Cognitive Behavioural Therapy made a night-and-day difference to my ex for social anxiety. She had extreme trouble talking in the presence of strangers, and wasn't able to do any public speaking in class. Her studies were made more difficult because she had nobody to talk to about the work, as she couldn't meet anyone. She had minor panic attacks before meeting my friends, and couldn't engage in group conversation once she did.
Our university ran a free group clinic, as there were researchers working on it, and the psychology department ran very cheap counselling to train their PhD students.
The group therapy program was just about what you'd expect. They just led her through increasing exposure. I found the activities kind of funny. In one of them, the group brought a cupcake, and sang "happy birthday" in a cafe to the subject, who was of course embarrassed. But then nothing bad happens, and their autonomous nervous system learns not to freak out. In the end stages of the program, she was given homework to start conversations with X strangers per week, for steadily increasing X until the task became contrived and she was switched into maintenance mode.
It's been one year since all treatment ceased, and she has no social anxiety problems. She's involved in the executive committee for a society devoted to one of her main hobbies (knitting), and is comfortable, say, going to an internet meet-up alone. She's still "introverted", but does not experience social anxiety.
There were other members of the group it didn't seem to help for. My ex said that when it co-occurs with depression it's much worse, because the depression keeps them from having that "I want to become stronger" mentality, which seemed to be crucial.
Thanks, this is the kind of thing I was looking for. I can totally see how that would help with social anxiety.
Major consequences for failure seem to be very effective motivators, but since I want to undertake projects that are difficult enough to have a significant chance of failure, I would like these consequences to be highly motivating without being horribly costly, if possible. Ideas?
Cross domain costs tend to be the most effective motivators for the least amount of investment. A $10 bet is a reasonably effective motivator for me; a $100 bet is more effective but not ten times as much; a $1000 bet is even more effective but not 100x as much. Similarly doing something embarrassing in front of 5 people is effective; doing something embarrassing in front of 50 people is only marginally worse. The more of these consequences you layer on, the cheaper each one can be individually.
Eg, Working out. My family knows I'm trying to bulk up and not to let me slack off (weak social consequences). One friend has a $20 bet with me if I don't go at least twice a week (financial consequences). My girlfriend has a standing bet that I must uninstall all games from my computer for at least a week if I fail to go to the gym at least 2x a week (hedonistic consequences), we'll also spend the time watching some terrible rom-coms or The Hills or something (pretty sure it qualifies as torture). Another friend gets a couple hours of my week for the next month editing her Harry Potter fanfiction if I slack off (time commitment). Also my mother gets to choose my haircut next time I see her should I slack (embarrassment/autonomy loss).
I have set times to be going to the gym. This means that even if I want to slack off, I can't. My computer won't allow me to visit my favorite websites while I'm supposed to be at the gym. I can't play any of my games online while I'm at the gym because my friends will know. And it's not like I can do any other fun things because my girlfriend and friends are in on it as well. I've got a very strong web ensuring that I act in my own best interest. Each minor individual commitment strengthens my total commitment. It also helps insure my friends and family act against me in concert. It's hard to get a defector to help you slack when everybody has something to gain. So although the aggregate costs are minor, they way they combine is much more effective than any single large cost could possibly be.
I will note that Working Out is a goal with broad social support. I assume losing weight and quitting smoking (if I needed those) would work similarly. I'm pretty that another goal of mine, learning Lojban, would not provide comparable results. When I attempted to go back to the Uberman sleep schedule I actually encountered a united front to stop me. I'm still trying to figure out how to diversify motivators for unpopular goals.
Caffeine pills in the morning. Previously, if there wasn't something that I absolutely had to get up for in the morning, it would take me several hours to get up from the first time my alarm clock rung. Sleeping 12 hours a day wasn't unusual. Taking a 100 mg caffeine pill from the moment the clock rings not only helps me get up early, it also makes me feel more energetic and good.
Establishing a morning routine. After waking up, I do a 10-minute run around the block and then take a cold shower. Some Internet browsing while I eat breakfast, then to do whatever I'm supposed to do that day. It doesn't always work, but it works better than just getting up and thinking "I guess I should start doing something soon". The combination of running followed by the cold showers also makes me feel great for a while.
Getting up early. If you get up at 7 AM, you can accidentially get stuck online for three hours, after which it's still only 10 AM and you still have plenty of time to do things. In principle, if you woke up later you could just go to bed later, but my brain refuses to see it that way. 5 PM is on some level still tagged as late, regardless of when I woke up.
Not getting an Internet connection to my apartment. I can still access the 'net via my phone's GPRS, but the slowness makes me far less prone to getting stuck in a "check e-mails, Facebook, IRC, e-mails" cycle. The slowness also made 'net browsing more uncomfortable at first, which helped reduce the time wasted online, but I pretty soon got used to that. Regardless, I still find this useful. If I need fast Internet, I go to the library or university.
