenaline. I learned that it’s possible to reduce the chemical response by relaxing and breathing, and we can reprogram the brain by talking to the computer. What a relief to have a set of cognitive tools I can use at my own pace!

Can you give an example?
Take my need to sit in the aisle seat in a movie. My brain would tell me that there was a very strong chance that I would vomit on myself or on other people, and the embarrassment would kill me. If I’m on the aisle seat, I can get out quickly, without upsetting anyone else. No one will even know I was here. (I never did throw up in the past. I think what was happening was that when I was a teenager, my parents would drag me to concerts. I was overweight and dressed in clothes that were too tight. I could hardly breathe. In a state of extreme anxiety and discomfort I would think, “Oh my God, I’m going to throw up.”)
    As a social phobic I always felt on the outside, judging people and feeling that they’re hostile. I love the movies so I chose this for my first success ladder. I moved into different seats and watched my reactions. I saw my thoughts about all the ways I might offend people. I used my breathing and relaxation skills and told myself, “I’m not going to die; I can handle this.” Being the scientist, I observed the thought that I might need to leave the theater, but I didn’t leave. With each success, I moved further toward the center. I even disturbed other people, saying excuse me, and nothing happened. My goal was to sit in the middle of the theater…and be part of this global experience, which you miss if you’re always on the outside.
    The big step was to see Deep Impact. The cinema was packed. I noticed my uncomfortable stomach and remembered those experiences as a teenage. But I breathed and I talked myself through it. I was sitting in the middle of the movie theater and noticing what a wonderful, warm feeling it was to not be on the outside. The more I build up these successes, the more that inner threatening voice can’t stop me.

What were the steps on your success ladder about being looked at?
With an elevator phobia you can go floor by floor, but with social anxiety you have to be really creative. It seemed overwhelming at first. Then I decided to cut out pictures of strangers looking at me. I found a picture of three female models but felt terribly uncomfortable. I asked myself, why is this so difficult? Because none of them are smiling! I’ve got to start off with people who look friendly. So I a group of six office personnel who were all smiling. At first; I was so frightened; the picture was zinging with energy! Then I reframed my thoughts. “They look like nice people. If I walked into this office, I’m an adult, I could walk out again.” “Actually the glasses he has on remind me of the ones my mother has.” Every time I had a fearful thought, I did my relaxing breathing and changed the message.
    At the end of three days, I felt no threat looking at the picture and I wasn’t hyperventilating. I talked myself through the experience, breathing and relaxing, while changing my thoughts from these people who were going to devour me to just six people. I did the same thing with two other pictures. I used a lot of humor, joking with myself to make it entertaining. All the time I was being a scientist and watching my thoughts and reactions so I could make a choice. From pictures, I went to steps of making eye contact with real people.

How do you think working this hierarchy is affecting your everyday life?
For me, despite the discomfort, sometimes the tears, I didn’t die. The miracle is that my life is opening up and I’m lightening up--seeing the best in everything, not always seeing the negative, taking a chance on smiling at a stranger. I’m having more interactions with strangers. I’m in a traffic jam and I look over and smile at the person in the next car. I’m in a public place and I say something to someone about the weather. Two months ago I wouldn’t have even looked at that person. There’s been a sense of inclusion. People don’t seem like hostile strangers and I’m initiating these contacts. I’ve spent forty years of my life reducing my life. I did miss out. Now I’m learning conversation skills, assertiveness skills. I’m having fun going around to shops saying “hi,” or “These don’t fit, I want my money back.” I’m learning that even if someone is not friendly towards me, I can still come out with my dignity intact. And if they are rude, it’s not even personal. They are just having a bad day, and it has nothing to do with me.

Any advice to your peer friends?
I would say don’t give up. The beauty of doing this work is gradually you realize you are not alone. After years of this greyness, it’s such a relief and a sweetness to realize that day to day life is not this terrifying people eating monster. It actually can be challenging without being destructive. There’s hope. There is a way through. You have to use the tools.

From Fall 1998:

My last dental appointment involved getting a new crown. This required a lot of drilling and holding molds in my mouth for an extended period of time. I had been through this procedure before and I was anxious about it.

One of my recent strategies for recovering from my panic disorder and phobias has been to let people know what I am dealing with. I had been closeted about this issue for years because I felt so much shame and embarrassment. I am learning that truth telling is met with far more understanding than I ever anticipated.

I decided to take care of myself on this visit by being honest and straightforward. I explained that I was feeling anxious and that one of the ways this manifested was in a nervous bladder. My dentist assured me that if I needed to use the bathroom (or needed anything else during the procedure), I could simply raise my hand. I told him that I might need to get up several times. Just saying this out loud reduced my level of anxiety.

And then, by making a simple statement, I learned a valuable piece of information, that I feel all people with anxiety should know. I told the dentist that the thing I objected to about having novocaine was the way in which it seemed to overwhelm my nervous system. His response was: "Oh, that’s the epinephrine (same as adrenaline). I can take that out of the shot. I’ll red flag your chart to not use it in the future." He explained that it functioned to anesthetize the area for a longer period of time but that if my shot should begin to wear off before he was finished, I could signal him and he would give me another shot. What a difference this discussion made!

Part of my social conditioning growing up emphasized not questioning others or speaking up for myself. At fifty-one I am finally learning to take care of myself. So what if others think I’m peculiar, or fussy, or anything else I imagine they are thinking. Taking care of myself in that dental appointment meant that I could handle the procedure without feeling panic. I brought my own bottle of filtered water because I don’t like the taste of the chlorinated water running through his system. I simply filled the cup at the basin as needed. When the assistant wasn’t fast enough with sucking out the drilling debris from the old fillings and I felt like I was choking, I made my needs known. On other occasions I had hated the taste of the numbing swab the dentist uses prior to the shot of novocaine. Another red flag is now in my chart not to use that. I’d rather have the needle directly than taste that awful taste (which doesn’t seem to make that much difference in how the shot feels anyway). At one point during our session my dentist suggested I take a bathroom break because the next several minutes would involve work that couldn’t be interrupted.

At the end of the session I thanked my dentist for his sensitivity. His assistant then asked me some questions about my condition because she, too, had e xperienced what seemed like panic in a couple of situations. Because I had been open about myself and my needs, the door was opened for some two-way education. I like to think that I wasn’t the only one who learned semrthing important from that experience.