The author of How To Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety, and Harvard Medical School Psychologist shares not only the science of Social Anxiety and ways to deal with it but some of her own battles with it.

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Retailer link for Dr Hendriksen's book:

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Her website:

https://www.ellenhendriksen.com/

Twitter @EllenHendriksen

Her podcast is called Savvy Psychologist and can be found wherever folks like to get their podcasts

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Episode Transcript:



Dr Ellen Hendriksen (transcribed by Kajsa Lancaster – kajsa.lancaster@gmail.com)

PG: I’m here with Dr. Ellen Hendriksen. You’re a therapist and you deal with a lot of different issues, but the one that your book is about is social anxiety, and the book is called How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety. You have experienced social anxiety, and as we were just getting ready to press the record button, she said, ‘Well, I’m actually experiencing a little bit of anxiety right now, should be begin there?’ And I was like, that would be awesome! So, walk me through what you’re feeling and… etc.

EH: Sure. Yeah, social anxiety is near and dear to my heart. I guess I’ll start out saying that I am to the point now that it doesn’t own me, that I still get anxious but I can still forge ahead and do whatever it is that I am fearing or am worrying about. So what I do with my clients is I’ll ask them, in order to gauge their anxiety, I’ll kind of take their temperature: I’ll say, ‘On a scale of 0 to 100, 0 being, you’re on the couch at home watching Netflix alone, you’re chilling; 100 is a panic attack or, like, the worst anxiety you can imagine. Where are you right now?’

PG: Where would a toilet overflowing at somebody’s house at a party? Would that be a 99?

EH: (Laughs) Well, I mean, it depends on the person. Some people, I’m sure, could handle that with aplomb.

PG: Your boss’s house.

EH: Oh god, well, for me, that would be a 99! But you know, I’m sure there are people out there for whom that’d be, you know, they’d open the door and be like ‘Yay, I need a plunger! Can somebody bring me a plunger?” And it would be fine! So it depends on the person. So right now, I’m probably about a 40. I feel like I just had some strong coffee – like, there’s some adrenaline, there’s a little bit of tingliness, I can tell I have the urge to turn inward, like I want to start monitoring what I’m saying, I want to do impression management… Well, we can talk about this later, in terms of what to do to help lower that anxiety. I’m deliberately turning my attention outward. I wish your listeners could see us right now – I’m looking at your face, and, you know, I’m trying to answer your questions. I’m putting my attention to the story I’m telling and what I’m doing right now, as opposed to trying to think about how it is coming across, or –

PG: Making it all about you.

EH: Exactly! Exactly. Rather than my attention being on me, me, me, I’m trying to make it on this, this, this.

PG: Right. So, more the process than the result.

EH: Right, right.

PG: One of the greatest pieces of advice I ever got about social anxiety and a tool to cope with it when you’re at a party with a bunch of strangers, is to just ask people questions, and just keep going. And I’ve never run out of questions – I’m a naturally curious person. That has been the single greatest tool for me to cope.

EH: Absolutely. Yeah, I think that’s a great tool. That’s a tool that I use as well, and I think, like any tool, overused, it can come back and bite us in the butt. Because part of social anxiety is not wanting to reveal much about ourselves. And so, doing the things that kind of artificially tamp down that anxiety are called ‘safety behaviors,’ and a lot of people with social anxiety – myself included – I have definitely been guilty of just peppering other people with questions in order to feel like I am hiding or I am concealing myself; I don’t have to reveal anything about myself. And that, again, tamps down that anxiety, but what happens is like, it’s kind of like trying to hold a beach ball under water – that eventually it will rebound, and it will rebound with force. So, while it can absolutely be a good tool, again, overused can get in our way.

PG: That makes total sense. What are the negative self-beliefs or negative self-talk that your brain is shouting at you? Or whispering?

EH: Ah, yes. It’s interesting. So, a lot of people say to me that their inner critic, their negative self-talk, is kind of an asshole. Like, yells at them or is very harsh. My inner critic is actually more like an old lady who clutches her pearls. Like, ‘That’s inappropriate! You can’t say… What will people think?!’

PG: ‘Well, I never!”

EH: Exactly, exactly. (Laughs) So, I’m sure that’s not unique, but for me at least, it’s less of ‘What the hell are you doing?’ and more just like, ‘You, the, y-y-you can’t do that! Wha… That’s inappropriate!’

PG: Okay. Continue, describe your…

EH: Oh, sure! I mean, I think, to be perfectly honest, in this moment, it is fairly quiet.

PG: So, as we began talking about it, it began…

EH: Yeah, the anticipatory anxiety is always worse. Well, okay, 99% of the time, is worse than the moment. And once you get into it, or at least once I get into it, the anxiety starts to go down. If I could draw it, it would be like a wave: it increases fairly quickly – it’s a pretty steep slope – and then it plateaus, because it’s physically impossible for anxiety to keep ramping up and up and up until your head explodes. It can feel like that, absolutely! But eventually, your peracetic nervous system is going to kick in, and it will plateau. And as you stick with it, it will start to decline. And as you do that over and over again, the intensity and duration of your anxiety will lessen.

PG: As you ride it out and see that it was a molehill instead of a mountain, as you describe in your book.

EH: Exactly right, yeah!

PG: In one of the graphs in your book you showed, at the peak of that graph where it shoots up in the first couple of seconds, that that’s where avoidance normally comes in – where people would lose themselves in an addiction or shut down or… Talk about that.