Making sure I'm social enough. At one point I noted that I need to see people in a fun context every 2-3 days, or I get lethargic. Even if I have a lot of deadlines and it seems like I should really skip anything "unnecessary", doing so often leads to less getting done. Since then my "social timer" seems to have extended, but I still need to see people somewhat regularly.
For the most part, I just haven't been trying.
(I suppose my effectiveness has increased in some ways, but they're mostly the result of change in the outside world rather than any kind of improvement in myself. For example, it's easier to look things up on the Internet today than it was twelve years ago.)
I got some positive change out of therapy, although I suspect I'm conflating therapy with some other positive stuff that happened to me around that time.
Going through almost exactly the same routine every week with respect to dealing with my negative emotions made troubleshooting negative states a habitual exercise rather than something to be occasionally stumbled over or only done with external help. Essentially, I view most of my time in therapy as training in how to be my own therapist. When I find myself frustrated/sad/demotivated/etc I can seldom stay that way for more than 15 minutes without automatically entering troubleshooting mode and asking myself why exactly I'm feeling that way, what can I do to deal with it, and so on. Prior to this particular therapist I knew all of the techniques but had trouble convincing myself to apply them consistently (or at all most of the time, since I'd already convinced myself that I was a lost cause and the techniques wouldn't work for me).
Oh and she also helped me defuse some particularly irrational and damaging beliefs that I was holding onto despite abundant evidence to the contrary, mostly by forcing me to acknowledge that the evidence existed. Before that I'd been very good at rationalising it away, but when led through it step by step by an outside source I had to choose between defying the data and updating my beliefs at least slightly.
Other things that have made me more effective include:
I went to grad school. Just being required to do more work has resulted in... me doing more work. I fritter less time away on video games and the internet and spend more time learning cool things. The externally imposed deadlines seem to do the trick, though the environment is also more conducive to actually being interested in learning than undergrad was (probably a function of peers, among other things).
My wife and I attend a therapist/counselor due to my deconversion. It has helped. If I had to try and pinpoint how, I'd say that simply having someone you're going to see regularly (for us, about 1x/mo) about your relationship has increased my desire to reconnect and work through conflicts rather than simply play the silent treatment game or be an ass about her mistakes or times when I've been hurt.
She's said the same. Basically, accountability. If I'm a jerk... I'm going to end up being embarrassed for my immaturity. I know better via in "far mode" but in "near mode" the desire for power and retaliation is still quite tempting and surrendering to a third party has a definite affect.
Our counselor also uses something called the "Emotionally Focused Therapy" method, which views romantic relationships as emotional dependencies/needs in order to help couples recognize that most arguments are not really about the topic of the argument but more aptly translated into phrases like, "Do you really value me? Are you here for me? Am I worth your time?" I haven't read the whole book and haven't really compared it to other views on this, but the method claims to have a higher success rate than others.
'Nuff rambling about my dirty laundry. Just wanted to chime in that at least one type of therapy in one setting is helpful.
For a different example that I think very poorly of, in my teen years during my drug/alcohol abuse state, my parents took my to a psychologist who after a perhaps 20min session in which I barely said anything other than the fact that I didn't really like my life and didn't get along with my parents, asked me if I'd like to try some anti-depressants to see if they'd help. While I may have had some symptoms, I was surprised back then and still am that after such a short period of time someone would have been ready to prescribe me something.
Edit: In re-thinking... could a counselor who's simply providing "accountability" be replaced by a close mutual friend, mentor of sorts, or someone else? Probably, though the guy is very good at guiding conversation, mediating, etc., and I was very impressed that he asked for specific goals in our first session. Basically, he asked, "If this work between us went perfectly, how would things look like at the end of many sessions?" I thought that was fantastic, as I really worried before deciding to try this that we'd be emptying our pockets for nebulous emotional venting sessions.
Therapy/counseling, for us, I think also adds incentive to care because we're paying for it. I want the best out of this guy's tool bag and having a financial investment in trying to improve our situation helps me, at least, stay focused on trying to work hard in our sessions.
Major consequences for failure seem to be very effective motivators, but since I want to undertake projects that are difficult enough to have a significant chance of failure, I would like these consequences to be highly motivating without being horribly costly, if possible. Ideas?
Hmmm. You don't mention major consequences of success as motivators. Is this simply an instance of status-quo bias, or something more interesting? Is it possible you should be setting your sights higher and attempting more ambitious projects with a high up-side? Graduate or professional school, say?
Yeah, good observation. I think I don't emotionally reward myself for success enough; not sure the best way to fix this. Doesn't change the fact that, given that punishment for failure is a motivator (and it is), it's best to punish myself in highly motivating but not highly costly ways.
