CBT Question from a non-believer

[Sir Real]

For me personally I'm 99.9% certain that my SA is a result of genetics/brain chemistry rather than any learned negative behavioural pattern, and would go as far as to say it's not even a combination of brain chemistry and learned negative behaviour but totally the former. I didn't develop SA at a particular stage in my life, I've always had it, from my earliest memory as a toddler.

With the above in mind I can't see any real possible benefits from CBT for someone like myself, and would assume that those who say they have benefited from it have developed SA later in life through negative experiences that have damaged their confidence rather than from anything more deep rooted that has been with them their entire lives.

The way I view it, CBT working for me would be the equivalent of someone with a totally happy/positive disposition taking a CBT course to turn them into a depressive and the result being a successfully depressed person. I just can't see it peeps.

Would be interested in people's views/experiences.

[anne123456]

I've always had SA-from very young childhood (as early as I remember and my parents remember even before that). My parents both had SA, so I think there was a genetic component. But-I still think CBT has worked (in part) for me. I think the brain/psyche can be hurt by experience, but it can also be helped. Yes, you can turn a happy, positive person into a depressed one with enough bad experiences, but you can also turn a 'genetically anxious' person into a reasonably confident, non-SA person.

However, I do think there is a difference between those who developed SA later in life (usually as teens) and those who always had it. For me, it was a big issue how to define myself-if I lost SA, I would be losing part of 'me', if that makes any sense. I think those who developed it later see getting rid of SA as a return to how they felt before and I have no 'before'. I also think ppl who have always had SA develop coping strategies (for good or ill) very young. That may help for a while and maybe may help throughout life, I don't know. But we can have such ingrained patterns of behaviour it's difficult to break.

Just my thoughts
Anne

[Sir Real]

Thanks for that Anne, makes a lot of sense and I can relate to a massive chunk of that. As you say I think having SA from 'the beginning' can leave you with behaviour patterns and survival mechanisms that may appear almost impossible to break.

Having been to my share of meets over the years it does seem that the majority of people seem to have developed SA in their teens or at some other point rather than having had it all of their lives.

I guess the bottom line for cynical old me is that I don't believe that any amount of reading or listening to CBT CDs is going to alter my brain chemistry(which is what I believe needs to happen), for that would surely be a medical miracle.

[tigerbanana]

I've had SA for as long as I can remember too. My father also had SA for a large part of his life (although now he's the most extroverted person you're likely to meet). As a child, my extreme shyness wasn't considered anything unusual for someone my age and it was assumed I would grow out of it. I think you generally get too breeds of little kids, those who have absolutely no sense of shame or awareness of how they appear to others at all and those who are very shy indeed, the type that don't speak and cling to their mothers. Most of those shy kids do grow out of it, but I never did..and by the sounds of it neither did you. So we're not the only ones.
Does that really mean that our SA is completely down to genetics? I seriously doubt it. You said both your parents had SA, that might put a case towards believing your SA is a result of your genes but it puts a case towards believing that it is learned too.
I can believe that our genetics could make us more naturally prone to developing SA but I don't think that's the whole story.
Your experiences from babyhood onwards constantly influence who you are and contribute to, reinforce or challenge your beliefs and effect your emotional reaction to things.
Don't you think there could be a child born who has the sort of brain chemistry that makes him naturally more geared towards being care-free, positive and confidant that might have so many negative experiences in life that it could result in him developing depression or an anxiety/drink/drug or some other kind of problem? I've seen this happen.
If that's true then it also means a kid born who is naturally more worried, anxious,negative, frightened can also go through experiences that effect him positively, and create confidance, etc.
For those of us who can't remember a time without SA, it's pretty much impossible to imagine a life without it, I think it would definately take a lot of work and reinforcement to really overcome SA but I don't think it'd have to take a miracle, a miracle's something we have no control of.
Personally, I don't think I'd have any problem defining myself if I were free of SA. Actually I think it would be more like freeing the real me, who others could actually see, whereas now I feel like I'm in hiding.
I have to say I haven't tried CBT yet, but I want to, if someone told me witchcraft could cure my SA..I'd try that too, there's always hope and I really think if you believe CBT cannot possibly work.. it won't.