EH: Right, right. So, let me back up. Social anxiety is this perception – emphasis on perception – that we have a fatal flaw, that something is wrong with us, and that unless we work really hard to conceal that or hide that, it will be revealed and become obvious to everyone around us, and they will then judge us or reject us for it. It usually comes in four flavors: It could be our physical appearance. It could be that it will be obvious that I am fat or I am ugly or I’m having a bad hair day or my skin is weird. The second flavor is signs of anxiety themselves – that I’m turning red, or my hands are shaking, or I’m speaking with a trembling voice, or I’m sweating through my shirt. That’s the second flavor. The third is our social skills. So: it will become obvious that I have nothing to say, that I am going blank, that I have no personality. Or the fourth one is another big one, and it’s that our general character is wrong, it’s that I’m incompetent or I’m stupid or…

PG: I’m embarrassing.

EH: I’m embarrassing! I’m a burden. I’m annoying.

PG: I make people awkward. They just tolerate me.

EH: Yes, yes.

PG: They’re just being kind.

EH: Right, nobody really wants me here, they’re just being nice, something is really wrong with me. And so I need to work really hard to conceal that. And what happens is that, because of this perceived flaw, we avoid. We could avoid overtly – that means that we don’t show up to the party, we don’t raise our hand in class, we stay at home with the shades drawn. Or we could covertly – we might show up to the party, but not make eye contact with anyone, or talk only to the person we came with, or walk in and slug down three shots at the bar as soon as we come in, again, to try to tamp down that anxiety. So that’s how avoidance works – it can be overt or covert. I’m more of a covert avoider, in my past. In college I would go to the party, but again, not make eye contact, or would stick to my friends, or things like that.

PG: Would someone who is the life of the party sometimes fit into that because there is often a mask of them fearing intimacy?

EH: Oh yeah, sure, sure! Just like at the beginning when we talked about asking questions. That is a wonderful tool, but overused can become a safety behavior. A great tool to use is to play a role – to give yourself an assignment.

PG: Is Piece of Shit a good role? Is that self-defeating?

EH: (Laughs) I was thinking more something like, ‘Okay, I’m going to go to the holiday party and talk to three people,’ or ‘I’m going to be the…’ I don’t know.

PG: ‘I’m going to help out in the kitchen.’

EH: Sure, right, exactly. But that, that can backfire when it becomes a mask, when it becomes a way to actually covertly avoid. But having some structure can be really, really helpful. I always like to talk about one of my – I’m a true nerd, because one of my favorite studies is by Dr. Simon Thompson and [Ron Rupee], who are two Australian psychologists. They staged this wonderful study where they took women from opposite ends of the social anxiety continuum – so, women who had diagnosable social anxiety, and also women who were more outgoing and confidently chatty than average. And, one at a time, they sent them into a waiting room, ostensibly for an experiment that, unbeknownst to them, began as soon as they entered the waiting room. Then a research assistant would come in and sit down next to them and say, ‘Oh, hope we don’t have to wait too long.’ And then just wait, and see what response they had. So they would either chat or not, and every thirty seconds, for five minutes, this guy – it was always a male research assistant – would give another prompt, and see what happened.

PG: What kind of a prompt?

EH: Oh, you know, just like, ‘What are you doing after this?’ or ‘Beautiful weather we’re having!’ You know, the small talk.

PG: ‘Building’s on fire. Every man for himself.’

EH: (Laughs) Right, exactly. ‘What would happen if I pulled that red lever?’ Anyway, after those five minutes, then the researchers would come in and say, ‘Oh, thank you for coming! We really appreciate you taking part in this experiment. Alright, what we’re going to do is, for the next five minutes, I’d like you to pretend that the two of you are at a party, and to get to know each other as well as you can in five minutes. And then they would talk again, and this time they had structure; they had some direction, they knew what they were supposed to be doing. All these interactions were surreptitiously videotaped, and raters would watch it afterwards and rate the women on social competence. And, as we might expect, in that first five minutes they fell well behind – the women with social anxiety fell well behind the women who were more outgoing than average. But in the second five minutes, they were almost neck and neck. So, if you give people with social anxiety a structure – give them a role to play, tell them, ‘Here, this is what we’re doing,’ it magically gets better. It’s not social skills that is the deficit; there is actually no social skills deficit in social anxiety – it’s that there is a lack of structure. So if we give ourselves that, or somebody else can give us that, then we’re off to the races. So that’s another tool that can be used.

PG: The thought that just popped into my mind is, most people are surprised when they find out performers are shy. And that, for many of us, the reason why was because we could control the conversation, and we could play a role – and if you reject me, you’re rejecting the character; you’re not rejecting me.

EH: Right, there’s this third party thing, this character that is either being laughed at or rejected or – yes, absolutely.

PG: As you were sharing all those things with me – the four flavors – the thought that occurred to me is that, at the heart of all of those, is the belief that ‘I am not enough.’

EH: M-hmm.

PG: Talk about that, vulnerability, and authenticity, because it seems like those are the three – if not the top three, three really important things to understand.

EH: Yeah, I agree. Well, here, I’ll start with authenticity.

PG: And by the way, right now I’m in my head because it took me long to put that sentence together, and I’m imagining people bailing on the people, saying ‘I can’t listen to this guy anymore, he’s a stuttering old man who should die alone.’

EH: (Laughs) It’s interesting that you’re thinking that, because I, as you were talking, was thinking ‘God, I hope I can answer this question competently, I hope I can rise to the occasion and answer this great question.’ So, yeah… And I think, again, if people could see us – nobody looks anxious, you don’t look anxious, and I think that is something that folks with social anxiety can stand to be reminded of – that you don’t look how you feel. That all this stuff can be going on in your head, the chatter or the old lady or the asshole can be yelling at you, and you look totally normal. And I think we forget that most of the time we share our experience with other people – people can see what we see, people can hear what we hear, but not when it’s in our head! Not when it’s just our private inner critic talking. But we kind of act like it is a shared experience. We assume that they’re going to reject us, we assume that they’re just being kind, we assume that they’re just tolerating us.

PG: And the irony is, our shared experience is that.

