I have recently had quite a few clients with social anxiety coming to me for treatment with CBT and the spotlight effect is quite often at the core of this type of anxiety…Remember that time you had your hair cut differently? And you thought lots of people were looking at you as you walked down the street? Well they probably weren’t – they would be just thinking about their own stuff…This feeling that everybody is looking at you or judging you is called the spotlight effect and when people have social anxiety they often get depression as well, as it can have knock on effects such as avoidance and fear of going out… One way to deal with the spotlight effect is to imagine you are on a stage with the spotlight on you and then the theatre house lights are switched on and you see that there are lots of other people there on the stage with you too.
Last week was suicide prevention week and at the weekend I attended an online summit/webinar on this topic with talks given by various speakers. The best by far was by another health psychologist – Professor Rory O’Conner…he has spent many years of research in this area and he has recently published a book (which is now on my Wishlist with Amazon) called: “When it is darkest: Why people die by suicide and what we can do to prevent it.” Two of the most important things that struck me about his talk (which are covered in the book) are: 1. That there are many myths around suicide and 2. That there are certain things to look out for that will take somebody from the ideation stage to the action stage:
- Two of the myths around suicide are: (a) Suicide occurs without warning – this is a myth and (b) Suicide can’t be prevented -this is a myth too and there are others.
- There are several factors that make it more likely that someone will attempt suicide and two of these are: (a) knowing somebody else who has done it and (b) having a fearlessness around death.
So if you know someone who is feeling trapped or a burden on others, then do ask them how they are feeling (and mean it) and another myth is that talking about it plants a seed in their mind of autosuggestion – this is not true and conversely talking to somebody about it might help them seek help.
I have had quite a few clients recently who want to increase their self-confidence…and in the past I used to equate self-confidence with the psychological concept of self-efficacy (Bandura)…Self-efficacy being your belief in your ability to do something e.g. my PhD was mainly about young women’s belief in their ability to breastfeed their babies. However when I ask my clients further questions about their lacking in self-confidence, it is often about anxiety, but also about low self-esteem. Yes they may have low self-efficacy for managing their anxiety, but more often than not the low self-esteem has come first.. self-esteem being essentially about how much we like ourselves – too low and we suffer, too high and we are at risk of becoming narcissistic. Quite often the non-psychologist will confuse self-esteem and self-efficacy, but they are different concepts. However they can overlap, for example when we really care about something and our self-efficacy to carry out that task or learn that skill is low, then that can in turn affect our self-esteem…So next time a client comes to me saying they have low self-confidence I will by all means help them to cope if they are anxious, but may also look at their self-esteem…And sometimes it is better to reframe that as self-compassion.
I know I have written on time before (LOL – see my last blog on Time Again) but I have been inspired to do so again by a piece in “The Psychologist” this month.
The writer makes two points on time management which are interesting:
1.Time management is partly a privileged phenomenon i.e. f you can afford to pay some people to do tasks that you would rather not do, then that gives you more time for other things than somebody who has to do all the tasks themselves.
2. Research has shown that although time management is quite important at work; it is actually more important in our home lives and has a big impact on wellbeing, reduces anxiety and leads to better life satisfaction.
Obviously I am careful to be on time for my clients, but it is easier to do that when you are working mainly from home! I am still late to church sometimes, but I have found that if I allow more time to do things I usually get less stressed. And time-management of course is not a Rule for living, but a helpful guideline…
If you saw my post last year about fad diets, you will know that I was hospitalised briefly with a problem with my gall bladder… Well I finally had it out last month…And one of the things that helped me pre and post surgery was my knowledge as a health psychologist… I remembered that it is important to have knowledge of what was going to happen to me, but not too much i.e. no gory details. Research has shown this is very important – if you go into surgery not knowing anything, then you can’t prepare yourself for what you need to do afterwards to recover and if you know too much you maybe increasing your anxiety levels.
So if you have to have surgery for whatever reason use your chance to speak with the consultant and the anaesthetist to ask questions and write them down in advance if necessary. Use breathing techniques to calm yourself down on the day of the surgery, make sure you have people around to support you afterwards and don’t have unrealistic expectations about when you will get back to “normal”. Also do the physiotherapy exercises you have been given.
And yes “I’m getting there”…
Quite often I get clients coming to me saying they are not anxious they are stressed/ suffering with stress…I think that is partly because there is a stigma about having anxiety and maybe a little kudos in being so busy you are stressed?
However mostly I think it is a misunderstanding of the meaning of the word anxiety… So lets think of stress as the external force that is applied to something or somebody (remember GCSE physics?); so obviously a cumulation of many stressors in somebody’s life will probably effect their quality of life and / or their mood….However some people are very resilient and manage to juggle many stressors without ending up on a therapist’s “couch”…And don’t forget that old adage: “if your life doesn’t add up start subtracting!” And don’t be afraid to say no if you are being asked to do too much.