[ignisfatuus]

Originally Posted by tigerbanana

I really think if you believe CBT cannot possibly work.. it won't.

I thought that somebody might say this as it inevitably pops up whenever CBT is discussed. If CBT requires you to believe in it, then it is not an effective treatment. It should not require faith on the user's part to work. It either works or it doesn't, and any excuses such as the above do not explain away its failure. That being said, CBT has the capability to relieve or even eliminate SA if correctly tailored and applied to those who suffer from it (which unfortunately, at least in my experience, it is not). Conditioning is a powerful tool, the cognitive component being somewhat wishy washy IMO.

[tigerbanana]

I disagree. If someone goes into it convinced that it's not gonna benefit them then they're not really engaging in the treatment at all. CBT requires you to enter into the process and actively work at it. Just as any treatment does.

"Remember that no biochemical, neurological, or genetic markers have been found for attention deficit disorder, oppositional defiant disorder, depression, schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling, or any other so-called mental illness, disease, or disorder." Bruce Levine, Ph.D. (psychologist), Commonsense Rebellion: Debunking Psychiatry, Confronting Society (Continuum, New York 2001), p. 277

"There is no evidence that any psychiatric or psychologial disorder is caused by a biochemical imbalance." Peter R. Breggin, M.D., in his book Reclaiming Our Children (Persues Books, Cambridge, Mass., 2000), page 139.

[hardy]

"I've always had it, from my earliest memory as a toddler."

Thats just the point! We are all socially unskilled at that age . No one goes out pubbing and clubbing , partying or flying round the world alone at that age!! Social skills have to be learned .youre not born with them. You learn the skills through books (fiction) and films, tv etc. as well as personal experience . You can't avoid learning most of them.

CBT works by showing you that you have most of the skills . It then helps you to straighten out your concept of how other humans in the world view you and what you can expect to give or get from them. Then it leads you onto gentle exercise to learn the few remaning skills that you missed out on.

The main power of CBT is that it is based on research that shows SA is actually mostly to do with the sufferers negative view of other people . Wheras from the suffers point of view it feels like a lack of personality or social skill.

CBT is not a faith based concept (like religion) . Its a scientific principle and you only need to believe in it enough to carry out the work needed. tHe same as you have to believe its worth doing to work at any kind of project .

[Innerspace]

Originally Posted by ignisfatuus

I thought that somebody might say this as it inevitably pops up whenever CBT is discussed. If CBT requires you to believe in it, then it is not an effective treatment. It should not require faith on the user's part to work. It either works or it doesn't, and any excuses such as the above do not explain away its failure. That being said, CBT has the capability to relieve or even eliminate SA if correctly tailored and applied to those who suffer from it (which unfortunately, at least in my experience, it is not). Conditioning is a powerful tool, the cognitive component being somewhat wishy washy IMO.

I don't agree with this.
CBT doesn't require faith in order for it to help, but it does require the client to at least have enough belief in the principles it works upon to be bothered giving it a try and persevering with it.
Basically, if a person goes into any therapy thinking it won't work... then it won't... period!

Any therapy and/or treatment is only as effective as its application. So in the case of an SA sufferer who feels nothing in the world can help. It takes a personal leap of faith to go from that to thinking anything at all can help, but CBT itself requires no 'faith' in it other than an open mind and a willingness to apply it consistently.
An injection for an illness can work whether we believe it will or not, but therapy which works with the mental process needs the client to engage with it rather than dismiss it.

So, it can work if the client applies it, but it hasn't got a hope in hell if the client chooses to believe it offers nothing, so refuses to apply it. So, faith? No. Application? Yes.

I say this as a life-long SA sufferer, and by life-long i mean as far back as i can possibly remember, ie, pre-school. I also believe i had a (genetic?) predisposition to high anxiety levels. All i know is persistent application of altering my cognition has helped me vastly, and this is without proper CBT from a practitioner too.

Something to remember about the mind is that if we persistently tell it that something won't work (in this case CBT) then it simply won't. I know that i only started to get better once i decided that i actually could, and i wasn't actually the worst SA case in the known universe. That change in cognition was a major breakthrough for me, so now i realise that my cognition precedes my behaviour. Changing the cognition can alter the outcome.