EH: Uh-huh, yeah, absolutely. And nobody talks about that! Yeah, yeah. So, social anxiety is this – I will get to your question, but as necessary tangent, there’s this sense of wanting to blend in. There is a sense of wanting to be invisible and not be noticed, because we’re afraid that people are going to notice this fatal flaw. But, be careful what you wish for, because then what happens is, if that succeeds and we do manage to blend in or not be noticed, we have to deal with the consequences of not being noticed! We get talked over, people ignore us…

PG: We don’t get invited.

EH: We don’t get invited! Exactly. For example, I am working with this lovely young woman in the clinic right now. Well, I’m supervising her care, so I watch her sessions on video. And she is one of the 21% of folks with social anxiety who are externalisers. So the response to a threat – whether it’s a bus coming at us or the asshole in our head yelling at us – is fight or flight. Most folks with social anxiety are flight – let’s avoid, let’s not make eye contact, let’s scroll through our phone at the party rather than talking to people. But 21% of folks with social anxiety are fight. They come out swinging. So that looks like irritability, judgment, lots of moralizing. She falls into this category. But she’s only prickly because she’s scared. It’s like a porcupine or a blowfish. So she, in the same breath, will say ‘I don’t know why [insert roommate name here] did that to me, that was completely inappropriate, what is she thinking, that was wrong, that’s unfair… And she didn’t invite me to dinner.’ Again, there’s this rock and a hard place of not wanting to be seen or noticed or to want to blend in and have no one notice us and notice our fatal flaw, but then there are the consequences of that.

PG: We want to be special, but we don’t want to stand out.

EH: Sure, sure, sure.

PG: We want to control the ways in which we stand out.

EH: Right, right.

PG: It didn’t occur to me until about five years ago that my pursuit to try to be extraordinary in my professional career had something to do with me feeling cut off from other people. Now, mind you, I didn’t achieve being extraordinary in my career as a stand-up comedian, but it had never occurred to me that – how can you have both at the same time? People always puzzle when they hear about the movie star who is lonely. Talk about why it can be difficult for someone who – and I’m not putting myself in this category, but this is who many of aspire to be, the successful person, the person with notoriety – what their struggles can be in terms of worrying about what people think or struggling to find connection.

EH: Mm, okay, in terms of…

PG: Because they are so put on a pedestal, that they don’t get to experience, for instance, the moments we have in support groups where we’re one of the many.

EH: I see, yeah. Well, I think it can be particularly difficult when you’re not sure why people are trying to be friends with you. If you’re being approached because people want something from you, or, you’re just not sure.

PG: So to be vulnerable would be dangerous or fraught with landmines, if you’re someone who is very powerful?

EH: Yeah, absolutely. I think – oh, here, I think this is a nice tie-in to your question from before about authenticity. To illustrate, I’ll state another study. This is from Dr. Lynn Alden and Dr. Charlie Taylor at the University of British Columbia. Charlie Taylor is now at San Diego, but –

PG: They’re insufferable, those two.

EH: Oh my god. (Laughs) So, they have done this series of studies where they try to get people to drop their safety behaviors – again, those little behaviors that we do to tamp down our anxiety. Here, I’ll do another necessary tangent. In the book, there is this character who is a real person, his name is Jia Jiang. He came to the United States from China when he was sixteen and wanted to be the next Bill Gates.

PG: He wanted to wear out-of-date glasses?

EH: Right, exactly. (Laughs) And dockers, and, yes, exactly. So, he went through high school and college and business school, and was working at some Fortune 500 company, and he hit thirty and he was like ‘Okay, I think it’s now or never, I’m going to do this!’ So he quit his corporate job and founded a start-up. He loved it, it was really awesome, but as soon as he had multiple employees to support, and his wife had just had a baby, his funder bailed and he was left with no source of income to support anyone who depended on him. And this was relatively traumatizing for him, as you can imagine. He desperately needed to cast around for more funding to raise some money, but was paralyzed by the prospect of being rejected again. So he decided to make this into a project, and to put himself through a kind of boot camp style project that he called ‘100 Days of Rejection.’ Every day for 100 days he tried to get rejected, that was the goal.

PG: And he chose things that were very likely to experience rejection?

EH: Yes! So, for instance, he asked to get a haircut at PetSmart. He asked to be a live model at an Abercrombie store. He went to a fire station and asked if he could slide down the fire pole.

PG: He asked to take a nap at a mattress store.

EH: Yes, exactly, exactly. I love – and all of these have been videotaped or are online.

PG: How do you spell his last name in case somebody wants to search?

EH: J-I-A-N-G. And his first name is J-I-A. I think that his first two attempts, so Day 1 and Day 2, show a really nice contrast, an illustration of safety behaviors. The first day, he decided to ask the security guard in his building if he could borrow a hundred dollars. He sets up his phone to tape the encounter and kind of runs in quickly to talk to this guy, spits out ‘Excuse me, do you think I could borrow a hundred dollars from you?’ And the security guard gives him this quizzical look and says, ‘No,’ but then says, ‘Why?’ But all that Jia can here is the ‘No,’ so he goes ‘Okay, no, okay, sorry about that!’ and then he runs away. So there, his safety behavior was speed. He ran in, spit out his words, ran away, to try to just get this over with. That’s what he was doing to try to tamp down his anxiety. Then, in editing the video, he realizes what has happened, and also hears for the first time this guy say ‘Why?’ and realizes, ‘Oh, I could have told him about this project, or I could have explained what I was doing and why this request was so weird, but I was in such a rush that I didn’t hear it. So the next day he’s like, ‘I vow to do better!’ The next day he is at a burger restaurant, and he finishes his burger, and then he goes to get a refill on his soda. And he sees a sign on the machine that says ‘Free refills,’ and it gives him an idea. So he goes up to the counter, and he squares his shoulders and looks the guy in the eye and speaks in a normal tone and at a normal speed, ‘Hey, this burger was really good! Can I get a burger refill?’ And the guy just kind of looks at him, like ‘A what?’ ‘A burger refill, you know, like a free refill for soda.’ And then the guy gets it, and is like ‘Oh, oh, okay. No, no free refills for burgers.’ And Jia’s like ‘What, why not?’ You know, they have this very civilized conversation, and then, you know, it’s clearly a no, he got rejected, which was a success. And then he just says ‘Okay, thank you so much! I like this place. I’d like it even more if you gave free refills for burgers.’ Then he just saunters off. And it’s such a difference, because he is behaving as if this request was totally reasonable. And what he gets in response is a totally reasonable response.

