Doing well!

Long time, no see!

I'm in a contemplative mode right now, so I figured I could write an update. My social anxiety is better than ever. I'm feeling funny at times, but I just acknowledge it and brush it off: it's just like having a runny nose: just take a tissue, wipe your nose and move on. No big fuss. Just yesterday I casually invited my brothers in law out for lunch... me? alone with guys other than my husband?making the invitation without any hint of hezitation? - who's this girl?

I dropped yoga for a long time, and I just got back to it this last week. I am a different person, I found back my anxiety-free world. I see now that I have conditioned myself to be anxiety-free when doing yoga. So I need to keep on doing it. It's great!

I will be moving out of the country for 6 months and I am quite emotional and observant about everything around: admiring my neighbourhood, the trees, the birds, my car. I am packing my whole house and it's great to touch each object. Bring back memories.

For those of you that were around at the time when I had an impossible dream, the dream became quite possible. I am taking an online course of Health Care for IT Professionals and doing really well and I think by the end of this course I will be able to find some work. My doctor was already interested in me coming to review her workflow and help with their new EMR system.

The conclusion is: social anxiety can be beaten without medication. You can achieve your dreams no matter how crazy they seem to be. Just don't give up. Keep pushing yourself. But you need to know what you're pushing for: clarify your priorities and your goals.

My class graduated

For the last couple of years while I was blogging about social anxiety, I also followed a number of other social-anxiety related blogs. And, happily for all of us, it seems that we all graduated: 

• S A Dave got a job and he's doing pretty well there and has no spare time to write,
• "The guy at Successfully Shy" moved on with life (and Congratulations for the recent event!)
• Matt released his e-book
• Drew gave away his blog to Vladimir
• and I keep dreaming about starting to blog about something else.

I keep promising and I always come back. Well, I had a very promising proof of my emotional maturity this week-end and I also will start having a bit more time at work... so I think now it's the time to get this project going. 

It's time for a new generation of socially anxious to take over. The world is so much different these days: you have UTube and communities all over the place. Good luck to you all! 

Who, me? Self-centered?

This post might come as an unexpected and unpleasant surprise to some of you. It might even push some away if you haven't yet seen this idea. The first time I read about it, I was uncomfortable and resistant, but thinking about it some more, I realized it is so true.

This condition might look like we are caring a lot about others, but we mostly are caring about others in relationship to US: do they like ME, do they think I'm looking good, writing well, doing the right thing? We are quite self-centered. We bask in the happiness that someone likes us, we are anxious about saying the right thing or saying anything or not blushing, or not sweating. We fear that the wrong look or attitude might push some away. It's important for us to be called someones best friend, the best employee, the nicest person, etc., and we're desperate if someone else becomes the employee of the month, the best friend, etc.

I want to be nominated in the 5 best patient blogs, but I do not want to win, this would be disastrous next year when I might not even be nominated anymore. I will probably quit before that happens - running away is better than being demoted. I think this is actually a common trait, probably most people think more or less about things this way, we just take it to extreme.

So, what to do about it? It's ironic, but the first thing to do is to accept that we are normal, OK, looking good enough, acting OK, saying the right things, and when we don't, just accept that it happens to everyone: we all say stupid things every now and then, we blush at the wrong time, friendships die, relationships end, with or without our help. It's just stuff. And while being relaxed about us, we can now look at others with more compassion and love: see what they really are about, hear them, help them without caring what they think about us. Most people would feel more honesty in this approach and will be more attracted to us.

We need to relax, and we'll start seeing a bigger picture and doing things to help everybody and we will be appreciated even more. And if not, it just happens, just move on. We all are just fine and normal.

Challenges benefits

Paul Levy invited me and 30 other bloggers to participate in the blog rally "Engage with Grace". I think the subject is worth the discussion and I might write about end-of-life discussions and options at a later time.

Here I'd like to share my sense of great achievement with a challenge. Paul asked me if I am OK to be interviewed by a reporter for a newspaper article. I accepted saying that I would be more comfortable on email, but that I could do it by phone.

I talked to the reporter and it was fine. I was not as witty as I would have liked and I did not say all that I wanted to say, but I took the challenge and got through this. The article ended up not mentioning me or any blogger other than Paul, so I did not become famous overnight.

But I was so happy afterward, happy to have done this, happy that next time I will feel better about it, happy that I am just normal. I felt powerful. And I realized that without my social anxiety this would have been just another phone call instead of a very pleasant experience.

