Progress

Alright, so I haven't updated in a while, no I haven't suddenly forgotten about CBT. Actually these past few weeks I've sort of quasi ended treatment due mostly to an OVERWHELMING amount of school work and job obligations. I don't very much enjoy complaining so I won't go into those aspects, but suffice to say I've more regressed than progressed these past 3 weeks.

Today however was quite successful. I had my first appointment in 1 and a half weeks. I did what's known as an "in vitro" exposure, which honestly I think are best for beginning SA treatments. Exposures are absolutely essential to the treatment process and so it makes it even moreso important to have successful exposures. Doing exposures with strangers or friends/acquaintances is inherently more difficult because you don't have the opportunity to carry out a long conversation, you have to be assertive and find creative things to justify talking with strangers (which can be quite difficult), and furthermore you don't get feedback from them.

So my train of thought is (in in vitro exposures) is that the people enlisted to listen to me talk are doing so with the knowledge that I have SA, that I'm working to getting better, and so they're understanding if I show anxiety. This allows me to focus on getting better, rather than worrying so much about showing my anxiety.

Case in point:

Today I was to give a series of presentations to a group of 4 people, and as I went through my chart, I felt like my peak anxiety would be around 90. I felt my heart racing in anticipation, I felt the sweaty palms, the nervous tension. etc etc.

Went through the CBT exercises, then went into the conference room.

First exposure duration: 10 minutes.
So when I first started talking, I was very visibly nervous. Shaking, incoherent talking, losing breath, heart pounding etc etc. Then I started to kind of level off, I still felt an intense radiation of anxiety come over me as I felt they were judging me negatively. I forgot a lot about what I was talking about and hence I received a lot of "he looked nervous, etc etc" feedback

Second exposure duration 12 minutes:
I started off anxious again, but not as much. I felt like I knew it wasn't going to escalate, and I was able to focus on what I was talking a little bit more than my anxiety. Overall, the peak anxiety I felt was the same as the first session but on the average I was getting to pockets of time where I felt comfortable.

Third exposure duration 12 minutes:
I really started to engage the audience, I felt a little more confident due to an absence of anxiety symptoms, I was able to bring out more of my confidence and as I brought my confidence I felt a further decrease in my anxiety. By the end of this exposure, I literally felt no anxiety. Like I could talk for as long as I needed and it would have been as if I was talking to air.

Fourth exposure duration 15 minutes:
Felt no anxiety, had an increased sense of confidence, really got an engaging conversation going, I felt in control and the people enjoyed my personality. Again, to reiterate, I couldn't feel anxiety symptoms and my mind was able to enter a creative world that's only accessible in non-anxious states.

So the point I want to drive home here, is that I started out in anxiety attack mode, but by repeated exposure, I was able to get to a point where my anxiety was the same as that as someone without SA. That's a huge confidence booster and the fourth exposure session really made me feel happy! Because I don't get a lot of attention and I felt like for the first time in a long while I was able to accrue positive feedback which was reflected in their notes on my presentations.

The exposure session totaled about 2 hours which is actually short for what most "successful" exposure sessions should be. I want to layout this experience for readers to understand how they themselves should be conducting their exposure sessions that is to say, with repetition with the mindset that eventually your body will lose the ability to sustain the anxiety response and your anxiety will come down and as it comes down your mind will undergo what's called "extinction" where it reprograms itself to not automatically initiate the anxiety response in future situations.