However quite often stress the external force can cause an internal state of anxiety. And most people think that anxiety is just another word for feeling nervous, yet it can be so much more than that: so you may or may not be a worrier, but if you have brain fog, or find yourself being irritable/ snappy or you are often overthinking or over planning or being a perfectionist or you aren’t sleeping well or you are constantly restless or you have unusual physical symptoms – these can all be traits of anxiety…
Yesterday I attended a vigil in Bath for Sarah Everard and her family and all women who have been killed, threatened or inappropriately treated by men…and as usual when something becomes a meme in the media my husband and I discuss it…So we compared notes and I was able to count at least 20 times, when I was younger, that I had been either followed or inappropriately treated by people of the opposite sex; admittedly I have not been raped and no-one has attempted to kill me, but there was a close shave once when I had to get out of a car at traffic lights and then run like hell (thank goodness they didn’t have central locking in those days). My husband came up with about 5 episodes – including two women who had dementia.
So this got me thinking – even though strength and power are important factors – they are not the whole story. Neither are women inherently kinder human beings…So another important factor has to be about upbringing. As a psychologist I know that as we are brought up we are socialised into taking on certain inhibitions – some good and some bad and they then become part of our core beliefs or schemas… And people with dementia lose their inhibitions…. I don’t want to lay more guilt on parents, but I know my son would never do anything to threaten a woman… And I remember as a young parent I hated the phrase “boys will be boys”. So let’s not use it anymore, as it really is the thin end of the wedge.
ACT is Acceptance and Commitment Therapy and it was “invented” by Steve Hayes; it is essentially a combination of some CBT techniques and Mindfulness… Recently I did some training/CPD on this with Dr Russ Harris and I thought I would share the basics with you here:
- It’s about being in the present moment.
- It’s about accepting our emotions and feelings, even pain.
- It’s about defusing from our thoughts (see the post I wrote awhile ago on the Train as one way of doing this).
- It’s about being able to observe yourself – hence the image at the top of this blog.
- It’s about knowing your values and the sort of person you want to be.
- And it’s about committing to your goals and doing the things you want to do in your life, despite any pain etc.
- So if you want to know more go to YouTube and look up any of Russ Harris’s videos – two particularly good ones are The Evolution of the Human Mind and The Struggle Switch
So I am getting my first jab of the Covid vaccine on Sunday, as I am a health worker and therefore in the first phase of people who will qualify… has it gone through my mind that it might not be safe because of the rapidity it has been developed – why yes of course, however as a scientist myself I tend to trust the scientists most of the time.
In order for the vaccine to be successful in getting rid of this virus, we need to have about three quarters of the population vaccinated eventually in order to develop herd immunity… so what will encourage people to get vaccinated?
1.Well information alone is not usually very successful, but because this is a new vaccine, information about its safety and efficacy may well be helpful this time. Especially of it comes from a trusted source e.g. the GP practice that you are happy with.
2. Social norms are important too i.e. if you notice that a lot of people like you are having the vaccine, then you are more likely to have it yourself – hence my reason for writing this blog.
3. Convenience and opportunity – if you are given an appointment that is easy to attend at a time and place that is good for you, or if you are able to have it at your place of work that will make life easier too.
4. Being prosocial will motivate many people too if they think they are helping society to get back to some sort of normalcy.
So keep calm and get vaccinated!
In The Psychologist this month there is an article titled “Do you know yourself?” and I will try and summarise some of the main points here…it begins with the quote by Benjamin Franklin: “There are three things extremely hard:steel, a diamond and to know one’s self.” Yet if you google knowing yourself, it comes up with lots of images for Aristotle’s words about knowing yourself being wisdom…so obviously the lay perception is that people can know themselves well, but the evidence says otherwise!
Firstly most people think they are more intelligent than the average person, which is obviously impossible (and no surprises that erroneous presumption is higher for men than women!) Secondly people are often mistaken about some of their personality characteristics – we are quite good at knowing where we are on the introversion-extraversion continuum and also on the conscientiousness continuum, but we are poor at knowing how agreeable we are!
The reason we are poor at knowing ourselves is because of optimistic bias. And this in turn protects our mental health i.e. if we have high self -esteem (without being a narcissist) we will feel like we have a more satisfactory life. However optimistic bias is not so good for our physical health:- e.g. if we think that one more biscuit, cigarette/drink is not going to harm us we are often fooling ourselves…. Yet it is not all doom and gloom – we can become more self-aware through talking therapies or by practising meditation.