Instead of dreading what you can't do, take challenges and celebrate all the stuff that you can do!

Opportunities

It's almost two years since I started this blog, and the online world is so different now than it was back then. What great opportunities for anyone to get to terms with their social anxiety.

Part of it is this huge reference related to social anxiety: blogs, personal health oriented websites, forums, e-books.

And this is not all. You can find blogs about anything. This is great for people that feel isolated and don't feel like they can match anywhere. I found blogs that are a pleasure to read about anything of interest to me: social anxiety, any area of healthcare (doctors, CEOs, IT people, patients, etc.), people that wear glasses, people that do yoga, meditation, zen living, passionate about tribes, and so on. It's amazing!

I think that part of my success with social anxiety is finding people that have common interests and realizing that I'm not alone out there.

Go look for people that share your passions! I bet you'll find enough! Don't miss your opportunities!

Overcoming social anxiety?

I got a few emails lately from people thanking me about the blog and hoping to follow my steps in overcoming social anxiety. I know I heard this before and I didn't believe it and I know that probably the people dealing with this will feel that overcoming SA is the right way out of their misery, but I did not overcome it. It's still there, every day, every encounter. I just don't beat myself up over it. I'm OK with it and with myself.

I thought that the way out of it was to have at least one close friend, and I tried and I'm still trying to get there. I made a few tries and never quite got to it. Part of it (maybe the biggest part) is that I don't really have time to dedicate to a friendship. Maybe I created this lifestyle to avoid getting to close. It seems to be a pattern either in my choice of friends or in the way I am interacting with them. But that's fine. I just go on and try other people and other ways.

I also hate telephones. They are perfect for getting things done, clarify stuff, setting a meeting, managing an activity and keeping everyone in the loop, but just talking? It seems that anytime I try it, there is a bad signal, there is no return of calls after leaving a message, it's the wrong time, etc. Plus, I like to drive when I'm driving, work while at work, eat dinner with family and spend time with my kid when I'm around. This leaves open the between 9:00 PM and 7:00 AM... who would talk to you then... oh and did I mention that I also like to sleep at night? What a solid argument for avoiding yet another means of interaction!! See? I did not overcome social anxiety. I just accept it as part of who I am. It is my charm!

In conclusion, my advice is to not look for overcoming anxiety, but accepting it. Once you accept yourself for what you are, you become less tense and you do your best in most situations.

Another overview post

I've been slow to write lately and I would so much love to restart writing. I want to write about life and work, not necessary on this blog, but I'll keep you guys updated once I get started somewhere else. This post is another overview of my journey in beating anxiety.

• Educate yourself. The first thing I did was to figure out what's wrong and read a book about it. At the time I realized that I need to figure out what's with me because nobody else can figure it for me.
• Find a buddy. Next, I educated and engaged my immediate family in my fight with social anxiety. I think it is impossible to do it by yourself. Either a family member or a friend or even an Internet forum would work for that. You need a buddy.
• Find professionals to help. The next step was to talk to my doctor and find a therapist. This part took a long time for me because I was also dealing with a difficult pregnancy.
  
• Identify and stop the emotional dips. When I started therapy, for months and months, we just discussed the latest drama du jour. We wouldn't talk about anything else because there was always some crisis that I was in: work, family, friends, etc. there was drama everywhere. One of the most important things that I did was to drop friends and causes that made me have highs and lows: I stopped talking to friends that were depressed and were pulling me down, I dropped relations that I was too involved in: the kind where you check your email every five minutes to see if there's an answer, I dared to say no to social engagements that were making me uncomfortable. I just gave myself a break! That was a great way to work on SA. Once the main issues out of the way you can tackle issues one by one and take on only how much you can carry.
• Add challenges. I am a fighter, I'm always finding something to challenge myself, so this is not a struggle for me. The struggle is to not drop the ideas after the first disappointment. We had parties and I worked on my relationships at work, but the biggest challenge and the most successful was to start writing this blog.
• Open up. The person that inspired me to start writing the blog, Paul Levy, was the one person that paid attention to me and had a kind word for me throughout my journey. His fight for transparency in his hospital operation taught me that openness and transparency is the right way to work on my own issues. This was confirmed by Irvin Yalom's book. I told friends about the blog. I never got a negative reaction. Some were just quiet about it, but mostly I got some very friendly feedback.
• Ease the guilty feeling. I realized that my worst moments happen when I feel guilty: that I don't talk enough, that I'm too shy, that I'm not doing enough stuff around the house, that I'm not spending enough time with the baby, that I'm not working enough hours. The guilt just paralyzes you and it's useless. Once I gave myself permission to be shy and quiet and nice, and realized that I did spend as much time as I could both working and with the family and that there's not more time than that, things just became easier. I'm shy, so what? I'm quiet, so what? I said a stupid thing! Oh, well, it happens to everyone.
  
