Ep 141: Getting Comfortable with Anxiety

Episode Summary

Ellen Hendriksen, author of How to Be Yourself, clues us in on what might be triggering your teen’s anxiety and perfectionism–and what you can do to help them overcome those and feel comfortable being themselves!

Show NotesParenting ScriptsInterview TranscriptGuest Bio

Full Show Notes

The high school social atmosphere is pretty terrifying. You might remember the feeling of your heart beating against your chest as you asked a table full of kids if you could sit with them, or the way you got tongue tied trying to talk to your crush in the hallway.  As stressful as it is, it tends to pass in time as kids mature. For many teens, this is just a part of growing up.

But for some, social anxiety is a major challenge that keeps them from finding friends and blossoming into confident adults. Too often, these  teens let their social anxiety rule their lives. They flee any kind of challenging social interaction, falling into a pattern of avoidance. They never learn to challenge their fears and live in their comfort zones.

Today, we’re talking to a social anxiety expert to learn how we can help teens break this cycle. Our guest is Dr. Ellen Hendriksen, author of How to be Yourself: Silence your Inner Critic and Rise Above Social Anxiety. Dr. Hendriksen is a clinical psychologist and faculty member at the Boston University Center for Anxiety and Related Disorders. She’s also the original host of the Savvy Psychologist podcast, which has been downloaded over 15 million times on Itunes.

Dr. Hendriksen has spent years studying social anxiety, and she’s here to share all her expert knowledge with you today. In our interview, we cover what’s really going on in teen’s heads when they’re overwhelmed by social situations. We also get into all the wrong ways teens try to deal with social anxiety, and break down healthier methods for teens to shed the inhibitions that hold them back.

The Psychology of Social Anxiety

We all know what social anxiety feels like. But what’s going on in our brains when we’re getting butterflies in our stomach? And how is a socially anxious teenage mind different from that of an adult ? Ellen and I discuss how teenagers have prefrontal cortexes that have yet to fully develop, meaning their rationality can sometimes be lacking. Stressful social  situations are instead processed in their amygdala, a part of the brain that regulates emotion. This means that teens are prone to think that a slight social mess-up is a life-ruining disaster.

Dr. Hendriksen clarifies the difference between someone with a healthy amount of nerves and someone who might have an anxiety disorder. If social anxiety is a metaphorical fire, she describes the brain’s healthy response as “sending a fire truck” to put it out. For those who are more prone to being overcome with anxiety,  she compares the brain’s response as a “man with a bicycle and a bucket of water.”  It still works, it’s just slower. These people take more time to calm their nerves and find themselves seriously shook when they feel socially inept.

Interestingly, Ellen goes on to explain how social anxiety is really a fear of being “revealed.” Those who grapple with heavy anxiety over talking to strangers or being vulnerable with others often believe that there’s something about them that is wrong or insufficient. Of course, this isn’t true, but it can certainly feel true! For a lot of teens, this feeling is linked to their appearance–maybe they’re self-conscious about their acne or compare their body to those of  their peers. In our interview, Dr. Hendriksen and I discuss other ways teens tend to be insecure and how this causes them difficulty in social situations.

So how can we help teens who let their social anxiety run their lives? Before we can talk about what we should do,  Ellen explains behavior that we shouldn’t encourage, like avoidance, perfectionism, and what she calls “safety behaviors.”

How Not to Handle Social Anxiety

There are a lot of ways that teens tend to cope with social anxiety that only lead them further down an anxious rabbit hole. The most typical behavior, Ellen says, is avoidance. When situations make teenagers anxious, the quickest and most rewarding solution is to just get out of there. Dr. Hendriksen explains how  this only leads to more anxiety down the line, as teens never learn how to deal with the triggers they’re faced with everyday.

In addition, some people develop “safety behaviors”, or methods of shielding themselves from their anxieties. For a lot of socially anxious teens, walking around with headphones is a common safety behavior–it restricts  them from talking to anyone, and, in their minds,  saves them from embarrassing themselves. However, this behavior only  keeps them from making any new friends at all, and in fact sends the message that they’re uninterested in anyone, leaving them to remain on the outskirts.

