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Talking anxiety


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I get a lot of anxiety when I have to talk -- but only in specific situations. One-on-one with a friend, i'm good. One-on-one with a stranger, i'm usually good, sometimes not so much. In group settings of more than 4 my voice is shaky, I talk less often and for a shorter time, and my heart starts beating faster. Also, when talking to a therapist I get that. In an interview it happens, and also when talking to someone in authority.

I'm not nervous before it happens. Only during. My thoughts race, my brain fogs, and I can't think straight - I can't form sentences. I'm not nervous about anyone judging me - at least not consciously. I'm not afraid of embarrassing myself; the only thing I think is embarrassing about these situations is this stupid anxiety that happens. After it's over, I'm relieved, distressed, emotional, etc.

Anxiety meds I've tried don't do anything for this.

What's going on and how do I fix it?

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I think this is the kind of thing cognitive-behavioral therapy is useful with (i.e., extremely specific problems that occur only in certain situations). Are you seeing a tdoc who might be able to help with this? Books on CBT sometimes have useful techniques too.

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No -- therapy attempts were really awful for me. I always felt much worse after, to the point of suicidal thoughts (which I generally don't have). I know eventually I want to go, but I haven't yet felt emotionally strong enough to handle it.

About CBT . . . I've read about it a lot, and I don't think it applies to me at all. I am one of the most optimistic people, and I don't automatically think negative thoughts on a regular basis. If I do, I recognize it as such (have so for years) and I realize it's irrational and explain it to myself in my head why. When therapists tried to use the CBT technique, I felt like they were being very condescending and telling me obvious shit. Again, I don't go to therapy, so I could be wrong in this, but I just feel it's not right.

I think it's the cognitive aspect of the equation that I don't like. Behavioral therapy would definitely help, though. Like practicing, rehearsing, desensitization, etc. I just don't really know how to go about it from where I am now. I've also had a therapist recommend biofeedback a long time ago but I couldn't afford it at the time.

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Yeah, that's what I was referring to (practicing, rehearsing, desensitization). I may have mistakenly lumped it under CBT, although I think at least some of that is included sometimes (under the "behavioral" part).

You may be able to find something useful on public speaking in the self-help section of the bookstore (or online somewhere). It's a pretty common problem.

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I think that is the kind of problem that can be solved with baby steps and an understanding tdoc. I went to a therapist who was a social worker and she specialized in anxieties and phobias. I told her my problem, and she would give me little homework things to do - some daily, some weekly and then I would come back and report on how I did. If the things she gave me to do were too hard she would make them easier until I was able to do them. Slowly I started to see improvement. But this takes a lot of motivation and I was highly motivated to get rid of this phobia I had. I really had to do what she told me to do. It took a few months, but there was amazing improvement. I hope that if you decide to go the therapy route (I also used meds) that you can find someone really good at it, and that it will work for you. You do sound motivated to improve and thats the first step.

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you might want to check out the links on this page of interpersonal effectiveness skills and activities. it's from dbt, but you don't have to be borderline to learn something from dbt. "dear man give fast" has helped me out on many occassions. (dear man give fast is in links 8,9 and 10.) i encourage you to read through as many links as you can. you might read the first link and think "this doesn't apply to me" and dismiss it all, but the skills can be helpful even if you do not engage in self defeating thoughts. you just have to find the right skill set for you. anyway, i think it would be worth your time to read through the links.

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