• Define your dream. Spend time to think about your priorities in life, what you want to do. Dream big! Write it down, find things that you can do next week to help you get there, collect pictures and articles about it. Simply allowing yourself to think about your dreams will make you feel better, but making progress toward it it's possible too. It's important to know what's meaningful to you and go for it!
• Drop the fear. What are you fearful of: What other people say? That you'll lose your money, house, car, retirement money? That you will lose your job? That you will be killed? That you will get sick? That your partner cheats on you? At the end of the day, it really doesn't matter. We all will live less than 100 years unless you're really lucky. Money is an illusion. Other people mind about their own business more than about you, and if they mind about you for a minute, they will forget it right away. I've been in that anxiety free land for about a week or two and it was great. I aim to get back there.
  

I think that's it! This helped me. It's a journey that never ends. I am still working through most of these items. There is no end!

Good luck to all of you!

Brain programming and self-esteem

More and more I am convinced that my recent success in beating social anxiety has more to do with the amount of positive programming about myself that I got. It finally got to that critical level when I began believing it. And it could have been anything: tapes, more therapy, or anything else.

This is not a new idea, I encountered it in more than one self help books: You need to be sure that you are great and wonderful and beautiful and lovable. If people around you reinforce this idea, you will start believing it and acting on it.

Sometimes people make mistakes, even the smartest people act stupid at times. Allow yourself to do or say stupid things. It's not a big deal. Just apologize and move on not giving it a second thought. You will make better decisions if you strongly believe in yourself than if you worry about being wrong about anything you do or anything anyone else thinks.

Having this in mind, it makes a lot of sense to do as many as possible of the following

• Use tapes like those from Dr. Richards at the Social Anxiety Institute,
• Keep in touch with friends and family members that make you feel good, and excuse yourself from seeing people that make you feel bad about yourself
• Find a good therapist
• Participate in groups for SA or whatever groups where your presence is welcome and you are well-liked
  
• Do yoga. Yoga teachers are supposed to be supportive, so it is likely that in a yoga studio you would find a good environment for growing self-esteem

My yoga program was subtitled: Love living in your body. Every week we would hear a variant of encouragement to love our selves and our bodies. "Love your body for what it is now, not next year, not when you'll love 10 pounds or when you'll have a boyfriend. It's perfect, right now, just as it is. You can walk and run and jump and it doesn't hurt to do this. It helped grow these amazing children that you have and helps keep you alive. Touch your thighs and belly and arms and say Thank you, body, thank you!" It worked great and after more than an year of therapy in which I heard a lot of: you're wonderful just as you are, you just need to start believing it, it finally sinked in.

I'm playing with Facebook and Linked In these days and I am so happy to see people trying to connect to me... and I say that they are doing it because I am nice. It's great to love yourself, quite a novelty for me.

About.com

About.com has a page on social anxiety disorder and the moderator, Arlin Cuncic, released an article about the best SAD blogs. My blog is mentioned in that article positively... pretty neat if you think about it. I'm growing. The website is informative and has a forum and a newsletter. I think it's worth keeping an eye on it.

Thank you Arlin.

Meditation and living in the moment

If you were around for a while you know my hunger for comments. While feeling better over the last couple of months, I (and my blog) survived without many comments for a while now. On Friday I had the great pleasure of finding two very nice comments... Woohoo! I inspired someone to do something about their anxiety.

A new social anxiety blog is out! Please welcome travel.trekker1 and wish her good luck in your journey. She seems like a good buddy for me so I am looking forward to more posts and communication.

And an additional note about the last blog I wrote about: Matt Ambrose at Overcoming Social Anxiety: this is a must read. It is kind and gentle. It is the best writing on social anxiety that I stumbled upon. It makes me feel good about myself when I read it.

