Can't Live Like This Forever
March 17, 2013 8:04 AM   Subscribe

It's been four + years now, but I continue to experience a lot of social anxiety & PTSD related symptoms. How do I come to terms with the idea that I can't escape my past and the people from my past?

Between 2011-2012, I saw a few mental health professionals due to my deep depression, severe social anxiety, and PTSD. My PTSD was expressed through dissociation/depersonalization/derealization.

Things are better now, but I still feel very socially anxious which I think is connected to my traumatic experiences. I avoid many places (regardless if I'm alone or with family/friends) out of fear that I'll run into certain people from my past.

But, now that I'm in a better space, I'm realizing just how unhealthy this type of behaviour is. I relate to all ofthese
symptoms. My social anxiety stems from feeling ashamed. I feel ashamed about how others treated me, but also how I reacted interpersonally prior to, during, and after being treated in a particular way during this traumatic year of my life.

I've lived with this social anxiety/PTSD for 4+ years now. I'm realizing that living like this will not allow me to progress in life. I will continue to live in fear and continue to avoid many things in life out of fear that I can't control the situation, won't be able to predict everything about the situation, and will not feel safe enough to explore new things in life like meeting new people, joining new clubs/groups, attending new places, etc.. I ultimately fear that my life will continue to feel like it's at a stand-still if I don't change things now. I really don't want to miss out on life because of my past.

With that being said, I'm not too sure about how to improve my mental health. I have tried medication before (quite a few different kinds, actually), but the problem is that I think my emotional numbness affected my ability to notice the affect that the medication had on me.

I also don't think talk therapy will be helpful in this case. I don't have much of a recollection of what happened. Although, at one point I did and I tried addressing what happened to a psychologist before. It was helpful to share that with someone, but I'm looking for more concrete ways of improving my social anxiety that's PTSD related.

So, really, what are my other options? Is it possible to improve things on my own? I will be moving back to my hometown for a year, so I think that should help me out. I have noticed that spending time outside of the current city that I live in makes me feel less socially anxious. I think that's because there are a lot of triggers where I'm currently living.

After moving back to my hometown for professional & personal related reasons, I want to move elsewhere. But, I'm finding it difficult to come to terms with the idea that I can't escape my past and people from my past. I know a lot of people that live in one particularly large city (a city that I've always been interested in moving to), yet I fear running into these people and the fear itself is enough of a daily trigger for me. I don't want to live anywhere else though. (My other options aren't really options since it's difficult to move there because of immigration related laws.) I also want to learn how to stop feeling afraid. I realize just how strong and irrational this fear is, and I can't live like this forever. I can't continue to live a life where I feel trapped despite living in a world that's so incredibly large and filled with billions of people.

With all of this being said, how can I improve my life so that I feel less trapped, more in my head, and able to live more freely despite my traumatic past?
posted by anonymous to Human Relations (11 answers total) 8 users marked this as a favorite
You don't say whether you tried EMDR therapy specifically, which is for PTSD. Even if you can't remember the exact details of an occurrence, EMDR is still possible, because you can focus on a negative thought or belief instead of a bad thing that happened to you (e.g "I will never be lovable" or "I am a bad person"). You then tie these beliefs to a representative image in your head and think about them and process through them using cues from the therapist. You may want to look into it - I am doing it for PTSD after an abusive relationship, and it is working well for me so far.

Good luck.
posted by sockermom at 8:15 AM on March 17, 2013 [2 favorites]

I will be moving back to my hometown for a year, so I think that should help me out. I have noticed that spending time outside of the current city that I live in makes me feel less socially anxious.

Why not move to another city? There's a lot to be said for, if you don't like where your life has taken you, pick up and get on a plane.

I think you've really limited your options here, and entirely artificially. You don't have a choice between your current, difficult city and returning to your home town. You have a choice between your current city, your home town and anywhere else in the world. Even if just for a while.

I also want to learn how to stop feeling afraid

You have to do the things you're afraid of before you can stop being afraid of them. Over and over. I don't think anyone knows any other way of making that work.
posted by mhoye at 8:25 AM on March 17, 2013 [7 favorites]

with respect, you're ruling out some of the most basic and provably effective ways for dealing with ptsd and anxiety (medication and therapy). however, you might try reading some books that teach the techniques of cognitive behavioral therapy (like David Burns' Feeling Good), books on meditation (like Sharon Salzberg's Real Happiness), and books on self-compassion/self-love (like Cheri Huber's There is Nothing Wrong with You). The last two books are coming from a Buddhist perspective, but I can promise you there's nothing cultish/harmful in either one.
posted by facetious at 9:22 AM on March 17, 2013 [4 favorites]

I also don't think talk therapy will be helpful in this case. I don't have much of a recollection of what happened.

It doesn't matter what you remember. Therapy can help you deal with challenges in your life right now. In particular, it can help you find strategies to address your dissociation. The problem with dissociation is that it becomes a habit; the more you do it the more automatic it becomes. Therapy can help you find other ways to approach triggering situations. Please get therapy. This is what therapy is for.
posted by medusa at 9:35 AM on March 17, 2013 [11 favorites]

One of the biggest difficulties with anxiety is that it makes you decide you couldn't possibly get better and you certainly won't do X, Y, and Z specific treatments for anxiety because of this list of random reasons.

Please pursue behavioral therapy for social anxiety. That has nothing to do with what you remember, it has to do with how you are today when you walk out the front door. Look into EMDR.

Anxiety is very difficult to bootstrap out of because you don't have any leverage. You need another person, one who knows how to guide you. Your perspective is damaged and you need additional sets of eyes. You have anxiety about what people think of you, which is why you're trying to talk yourself out of therapy. Don't let it win.