PG: Because the manner in which he went about it was reasonable.

EH: Exactly, exactly. So when I interviewed Jia about this story, he said, ‘I didn’t blow a horn, I didn’t do a funny dance. What I was asking for was out of the ordinary, but the way in which I did it was very ordinary – it was very respectful, there was nothing odd about it. And people respond in kind. They are respectful and they roll with it. He says, ‘I can now ask anything of anyone anywhere. It’s in how you do it.’ So, there he used no safety behaviors, he just acted as himself as he would without fear, and he got a totally reasonable response. And, again, getting rejected was his goal – the goal was not to get the burger, the goal was to get rejected. But he learned something about the process.

Okay, so, back to Lynn Alden and Charlie Taylor. So, they ran this series of studies where they recruited participants with social anxiety and had all of them interact with another lab assistant and have a five-minute ‘getting to know you’ conversation. For half the group they said, ‘Okay, getting over social anxiety is like getting into a hot bath – at first it’s really uncomfortable, but if you just hang in there, you’ll get used to it. That was Group 1. But then for the other group, they explained what safety behaviors were, and they said, ‘What do you do to try to tamp down your anxiety? What are your safety behaviors.’ And people might have said, ‘Well, I giggle after every sentence,’ or ‘I put my hand in front my mouth when I talk,’ or ‘I think really hard about what I’m going to say next.’ Any number of things.

PG: Would not leaving the house be a safety behavior.

EH: That would totally be a safety behavior! That’s overt avoidance. The safety behaviors are covert avoidance. So they asked the participants, ‘Let’s do an experiment. Try dropping that behavior. Try not to do that as you have your five-minute ‘getting to know you’ conversation, and let’s see what happens. Because you’ve never had a chance to learn what happens if you don’t do that. So let’s see if, essentially, if you don’t conceal your anxiety, let’s see if all your unconcealed anxiety comes spilling out. Let’s see if what you fear happens and that you will be revealed and that you will be judged or rejected for it.’ They didn’t say it in those words but that’s essentially what they were telling them to do. So what happened is that the group that dropped the safety behaviors reported being less anxious, and enjoyed themselves more, but moreover, when later the researchers went back and asked the confederates, the lab assistants who were having the conversation with them, ‘Which of the two groups did you like better?’, they inevitably said ‘The people who dropped their safety behaviors.’ Because safety behaviors take up a lot of bandwidth. They were doing this impression management, they were doing self-monitoring, and that takes up a lot of our brain space.

PG: And ironically, sometimes they can be annoying. The very thing you’re trying to avoid –

EH: Yes! Exactly. Or they can look odd. I’ve read some vignettes where there was a case where a man in England would go out to the pub with his friends, but he didn’t want them to see his hands shaking, so he would turn around every time he took a sip. He thought this was a great way to hide his anxiety, but it looked weird! Likewise, there was another woman in this case study who had a kind of pre-prepared list of topics that she felt qualified to talk about, and she would kind of forcefully steer conversation into one of those topics so that she could, in her eyes, sound like an expert – or, not sound like a dumbass, basically. But it came across as giving a lecture or being preoccupied or not listening. So yeah, the safety behaviors often come across, not only as inauthentic, but can cause the exact thing we were trying to avoid.

PG: It seems like trust is a big issue at the core of a lot of these –

EH: Right, exactly. And I think, it’s to trust that you are enough and that you can let go of those safety behaviors. In the book, I call them the life preserver that’s keeping you under water. Try to let go of those little habits that we have and see what happens. And according to these studies, what happens is that we feel better, we feel less anxious, and the people talking to us like us more, would rather have us a friend, and find us to be more authentic. And that, I think, is key – that the very things we are doing to try to hide what we think is our authentic self, this flawed self – if we let those go, what actually comes across is someone very likeable. We have enough bandwidth to fill in the gaps with natural curiosity and friendliness.

PG: The things you can’t plan for.

EH: The things you can’t plan for!

PG: Being in the moment.

EH: Exactly! And that is what makes people like us.

PG: And I also think, because the other person – when you get a sense that the other person is in the moment, you feel listened to, which is what you look for in a friend.

EH: Absolutely. Interestingly, especially for men – folks with social anxiety think that they have to project confidence and competence; that that is what people are looking for. But, in fact, when we ask people what they are looking for in a friend, that’s not at all what they want. What they want is warmth. And that is defined as simply being kind and trustworthy. So there is nothing about confidence or competence in there; it’s just being friendly. And we can all do that; we all have that inside us.

PG: So is it fair to say, then, as somebody begins employing these tools, that they begin to get a sense that there are more trustworthy, safe people in the world than their brain had told them?

EH: Absolutely, yes! That is definitely what happens. Anxiety in general, but also social anxiety, tells us two lies. One is that the worst-case scenario that we can imagine is a foregone conclusion – that that thing will absolutely happen. And the second lie it tells us is that we cannot handle the world out there, or people, or whatever it is we’re afraid of. So when we slowly try to practice and stretch and grow and drop those safety behaviors and do the things that we fear – and we can do them slowly; we don’t have to dive into the deep end of the pool, we can inch ourselves in – then we gather evidence and get enough experience under our belt to realize that that worst case scenario that we can imagine usually doesn’t happen, 99% of the time does not happen, and also that we can handle this, that we can cope. And even if that worst-case scenario happens, we can still cope! And that we have both the inner resources, but also external things – people we can call on or things we can do to self-soothe to get us through those little foibles and blips and bloops of daily life that happen because we’re all human.