The guys at the Mental Health Blog Research Study have their survey up and you can take it if you want to help research anxiety disorders and blogs. Email mhblog@tcnj.edu before July 10, 2008 if you are interested.

In one of the latest comments, a reader talked about how difficult it is to be living in the moment. I've been working on this for the last half an year, so I can tell you what worked for me:

- Some sort of vigorous activity that requires concentration and doesn't leave you time to drift into thinking. Ashtanga yoga does this for me. But it took a while. For weeks I kept just thinking how hard it is, what comes next, this is hard, this is easy, and when is the end of the class, etc. I'm now just concentrating on the current posture and it's great.

- In the beginning, use your senses with strong cues: eat something you really love with great attention and pleasure: enjoy a chocolate truffle for a minute or so, smell a great perfume, listen to the birds singing, or to the ocean waves. Eventually you will start being aware of all the chatter around all the time and you will feel and touch and smell things without judgment, for example smelling something foul will just bring awareness not necessarily disgust.

- Read. You will be surprised how many successful people (like Seth Godin or John Halamka) have some sort of meditative practice and preach living in the moment and utilizing the time while you have it... NOW! to do something rather than think about what you could have done or what you will do.

- When overwhelmed with thoughts, ask yourself if there's anything I can do about this right now (can you write an email, make a call, etc. to make the idea happen)? If yes, just do it, if not, let the thought go. I used to fantasize a lot about spending time with friends and intelligent discussions we would have, etc. Now when I think about this, I just smile, say I love you to my imaginary friends and then think: Hey but you are not really here so Good Bye, I'll see you next time! No beating up, no frustrations, no expectations.

And because my commenter mentioned Eckhart Tolle, here's the list of things that helped me in my journey:

- The yoga teachers training at the Yoga and Healing Center in Scotch Plains, NJ - graduation in two weeks... need go practice and learn
- A Yoga, Chocolate and Wine seminar with Yoga Dave
- A 3 hours seminar with Bijan and reading Effortless Prosperity daily lesson and trying to practice it
- Reading A New Earth - Eckhart Tolle

The wavy line of anxiety

I noticed that with anxiety you can't just relax and let things the way they are. You continuously need to push through and challenge yourself. Any time spent in the comfort zone makes the anxiety take over more and more... You can give yourself a dy off, but that's a bout it, next day just start over and get into challenges again and again.

Of course the ultimate cure is living in the moment and realizing that all these things we so dearly care about (like other people's opinions or what X and Z said) ultimately don't mean anything. So complete relaxation is the cure. But even if you get there, there is a lot of work in continuing to do it and not getting back into your anxious spot.

Here's a visual cue that I'm using to think about this: take a piece of paper and write down any activity that involves interaction with other people grouping them from the ones that cause most anxiety to the ones with least anxiety. I would have an interview on TV on the left side and friendly chatting with my husband or interacting with my happy kid on the right. Now draw a wavy line to separate the activities between comfort zone and anxiety zone.

The aim of every day is to push that line more and more to the left including more and more activities that are uncomfortable. Doing them time and time again will make them shift into the comfort zone.

When you relax and don't push, the line will not be stable: it just moves to the right and you get more and more uncomfortable.

So in order to make any progress or even keep the statu quo, you need to work all the time, every day and every hour and push that line. It's a Sisyphus job, but it's the only way you can live and enjoy life.

No rest for the weary! Good luck and keep pushing that line!

Living in the moment

One of my favorite authors, Irvin Yalom, describes the aim of therapy as opening up first to your therapist and then to the world. I loved his comment, lived by it and wrote a post about it a very long time ago.

However, with anxiety, I think you can be open all you want and still be anxious. It eases up some of the attempts to hide the anxiety, but it doesn't resolve the problem.

I think that with anxiety, the aim of therapy is to minimize the time a problem hangs out in your head. It used to be that I had problems that we discussed through multiple sessions: I worried about those things constantly for weeks: bad, very bad. Those are stale thoughts.

Let's say you have a 10 minutes phone conversation. You hang up and then start replaying the phone conversation in your head over and over again for days. You beat yourself up over what you should have said, you are very proud of what you said well, you interpret what you heard in numerous ways, you have emotions that might not have anything to do with the actual call, they are just emotions brought on by your thoughts and your interpretation of the phone call.

I knew that therapy was over when any of the issues I brought up were about one day old at most. The problems would come and go, wash over me, were processed in real time and went away. No stale thoughts, no interpretations. You can think clearly and not reactive with a fresh problem.