I bought David Allen's book Getting Things Done and started applying some of the things mentioned there.
More specifically: I stopped using my calendar as a todo-list ("Tuesday: do some school stuff"), now it only contains things that are bound to a certain date/time. Also defining my todo's better (not "do some school stuff" but "read p. 20-35 and make a short summary") has been helpful.
If I have a bigger project / cause of stress - at the moment my bachelor thesis would be a good example - I write down the next action I need to take regarding it. This usually helps a lot. As he states in the book: "There is no reason ever to have the same thought twice, unless you like having that thought."
The cold showers thing that Kaj mentioned sounds very interesting, have to give it a try.
I did get some benefits of therapy a while back, after the death of a close friend. I really did not feel comfortable at all talking to anyone about it, and so I hadn't been coping very well. It is occasionally useful to have someone who is certainly going to listen to you, and who is bound by law not to tell anyone else what you say. Helps to get things off your chest. Other than that, I've got basically no experience with mental health professionals.
In addition to what others have said, there's a lot of potentially useful fail-data at Troper Tales: There Are No Therapists, one of the more grim pages on TV Tropes. (Note: due to the lack of links, this page doesn't share the usual TV Tropes time-sink warning.)
I don't know that it was especially unhelpful for me compared to other people, if that's what you mean, but I suspect so, since so many people bother with it..
If you mean how was it especially unhelpful for me compared with other interventions? Well, I dunno, it just didn't seem to help much. It made me feel better about as often as it made me feel worse. It wasn't a source of great insights since I could usually predict what my therapist would say in response to any given thing, and I'm very introspective in any case. And I've never noticed that it seemed to improve my capacity to get shit done.
I'm more interested in how you think therapy is usually helpful, or how you have actually found it to be helpful. (And if you live in my area, the name of your shrink.)
I went into therapy as a treatment modality for depression, in which capacity I hoped it would help me get less depressed. If it worked for that at all, I couldn't tell. I was also hoping it would help improve my emotional resilience and capacity to get stuff done, or at least teach me things I didn't know before. All I can say about that is that all the stuff on my list worked a lot better.
At this point I'm just kind of confused about what your questions are getting at. I'm not offended or anything. This just isn't the kind of feedback I was expecting to "Therapy didn't work for me, but I'd love to hear about how it worked for you, if you can be really specific."
I want to be more resilient in the face of failure and of people being mean to me. And my episodes of major depression have usually been precipitated by environmental factors, but I suspect based on their repeated ocurrence and my family history that I do have a biological predisposition for depression. I am currently feeling fine, but I consider it quite probable that if I were subjected to a significant environmental challenge, I would have to seek treatment again.
So when you were in therapy, you tended to talk a lot about your problems and how you conceptualized them, and the therapist would point out more dots to connect? Or just ask useful questions that helped you notice more dots? Or how did you find the extra dots?
What variety of psychotherapy did you use?
Psychotherapy has helped me with tremendous self esteem issues (though i still have them but it used to be WAY worse). I did have to go through multiple therapists to find a good one (many add a ton of crap into their practice ).
ADD meds. (Depression meds were somewhat helpful when I was actually depressed, however.)
Are you actually diagnosed with ADD? I took it for granted that you were at first, but then it occurred to me that some people attempt to use these for augmentation above the baseline. This works better for some people than others, but it can be accompanied by some pretty serious side effects.
Personally, I consider halting the use of my ADD medication in my first year of college to be one of the most glaring failures of instrumental rationality in my life, particularly given that I already knew that in the past, medications had radically changed how they affected me after interruptions to consistent, regularly applied dosage, so I did not have good reason to suppose I could go back to it if I felt it was necessary.
Like many people here, I think a lot about how to become more awesome. I'm fairly optimistic about my chances, because I can clearly remember times in the past when I was less awesome than I am now-- not necessarily less rational, but less productive and with fewer relevant skills.1
So I've been thinking about what changes I believe have most improved my effectiveness, changes which have caused me to learn many useful things and/or greatly increased my productive capacity. I found the list interesting:
Things which are notably not on the list:
So how have you actually improved your own effectiveness?
1 Some of these less-awesome past versions of me suffered from clinical depression, but the last time I had a major episode of depression I was able to deal with it much more purposefully than in the past and still accomplish a large percentage of the shit I was supposed to be doing, so I think there has been improvement independent of my state of mental health.
2 Major consequences for failure seem to be very effective motivators, but since I want to undertake projects that are difficult enough to have a significant chance of failure, I would like these consequences to be highly motivating without being horribly costly, if possible. Ideas?
3 I have learned a lot from pleasure reading, but I'm not sure how much was actually useful, and since I've been reading for pleasure since I can remember there's no easy before-and-after comparison to make.