Anyway, i'm with tigerbanana and Hardy on this one.

[Sir Real]

Originally Posted by markimark

question for SIR REAL if i may. what if anything then are you doing to attempt to combat SA? Im not being critical here im just wondering cos i too have doubts similar to yours but thinking about it - if i ask myself the same question i have just asked you then the answer truthfully is NOT A LOT!

Firstly a big thumbs up for all of the feedback above. I guess I was hoping people would come out and say largely what they have so as to give me the push I needed to give CBT a 'real' go.

In answer to your question markimark I have completed a CBT course before but I never really committed myself to the practical side of it, largely through an ingrained belief that 1) I wouldn't be able to deal with the practical exercises and 2) that for the reasons I stated above, it wouldn't benefit me anyway - my broken machine would remain broken no matter what I tried. Those two factors combined with me being a lazy sod meant it had zero impact on my SA. In addition to CBT I've also read numerous books, had a stint on Seroxat and gone to one-to-one counselling, but all done with a cynical view that I am what I am and nothing can change that.

Here's to future days

[Sir Real]

Originally Posted by markimark

thanks for the reply. From one lazy sod to another best of luck!

Cheers

I always considered myself a shy kid from the earliest of ages too, but I overcame social anxiety using CBT, so there's proof it works for some.

I still have depression though, I am yet to have CBT for that... if I can ever pull myself to do it

[OldBailey]

I've had SA as long as I can remember (and it's not a matter of social skills, some kids are more outgoing than others) but I don't think that necessarily means it's caused purely by genetics. For what it's worth, I think we're born with traits that, as well as having advantages, make us more prone to problems like SA, OCD or depression but don't cause it. Events in very early childhood, while the brain is still growing rapidly, are going to have a profound affect on your brain chemistry and, therefore, on your thought patterns in later life. Although it might be harder to rectify the problem if it stretches back this far I don't think it's impossible.

[anne123456]

I guess the real question you (Sir Real) are struggling with is not whether CBT actually can work for you, but the bigger question of whether you can actually get any better. Whether it's worth the risk of really trying and possibly failing. But things aren't really that black and white-as I said CBT type therapy helped me, but not completely, one on one therapy helped also, but not completely, medication for depression did help a lot but mostly just for the depression. My feeling is that I have a lot of 'baggage'-genetic, environmental and mostly trained responses to situations. I don't expect to be 'cured', I don't even know what that means, but I do keep struggling to lessen my irrational anxiety. For me, CBT type thinking helps on a daily basis.

As a small example, you may know I lecture/teach a lot and have done for years. For some reason in the last month I've gone into a complete panic attack about writing on the blackboard (95% of my lectures are with overheads/powerpoint), and I've just been avoiding it and it has led to some very awkward situations. But I've been thinking about it and trying to see where the fear comes from and today did a tiny bit of writing on the board. I was very shaky, but noone noticed (I think!) and will keep trying again and again using the CBT type thinking until I hopefully will forget this fear. There are lots of small situational fears I've conquered like this. It's not a cure by any means but its a way of moving forward rather than back. I have no dreams of being completely free of anxiety but I know I can get better and better.

I hope I didn't completely misread your post and this makes some sense!
Anne

[Oddbod]

Sir Real: Just wanted to let you know that I totally relate to everything you said in your first post. And here is one of my favourite articles on genetics and SA (anyone here double jointed? I am). I will copy it over 2 messages to keep within the character limit.


DISCOVER Vol. 23 No. 4 (April 2002)
The Biology of ... Panic
The Sum of All Fears
The clue to understanding anxiety may be written in your genes
By Jocelyn Selim

When Charles Darwin returned to England in 1836 after his five-year voyage on the Beagle, he was 27 years old and on the cusp of one of the most brilliant careers in the history of science. He was also a bit of a wreck. He began complaining of "constant attacks"—heart palpitations, trembling, shortness of breath, and "swimming in the head." When offered a secretaryship at the Geological Society of London, he declined, explaining that "anything that flurries me completely knocks me up afterward." Two years later the once-intrepid traveler moved to his country home in Kent and became a legendary recluse, leaving only when absolutely necessary and then traveling in a carriage with darkened windows. On one rare trip in 1861, a brief speech in front of the Linnean Society prompted a 24-hour vomiting episode.