I am a project manager, so I do have problems that last days or weeks, but when I get back home, they don't exist and they shouldn't exist. Tomorrow is another day that I can deal with them, and looking at them with fresh eyes is always easier. Bringing my problems home is a sure way to trigger terrible-twos behavior and upset everyone else.

I am now working on really living in the moment and being present at any time, no afterthoughts, no interpretation. Something happens: it causes emotion: let the emotion be there, feel it, enjoy it, express it and move on to something else.

This is the aim of meditation and yoga, and I recommend either or both for social anxiety or just any kind of anxiety.

And another reason to live in the moment from Dr Rob.... And from Dr Rob again a great quote for good laughs. It's short enough that I am including it all to spare you the need to transfer over, but Dr. Rob's blog is a must read!

"Why did God make it that you have teenagers at the same time you are going through menopause?"

Wish me luck! I think I'll be there! I should perfect this living in the moment thing by then!

We are all in the same bucket

One of the first things that my therapist did with me and the most successful for gaining my trust was to explain that everybody has at some level the same anxieties that I have. She used herself and her experiences as an example and it was extremely powerful.

She made sure I understood that I am not crazy and that my thoughts are reasonable and my anxieties not so unusual.

It is tough and very lonely to have social anxiety without knowing what's going on. You feel really really lonely and you think you are some kind of monster that nobody wants to be with. Once you find out that it's not that uncommon, this knowledge comes with a bit of relief that there are other people having the same thing and that there is hope, but on the other side, you have a mental health issue/disease which officially puts you in a I'm at least a bit crazy category. Deciding to do therapy or taking medication is again a step forward, but it comes with the issue of having to admit it to others.

This is why establishing that you are not crazy is a great first step in therapy. Brilliant!

Once we know that we have social anxiety, we tend to identify all our traits that prove that we have social anxiety. Sometimes what is a simple difference between people's behavior becomes in our mind unbreakable proof of our being abnormal. And I think we feel attracted to people that are different and that we desire to be like and don't realize that there are enough people out there just like us.

Just recently I noticed this with me. I considered as a typical social anxiety trait the fact that I only dated two men in my life. I found out that my latest hero, John Halamka, married his first and only date. I don't know that he has social anxiety or not, I suspect not too much, but maybe some people are just more efficient this way. Friends that I stayed with, I liked from the very beginning, so is that so bad? Just like people that start drinking in college because they think that everybody else does. Some people just don't drink and some people don't need to date a lot! Does that make us unusual? Probably, but crazy... no!

So, take heart! You're probably not as weird as you think, and almost everybody has anxieties in one way or another.

Preparing for therapy

So you found out that you have social anxiety. And you read that the best treatment is a combination of drugs and therapy, probably CBT - cognitive behavioral therapy. I'm pretty sure you heard that you probably have a bio-chemical imbalance... oh, that sounds so good: it's not in your head, it's a disease!

Here's my take: forget about drugs... ignore drug advertisements, ignore doctors that insist that you can't do it otherwise, ignore articles. Forget about them. Be strong and work through it for an year. Then you can decide that what you're doing is not enough.

Drug companies and medical insurance companies are not on your side. They are in for making profit, not for keeping/making you healthy. There's a lot of money involved and they are all thrown to convince you that you need expensive drugs. Lots of doctors are biased by the same advertisements. Forget the free samples. They will not last forever and then you'll end up with an expensive drug that you'll probably have a hard time weaning from.

A word on Complementary and alternative medicine: I think it's mostly placebo. I also think placebo is a wonderful thing that you should fully benefit from. But don't spend a fortune on it. Keep an eye on the wallet. Hey, that $2 bottle of homeopathic medicine that makes you feel so good: go ahead and use it! Omega 3s are making you more calm: go for it! But hundreds of $ a month for this stuff, forget about it!

This leaves you with one task: finding a good therapist - the right therapist. Psychologists are OK, but don't necessarily insist on a doctor. My therapist is a psychiatric nurse and she's excellent. Ask around: ask doctors, friends, family. If you can afford it, a therapist that does not accept any insurance is a good sign: probably successful enough to not need it, and less hassled by insurance companies (and more willing to give that time and attention to you, not your co-payment). Insurance companies are not your friends. Forget their referrals, they will send you to the cheapest guy in town.