Another problematic tendency teens adopt to try and remedy their anxiety is perfectionism, says Dr. Hendriksen. In order to try and become less insecure, they set certain labels or goals they want to reach. They adopt an attitude of all or nothing–they have to be the prettiest, the funniest, and the coolest, or they’re not worthy of having friends at all.  But then they find themselves feeling ashamed when they can’t meet their own standards, says Ellen. And when they feel bad, they strive for their high standards to “fix” themselves, only to fall into a cycle.

If these mechanisms only lead to disaster, what can we do to help kids beat their anxiety for the long term?

Healthy Ways to Work on Social Stress

Thankfully, Dr. Hendriksen has plenty of methods for dealing with social anxiety that are actually effective . One very powerful practice is cognitive restructuring. This entails challenging the natural, irrational assumptions of an anxious brain. Those with social anxiety might assume that talking to strangers will go horribly wrong, that they’ll be called names and the whole world will explode.  

The first step of cognitive restructuring is narrowing down what it is you’re afraid of. Anxiety tends to be vague, Ellen explains. Teens might have generalized fears of public speaking, but what is it exactly that they fear will happen? 

Let’s say your teen afraid that the whole crowd will laugh at them. The next step, says Dr. Hendriksen, is to help them evaluate just how statistically likely it is that their fear will occur. Have people laughed at them during a speech before? How often does that really happen? And if they still think their fear is likely to unfold in front of them, have them ask themselves how  bad it would be if their fear did come true. Yes, they would be embarrassed, but chances are, the people in the room would forget about their speech by the next day and life would go on as normal.

In addition to cognitive restructuring, Dr. Hendriksen emphasizes the importance of breaking the cycle of avoidance. Teens need to breach their comfort zones, she says, in order to truly leave their anxiety in the dust. When they face their fears, their brains gather data to understand just how greatly they  overestimated the danger. They can dive back in with less fear when they’re challenged again. For socially anxious teens, going up to a group of strangers might seem like the most frightening thing in the world, but it will give them the courage to be confident the next time around.

In the Episode…..

Ellen was lovely to speak to this week! Along with the topics above, we discuss:

  • How social anxiety can actually be good sometimes
  • Why introversion isn’t necessarily linked to social anxiety
  • How self compassion is a better alternative to self esteem
  • Why we need to evaluate how we look at friendship

Social anxiety is a serious problem for some teens, but with Ellen’s advice, we can help teens ditch their fears and live their best lives. If you want to check out more of Ellen’s work, you can find her Ellenhendriksen.com, where she’s launching video classes very soon and also has a weekly newsletter. As always, don’t forget to share and subscribe and we’ll see you next week.

Although it’s hard to raise teens who think critically, Charlan’s advice can show us where to start! I had a blast interviewing Charlan and I hope you enjoy the talk as much as I did. Don’t forget to share and subscribe and we’ll see you next week!

Parenting Scripts

Word-for-word examples of what to say to your teen

1. Bring up the pitfalls of talking in absolutes:

“When we speak in absolute trait-like terms, like ‘I am smart’, whenever, inevitably, evidence comes along that is counter to that, our bubble bursts. Then we start thinking in very all or nothing terms, like ‘maybe I’m not smart’.”

Ellen Hendriksen

2. Put the anxiety aside to uncover what your teen wants:

(Members Only)

3. Remind your teen they can try something new gradually:

(Members Only)

Complete Interview Transcript

Andy: So, talk to me a little bit about this topic. How does one become an expert on being oneself? That seems like a really interesting thing to, to study and to learn about. And I’m curious what got you into that.

Ellen: Sure. So yes, I am a clinical psychologist and under that umbrella, I am an anxiety specialist. But under that umbrella, social anxiety has a very special place in my heart. So, that is my super specialty. And I got into the idea of writing how to be yourself for just a variety of factors. So one is that as an anxiety specialist, and watching myself work with all these clients who come in with social anxiety, I realized that a lot of the evidence-based techniques, the things that really work were inaccessible. They were either in the ivory tower, they were stuck in research labs, clinical research labs or they were stuck in boutique private anxiety centers.

Ellen: Not to knock my own workplace, but I’m in a university affiliated anxiety, specialty center and we don’t take insurance, which is problematic. But we are dealing with this as it is now. So, my goal is to be a bridge. I want to take what is known, what works in that ivory tower in those specialty centers and make them as accessible as possible. And so, I love what you do. I podcasted myself for five years, and then, writing this book was another big part of trying to just spread the word, just get really good information out there to people who wouldn’t otherwise have immediate access. So, for the price of a book or for a free podcast, we all deserve the best.