Darwin never learned the true nature of his malady. Physicians of the time diagnosed it as anything from "dyspepsia with aggravated character" to "suppressed gout"; their successors might have attributed it to a weak nervous system or a conflicted superego. But according to a team of researchers led by Xavier Estivill, a molecular geneticist at Barcelona's Medical and Molecular Genetics Center, Darwin's agoraphobia may have had a more specific origin. In a study published in the journal Cell last summer, Estivill contended that nearly every social phobia and panic disorder is rooted in a single stretch of about 60 genes.

Anxiety disorders first caught Estivill's attention 14 years ago through the work of physician Antoni Bulbena. While working at the Hospital del Mar in Barcelona, Bulbena made an odd observation: Patients who were double-jointed complained of nervous disorders far more often than others—fully 16 times as often, a follow-up study showed. Intrigued by the coincidence, Estivill traveled to a small Catalonian village near Barcelona, collected DNA samples from families known to have both conditions, and began combing through the samples for common characteristics.

Such comparative research usually entails a genome-wide analysis—an onerous process of lining up corresponding segments of DNA and looking for shared sequences. But Estivill, on a hunch, took a shortcut: He first examined the blood and then the sperm cells of 10 of the patients for genetic abnormalities that might contribute to the association. It was on the 15th chromosome that he found what he was looking for: Eighty-seven percent of the double-jointed and 90 percent of the anxiety-afflicted villagers carried a duplicated region spanning the length of about 60 genes. When Estivill repeated the study in a group of unrelated Catalonians, the association was even stronger: Ninety-seven percent of those diagnosed with an anxiety disorder carried the duplication compared with 7 percent in the general population. "It was astounding," he says. "You just don't expect that much of a relationship between a single region and a complex disorder that's supposed to be the result of many genes."

If Estivill's numbers hold up, says University of Oxford molecular biologist Jonathan Flint, they will demonstrate the most specific genetic association ever reported for a psychiatric disorder. "It's got a lot of people excited," Flint says. Like many of his colleagues, however, Flint still has nagging doubts. During the past year alone, he notes, an average of one study a day has been published purporting a genetic link to some psychiatric illness or other. Granted, no other study has produced statistics so compelling, but if the link was so obvious, why had no one found it before?

The answer, Estivill says, is that the duplication isn't being passed along according to standard patterns of heredity. Most other genetic disorders are caused by a hereditary mutation at a specific location on a specific chromosome. Cystic fibrosis, for instance, is caused by a mutated gene that codes for a faulty protein that makes the mucus in the lungs too viscous. Such genes might be dominant or recessive, but once they appear in the DNA, they are passed down through the generations virtually unchanged.

[Oddbod]

Estivill's duplication doesn't work that way. Not only does its position change along the chromosome, but its sequence is sometimes inverted or otherwise rearranged. Stranger still, those changes sometimes occur from cell to cell in the same individual, not just between parents and offspring. The reason, Estivill suggests, is that the duplication itself isn't being passed along. Rather, it's the tendency to duplicate that's inherited.

There are two ways such a pattern of inheritance could occur, he says. The enzymes that repair or copy DNA could be faulty and more prone to making doubling errors. Or the problem could have a more novel origin. The 60-gene duplication area is surrounded by smaller repeated sequences known as duplicons. Such duplicons are usually just junk DNA, but under certain circumstances they could cause trouble. "If the smaller repeats are very close copies of each other, they could throw off the copying machinery—trick it into making it see something twice and make a double copy of a nearby region," Estivill says. "It's impossible at this point to say exactly how this is happening. You've got to keep in mind that this is something no one has ever seen before."

In essence, Estivill is proposing an entirely new mechanism of genetic disease. "It's not an unreasonable explanation, given his observations," says Brad Schmidt, a psychologist at Ohio State University's Anxiety and Stress Disorders Clinic who has been looking for anxiety-related genes for nearly a decade. "I have a hard time believing something that looks as complex as panic disorder and phobias could really be that simple, but then the history of science is full of cases that looked very complex from one angle and turned out to be very simple when viewed another way. We've assumed that because drugs like Xanax and Paxil are so effective, all sorts of combinations of genetic variants of their receptors must play a role. But that line of thinking might be right up there with assuming that an aspirin deficiency causes arthritis."

