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jobe_smith comments on Open thread, 21-27 April 2014 - Less Wrong
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How strong is the evidence in favor of psychological treatment really?
I am not happy. I suffer from social anxiety. I procrastinate. And I have a host of another issues that are all linked, I am certain. I have actually sought out treatment with absolutely no effect. On the recommendation of my primary care physician I entered psychoanalytic counseling and was appalled by the theoretical basis and practical course of "treatment". After several months without even the hint of a success I aborted the treatment and looked for help somewhere else.
I then read David Burns' "Feeling Good", browsing through, taking notes and doing the exercises for a couple of days. It did not help, of course in hindsight I wasn't doing the treatment long enough to see any benefit. But the theoretical basis intrigued me. It just made so much more sense to be determined by one's beliefs than a fear of having one's balls chopped off, hating their parents and actively seeking out displeasure because that is what fits the narrative.
Based on the key phrase "CBT" I found "The now habit" and reading me actually helped to subdue my procrastination long enough to finish my bachelor's degree in a highly technical subject with grades in the highest quintile. Then I slipped back into a phase of relative social isolation, procrastionation and so on.
We see these phenomena consistently in people. We also see them consistently in animals being held in captivity not suited to their species' specific needs. I am less and less convinced that this block of anxiety, depression and procrastination is a disease but a reaction to an environment in the broadest sense inherently unsuitable to humans.
The proper and accepted procedure for me would be to try counseling again, this time with a cognitive behavioral approach. But I am unwilling to commit that much time for uncertain results, especially now that I want to travel or do a year abroad or just run away from it all. (Suicide is not an option) What lowers my odds of success even more is that I never feel understood by people put in place to understand in various venues. So how could such a treatment help?
I am open to bibliotherapy. I don't think I am open to traditional or even medical therapy.
I have suffered from social anxiety continuously and depression off and on since childhood. I've sought treatment that included talk therapy and medication. Currently I am doing EMDR therapy which may or may not end up being helpful, but I don't expect it to work miracles. Everyone in my immediate family has had similar issues throughout their lives. I feel your pain. Despite not being perfect and being in therapy, I feel like my life is going pretty well. Here is what has worked for me:
Acceptance: Not everyone can be or should be the life of the party. Being quiet or reserved or shy is a perfectly acceptable way to live your life. You can still work on becoming comfortable in more social situations but you are fine right now. There are plenty of people who will like you just as you are, even if you social skills are far from perfect. Harsh self-judgement can make anxiety worse and lead to procrastination and depression. What I try to do as best I can is to just do whatever I feel like in the moment, and just let the world correct me. I try not to develop too many theories about how the world will react to me since I know from experience that those theories will be biased and pessimistic.
Decide what you want from the world: I guess this is somewhat generic life advice, but it has really worked for me. I decided fairly early on what I wanted to get from the social world. I wanted 3 things. - marriage - children - a good career
Deciding those things, I plugged away at getting them. I was completely incompetent at talking to women but with some help from e-harmony I found one who I was able to be comfortable with and who liked me. We got married 6.5 years ago and we have a 2 year old daughter and another child on the way. Professionally, I found a career that involves a minimum of politicking and no customer interaction. And yet it is both intellectually satisfying and highly remunerative. Even though neither my home life nor my professional life are perfect, achieving my basic life goals has given me a deep feeling of confidence and satisfaction that I can use to counter feelings of anxiety and depression as they come.
Each step I took along the path towards my goals gave me more confidence to move forward, but that confidence wasn't necessarily automatic. I have to periodically brag to myself about myself because otherwise I will naturally focus on my failures and weaknesses and start to feel like a loser. You should be very proud of your accomplishments in college. Most people could not do what you have done. Remind yourself of that. Feel good about yourself.