PG: And I think in those moments when we are obsessed with the worst-case scenario, we rule out the supportive element of a community that we’ve built – that we don’t go through life alone, or we have the choice to go through life alone or to dip our toe in the water of vulnerability and intimacy. And yes, have some bad experiences, but always be able to learn from them and to be able to carve out a life that has meaning and purpose, and it becomes expansive because we take greater chances, and when we fall down, it’s easier to get back up and try it again.

EH: Yeah, yeah. The falling down actually is endearing to others and makes us more likeable. There is a classic study from 1966 where Elliot Aronson divided participants into four groups, and he had them all listen to a tape recording, ostensibly of a college kid trying out for his college Quiz Bowl team, like a trivia team. In the first two groups there are two recordings. One is this very competent Quiz Bowl contestant who is very impressive. He talks about his résumé and has lots of extra-curricular activities and answers most of the questions correctly. So, solid guy. And in the second tape the guy is kind of a dufus, an answers less than a third of the questions correctly, so is not particularly competent. Then, in the third and fourth group the tapes are exactly the same, except at the end you hear this clatter and the scraping of a chair, and you hear him exclaim, ‘Oh no! I’ve spilled coffee all over my new suit!’ And over many, many participants, what happens is that, when asked which contestant they like the most, inevitably it’s the competent guy, the guy who seems pretty solid, who spills coffee on himself! That’s the guy that people want to be friends with.

PG: So those two things.

EH: Yeah, so you need some kind of base of competence, but what I always say is that – for everybody who is now thinking ‘Oh my god, that’s not me, I would totally be the dufus guy, I’m not competent’ – the simple fact that you are thinking about that and are cognizant about that, means you don’t fall into that category. Because people who are aware – if you are truly incompetent, you don’t even know it! So, everybody who is thinking, ‘Oh my god, that’s not me’ – you’re fine, you’re totally fine.

PG: Right.

EH: That’s why, when Jennifer Lawrence falls on the red carpet, we think it’s adorable. Little humanizing mistakes happen, and we all say ‘Aww!’ or it makes us feel so much better, or it’s validating, or it’s humanizing. So when we go out into the world, it’s important to remember not to be perfect. We don’t have to be perfect.

PG: Have you ever said to yourself: the most important quality I look for in a friend is perfection? (Laughs)

EH: Oh, god, no!

PG: Nobody has ever said that!

EH: Nobody ever, exactly. Right. Perfectionism is a big driver of social anxiety. We think that people think that way. Maybe not literally, but there’s this idea that, ‘Oh, I have to present well, I have to do this impression management, I have to come across well, and if not impressively –‘

PG: ‘I can’t show my soft spot, because I will be destroyed.’

EH: Exactly! ‘I can’t show my weaknesses.’ But actually, showing the weaknesses it what makes people like us more.

PG: I think it depends on how we show the weakness.

EH: Sure, sure.

PG: Because if we say, ‘Let’s go have coffee,’ and then we talk about what a piece of shit we are for 60 minutes. That is not vulnerability; that’s taking someone hostage in a conversation.

EH: Right, right. The way intimacy is built – and I don’t mean sexual intimacy, I just mean getting to know someone – is that it is reciprocal and gradual. It’s kind of like saying, ‘Here’s a little bit of my stuff.’ And then what happens is, the other person will go ‘Well, here’s a little bit of my stuff,’ and then you keep doing that, and you get to know each other on this gradual, reciprocal level. That’s disclosure, that’s telling somebody what you think and do and feel. Whereas taking somebody hostage, that’s confession.

PG: Trauma bonding [xxx 56:16].

EH: Right! It’s the people where, in the first conversation, they tell you all their childhood trauma. And you know, there are some places where that is actually appropriate. I have a client who is in AA and that is often how she gets to know somebody for the first time, that they’ll tell their story. So she knows all the dark stuff, and then they go back and kind of do the gradual and reciprocal. So it can be inverted; it’s not a hard and fast rule.

PG: But it’s appropriate in that support group to do that because you’re there for that.

EH: Exactly, right. If you just meet somebody not in that context, it is more appropriate to do the gradual and reciprocal. Because saying your whole truth right away can turn people off. Your whole truth is absolutely valid and should be shared, just not at the first conversation.

PG: And I have found – because I’ve been guilty of that – is that what I’m looking for isn’t intimacy; I’m objectifying that other person so that I can fulfil my fantasy of being rescued emotionally from all of my doubt and my pain, etc, etc.

EH: Yeah, and that’s a big burden to put on another person.

PG: And it’s dehumanizing. Not in an overt way, but you’re making it all about you and your pain. I’m just talking about me. And I’m not trying to lecture you as if I know more, I’m just throwing this into the mix as, that’s a thing that I do that, uh… When I say ‘uh,’ that’s one of my safety behaviors, because I’m afraid that if I take too long between sentences, I’m going to get steamrolled, or I’m going to bore somebody, or I will look forgetful, and I’ve been trying to work on it for a long time, and it’s really hard because I’m so used to it.

EH: M-hmm, it’s a habit, yeah, of course.

PG: I’m afraid that my way of speaking is going to be stilted and it just – it’s so ingrained.

EH: Yeah, there is a well-worn neural ski slope going down one path of your brain. It’s as if you – there’s a well-worn hiking trail through that path. So you’re trying to bushwhack your way and create a new hiking trail that’s kind of overgrown right now, and so yeah, it is harder, it does take more energy.