Andy: There are great tools. The research is being done.

Ellen: Exactly. We all deserve the best tools, yes.

Andy: So, at the core of all of this is this idea of avoidance and the double-edged sword of avoidance, where it does, in the short term, it makes you feel better to just not have to deal with whatever the situation is that seems scary to you or awkward or hard to deal with. And you get to not have to face down that negative emotion and so great success, avoidance wins the day. But, of course, in the long-term, avoidance is disastrous. So, why do you think that’s such a difficult thing? And this, particularly to me, it seems really important during the teenage years. As a parent, watching for where your teenager might be avoiding things and providing that nudge to engage with those things.

Ellen: So much to unpack there, great, great question. Okay. So, I’m glad you started with that because avoidance really is the heart of the matter. And not, not even just for social anxiety, avoidance is the heart of many psychological disorders, but particularly the anxiety disorders. And not even disorders, what I call lowercase S social anxiety. Okay. So, if we’re faced with something that we fear, our anxiety is going to shoot up, that makes sense. We get thrown into fight or flight, but if we don’t have to deal with that thing, our anxiety plummets like a stone. And that’s highly reinforcing, that is like crack. It feels really good. Like, “Oh, I don’t have to talk to those people. I don’t have to give that presentation. I don’t have to raise my hand in class. Oh, she didn’t call on me.”

Ellen: However, just like you said, it is disastrous long-term. Short-term, it provides relief. But then inevitably, another anxiety provoking situation is going to happen again and blammo or anxiety shoots up again. And so, we end up in this yo-yo pattern of anxiety, avoidance, anxiety, avoidance, anxiety, avoidance. And so, what we want to do is not to throw ourselves into terrifying situations, but to be cliche, push ourselves out of our comfort zone, just a little bit and hang in there and to do the thing kindly. We can be nice to ourselves as we do the hard thing, but to hang in there and to do the thing.

Ellen: And then our brain recalibrates and we gather evidence and experience that refutes what I call the two lies of social anxiety. One is that the worst case scenario is bound to happen. The worst case scenario is a foregone conclusion. So, everybody’s going to point and laugh, or the teacher will say, “You were supposed to know that.” or just other disastrous things that our brain, of course, immediately latches on to.

Ellen: So that’s one. And the second lie of social anxiety is, I can’t handle it. I can’t deal with rolling with the punches. I can’t handle the blips and bloops that teenage social life is going to inevitably throw at me. And so, as we hang in there and do the thing, we face our fear. Then again, our brain recalibrates and says, “Oh, okay, well, the last five times I did that, my worst case scenario didn’t happen, so maybe that actually won’t happen.” Or, “The last five times I did that, that wasn’t perfect. That was ungainly or awkward, but I survived. Maybe I can do that again.” and that’s how we gain confidence.

Andy: So, we jumped in here, started talking about social anxiety and there’s kind of this, the assumption that it’s not good. We don’t want it that. We want to be confident and rah rah and all of these nice and wonderful things, and we don’t want the social anxiety. But you actually do point out a little bit here on page 47, you start talking about actually the ways in which social anxiety is a little bit of a good thing. So, how is that possible and why do you talk about that?

Ellen: Such good questions. I’m glad you asked that too. So, social anxiety is a package deal. So, it goes along with… of course it’s very uncomfortable. It’s not great to be in the laser beam of a socially anxious moment. But it goes along with being empathetic, with being pro-social, which means being thoughtful, being kind, being considerate. There was some weird random things that are in that package deal. We remember faces better. I think because we’re attuned and focused on. And we’re highly conscientious, which is the number one predictor of both objective and subjective success in life.

Ellen: So, things you can actually measure and things that are more intangible like happiness. So, that conscientiousness is a real heart of social anxiety. And at its core, is really good. When it tips the scales, when it tips the balance, it can turn into perfectionism, which we can talk about. It can turn into caring too much what people think. But when we roll that back just a little bit, when we turn down the flame a little bit on social anxiety, turn down caring too much what people think, we just get caring about people, and that’s always a good thing.