If Estivill is right, such chromosomal rearrangements could lie behind many other hereditary disorders—schizophrenia, obsessive-compulsive disorder, and depression among them. Or for that matter, patterns like the duplication could cause any illness—from asthma to heart disease—that has been blamed on the effects of many genes working in concert. So far, attempts to unravel the genetic basis of complex conditions have been embarrassingly unsuccessful, Flint admits. "When attempts to find particular combinations of genes fail, the common wisdom just assumes they are even more complex than anyone thought. A mechanism like Estivill's could potentially explain quite a lot."

Since isolating the duplication region, Estivill has gone a step further, pinpointing his patients' anxieties to a double dose of at least one neuroreceptor coded for by one or more genes. "We can't be certain. We haven't identified all the genes in the region," he says. "But this one is a type thought to play a central role in the brain regions activated by fear." Mice that Estivill has bred with an extra copy of one gene scare more quickly and run away faster when faced with rats, bright lights, and other mouse horrors.

Such discoveries may well lead to treatments for anxiety disorders, but an outright cure would be going too far. Unlike hemophilia, Huntington's disease, and other hereditary illnesses, a certain amount of anxiety is good for people. "It's part of a highly evolved and adaptive defense mechanism and protects us from getting too close to cliff edges or hungry lions, just as the immune system protects us from bacteria," says Randolph Nesse, an evolutionary psychiatrist at the University of Michigan. Panic attacks are less a problem of maladaptation, Nesse says, than a case of too much of a good thing.

Even Darwin recognized that his suffering had some benefits. Before he died, he admitted that "ill-health, though it has annihilated years of my life, has saved me from the distraction of society and its amusements." Without panic disorder to focus his passions and spare him from interruptions, some researchers have suggested, Darwin might never have written On the Origin of Species.






RELATED WEB SITES:

For more about psychiatric genetics, see Jonathan Flint's Web page: www.well.ox.ac.uk/flint; to learn about clinical aspects of anxiety disorders and Brad Schmidt's work, see anxiety.psy.ohio-state.edu; and for more on the evolutionary perspective from Randolph Nesse, see www-personal.umich.edu/~nesse/Articles/ Fear&Fitness-Ethol&Sociobiol-1994.PDF.

[hardy]

Quote OLd Bailey "and it's not a matter of social skills"

I think thats a good point . It can FEEL like mainly a problem of skills and "how to perform" , "how not to panic" , "how not to blush", etc etc but it turns out from clinical studies that it is mainly to do with how we think others percieve us . Perception is all about "cognition" and therefore CBT is aimed at giving us a more realistic understanding of what others think of us and in effect how to "mind read".

[VeganBoozhound]

Originally Posted by OldBailey

I've had SA as long as I can remember... Although it might be harder to rectify the problem if it stretches back this far I don't think it's impossible.

I've had SA for as long as I can remember too. Last year I started CBT, I didn't really believe that it could help me either however after 11 months I was discharged, deemed 'cured'. So it can help, no matter how far back your SA goes

[Boc11]

I have just started CBT via the NHS. I must admit I don't have a lot of faith that it will work, however I am definitely willing to give it a go and do all the 'homework' that is asked of me.

[Olivier25]

Hi guys
Im new here and wanted to add my 2 cents of what i believe to be true from personal experience...

"For me personally I'm 99.9% certain that my SA is a result of genetics/brain chemistry rather than any learned negative behavioural pattern, and would go as far as to say it's not even a combination of brain chemistry and learned negative behaviour but totally the former."

do you know when someone has a completely ****ed brain chemistry?

someone droped in a pool full of sharks!

ok this may be a very very bad exampl lol
but what im trying to say is that when you feel bad because of the things you think, then your brain chemistry is in line with your fears etc..
Toughts have a direct connection to your brain chemistry. Toughts are stored in the brain after all.

they are not some esoteric thing that floats in the air. its all interconnected.

so if you believed today was the best day of your life, then your brain chemistry would be fine would it?

what u believe change your brain chemistry.
that leads me to quote #2...