PG: We were talking about the manner in which you do things when you fall down, and I had an epiphany about a month ago, that I will often say, almost every process is two steps forward, one step back.

EH: Absolutely.

PG: And it occurred to me one day that having compassion for ourselves during the one step back is actually a step forward.

EH: M-hmm, yeah, because we always focus on the step back, whereas I think simply noticing that it’s a step back and getting up and trying it again is what is actually the success. I think that ties into how confidence works. Because I’ve had so many people come into my office and say, ‘I wish I could retreat from the world and work on myself and gain confidence, and then reemerge like a butterfly out of a cocoon and then live my life with confidence.’ And I always say, ‘That’s awesome! I’m glad you’re motivated, I’m glad you’re here, you’re in the right place – AND, let’s do that in the opposite order. Let’s have you live your life in order to gain confidence. It’s kind of like the relationship between mood and behavior. We often think that we have to feel like doing something before we do it. We think we have to feel like working out before we go to the gym, we think we have to feel inspired before we sit down and write. But in reality, we can switch those. We can lace up our shoes and go to the gym, and go through the motions. And usually, we’re glad we went. Usually our mood catches up, and we’re like ‘Oh, this was good!’

PG: ‘That wasn’t as bad as I thought it was.’

EH: ‘That wasn’t as bad as I though! I’m glad I was here!’ Or we can sit down and start typing and then inspiration, maybe or maybe not, will strike, but it certainly wouldn’t strike if we just waited around, you know. And so, with confidence, it’s the same way. We have to put the action before the confidence. When we take the step back, that’s our opportunity to just go through the motions and get back up and do that, and then our confidence will catch up and will gather that evidence that the worst-case scenario doesn’t happen. And, even if that step back was the worst-case scenario, we can handle it! We can cope.

PG: It’s kind of like having a dream of playing at Wimbledon, but you never want to play tennis with anybody. You’re just going to play tennis against a wall.

EH: Right, right, exactly.

PG: Where did we leave off before that? We talked about…

EH: We talked about disclosure, we talked about…

PG: Oh, the manner in which you reveal things to each other, intimacy; how you begin. It’s a give and take. Was there something after that, or did we kind of wrap it up?

EH: Oh, and then we talked about how spilling coffee on your suit is actually attractive.

PG: Yes. That’s why I always love in a movie, when someone in the beginning of the movie does something that’s kind of cringeworthy or selfish or something that you wouldn’t want other people to see. I shut down if I’m watching a movie where someone is rescuing kittens and they’re charming and… That, to me, is just –

EH: You don’t want to route for them! Absolutely, right. You want to see humanity. Not super-humanity. You want someone who is human, not super-human.

PG: Yeah. What else would you like to share with the listener?

EH: Well, okay, so I think one important thing is that – whenever I tell people I’ve written a book about social anxiety, to a tee, people say, ‘Oh my god, I need that book!’ And I think that because nobody really talks – well, I guess this is changing, the tide is turning, but certainly as of a few years ago, very few people would talk publicly about their social anxiety. I think it’s important to say that – social anxiety is kind of the technical term for being shy – and if you ask people if they are shy, 40% of people will say yes, will identify with that. And furthermore, if you change the question, and say, ‘Have you ever been shy? Were you shy a child, were you awkward as a teenager?’ Then 80% of people will say yes. And furthermore, we all have our socially anxious moments. 99% of people can identify with the socially anxious moment. So I would argue that social anxiety is normal, that we’ve all been there. Now, it is true that 13% of us will kind of cross the line into something that gets in the way of living our life.

PG: Is that the big ‘S’ Social Anxiety?

EH: Yes, that is capital S Social Anxiety. It becomes diagnosable when it causes great distress. Say that we find out that we have to give a presentation on Friday, and we find out the Friday before. And the next week we spend fantasizing about calling in sick and having diarrhea and freaking out. That’s great distress. That is not proportional to the presentation. It would be proportional to kind of have it in the back of your mind, and wanting to do a good job, and preparing, and then the day before maybe you feel anxious and you sweat and whatnot. That’s proportional.

PG: Butterflies.

EH: Exactly, exactly.

PG: Dread.

EH: Dread! That’s a perfect word. Yes, yes, yes. Or it gets in the way of living your life. So, for instance, the student who consciously decides to forego 20% of their grade because they cannot raise their hand in class and get those class participation points. They say, ‘Well, I guess the highest I get is an 80%, oh well!’

PG: That’s a problem.

EH: That’s a problem! Or if one were to forego a promotion at work because you’d have to give presentations. You say ‘I cannot do that!’ and then you lose out on career advancement. That would be a problem. That’s the capital S, diagnosable Social Anxiety. 13% of Americans fall into that category at some point in life, which, when you think about it, is huge! 13%! That’s a lot of people. So the take-home is that – again, I think people are starting to talk more about it now, but certainly it has been like there’s this sense of isolation in that past, that ‘I’m the only one who feels this way.’

PG: And then shame comes in, knocks on the door.

EH: And shame! Yeah, exactly. It’s a sense that, yeah, it’s the fatal flaw, it’s the perceived flaw – ‘I’m not good enough,’ no matter what flavor it is.

PG: The ruminating self-obsession.

EH: Exactly, yeah, yeah! That has a name, actually. If the ruminating self-obsession happens before, it’s anticipatory social anxiety. And if it happens afterward, if we kick ourselves and replay the lowlight reel of everything that just happened in an interaction, that’s called post-event processing. So there’s a before, there’s a during, and there’s an after. And all of those can converge to form that capital S Social Anxiety. But the good news is that there is hope no matter where people fall along the continuum. Using the tools of, like, give yourself a role or turn your attention inside out, or lower your standards so that you don’t have to reach those sky-high, perfectionistic expectations, can all help chip away at that.

