The Acceptance Paradox

Coming to you from the center for Social Confidence in Portland, Oregon. Welcome to Shrink for the Shy guy Helping men everywhere go from social anxiety to social domination with your host, Dr. Aziz.

Hey, welcome to today's show, which is called the Acceptance Paradox. This is a really fascinating concept and I go in depth in it with my guest expert, Marina Gershkovich, who has been doing some really fascinating research about social anxiety, about the power of acceptance, and about what I call the acceptance paradox. So we're going to get to that in just a minute. I do want to also share with you that we have a new hotline set up for the show that you can call in with your questions. That's how I'm getting more and more of my Ask the Shrink segments and how do I talk to her? Segments where I'm giving advice on how to create relationships or any questions you have related to social confidence. You can access the hotline by calling 206-338-3176 and ask me your questions. You can also ask questions through the website of shrinkforthshyguy.com there's a way to send a voicemail via the web to me that I will personally listen to and answer in an upcoming. You can also send the questions and emails to hostrinkforthyguy.com and of course, you can also follow the show on Twitter shyguyshrink. That's shyguyshrink. And Facebook. It's facebook.com shrinkforthyguy so get connected in any one of those ways. You can find out about updates from the show, special segments, and ask questions to be able to get your questions answered on the show. I look forward to connecting with you. This is not kind of a one way me talking at you. This is actually a conversation. I really love to tailor what I'm doing to meet the needs that you have to really help you overcome the challenges that you want and get the confidence that you need. So the acceptance paradox, here is the basics of it. In its essence, when you accept something, it diminishes, and when you fight it, it grows bigger. Another really simple way that this is often communicated is what we resist persists. And so this is so common and so important. In fact, pretty much this whole episode is dedicated to my interview with Marina because there's so much good stuff in there that teaches about this. And she's an expert in acceptance and commitment therapy, which is a very powerful modality that, as the name would imply, is very focused on acceptance because time and time again I see so much of the anxiety we might have is about the anxiety. Oh my God. What if someone saw that I was anxious? I shouldn't be feeling anxious. What's wrong with me? I need to get rid of this anxiety so I can feel better about my life. And there's this harsh tensing, rejecting energy that we have towards ourselves and particularly the anxiety in ourselves. And what this does is on the surface, it seems like it makes sense, right? Like you got a problem, you extract the anxiety like a tumor and you throw it into a biohazard bag and burn it and it's gone forever. But it doesn't work that way with our emotions. The anxiety is a part of us and it's telling us something and it needs to be dealt with in a different way. And the more you fight it, the more you hate yourself for it or wish it was not there. Paradoxically, the more it stays, the more it intensifies, the more it starts to control you and run your life. And the beauty of what Marina teaches is how you can feel the anxiety and move towards what you want anyway and have it be there, but not running the show, not be the boss of you in a way. So without further ado, let's jump into that interview with Marina.

Expert interview.

So today's guest expert interview is with Marina Gershkowicz, who is a PhD candidate in clinical psychology at Drexel University in Philadelphia. And what's fascinating about Marina is she has found a need out there for people with social anxiety and debilitating shyness who need help, need treatment, but for whatever reason aren't getting it. And there's some interesting statistics about how long someone will wait to get help when they're really struggling with social anxiety. And so she's done some really interesting things to pioneer creative ways to reach people that need the help and provide them with the help with the treatment. So she's created an online treatment training program that's an eight week program that's got different modules to help people overcome social anxiety. So I'm incredibly excited to talk with you, Marina, about what's in the program, how you came up with it, and hopefully people listening can leave with some practical tips to apply some of what you teach in your program. Thank you so much for joining us on the show.

Thank you so much for inviting me to speak with you, Aziz. I'm very excited to be here.

Yeah, well, great. So let's just start with what is the online program. Give me just a brief kind of 30,000 foot view of what exactly it is, sure.

So just a little bit about my background. Over the last four years, I've worked as a project coordinator for our in person treatment study for social anxiety disorder Drexel here in Philadelphia. And in my work here, I was struck by the number of individuals contacting the clinic to express interest in the treatment, but who are unable to come in due to their incredibly high levels of anxiety. And moreover, I came to realize that many others came cannot receive adequate treatment because of the limited availability of clinicians who have expertise treating social anxiety and also because of financial costs. And we have treatments that have been demonstrated to work in treating this disorder. But research shows that only 20% of people with social anxiety seek and receive treatment.

Wow. Yeah, that's even more dismal than I realized.