Andy: Yeah. And the opposite of having too low of social anxiety is not a good situation. It’s maybe worse because we can use some of these techniques to talk about in this book and we can dial it down, but it’s kind of actually maybe harder to just create it out of thin air when we’ve got a person who doesn’t feel any of it.

Ellen: Right. No, in the book, I talk about how you would think intuitively, the opposite of social anxiety is confidence, but that’s not actually true. The opposite of social anxiety is psychopathy, is being a psychopath, which is characterized by fearless dominance and self-centered impulsivity. And we certainly, we don’t need any more psychopaths in this world. So, yeah. So, the opposite of social anxiety is something really not good.

Andy: There’s a study that you talk about in this book and we get a bunch of babies, 117 babies, and we bring them in and we start looking at how they respond to a bunch of different things in the lab in terms of just seeing new things and being exposed to new things, having a new person come in and seeing, what do they go run and just play with this new person or are they more wary? And they divide the babies into categories based on whether they’re more the kind of hang back, be cautious kind of baby, or the more, just jump right in, everything’s good kind of baby. But then, what I thought was really interesting about it is, you say they then follow up with these kids 13 years later, or something like that when they’re teenagers. And what they found when they followed up was really interesting. What was it about the kids 13 years later that was so fascinating?

Ellen: So, this is the work of Dr. Cynthia Garcia Cole, and she is an esteemed psychologist. Now, forgive me, I can’t remember the name of her university. She is now in Puerto Rico which is where she grew up, but she spent all day long and storied career at Brown University. And I was privileged to be her student at one point, I took a class that she was teaching. And so, I got to see her work, not only through the pages of a journal, but up close and personal. And so the study that you talk about was her dissertation. And so, she brought all these 21 month kids, toddlers into the lab. And yeah, I was going to say subjected, but that’s bad. Had them experience some novel situations, had them meet a research assistant as a new person had them join her in some play, had them see a robot that the lab had built and wanted to see how they reacted to novelty and how they rolled with the punches.

Ellen: And so, some of those kids stuck in their mom’s lap, didn’t want anything to do with this. And some ran into the room ready to explore. And so, the level of inhibition was really different. Now, you would think that the kids who were more reticent, again, stayed in mom’s lap, were shy, painfully shy even, would be in for a tough time. But that group, particularly, the shy, inhibited kids as teenagers sorted themselves into two groups. Some of them indeed, did have some trouble.

Ellen: They had some separation anxiety, had some social anxiety, generally not more warriors, whatnot. But others, while retaining their shy, perhaps being wired to be more anxious than the typical kid, were just fine. They were quiet, but they were confident. They were doing just fine. And those were the introverts. Those were the non-anxious introverts. And so, genetics is not destiny. Personality is not destiny. I think there’s certainly been a fantastic and well-deserved introvert power movement recently. However, introversion is still associated with being more anxious or being more prone to depression and some not great things. But you can absolutely be a non-anxious introvert. And I think the key there is ironically, avoiding avoidance. Again, doing the things and to be a cliche, getting yourself out there and learning, “Oh, I can do this.” or, “Hey, I can handle what life throws at me.”

Andy: So, you write a bit in this book about what is going on inside of the brain during social anxiety. And I found this really interesting, because you are writing in here about the amygdala and the prefrontal cortex. And you’re writing about how we all have this natural response for our amygdala when we get into a socially stressful situation, our brainstem is going, “Ah, what’s happening here? This is scary.”

Andy: But then, people who are less socially anxious, then their prefrontal cortex kicks in and says, “Well, wait a minute. This isn’t that big of a deal. I think we can chill here.” And I thought this was really interesting because this is what a number of people have said is going on in the teenage brain, that just in general, that the teenage years is described by neuroscientists as this period where you have this really strong amygdala response, but you haven’t really myelinated those paths to the frontal cortex yet. And so, you’re not able to then inhibit that response. So, I just thought there was a really interesting parallel there between social anxiety and just adolescence. And I was wondering if you could speak to that, or is that then kind of social anxiety going to be really emerging a lot during the teenage years, or how do those two things relate?