PG: And have compassion for yourself, no matter where you are at in this thing.

EH: Absolutely.

PG: One of the things that I like about your book is, you integrate a lot of scientific fact.

EH: Mm, I’m a data nerd. (Laughs)

PG: Yes. And you – what did you do at Harvard Medical School?

EH: That’s where I completed my clinical training. The last year of grad school is called Internship, and you do a ton of just working with patients, it’s kind of a capstone. Then I stayed on for a post-doc and did some research and worked with more people and fell in love with mostly the clinical work.

PG: Talk about the prefrontal cortex thing. The MRIs.

EH: Mm, sure thing! Do you want to know, it’s the studies of –

PG: The psychopaths.

EH: Yes! Yes, yes. The prefrontal cortex. There have been some lovely studies showing that the amygdala, which is the fear center of our brain – and it’s not only for fear; it’s also a part of the eating system and sex system and many other systems.

PG: It’s the Fox News part of the brain.

EH: Exactly, yes! (Laughs) It is the lynchpin of our fear system, and it sounds the alarm whenever there is a threat. What happens is that when FMRI studies, brain scanning studies, are done for folks without social anxiety, the prefrontal cortex can shut down the social alarm of the amygdala fairly quickly and fairly efficiently. In folks who do have capital S Social Anxiety, the response is slower and less robust. The analogy I like to use is that, in the folks without the social anxiety, it’s as if the prefrontal cortex dispatches a firetruck to the scene immediately, whereas in folks with diagnosable social anxiety, the prefrontal cortex dispatches a guy on a bicycle with a bucket of water to put out this fire.

PG: And the prefrontal cortex would be the part that says, ‘You’re overreacting, everything is okay.’

EH: Right, right. Let’s say, our friend hasn’t texted us back, the amygdala immediately says, ‘She hates you and is going to break up with you as a friend.’ And the prefrontal cortex says, ‘You know, she’s probably just in a meeting. Give it a few minutes. It’s okay, let’s chill.’ The good news there is that the architecture is all there. People with social anxiety, diagnosable or not, they have all the same parts of the brain as people without social anxiety. So it’s a matter of strengthening those connections.

PG: Because there’s a plasticity? With the brain and the pathways that the neurons…

EH: Yeah, yeah. I’m forty, and when I was growing up and in school, there was this thought that the brain was pretty much set, and what you know is what you know, and the neurons can’t reproduce and blah-blah-blah. But actually, more recently what has happened is that it’s shown that the brain is quite plastic and that anything you do frequently can change your brain. What I learned is that the brain affects behavior, but what we’ve learned in the meantime is that behavior can also affect the brain. So, again, anything you do frequently from play the violin to drive a taxi to watch porn to anything, can strengthen those particular connections in the brain. So, practicing social confidence – going out there and not avoiding, or dropping our safety behaviors, or slowly doing the things we’re afraid of –

PG: Making mistakes.

EH: Making mistakes! And realizing that it’s not the end of the world, and we can cope – it strengthens those connections. The architecture is already all there, and we can influence the strength of those connections through our behavior. By practicing, we can train that guy on the bicycle to drive the firetruck and to, instead of bringing the bucket, to hook the hose up to a fire hydrant, and we can learn a more robust response.

PG: So, for instance, tomorrow I could go get a toy gun and go rob a bank.

EH: (Laughs) And practice that?

PG: And practice that.

EH: Sure! Yes, technically, you could.

PG: And then, if they catch me, say this was just a –

EH: Ellen Hendriksen told me to do this.

PG: I want you to read her book… Why are you cuffing me? You don’t understand.

EH: Here’s her number. Please call her. Here’s her license number, as a psychologist, yes.

PG: Yes. Uh, what were we – urgh, once again I derailed –

EH: That’s okay!

PG: Oh, I know what I wanted to ask you: Do you see that area of the brain light up in the MRI? Does the color change? How do you know scientifically that this is happening? What are these signs?

EH: Sure. So in the MRI – uh, this might be beyond my capability. Hmm. I’d rather not answer that, because I don’t want to get it wrong.

PG: Okay.

EH: Hmm…

PG: You’re a liar and I need you to leave.

EH: Yes! (Laughs)

PG: Your worst fear did come true!

EH: No! Now you like me more, because I made a mistake!

PG: (Laughs) I’ll make you coffee and then you can spill it, and then we’ll be best friends forever.

EH: (Laughs) Yes, yes.

PG: Until you find out who I really am. And then you’ll abandon me and I’ll die alone. This has been terrific!

EH: (Laughs) So you asked me about psychopaths. Okay, so! Another thing I will hear often is, ‘I need a personality inversion. I wish I could just not care what people think!’ And I totally understand what people are saying. I get it. And – careful what you wish for! Because, I said before that 99% of people can identify with the socially anxious moment. And that balance 1% is psychopaths. So there, there is a fearless dominance, there is a sense of entitlement.

PG: Lack of remorse.

EH: Lack of remorse, lack of empathy. Or there is a cognitive empathy – ‘I can figure out what you’re thinking and figure out how to manipulate you to do what I want.’

PG: Right. But there’s no real human connection, there’s no intimacy.

EH: Exactly, right. So, to quote, I forget what researcher this was, but she says that psychopaths can understand emotion, but it’s in the way that a colorblind person looks at a stoplight. They know when it’s red but they don’t really have an understanding of what red is.

PG: So there’s a lot of mimicking to get what they want.

EH: Right. And, scarily, when psychopaths go to therapy, they actually get better at being psychopaths because they learn from the therapy how this is really supposed to work. It’s like looking behind the curtain or looking under the hood – I’m mixing all my metaphors. It’s like learning how the sausage is made, and then they can go out and –

PG: My car runs on sausages, by the way.