You deserve assistance with this. Let yourself have it. It doesn't matter where you live, because you're still going to be you the whole time - it's not going to fix anything. Do the work; it is good work and you deserve the fruits of it.
posted by Lyn Never at 9:48 AM on March 17, 2013 [11 favorites]

You have been through something awful. Part of the healing process is being able to forgive yourself for your involvement in this awful thing. I don't know what happened to you. What I do know is that you deserve to heal. You deserve to be happy. You deserve your life. You have a right to let go of the past and stand free of it.
My faith has helped me through all sorts of terrible things. That's kind of what it's there for.
Forgive yourself.
Pray for the ability to forgive others.
Move freely through your life.
The worst thing that could happen has already happened and you survived it, there is no longer anything to fear.
Just let go.

Also, medication can do wonders.
posted by myselfasme at 11:42 AM on March 17, 2013

I also don't think talk therapy will be helpful in this case. I don't have much of a recollection of what happened.

I totally get why you would think this. There are types of therapy that are totally focused on getting to the root cause of your problems, unpacking it and helping you deal with it. These kinds of therapies will probably not be helpful for you, and might even be harmful because of the very real possibility of developing false memories.

But there are other types of talk therapy, especially those in the Cognitive-Behavioral family, that aren't so interested in what caused the problems you're having, and instead are focused on helping you deal with those problems as they exist in your life right now. You sound like an excellent candidate for that kind of talk thera[y.
posted by Ragged Richard at 12:26 PM on March 17, 2013 [1 favorite]

It sounds like you are looking for systematic desensitization - other words, teaching your brain that it doesn't need to react with fear when presented with certain stimuli (thoughts, places, things). I assuming I have my buzz words right, It is passed on the concept of extinction in classical Pavlovian type conditioning. You gradually expose yourself (often in imagination) to the fearful situation and with practice, learn to respond without fear. Some people can do this for themself but it is much more likely to be efficient and effective if you have a professional guiding you through the process and making you sure you don't get stuck or reinforce the trauma. As others said, even if you don't have the specific memory, you know what triggers you and that is enough to work with.

EMDR is a particular approach to this that is popular right now - there are others, equally effective. You would want someone trained in cognitive behavioral therapy as applied to trauma. This is very do-able. Afterwards, there would still be other pieces that you would probably want therapy for but it sounds like focusing on this right now will help you be much happier.
posted by metahawk at 2:21 PM on March 17, 2013 [1 favorite]

The Anxiety & Phobia Workbook might help. It's a cognitive-behavioral training book like Feeling Good, but specifically focused on anxiety. The book description:

The Anxiety & Phobia Workbook has already helped over one million readers make a full and lasting recovery from generalized anxiety disorder, social anxiety, specific phobias, panic attacks, obsessive-compulsive disorder, and other anxiety-related issues. Packed with the most effective skills for assessing and treating anxiety, this workbook can be used alone or as a supplement to therapy to help you develop a full arsenal of skills for quieting worried thoughts and putting yourself back in control.

This new edition has been thoroughly updated with the latest anxiety research and medications, and also includes new therapeutic techniques that have been proven effective for the treatment of anxiety and anxiety-related conditions. Each worksheet in this book will help you learn the skills you need to manage your anxiety and start living more freely than you ever thought possible.

With this workbook, you'll learn a range of proven methods for overcoming anxiety:

Relaxation and breathing techniques
Challenging negative self-talk and mistaken beliefs
Imagery and real-life desensitization
Making lifestyle, nutrition, and exercise changes
Acceptance and commitment therapy
Skills for preventing and coping with panic attacks

posted by jaguar at 2:37 PM on March 17, 2013

I am so shy and awkward that dealing with strangers had become genuinely terrifying, but a few years ago circumstances forced me to take a job that required me to deal with the public a lot, and I've found that I can actually do OK with it. It was sink or swim, and I have been clumsily paddling along. I still despise trying to make small talk with strangers, but in a professional setting there's always stuff to ask people or tell people. Even if I'm having a freakout, I can just kind of go into smiling android mode and give the same spiel I've given 1000 times before.

I was picked on and beaten up a lot in my childhood, and it screwed me up in all sorts of ways. I'm transgender, but I've never had the guts to live full-time as a woman because I know I wouldn't pass and I simply could not deal with that kind of constant public scrutiny. (I got gawked at and randomly attacked enough when I was 9, thanks!) Before I started working with the public, I had reached a point where the world was getting really scary, and I was becoming afraid of strangers beating me up. It felt like there were all these violent people out there, and I was risking a beating just by going out at all. I hadn't become properly agoraphobic, but agoraphobia was starting to make sense.

And now here I am dealing with strangers all freaking day, and I'm surviving it. Seriously, maybe you should try some volunteering, something to get yourself out there. You may be surprised by how quickly some of these fears fall away.
posted by Ursula Hitler at 4:56 PM on March 17, 2013 [1 favorite]

I deal with a lot of mental health stuff too (was going to post about my stuff but have to wait another day) and have read the books people recommend here. I second them, as well as meditation.

There's something called tonglen meditation that could be good for you to practice if you go about it gently and NOT when you are most in crisis. It's a good way to bring your feelings more to the surface and then use them to find compassion for yourself and others who are in similar situations. There are some good guided ones out there. It can be hard at first to intentionally feel unpleasant feelings, but remind yourself that you are safe and can stop whenever you need to.

I also have done EMDR and found it helpful. I did it about ten years ago and haven't done it since then despite having new trauma to work on--I don't know if my current therapist does it--but I would give it another try.

Therapy can be very hard, especially if you're not ready, but I think a good therapist is used to that and can gently guide you through whatever stage you're in. My therapist, for example, is very good at finding meaning even in things that initially seem insignificant to me, like silly dreams or symbols I like.
posted by mermaidcafe at 5:04 PM on March 17, 2013

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