Ellen: Yeah, that’s a, that’s another good question. So social anxiety typically begins between ages eight and 15. So, that is exactly when the teenage brain is getting that upgrade that starts in the back and moves its way to the front. I’m pointing to like the back of my head, base of my skull right now. It starts in basically the brainstem and then works its way up over your head, towards your forehead. And then, if you put your hand on your forehead, like you’re checking for a fever, that’s your prefrontal cortex. And that is the last part of teenage brain to be upgraded, which unfortunately, is also the part of the brain that’s responsible for organization and planning ahead and all the things that we lament, stereotypically limit with teenagers, “Oh, why can’t they… How did they not see that coming?” or, “Why did they not plan for that?” But so, in social anxiety, again, all the architecture is there. It’s just a little slower.

Ellen: And so, the analogy I use is that, in the face of threat, the more typically wired non-socially anxious brain dispatches a firetruck to the scene where the socially anxious brain dispatches a guy on a bicycle with a bucket of water. So, it’s just slower and not as adequate or response. But the good news is that that can be retrained, that those pathways, if we consciously use them more… So we can push back cognitively with our thoughts and beliefs and questioning the rules in our head, or our actions. We can also put action first and do the thing before we feel ready.

Ellen: We can talk more about that as well. Then our actions can actually change our brain. There are studies showing that anything you do very often, like folks who drive a taxi have like this amazing spatial, that portion of their brain is very well-developed. Musicians, that part of their brain is well developed. And so, our brains are actually pretty plastic, which is surprising, even into adulthood. But definitely when we’re in those teenage years, it’s probably as plastic cause it’s going to be with the exception of zero to five. And so, we can help that along. We can turbocharge that process by questioning that inner critic, those socially anxious thoughts that keep kind of whispering in our ear, and by not avoiding.

Andy: You have a Mad Lib in this book. Man, this is a highly recommended Mad Lib that you’re including here, and it’s pretty simple. It just says when blank, it will become obvious that I am blank. Okay. So, what is going on with this?

Ellen: So technically, social anxiety is a fear of being judged. But more than that, and this is the work of Dr. David Moskovicz at the university of Waterloo. So, he thinks about social anxiety and a different way than the Canon. But I think he’s really onto something. And he, in talking to him, he said, “I have people with social anxiety write to me and say, that’s it. You got it.” And so, I think that rings true for people who live with this condition. And so, it rings true for me as well that social anxiety, more than just the fear of being judged, is more of the fear of being revealed. That in capital S social anxiety disorder, there’s this belief that there’s something wrong with us, that there’s something like insufficient.

Ellen: And my big asterisk, my big disclaimer with clients is that that’s a distortion. That’s why this is a disorder. So, just because you think, “Oh my God, I’m such a loser.” or, “Oh my God, I’m incompetent.” does not mean it’s true. It’s a distortion. Anyway, okay. But he believes that social anxiety is essentially the fear that that distortion is going to become obvious to everyone around you. And that the distortions fall into one of four buckets. One is appearance. So, I’m fat. My skin is blemished. So, that goes with acne with the teenage years. My hair’s a mess. I’m not dressed appropriately. So appearance. Second bucket is the signs of social anxiety themselves. So, people are going to see that I’m blushing, that my hands are shaking, that I’m sweating through my shirt, that my voice is quivering.

Ellen: Third bucket is our social skills. People are going to see that I have nothing to say. People are going to see that I go blank. People are going to see that I’m not funny. I’m not cool. And the fourth bucket is kind of our entire personality, it’s our whole character. People are going to see that I’m boring. I’m a failure, I’m a loser, I’m incompetent, I’m a freak, fill in the blank. And so we don’t have to just stick our finger in one bucket. We might have all four of those buckets all you can worry about.

Ellen: And it can change from situation to situation. I don’t know, somebody who has difficulty using the phone, has phone anxiety might, in that situation, worry, “Oh, they’re not going to understand me and it’s going to get really awkward.” whereas then in class they might think, “Oh my gosh, the teacher’s going to call on me and I’m going to give the wrong answer or go blank, and everyone’s going to think I’m stupid.” So, there are different reveals in different situations.

Ellen: And also, it changes as your stage of life changes. So, for me, I have my own history of social anxiety. And in college, the reveal is, “Oh my God, everyone’s going to see that I’m a big loser.” And so, I would try to compensate by making sure I was very socially busy. And then when I was starting my career, the reveal morphed into, “People are going to see that I’m incompetent.” And so, I tried to overcompensate, overachieve to make up for this perceived deficit, this perceived problem, which I have since learned was a distortion. And so, it takes a while to learn that, but I did it the hard way. And that’s why people have this book. They don’t have to do it the way I did.