Two books you need to read before starting therapy:

• Health and Suffering in America: The Context and Content of Mental Health Care
  by Robert Fancher
• The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients
  by Irvin Yalom

The first is a very down-to earth book about mental health care and will give you some food for thought. The second one is more practical, and will clarify some of the things that will happen in therapy - patterns of interaction that we all go through.

I love Yalom. His books followed me on each therapy session and I always ended up admitting that he was right about this too.

It's not easy to go through therapy. There will be rough spots. There will be challenges. You need to find someone that will be there for you all the way. And you need to have the strength to go back again and again. Each step up will be preceded by a very difficult breakthrough. Don't give up because it's hard. Always know that this will be over and it will be better soon.

I imagined that in therapy you talk and talk and then you discover one thing that caused it all and then you talk about it and you cry and that's it... it never happened to me. I had a few moments of "this is it", here's the problem, but a week after that the problem was still there. So there are no rules.

And last advice: if a therapist does not work, just move on without judgment. It just isn't the right person at the right time: it's not you, nor the therapist, just grist for the mill. Forget about it and find someone else. The CBT therapist that I kept bitching about in my blog ended up being really helpful more recently. I just wasn't ready when I saw him. But somehow what he said in those first 5 weeks of therapy stuck with me and I'm remembering and appreciating it now. I guess I am now ready for cognitive-behavior therapy. Only I don't need someone to help.

More to come... I'm enjoying writing this.

Starting therapy - my story

In 2004 I was not sleeping well and not feeling well. I visited my doctor and she diagnosed anxiety, prescribed Clonazepam and suggested that I start seeing a therapist.

I felt great on Clonazepam, but I hated that i needed more and more to sleep better. I took it for 3-4 months while I was under a lot of stress at work and then got off of it. The weaning was scary. My anxiety shot up very bad. I didn't sleep for a night or two. I resisted starting it over and after a week I was fine but I started being scared of medication.

I looked for a therapist and it looks like there's one at every street corner. I had the sense that I shouldn't just pick one, but I had no clue how to find the right one. At that time I had no idea that social anxiety was even defined. I had no idea what was wrong with me in the first place. I called a couple of therapists and found out they are really busy. I finally found one near my house that reluctantly found a time for me. I went there for 4 weeks and left disgusted. The therapist seemed to be more interested in my $10 copayment than my well-being. It did not go well.

I had the idea to search the web for extremely shy or something along these lines. I found books and I found that a disorder exists and it has a name. I ordered the books and started reading. I was not alone anymore... there were people that knew what I felt.

I got pregnant and momentarily dropped the idea of "fixing" the social anxiety. In April 2006, I decided it's time to attack it and get it over with. It took me two years. I am not over with it, I just accept myself and my social anxiety as part of myself. It's there, but it doesn't stop me from important things in my life.

I first went to a CBT (cognitive-behavior therapy) specialist. He was teaching at a big New York university, so I figured he must be good. I went there for 5 weeks. I didn't feel we were doing enough, and he felt he can't help me. He suggested that I see someone else, but did not offer any help with a name or anything. I failed again.

A month or two later I called a number that my new doctor gave me. It was supposed to be my last effort with therapy before giving up and asking for medication to help me cope. I was not optimistic. On the phone, this new therapist mentioned all the reasons why I shouldn't see her: too far away, no time, etc. but I said I don't know what else to do and that I need to talk to someone.

I went in once and was hooked. She had a few soundbites that I loved, among others "oh, men, my dear...". But the most important one was: "Ileana, no matter what will happen, I will be here for you." And she was there for me, even if it was difficult at time for me and her.

Next post will be about what I'd suggest that someone does before starting therapy... we all live to give advice, don't we?

Quote

A quote from The Winter of our Discontent - John Steinbeck that the ones of you that have social anxiety might find helpful:

My sudden fear that I might be showing through was very great. I had made myself believe that the eyes are not the mirror of the soul. Some of the deadliest little female contraptions I ever saw had the faces and the eyes of angels. There is a breed that can read through skin and through bone right into the center, but they are rare. For the most part people are not curious except about themselves. Once a Canadian girl of Scottish blood told me a story that had bitten her and the telling bit me. She said that in the age of growing up when she felt that all eyes were on her and not favorably, so that she went from blushes to tears and back again, her Highland grandfather, observing her pain, said sharply: "Ye wouldna be sae worrit wi' what folk think about ye if ye kenned how seldom they do." It cured her and the telling reassured me of privacy, because it's true.