EH: So does mine! The exhaust smells of pepperoni. So they go out into the world and can be better psychopaths.

PG: It’s almost like the guy that goes to prison and then learns how to be a better criminal.

EH: Yeah, yeah! Exactly, exactly. There have been studies where both MRI studies and self-report studies that show that the inverse of social anxiety is psychopathy, so that’s not what we’re going for!

PG: So it would be a very active prefrontal cortex, which is judgment, and then very little prefrontal cortex, lack of judgment.

EH: Sure, sure. Yes. There’s, uh – let’s just say yes.

PG: Did you want to expand on that?

EH: No.

PG: What are you afraid of right now?

EH: No, no, no. I’m trying to think if there was a more accurate way to say that, and I cannot think of a more accurate way to say that. Yes.

PG: I see. What else would you like to talk about?

EH: Okay, so, a takeaway –

PG: By the way, we’re good.

EH: In terms of time?

PG: Yeah, we’re at an hour, so…

EH: Oh wow, okay! Alright, so then I can – here, let me see my little talking points. There’s one thing I do want to end with. Let me see if there is anything else. Social anxiety is normal, tips, confidence… If you want, we can talk about how to help a friend?

PG: Yeah!

EH: So, one thing I’d like to leave people with is the idea that social anxiety is a package deal. That is actually comes bundled with some really excellent traits. So folks with social anxiety – this is part of the perfectionism – is that we have very high standards, that we are conscientious, that we work really hard to get along with people in an increasingly diverse world, that we are empathetic. It’s the opposite of psychopathy, again – they have no empathy, we’re very empathetic; that we are helpful and altruistic, we care about people. It’s the flipside of not caring what people think is, we care about people.

PG: So this is the silver lining?

EH: Yes, exactly. And it’s especially notable that as we work on our social anxiety, that those things don’t go away. That as our fear recedes, all those good qualities do not. My favorite clients to work with are those who have social anxiety because they are inevitably lovely people, and it is my privilege to help them realize that it is amazing. That is one of the most rewarding parts of my job.

PG: So, the world would be such a better place if every person really explored what their fears are.

EH: M-hmm. It’s hard! It’s so hard.

PG: It’s so hard.

EH: Absolutely. I feel like I’ve come a long way. I used to not buy shoes that click-clacked on the floor because I thought they would draw too much attention. In college, my wardrobe consisted pretty much of black, white and denim. I remember in my senior year, I co-coordinated a peer counselling group. That was kind of my first inkling that maybe I should be a psychologist if I did this for fun. (Laughs) I facilitated a group of peer counsellors, and one meeting we had, they all decided amongst themselves that they were going to wear black, white and denim.

PG: (Laughs)

EH: I walked into the room and simultaneously felt very comfortable, like ‘Oh! This is very familiar and very comfortable, hmm, what’s happening here?’ and at the same time I was a little freaked out because – this sounds so weird, but I realized that they could see me, and that they had seen me enough that they had found a pattern and could mimic it. And that was equally touching, it was endearing – I mean, I’m 99% sure that they did this out of love and not to mock me. There is always that 1% going ‘hmm, I don’t know!’ But there was also a realization of, ‘Oh…’

PG: I exist.

EH: I exist! People can see me! I am real. So yeah, that sense of wanting to blend in, and wanting to be invisible, and realizing that that is actually not the case, and I was trying to hide in plain sight. It was, um, not a wake-up call, but it was like, ‘Oh yeah, they can see me.’ So yeah, I’ve certainly come a long way since then. I still have my moments – like, I do not like to be on camera. I’m actually really glad that this is not a video podcast. I can do it, I can, I have done video interviews, I’ve done live web interviews, and I don’t like them but I can do them. I get weirdly formal around authority figures. I do not like conflict – like, I’m really working on not caving immediately when there is a conflict. So I still have my moments, but in general, they don’t own me. I can feel anxious and that’s okay, I can surf the wave. I can go up that graph and know that it’s going to plateau, and that if I stick with it, it will decline. And the more I do that, the easier it gets.

PG: And in that moment, are you trying to be mindful, are you looking around the room, are you changing your breathing, or are you just sitting through it?

EH: In general, I will try to turn my attention inside out. It’s as if there is a loud radio on in the background, and that’s the inner critic, and so I just deliberately ignore it; I turn my attention away from that deliberately and to whatever the task at hand is. I don’t try to distract myself – distraction would be paying attention to something that’s not the task at hand. So I pay attention to whatever I’m supposed to be engaging in. And that’s very helpful because then you’re present, and you are there to realize that this is not as bad as your inner critic told you it was going to be. And I’ve learned that it doesn’t have to be perfect, it doesn’t have to be a performance, and that yeah, part of it is just riding it out, and knowing from experience that as I ride it out, it will get easier and I will be more comfortable.

PG: And another thing that I discovered very late in life is that the most important quality I look for in a friend, and I imagine other people look for in friends, or one of the most important qualities, isn’t whether or not they make mistakes – it’s how they handle it.

EH: Yes!

PG: Do they apologize? Can they be self-reflective, without becoming self-obsessive?

EH: Sure, yeah. I forget who this quote is from, but it’s like, ‘Life is not what it is but what you make of it’ or something like that. I’m butchering that, but it’s essentially that the problems that come your way, how you handle those are what define you, as opposed to the problems that you have.

PG: And the very thing you struggle against can be the thing that binds you or connects you most deeply to other human beings and makes life so enjoyable and purposeful.

EH: Absolutely, yes.

PG: Your book is called How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety. Ellen, thank you so much, it’s a really great book and I think it’s going to help a lot of people.

EH: Oh, that is the goal! I hope so. This is the book I wish I had had twenty years ago, and I’m happy to, yeah, hopefully it will be helpful to people. And it was a delight to talk to you! This was really fun.

PG: Thank you.

EH: Absolutely.