Yeah, it's pretty shocking. And so, as part of my research, I was motivated to find ways of helping to deliver treatment to those who need it. And technology provides us with the ability to do just that. So the program that I've developed, it's similar to an online class. It consists of eight weekly modules that individuals complete in a sequential order. And the modules, or the mini lessons, they include multimedia components such as videos, illustrations, homework assignments. So it's not just the traditional self help that we think of like reading a book. It's also different from traditional in person therapy in that you can actually watch a video illustrating a concept instead of just discussing it. So in a sense, it's just an engaging program that's based on a treatment that has been shown to work.

That's great. I know that you. I was reading an article about you online and said something about a pilot study that you guys have done. So is this something that you've actually tested with people and seen what the results were?

Yes, absolutely. So for the pilot study, after developing this program, I wanted to see if one participants were satisfied with the program in terms of the content, ease of use, those kind of things. And then secondly, I was also very interested to see if this program would work in decreasing symptoms of social anxiety. So the program itself is eight weeks long and asks the individual to log on at least once a week. But what I've also realized is that a lot of self help programs, no matter how effective they are, if people don't do them, they don't work. So for this reason, I wanted to increase accountability by including brief therapist support. So in this pilot study, in addition to logging onto the program, individuals would speak with a therapist for 10 to 15 minutes a week. And this time was not meant to be a therapy session, but just a time to clarify concepts and to provide help with homework assignments. The other novel thing about this project was that this therapist support was provided through video conferencing.

Okay, so that helped access to people that were too far of a distance or that reluctance to.

Exactly. And video conferencing has not yet been studied as a supplement to Internet programs. And my rationale for using video conferencing was that it provides the face to face with another person. It provides accountability not just to an anonymous person or a computer, but to a therapist that the patient could see. And this in itself could also be viewed as a mini exposure. And, you know, exposure has been shown to work for treatment of anxiety disorders.

Let's pause for a moment with this interview and take a quick break and come back right after this.

What is it?

Hi, Nerd King. I'm so glad I finally got a chance to talk with you. I need your help bad. Mm.

Hang on. I am chatting with two hotties headed for Comic Con.

Uh, okay.

Okay. That's enough for now. I shall leave them wanting more. What is your question? If you do, in fact, have one.

Okay. There's this group of three guys, and they keep teasing me. They push me, they make fun of me. They do it all the time, especially in front of the popular girls. It makes me look terrible. I hate it. I need to know what to do. Nerd King.

Hmm, I see. Are these men perhaps taller than you?

Yes.

More muscular?

Yes.

Better looking?

Yes.

It's worse than I thought.

So what do I do?

Silence. I am assessing your situation. Okay. Possibility four gets one. Three, and then there's two. And then. Better looking. Hmm. Okay, I've got it. Here is what you must do if you want to vanquish this band of ruffians. You must go into a nearby forest and creep slay rats and bears to acquire gold and items until you have reached level six. What is your level six power spell?

My. My power spell?

Ah. Amateur. Hang on, I'll look it up. Yes. Oh, here it is.

Ooh.

Ring of Fire. Better than I anticipated. All right, once you have reached level 6, charge your ring of fire spell. Gather in a group of four of your friends. Making a team of five. Five versus three will have much better odds. Of course. Have your friends wait in the forest. Make sure two of them have range. Weapons.

Range weapons?

Yes. Bows, ice, arrows, magic missiles. For the love of Galaxia, stay with me, man.

Okay, okay.

Next, go by yourself and attract the attention of this band of ruffians. Be sure to look weak and helpless shouldn't be too hard for you to pull off. Okay. As they move towards you, run towards the forest. Run. And when they follow you in, you and your friends will gank them. Hit them with everything you've got. Use your ring of fire.

Okay. So attack them in the woods and burn them.

Are you deaf as a Telosian bat? Yes. Hit them with everything. They will think twice before messing with you again.

Wow. What a great plan. Thank you so much, nerd king.

My wisdom is obvious. Now if you'll excuse me, I have a League of Legends tournament starting in five minutes. I must prepare for battle by reading the online FAQ twice. Good day, sir.

But I. I have one more.

I said good day.

Are you tired of feeling less than and inferior? Are you tired of people deriding you or making fun of you in subtle ways at work or elsewhere in your life? It's time to take charge of this and raise your self esteem. And as you respect yourself more, other people will too. And you're going to learn how to handle when people are being jerks. In order to get this confidence, you need to transform your self esteem and improve your social skills. Go to www.yourconfidencecode.com to find out exactly how you can do this starting today. Mm, yeah. I mean that makes so much sense. And I think we all have the experience of getting some sort of self help or self improvement program and then, I don't know, being excited and motivated for the first week or two and then something just comes up or whatever.