"If CBT requires you to believe in it, then it is not an effective treatment. It should not require faith on the user's part to work. It either works or it doesn't, and any excuses such as the above do not explain away its failure."

cbt does not require to believe in it but change your beliefs, but i understand what you mean.

What u mean is if you are told to believe something in particular versus what you are now believing, then it wont work.
Especially since you dont feel these beliefs to be true.
You have to realize you are already doing this in your life.

All our lives we have beliefs about ourselves, about life and others.

Whether these beliefs help you or harm you a a different thing.
SO all youre asked to do is to choose your beliefs better.

its not about faith but beliefs.

We dont see the world as it is.

we only see the world as we think it is, through filters.

these filters are beliefs. and as we live an event we will filter the events through our beliefs.

personally i think cbt is not bad but is flawed.

It asks you to constantly change your toughts as the negative one come ups.

One should be able to dig at the root of the problem and solve it.

I personally found something that worked for me.

Now im looking to find something to do with my lifeand help others with my experience.

there are so many things to be said here...

I decided the best way to share all i want to share is to make some sort of short ebook i ll post for free here and elsewhere where i ll share what helped me the most.

That way i wont have to write my toughts over and over again in many posts.

it wont cover everything cause itd take too much effort and time for now but itll cover what made the biggest difference.

I'll drop a note on this board when it's done.

Remember everybody, dont analyze too much and dont take yourself too seriously ; )

have a good one

Olivier

[hardy]

Surely , Oliver, what you think other people think of you MUST be learned . Youre not born with it.
Just as I learnt that the moon is say 250000 miles away . its a hard fact . if reliable scientists measure it and it turns out to be 238900 I would be happy to relearn that fact and BELIEVE the new value.
What stops me having a happy social life is my belief in a "fact" that 90% of people would find fault with the things I say or things I do.
If I could find a method of changing my behaviour or did experiments which prove most people would not find fault or codemn then I would change my belief to accept the new fact.

I would go so far as to say that even some "hard wired" thoughts or fears can be reprogrammed.
eg many bioligists now believe that fear of snakes may be hard wired in the human brain as an ancient survival mechnism. I think you could change even such a belief and come to be a snake enthusiast.

[Olivier25]

Hi Hardy,

How are you?

Olivier here.

you said...

"What stops me having a happy social life is my belief in a "fact" that 90% of people would find fault with the things I say or things I do.

If I could find a method of changing my behaviour or did experiments which prove most people would not find fault or codemn then I would change my belief to accept the new fact."

just my opinion:
whats stops you from having a happy social life is not the fact that others might find faults with what you say but rather
that it is possibility one or more people will find a fault with what you say.

If you didnt care about that, of course we all know that, you d agree youd still have a happy social life as the ones who never agree with you would fade away from your social life and those who fit well with you would not find faults all the time.

Even if 90% of people would not be a real good fit with you, that still leaves 10% of the people.

thats like alot of people if you ask me.
How many people even have 5 real good friends?

WHAT ABOUT THIS
When you talk(or used to talk when you had a little social life)
to someone, do you mind at all that they have differing opinions
throughout your conversations and possibly some wrong facts?
Or do you even expect it to happen and it just make the conversation a bit more interesting?

wouldnt it be dull if we'd always all agree and never have a differing point of view?

BUT THATS NOT EVEN THE POINT TO ME
you said:
"If I could find a method of changing my behaviour or did experiments which prove most people would not find fault or codemn then I would change my belief to accept the new fact."

I want you to answer this...

What kind of person need a guarantee people will not find fault
with what you say in order to go out there and have a happy social life?

I think I know the answer but I want you to
answer this by yourself first.

I hope I dont sound like im preaching or judging
or know better than everyone. Typing texts often have this problem where we dont know the tone of the person writing.
Im certainly only trying to help and am here giving my opinion with a smile.


P.S. If you are interested, you can email me at micfo07 "AT"hotmail.com and I'll sebd you my free report ebook
when its done where I discuss what helped me most
in getting rid of SA. Just email me and i ll keep your email adress.

Olivier