The whole book is wonderful and you should read it!

Models

I had this post already written, so I will publish it, but the next few days/posts will take a different turn, as my father unexpectedly (he was 82 and had a heart condition, so as unexpected as this can be) died yesterday. I am on the way to visit my family.

My first and best model was my father.
__________________________________


All my life I was in search of a model, someone that I can shape my life on. Someone that I can learn from. I kept looking and when I found someone that almost matched my dreams, I would put them on a pedestal and keep them on my Olympus mountain. I honored and feared them.

This might have been an important part in my social anxiety. I was shy with mostly everyone, but with my models, I was frozen. I couldn't say anything in fear of saying the wrong thing and making them reject me.

I must have lost a few friendships in my need that my friends are the perfect models, and in not accepting them to be in any way wrong or faulty, or just think differently. I would put them very high in my expectations, and when reality set in and I would see they are just human being, I left unsatisfied.

In this respect, I thing blogging has been a great help, not necessary me blogging as much as reading other blogs. As opposed to the rest of my life where I had one model that had to live up to my expectations, I found lots of models. I can enjoy and learn from each of them, but the pressure on them being perfect is not there... plus what do you know about a person from their blog?

So, who am I learning from these days?

Paul Levy - Last year I called Paul my hero... he's still my hero. He just recently got the awards for The Best Medical Blog and The Best Ethics/Policy Blog for 2007. Well deserved! I agree with the rest of the voters. Paul is cool.

John Halamka, MD - the CIO at Paul Levy's hospital, BIDMC, and a bunch of other places (like that insignificant Harvard Medical School). John successfully embodies the saying: accept what you can't change and do the most out of what you can change. He makes things seem simple, but acknowledges the complexity of each situation. He couldn't have done all the things he did with a different attitude. I think I will be raving about him a lot in future posts.

Jolie Bookspan-The Fitness Fixer - I met Jolie in person, the only blogger I have actually met. We liked each other and I hope we'll get to meet again and do things together. She's strong enough to do anything she wants to do. I love her ambition and what she does with her life.

Seth Godin - I think he has the most popular blog... and it is worth! I just subscribed and hung out for a month or two... this is the best that blogging has to offer. One short post after another, one small idea after another, he made me understand where I can go from here. I will talk about him some more as well, but I highly recommend his blog!

All my social anxiety friends and their progress: SA Dave, Drew at Shy and quiet, Leila as the Perfect Hypochondriac and "the Guy from Successfully Shy". Guys, you're all doing great! It is so good to see how much we've accomplished against our common enemy! I'm reading you all and keeping in touch with your progress. Keep going!

The good, the wonderful and the rest

I noticed a few positive things this week. First, I was doing a user training. I did not have enough time to prepare and I didn't do a spectacular job. I did trainings with brand new computer users and I know what it takes to get them up to speed, but this time I just didn't have the time. One of the people at the course gave me an article from New York Times on how to teach computer skills. In the past this would have embarrassed me terribly. I would have been upset for days.

I'm not happy that I was criticized, and I wish I did a better job, but I recognize that the problem is not me not trying enough or not being able to do it, but the fact that you need time to prepare a training course. I am unhappy, but not paralyzed... this is new!

Along the same lines, the other day we had a few friends for brunch and we were talking about the American students not being culturally savvy enough to recognize a well-known Marx quote. I didn't recognize it either and that got me a bunch of sarcastic comments. I would have died from embarrassment. After the initial shock, I thought about why I don't know that... and I came up with an explanation that I think was instructive for everyone.

I grew up in the 70s-80s Romania. At that time Romania was a socialist country, but we weren't very close to Russia. Romania did not want to participate in invading Czechoslovakia in 1968. So I actually did not learn Russian, nor did I study Marx or Lenin. I pretty much kept up with what we learned in school: basically no foreign literature, dry and boring history and geography lessons, very little musical education and no other art education. I learned French and German in school and English in private lessons with my favorite teacher. I read all the books that I found in the house, but without much guidance from anyone. My parents were trying to keep sane at the those insane times by talking to each other and getting feedback from each other on the very crazy things that went on with their jobs.

