Transcription
Oh Meredith, we know each other. And about the way we usually start a CBT session is to set an agenda. Okay? So we might have several ideas about what we want on the agenda, but the first thing is usually for us to make a problem list, okay, together, about whatever it is that you might want to work on, okay? And we'll do the problem list, and then we'll explore the thoughts and the behaviors that might be related to the problem. And hopefully, by the end of our time together, we'll have some clear idea about what's causing the problem and some ideas about how maybe change things. Sounds good?
Alright. So, um, one thing that I've even noticed lately is that I have a tendency to kind of hang back in groups and I tend to observe instead of participate, okay? And a lot of times, I get really nervous when I feel like I'm expected to speak up, and I want to speak up, but I kind of feel like I freeze, okay? And so, in particular, then in groups, the setting is big groups, little groups, it doesn't matter a whole lot, but generally, I guess medium-sized, like, you know, in classes that I guess, so I usually like maybe 12 people or so. So relatively small, medium. Women know what size affects, okay? And so, but in your head, you probably would say, "I would like to speak up," but for some reason, you feel inside some your nervousness about that. Definitely, okay? And then sometimes when I try to force myself to speak up, then I actually don't feel ready. I get like, um, I feel like my throat's closing and I get red-faced, okay?
All right. So that's sort of one possible issue for us to talk about. Could you maybe give me a specific example, a particular group situation, very as recent as you can, where you had this this feeling of hanging back and maybe maybe some fear of evaluation? Mm-hmm.
Um, so in my statistics class, each week we have a, it's called an inclusion activity. And generally, I guess it's past, I hope people feel like the group's more cohesive and included, okay? But I usually experience it as the opposite. So there's usually a task at the beginning of each class, like, "Take off your shoe and talk about the most interesting place your shoe has been." Stuff like this. Usually, I get really nervous. I might feel like I can't think of anything to say, and I feel like I usually end up saying something really awkward or lame, and I just, mm-hmm, don't feel good about it. Like I feel, yeah.
Can you give me that specific example of a the recent time when maybe, and then, and what you said to including sort of the the beginning, what happened, and then, um, yeah?
So when we did the, it's like a really weird example. When we did this activity, um, you know, probably six or when people had gone in front of me, and I was like, not listening to anything that anyone else was saying, just totally self-absorbed in terms of like, "Oh God, what am I gonna say?" and not being able to think of anything. And then when it was my turn, I was wearing a pair of shoes that like her, uh, hmm, kind of like they have lace on them. And so I took it off and I said, um, "I like these shoes because I get cool tan lines from them." So I didn't even really answer the question that was like, "Where have these shoes been?" or like, "The coolest places shoes have been?" or something. Mm-hmm. And then after I went, I didn't really listen to anything else anyone said because I was still like, stuck on, "Why didn't I answer the question?" and just kind of feeling awkward, okay?
So what I'm doing here is I've got several columns that I'm building. And the first one is your in the stats class, and you're going through and the inclusion activity. And the second one is the thoughts that you're having, okay? What thoughts are going through your mind? And the thoughts are, "Oh God, what am I gonna say?" Those are the early thoughts. And then the maybe the later thoughts are, "Why didn't I even answer the question?" Yeah. And like, "Why can't I ever be articulate?" Okay? "Why can't I ever be articulate?" Okay?
And then our third column is are the emotions that you might be feeling. And so as you're in that situation, and [Music] people are taking their turn, the teacher says, "You're doing the inclusion activity," people are taking their turns, and what are you feeling? How do you describe your emotional state?
Mmm, nervous. Yeah, like fearful. And like, it's almost like I anticipate anticipating embarrassment. But usually, I feel embarrassed. I put that in the phone, okay, column, just because it seems like the anticipation of it is probably a thought, but embarrassment when you're in the middle of it is probably a feeling. That makes sense. Mm-hmm.
And then so I got nervous, fearful, embarrassed as the emotions. And on a scale of zero, not at all, a hundred being the most of that feeling you could ever have, how would you rate? Let's let's get rid of nervous because it's sort of covered by fearful. How would you rate fearful? And how would you rate embarrassed?
Mm-hmm. Maybe fearful like four or five. I don't know. Four, five. [Laughter] So forty or fifty. Yeah, okay. Embarrassed? Yeah, so maybe a seventy. And that would be at the moment that you're talking, or right afterwards, or right before? Mm-hmm. Fluctuated at all?
Yeah, I'd say like both during and after. Okay. So during and after. All right.
And so, you know, the cognitive approach to thinking about what's going on is that it's not the situation that causes the emotional reaction, but it's what you're thinking that causes the emotional reaction. And so it seems to me like one of the things that's going on, "Oh God, what am I gonna say?" and "Why didn't I answer? Why can't I ever be articulate? Why can't I ever be articulate?" That sounds, it's actually, if we might have to start rating my anxiety now. And then I guess there's the other thing you said that you're anticipating embarrassment. And so are those words also go through your head?
Yeah, like, "I wish I could be more clever," or "I wish I could have just like a funny story right now." Yeah, or "Make people laugh in a way that I want them to laugh."
You know, one of the things I'm doing now is a lot of times when you think about the thoughts that trigger the emotions, these are the thoughts that we would categorize as, "Oh, less helpful," okay? Kind of unhelpful thoughts. And then over here, what we're doing is we're coming up with some thoughts that might be more helpful, okay? Recognizing that no thoughts are perfect, but some thoughts are more helpful, some thoughts are less helpful. And, you know, in your SAS class, you're going to do the inclusion activity every week, every week. And so one possibility is you could come in prepared to shift your thinking from the less helpful to the more helpful. Just idea. Forget it. Okay.