Exactly. Life takes over.

Exactly. Yeah. So this is a great way to make sure that they are continuing to work with it because. Exactly what you said. These things do exposure and other things do have a profound effect if they are conducted out and just really invested in.

Yeah, exactly. So in the pilot study that we did, the results were very positive and promising. For people with mild to moderate levels of social anxiety, the program resulted in decreased symptoms. In fact, some people no longer met criteria for this disorder when they finished the program.

That's great.

Yeah. And for those whose symptoms were initially more severe, the program served as kind of a first step in getting them to a point where they could feel more comfortable seeking in person help. So what's exciting is that the effect was very similar to an in person treatment studies. This program with just 15 minutes of therapist time was just as effective as a traditional in person 60 minute session with a therapist.

That's great. And they could do it on their own time and practice that stuff without Needing to drive and come in. That's exciting. Which makes me curious is learning a little more about what's in the program specifically. I came across a really interesting image that I believe you had actually drawn and created yourself. That was the metaphor of anxiety being like a game of tug of war with a big monster. Can you share a little more about this metaphor or how you teach this?

Absolutely. So the tug of war metaphor is not unique to our program. It's commonly used in the acceptance and commitment therapy which the program is based on. The illustration was my own, but the metaphor is commonly used in the therapy. And the idea is that we cannot always eliminate our anxiety, no matter how hard we try, but we can change how we relate to our anxiety. So imagine your anxiety as this big, ugly monster. Imagine that you're in a tug of war with him. You've got one end of the rope, and the monster has the other. In between you, there's a huge bottomless pit. The monster is being mean. He's yelling mean things to you. So you naturally, you'd like to get rid of him. You'd like to get rid of your anxiety. So you're pulling on the rope as hard as you can, but the monster keeps pulling on the rope and brings it even closer to the pit. So what's the best thing to do in that situation? Pulling harder comes naturally, but the harder you pull, the harder the monster pulls. So the harder you try to get rid of your anxiety, sometimes the more anxious you become. So you're kind of stuck. So the alternative might actually be to drop the rope. And dropping the rope means that the monster is still there, but it also means that you're no longer tied up in a struggle, and you suddenly have your hands and feet to be free to go and do something more productive with your life than to engage in this tug of war. So one thing to know is that a lot of times people say, well, what do you mean? Do you mean I should just give up? And that's not what we mean at all. Instead, it's not a resignation. It's more empowering because now you're in control of your life, and the focus of your life is no longer about the monster or your anxiety. So if we think of people struggling with social anxiety, most of the days they might spend avoiding situations because they don't want to be in a situation that provokes the monster to come up. They're trying to avoid feeling anxious, so they almost limit their lives to go around the monster, to not feel, to not hear. Him yelling. But instead, what we're saying is, then the monster is in control of your life. By avoiding things that you want to be doing, by not living the life that you want to live because of your anxiety, the monster is in control. So it's kind of a new or a different way of thinking about anxiety.

Absolutely. Because I think a really common idea with social anxiety is, well, when I am more confident, when I've overcome this anxiety, then I'll go start that conversation with that person or go to that party or gathering or do something that is uncomfortable to me. And what I hear you suggesting is that it's about choosing something and then moving towards it even though there is anxiety. Is that right?

Exactly. You got it. And one other exercise that we tend to do in therapy is the and but exercise. And in this exercise, you substitute the but with and and. It sounds very simple, but it's very effective. So if somebody might say, I want to go to the party, but I'll be anxious, instead, what we're saying is let's substitute that but for and let's bring that anxiety with us. So I want to go to the party, and I'll be anxious. So this way, anxiety is no longer a barrier in your life.

So then this leads to a really interesting question, which I get a lot from people, is I think what comes along with social anxiety is a sense of shame around that anxiety. If I'm anxious and people see that I'm anxious, then they won't respect me at work. My boss will think less of me. People of the opposite sex or that I'm drawn to will think I'm unattractive. And there's all this meaning associated to anxiety that makes it really dangerous in a way, socially dangerous, from the perception of some social anxiety. So what would you say in response to that fear?