I don't believe this is my fault. I am able now to round my education, and I'd like to, but, again, I recognize that there is a compromise between all that you want to do and what you can do... and I am choosing having a job, spending time with my child and family, reading other stuff and sleeping 7 hours a night or more. I hope I will be able to read and learn more with my child or when I retire. Until then, whatever culture I have is good enough.

And the third good thing, and the best, is my husband. When I started therapy we were both a bit nervous about it. It opened the possibilities that we will both discover things that we might not like; it is not uncommon for women to discover their power and "free" themselves of the evil men, etc.

Last year, whenever we had friends over or met other people, I would ask my husband to reassure me: Was I OK? Did I do well? How did I come out?

Now, when we go to bed, he cuddles and hugs me and says: I like you, I really like you. I like what kind of person you are, what kind of mother. I like that you are witty and smart and nice. I like the person you are... He used to reassure me to make me feel good about myself, but this is different. I think it's wonderful that I turned out into someone he likes and that I am now coming out of my shell enough for people to see that.

On the uncomfortable note, I am changing my gastro-enterologist and I feel very uncomfortable to face the old one. I called to ask for a test result and the nurse asked me to make an appointment. I got very anxious... There's more work to do. I am very uncomfortable confronting anyone. Bad news are difficult to give, I guess!

Tips

Giving tips: to whom, how much, when, how, etc. was a big issue for me. I had an idea what was customary back in Romania, but when I got to US I realized that's a completely different culture likely with different tipping rules. The envelopes in the hotel rooms and movies sort of give you an idea. I looked at my husband's habits figuring this will help me. I read Internet advice... things didn't match. I was confused and panicked whenever I was in a situation where tips were likely expected.

I think I got it now: there are no rules - each person does whatever they feel like: some tip more and everybody, others don't tip at all. You can get excellent service without tipping and people don't necessarily remember you even when tipping. So I am just listening to my heart and do what feels right at the moment.

I decided that during Christmas with the daycare center teachers. They are really nice to the kid, and while he has a teacher in a small group, she's there only 3 hours a day, and he is there 8 hours a day, so obviously there are lots of people taking care of him... so who would I give money and how much? Last minute, I decided: I'll get a bunch of nice chocolate gifts, enough for everyone. I got a small baby gift for one of the teachers that was pregnant. I put them all in a bag and wrote a nice note about thanking them for being his second family.

It went well... they are nice to the kid no matter what... and what they think or say behind my back... I don't care anymore. Nice words mean more to me than money and I think I made some people's life better when I said nice and heartfelt stuff.

Yesterday I got gas. It was really cold out here. And I thought about the poor guy that was in the frost all day filling up gas tanks, and I gave him two bucks. It felt the right thing to do.

Now I can relax about my tipping habits and find something else to worry about. So long!

Medication for SA

There was an article in New York times last week written by Dr. Carlat about being paid by a drug company to present a drug to other doctors. It has raised huge waves over the Internet and got me thinking at various levels. The aspect I would like to comment on now is the personal one - do you medicate for social anxiety or not?

My long time readers probably know already where I stand. I do not take any medicine for this and I am very happy with this decision... actually more and more happy the more I learn about it.


The problem is that therapy is not cheap. Insurance companies will not encourage therapy vs. medication because it is not cost-efficient for them. My insurance company has estimated the average annual cost for an anxiety disorder at around $1900. This includes doctor, medication and tests. Depending on the type of anxiety (low or medium) the doctor costs are between $600-$800. I am not sure how they calculated this, but they reimburse a therapist at $90/session for 20 sessions a year. This makes $1800, more than they plan to pay for both the doctor and medication.

So doctors are assaulted by both insurance companies to recommend medication and by drug companies to recommend their product (insurance might be more interested in cheaper drugs). Read that article in NYT... the push by drug companies can go beyong the short skirted girls with free samples and lunches and the ads we patients see on TV... it can go with respected doctors and researchers supporting one or another drug, with studies paid by drug companies. How can you not be influenced by all this?

So what are we patients left to do... I think I would resist as much as possible and do anything possible to avoid getting on meds. Happiness does not come in a bottle.

I am thrilled at the series of events that made me not take meds and try anything else: it basically had to do with the baby: I wanted to breastfeed at any cost. The baby was thriving and very healthy when breastfed and it kept me going and trying new things until it worked: a new therapist, exercise, meditation... anything to make it get better.

If this didn't convince you, read this article about someone trying to quit taking Effexor.