So what else besides this is silly and what I say doesn't matter all that much? "I can be clever sometimes." "I can be clever sometimes." Good. That's sort of a counter to the "Why can I ever be articulate?" or "Why can't I never be articulate?" either way you say it.
Let's pretend for a second that you were talking to a friend who had exactly this same scenario, and she was telling you the way that she talks to herself, "Oh God, what am I gonna say?" and "Why can't I answer that? Why can't I ever be articulate?" "I know I'm going to embarrass myself." And so she's talking to herself that way, how would you talk to her?
Mm-hmm. I think that I probably express surprise because I imagine that usually I don't perceive her as inarticulate or as embarrassing as she sees herself.
Okay, so you would be surprised and kind of reassuring to her and say, "Oh, you don't seem that way." And if you could be on her shoulder in the situation, what would you whisper in her ear? Your this is a good friend of yours, you want to be helpful.
Um, I would tell her she's funny and charming and usually has really cool stories. It's a teleco, she's had lots of good experiences. Mm-hmm.
So you'd be sitting on a shoulder saying things like, "You are funny and charming and you have cool stories to tell." What's it, what's it feel like when you imagine actually even saying those words to yourself in this kind of situation?
I mean, it sounds pretty ideal. Mm-hmm. But it sounds really far away from my garden experience. It's not what you're whispering in your own ear now.
What stops you from from actually doing this? From talking to yourself just like you would talk to a good friend? You're talking to yourself, you're kind of talking to yourself more like somebody who wanted to pull you down. And so I just think, huh, what about that good friend? I mean, can you be a good friend to yourself in those moments and say something more supportive? You, you are pretty successful in a variety of different things in your life, right? And so if you take one of those examples and you kind of break it down, are you able to, what do you do to prepare well?
For example, even for a statistics test, I would guess that you have to go through some preparation. Steady, steady. Mm-hmm. Okay. Kinda like studying.
Have you ever been in a like a play or a dramatic performance anytime?
Oh, no. I ever wait. Not even like from grade school? No. I think I maybe wasn't seventh grade, yeah, yeah, but I had a very small part. Yeah. I've always liked my whole life shied away from being assigned a retention. It never feels good to me. Yeah.
Ironic. Yeah. So you have taught before and spoken in front of groups, small/medium, yeah, but it never feels, they never feels comfortable.
Um, yeah, I hope so. Even right now, as we're as we're talking. Okay.
So I hear you say it never feels comfortable, right? Mm-hmm. Would you put that thought in the category of helpful or unhelpful to say that to yourself?
I'd say that's unhelpful. Mm-hmm. Okay.
What, what is it, what's unhelpful about that thought?
It kind of makes me feel like no matter how much I prepare, I still won't feel like I'm good enough or confident. Yeah.
And just before that, you said, "I always shied away from attention, it's never felt good." Okay. Well, that is pretty, yeah, good job noticing that. And, and I hear you saying that black and white thinking, it's maybe too general in that it doesn't provide any real hope for it ever changing. Mm-hmm. And in that sense, it does seem like it fits in that unhelpful category. Mm-hmm.
I mean, I definitely think like, you know, if you're nervous about something to a certain extent, that's healthy because it makes you prepare more. Mm-hmm. But at the same time, that kind of thinking of being like, "It will never get better, it will never be okay," probably isn't that helpful. Yeah. [Music] Yeah.
So I wonder if that's maybe, as we think about the preparation stage, that that's one of the things that you said for a stats test, you would study. I wonder, yes, there if there's some way you could study this way that you have been thinking about yourself. "I'm just not clever in a group. I'm just not comfortable. I've always shied away from that." I wonder if there would be different ways you could say things to yourself. Mm-hmm. For instance, for instance, "There are times when I am comfortable in a group." "There are times I am comfortable in groups." And that you probably would put into the more helpful, I thought category.
You, so it seems like you've got this for a circle of thinking in there that takes you down into a negative place. That the embarrassment kind of starts this negative spiral, takes you downward to, "You're probably not consciously thinking, 'I'll be alone and unhappy'," but somehow it's, it's related. "People will think you're stupid. They don't want to be around you." Mm-hmm. Yeah. And I feel like I am weak. Not really on purpose, but like I end up doing things to like make myself not seem like kind of invisible. And then usually I don't feel like that's as rewarding when I feel engaged and involved in a group of vampires. And you probably feel more lonely and unhappy based on withdrawing and being more invisible. And so you hold that belief of, "If I do something embarrassing, it will go down that spiral all happy," despite the fact that you told me just a couple minutes ago, you had a very embarrassing experience that now has made you as added to your repertoire as a good storyteller. It's another story you can tell. Yes.
So you can see that I'm questioning the evidence. And I wonder if, if you are questioning it too, or if you're just thinking, "I better go along with this for now."
Um, you know, I definitely think that you're right. I just like hearing you say that I'm a good storyteller. That's so not my, I don't think. Oh my god, sorry, tellers. So that's hard for me. This time, say sure. But I agree with the evidence. You, there is evidence that you have told some good stories. I'm not sure you would conclude that that therefore makes you a good storyteller. So sometimes you are a good storyteller, and sometimes you're a less good storyteller. So very careful about coming to any positive conclusions about yourself. But you're much less cautious. You're more of a risk-taker when it comes to jumping to negative conclusions about yourself. Would you say that's accurate?
And so as we kind of head down, sort of toward the end of our of our meeting today, I'm thinking about what might be some useful things for you to try, experiment with, to see if it's helpful for you in coping with this situation. We based problem.