Yeah, absolutely. So the way that we think of it coming from the acceptance and commitment therapy, so all of these fears are just thoughts, and it's essentially the monster yelling them at you, saying when you go in there, you won't be able to perform. People will see that you're anxious. And there's no way of actually testing this out because we're all social creatures. We can't always know what the other person's thinking unless we ask them. And a lot of times we won't. So it's almost better to envision those thoughts for what they are. They're just thoughts. And instead of them having this control and power over you, deciding what's important to you in life, Is it important for you to go to that job interview even if you might blush or you might be anxious and some people might see that you are so kind of almost zooming out and thinking about what's important to you in your life and have that drive your behavior instead of being absorbed by the thoughts that the monster is throwing at you.

Yeah. And that's an interesting question, is like what's important to you in your life? And I'd imagine that goes into values and what someone values. Can you say more about how someone can find those values and choose to follow them in spite of their fears?

Yeah, absolutely. And again, this is a big component of acceptance and commitment therapy. We spend a little bit of time talking to patients about what they value in their life. A lot of times, even people without social anxiety, we forget what our values are. Social. Some of these values are not very clear to us from the beginning. So we're so absorbed in the day to day hustle and bustle of things that we forget why we're doing the things that we're doing. And instead when we talk about values, we say, let's take a step back and let's really think about what you want your life to be about. With people with social anxiety, we take a look at what they're currently doing and a lot of times they're engaging in behaviors that are really only meant to control the anxiety or try to get rid of it. And we ask them, is that what you want your life to be about? Do you want at the end of your life, someone say, great job, you were successful in getting slightly less anxious at the end of it?

Yeah.

Go ahead.

I'm sorry, go ahead, continue.

Or do you want people to say, this person did all these wonderful things, they were a philanthropist, they were really involved in a charity, they really gave back, they volunteered. So that's a contrast to what we typically do. So as part of the values work, what we tend to do is just sit down and start thinking about different domains in our lives and what we want to accomplish and kind of the behaviors that we can be doing every day in service of that value.

Absolutely. And what I like to ask people that I'm working with is uncovering what those values are and making a list which is really fun, and having them prioritize, what do they value most? What's most passionate about, what do they really want to live the most? If they live the life that they truly want, what would it involve? And they get sort of excited about it. And then what I love to do is say, what are the values that you're living right now?

Absolutely.

At the top of the list, which is exactly what you described, it's management of anxiety, which is really the value of trying to maintain safety in a way, and not necessarily sort of a basic needs level of healthy safety. I mean, overly safe. Like, I want to make sure that no one ever has a negative thought or idea about me ever. And that's a value. And when they can see that contrast, it starts to highlight that they're not living how they really, deep down want to live and intend to live.

Absolutely. And I think in addition to wanting to be in control of how other people perceive them, it's also this kind of drive to always be comfortable. And anxiety makes us uncomfortable. And, you know, the value of being comfortable sometimes overrides all of these much more important values in life.

And so what would you say in that situation if someone is like, okay, I see that. That it's important to do it in spite of the anxiety. But, I mean, this anxiety is so intense that I just lock up, like, if I am in that conversation. I've had experiences where I get so overwhelmingly anxious that I freeze, my eyes bug out of my head, I start sweating, and it's just a terrible experience. So even how do I do it in spite of the anxiety when the anxiety just really demolishes me?

So I would say one is to do it gradually. So don't go into a situation that makes you super, super anxious right away. Work up to it. So with exposure, you want to really create a list of situations that make you anxious and do it in a gradual way. And then in terms of the techniques that you would use in the moment when you're doing these is to notice your anxiety, but to be willing to experience it. So a lot of times when people lock up or experience these physical symptoms and they really spiral out of control is when we notice the anxiety and then we try to fight it, and that almost makes things worse. So instead, what we say is, notice your anxiety and then just allow it to be there. And we talk about willingness, and willingness is a way of almost welcoming the anxiety no matter where it's at. Are you welcoming the anxiety if it's low? Are you welcoming the anxiety when it's high? And I think this brings in kind of this mindfulness component where you're just observing it without judging and without trying to change your internal experience.

Sounds like you stop making anxiety. The enemy that must be obliterated at all costs.

Exactly.

Wow. And this is I mean, it's just some really helpful information here to reorient how you deal with emotions and, you know, one. Not seeing them as obstacles that must be cleared before you can take action is one thing I'm hearing you say. And the second thing is that maybe they're not even things that need to be gotten rid of or eradicated in the first place that we can actually be with them. And what kinds of experiences do people have when they do start to accept their anxiety? So in that instance where they were really scared in the past and they locked up, if they started to accept the anxiety more, what kinds of things do you notice have happened?