Andy: That’s right. You can do it by filling in the Mad lib. And there’s a step-by-step system in here. You also, in addition to the Mad Lib, you have three magic questions. Why are they magic? And what are they?

Ellen: So, okay. The technical term for this is cognitive restructuring, which basically just means pushing back on your anxiety. It means pulling up the rug of your anxiety and shining a bright flashlight under it and saying, “Really? Is that true?” And so, try to question the automatic worries and assumptions. Okay. So, let me preface this by saying that anxiety is vague. And so, especially with social anxiety, it turns into something like, “Everyone’s going to hate me.” Or, “Something bad is going to happen.” which is so big, and almost anything happens and we say, “See, I was right.”

Ellen: Okay. So, the preface is to try to narrow that down and to specify what are feared outcome, what are we really afraid is going to happen? And that becomes easier to argue with. You know, you can’t really push back on this vague hazy thing. But if you can narrow it down and put it into focus, it is easier to argue with.

Ellen: That said, so then the magic questions become, how bad would that really be? And that’s not a rhetorical question. That’s not like, “It would be fine. You’d be all right.” It really is a genuine question. I’m like, “How bad would that be if that feared outcome occurred? If again, I’m calling to, I don’t know, order takeout. I realize nobody does that anymore, everybody orders online. But let’s just pretend we’re doing that. Okay. And for whatever reason, the person who picks up the phone doesn’t understand and we go through some awkward exchanges. How bad is that? Would that person remember that five minutes after we hung up? Would it be awkward in the moment? Sure. Does it have any penalties on life? No, none whatsoever. So, once we specify the anxiety, a lot of kind of socially anxious, awkward moments can be refuted in that case. How bad would that really be? Not great, but not terrible. So, that’s one.

Ellen: Another is, what are the odds? And this question you can bring out when it really would be bad, when it really would be catastrophic. But catastrophes are rare, and so we can think to ourselves, “Okay, what would have to happen? What events would have to line up for that feared, catastrophic outcome to actually happen?” And what are the chances of each of those things falling in line. So that, we can do the math. We want to do this in a very left-brain, nerdy, engineering type way, which I love by the way. We can say, “Okay. Well, maybe there’s a 5% chance of step one happening, and it’s 6% chance of step two, 50% chance of step three.” But then if you multiply all those out, you get this very, very tiny number.

Ellen: And then you can ask yourself, “Okay, the chances of my Tinder date climbing out the bathroom window of the restaurant because I’m so hideous and he never wants to see me again.” That has happened, absolutely. I won’t lie. That’s occurred probably, many times in this universe, but it’s not probable. It’s possible, but not probable. And is the anxiety that we’re putting into this proportional to the chances of that happening? And usually answer is no. So, what are the odds, is another question.

Ellen: And then, the third magic question is how would I cope? And there, that simply prompts us to realize that again, we can handle these things that as life throws curve balls at us, we can dodge them. We can catch them. We don’t have to just stand by as our social fear comes true, that we can cope either ahead or after the fact. We can reach out to friends. We can sooth ourselves. We can be compassionate, use some self-compassion. That we can handle things, and ultimately, it’ll be okay.

About Ellen Hendriksen

Dr. Ellen Hendriksen is the author of How to Be Yourself. She is a clinical psychologist who helps millions calm their anxiety and be their authentic selves. She serves on the faculty at Boston University’s Center for Anxiety and Related Disorders (CARD). Her scientifically-based, zero-judgment approach has been featured in The New York Times, The Washington Post, BBC News,  New York Magazine, The Guardian, Harvard Business Review, Scientific American, O: The Oprah Magazine, Real Simple, Business Insider, Psychology Today, Quiet Revolution, and many other media outlets.

During Ellen’s tenure as founding host of the award-winning podcast, Savvy Psychologist, the podcast was downloaded 15 million times, rose as high as #3 on the overall iTunes charts, and was picked as a Best New Podcast on iTunes.

Ellen lives in the Boston area with her family.

Want More How To Be Yourself?

Find Ellen on her website, Instagram, LinkedIn, and Twitter.