Wednesday, August 25, 2010

Tiny steps up the mountain: exposure and social phobia recovery

As once the winged energy of delight
carried you over childhood's dark abysses,
now beyond your own life build the great
arch of unimagined bridges.

Wonders happen if we can succeed
in passing through the harshest danger;
but only in a bright and purely granted
achievement can we realize the wonder.

To work with Things in the indescribable
relationship is not too hard for us;
the pattern grows more intricate and subtle,
and being swept along is not enough.

Take your practiced powers and stretch them out
until they span the chasm between two
contradictions ... For the god
wants to know himself in you.

—‘As once the winged energy of delight’ by Theodore Rilke

I stumbled upon this poem by Rilke and was struck by how apt a description of exposure therapy it was, particularly the last two lines of the first verse and the first three lines of the last verse.

As a severe social phobe with obsessional and self-defeating tendencies(!) I feel as if I am really exploring exposure for the first time in my life. But as I begin my tentative explorations, I also begin to see just how difficult the tasks – for there are many – are. There is so much work ahead.

I’m agnostic about my chances of recovery, each foot planted in an opposing camp, that of success and failure respectively. For about six years, I more or less gave up on my anxiety. It just felt too hard. Now that I’m beginning the work, now that I feel I have some of the equipment I need, I see that I was at least partly right. I see that the path is so steep, so strewn with embedded rocks and stubborn tussocks of grass, that I won’t ever reach the summit.

Yet while I’m by no means convinced that I will ultimately succeed, all progress will constitute success. Certainly I have no plans to get a job in the ‘real world’, or join a class. These achievements are for the moment impossible and may remain so. I have to see what I‘m doing as very small or I’ll get ahead of myself, try to travel too fast, and stumble. If I raise my expectations too high, I’ll achieve nothing. My work must be rooted in and held down by the realities and intricacies of the present moment.

What I am trying to do is make myself more comfortable with feelings. I want to be able to tolerate frightening emotions and thoughts in the presence of others. Paradoxically, this includes a great measure of discomfort.

A deep-seated, powerful enemy holds me back. It thunders down on me if I get too uppity, too relaxed, stray too deeply into the social world. It works through my social phobia symptoms but those benign clinical terms cannot describe its force. In a funny way it must love me; fearing my total annihilation, it is ruthless in its misguided attempts to keep me safe.

There are two voices running through my head intermittently. One of them gently reminds me that I have run out of time and that my greatest battles are already lost. For years I took this voice to be the unalloyed truth, but now I’m not so sure. The other one screeches against such a passive attitude and orders me sternly to stay on track. Like a scolding parent, it drags my thoughts back into line when they veer off into fearful or childish fantasies, and when my self-talk gets too self-indulgent. This voice, in the best tradition of Monty Python, is ‘cruel but fair’.

Battling silly thoughts yet giving into panic. Letting myself breathe yet accepting the fact that I may not be able to. Acknowledging childish impulses but refusing to mistake them for reality. None of this will create miracles. There are huge darknesses, gaping ellipses of selfhood, gutterings of uncertainty and terror. There are unpredictable hormonal spikes and the plummet of low blood sugar, which feels like the carpet of common sense being swept from under my feet. It may not cause the thinking that leads to my panic, yet it is the faithful handmaiden of that panic.

The greatest contradiction: to fight my anxiety I must give up fighting. But this doesn’t mean an instant cure; in some situations I can beg myself into a rag-doll limpidity of submission and still feel breathlessness well up. A lack of physical defences can cause me to feel more unsafe than ever.

Sometimes I experience what holds on to me as simply a form of extreme shyness. This surprises me, because I have a stereotype of shy people as being very quiet. I can be loud and exuberant and at times even overbearing and dogmatic (who’d have thought?) with those I know well. But the extreme self-consciousness I feel in front of those who intimidate me (people my own age or thereabouts; those of a high status or intelligence level; those who happen to be particularly good looking and attractive) can frighten me so much I begin to disappear.

In these situations I feel like a bird picking its way uncertainly around a patch of suburban lawn, alert to the tiniest pulses of the universe. Every intimidating thought, every minute surge of blood into a vessel, a daring remark that could lead into dangerous conversational waters, whether one too many people in the room happen to be looking in my direction: anything can spark off a kind of emptying of the Red Sea of my interconnectedness. I draw the room and the separate worlds of others into myself and force them to focus their entire attention on me.

Once, at my sister’s place for afternoon tea, some family friends dropped in unexpectedly. We sat awkwardly round a circular dining table in the formal front room. I was already feeling hemmed in when my mother gave me what appeared to be a ‘significant’ look across the table. I left soon afterwards. Furious, I later asked her why she’d thrown me that sudden stare.

‘I thought how beautiful you were looking’, she said. It was some years ago now, but even as I write this, not wanting to sound boastful, I don’t entirely believe her. Instead I believe she was worried for me, and that her look was a badly timed attempt to see how I was coping.

Social phobia may be the result of having no reassuring parent figure to return to in the earliest years of life. A shy baby cradled in its mother’s arms will brave an unknown horde of new faces for a few frightening seconds and then bury its head in mother’s familiar shoulder as it smiles bashfully. An introverted child playing with friends will suddenly experience a surge of existential aloneness, and will run back to mum or dad to cling onto legs and arms until the equanimity of the world is restored.

Adulthood involves no such havens. If the parent cannot offer the needed reassurance, perhaps the child never moves through this stage but remains stuck in it. The need to hide may remain, but can no longer be acted out. As the child enters the unknown world of adolescence with all its frightening new sensations, he or she might create certain internal defences as a substitute. In my case, these became my symptoms, warding people off and creating the safety I craved. Yet it has been a lonely safety.

There was one small thing I did recently that I was proud of. Dropping into my local supermarket, I homed in on the Oral Health section and searched for my usual pack of bargain basement toothbrushes. A very scary man was hovering in the aisle in the same area. Scary because tall, statuesque, brown skinned and attractive.

Normally I would have been unable to focus on my quest in the presence of such beauty, and would have cut it short in despair. This time I continued to search as he stood one or two feet to my right, torso jutting forward as he conducted his own interrogation of the shelves. These minor exposures are exactly what I need to seek out instead of instinctively avoiding them. They are tiny steps forward that can lead me, if not to the top of the mountain, at least to a place that has a better view.

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