So a lot of times when people are more accepting of their internal experiences, what happens is that they're able to carry on the conversation because they're no longer paying so much attention attention to this monster of anxiety. Instead, they're paying more attention to what the other person might be saying. They're paying attention more to their environment. So they're able to engage in behaviors that are again, consistent with their values, doing things that are important to them. So by being more mindful of this monster and no longer fighting it, it's no longer your enemy. It's just somebody you take along with you. Sometimes people do notice that their anxiety is lower once they stop fighting it, but that's not necessarily the goal. The goal of this treatment is not necessarily to make the anxiety lower because right now we're just changing the way that we relate to our anxiety. As a side effect, it might become lower, but that's not necessarily all that important because we're welcoming the anxiety no matter what because we're not going to let it be a barrier to our life.

Interesting. And such a radically different way that we can relate to our own feelings in the day to day. So I think that's really helpful for people to hear and for me and to get reminded of. It's just such a good reminder that what? And this is a little cliched at this point, but what we resist persists.

Yeah, absolutely.

Fight that monster and fight those feelings. We might think we're doing ourselves a favor because we're trying to protect ourselves from something uncomfortable. But what ends up happening is you just get locked in a battle that can last months or years, whereas a feeling can move through pretty quickly if we just open to it and accept it. So that's really interesting. You've mentioned a number of times acceptance and commitment therapy. Do you have any recommendations for a basic intro that is not too heavy in Psychological terminology and just a really simple introduction for acceptance and commitment therapy, especially as it relates to anxiety or social anxiety. Any recommendations for both?

Yeah. Get out of youf Mind and Into youo Life by Steve Hayes is definitely.

A good starting point and a great title as well.

Yeah, exactly.

So, yes, I encourage anyone who's listening, who's drawn to this program, to really go through it. Acceptance and commitment therapy is very powerful. It informs a lot of the work that I do with people. And just even as you listen to this conversation, you might start to realize there can be a relaxing or a shifting in your body, in your chest or your stomach. There's something that just unwinds when we realize we don't have to fight ourselves or be at odds with ourselves. And that's what I love about the acceptance and commitment therapy approach. So I think this is really helpful. Thank you so much for coming on the show and sharing your insights of what has worked. And also just a message of hope. Like, look, this is something that you can overcome, and you've done it with people. You've helped people online. It's really. There's so many ways that people can overcome this and that the only thing that gets in the way is, as you said, is just thoughts, just ideas. That stops us.

Absolutely. We sometimes get in the way of ourselves, but we don't have to struggle. So there's definitely a treatment that's available that can work for a lot of people.

That's so good. Well, thank you so much for coming on the show, Marina, and I hope someone reaches out, and I look forward to hearing more about further research that you do and hearing more about your program as it develops.

Thanks so much. It was a pleasure speaking with you.

So with the last bit of time that we have today, we're going to get into your action step.

Time for action.

Today's action step is to apply what you learned in the interview that I did with Marina, and basically to say yes to anxiety. Apply what you learned. Focus on acceptance. Use some of the techniques that you heard in this interview, and focus on acceptance and taking action in spite of the feeling rather than fighting the anxiety so much. Instead of saying, I'm not going to take action until I fix this anxiety and make it go away. Really breathe, feel, allow it to be there, drop the rope, stop fighting it, and say, what is it that I really value that I really want to do? And then commit to taking that action, even though there's that anxiety and seeing if you can just have a little more acceptance for yourself and for that anxiety and see what that does for you. In my experience, when I've shared this with people and I've done this and work with people in confidence coaching, it's led to very powerful results, especially in people who'd been locked in a pattern of resistance and fighting their anxiety for years. All of a sudden when they realize it's not a battle they have to win, they don't have to destroy and eradicate their anxiety to create the life that they want. They can go after what really matters to them in spite of it and let it be there. And then eventually it kind of is not really that big of a deal. Then something magical happens, something opens up in their lives. So I want that for you. So work on acceptance. Let go of needing to change the anxiety and just let it be there and go after what you really want in your life until we speak again. May you have the courage to be who you are, to accept yourself for who you are, and ultimately to go after what you really want and really value in this life. I'll talk to you next week.

Thanks for listening to Shrink for the shy guy with Dr. Aziz. If you know anyone who can benefit from what you've just heard, please let them know and send them a link to shrinkforthshyguy.com for free blogs, ebooks and training videos related to overcoming shyness and increasing confidence, go to social confidencecenter.com. Sam.