“Police!” The African American shouted at the train station in Richmond, California. The gang ran away, much to my relief. My legs were aching as I tried to walk up the stairs out of the train station with all my luggage. Many people have warned me that running marathons relatively untrained is a life-threatening event. But I am convinced my life was a lot more threatened by finding myself in one of the most violent cities in America, I was alone and unable to walk properly after running 42.2km that morning as a part of the California International Marathon.

I ended up there because the day before I flew in from Canada, and realized upon landing in the United States that I had left my driver’s license at home, making the rented car that was waiting for me utterly useless. The 2-day trip traveling for the marathon was an epic failure from A-Z so I decided to write this piece in order contrast the reality of what life is like vs. what we post on our Facebook or other social media about our lives. Here is my post from the trip:

Perfectly good relationships get often strained due to social media. Keeping up with the “Likes” and “Loves” becomes a chore, like doing our laundry, so we aren’t always responsive on friends birthdays anymore. Also, people that know us get annoyed that we often unknowingly post a glossy version of ourselves. It’s the nature of posting. Even though we spend 90% of our time working and parenting, we usually feel more of an urge to post in the 10% when we are traveling, skydiving or having a wonderful time in our relationships! Therefore, I thought this trip was a perfect contrast to what actually happened on my trip to Sacramento, California from Vancouver, Canada when I found myself here in the most violent city in the US, where kids get paid for not killing each other!

After the marathon, I rushed to the hotel to get my stuff and started fantasizing in my mind the food options the train station might have on my way. When I arrived there, there was no food nor time, so I boarded the train from Sacramento to San Fransisco on an empty stomach. There was also no food sold on board. To add salt to my wounds, the train just stopped for no good reason on several occasion. One reason was that 3 of the world’s slowest towboats had to get through and the train tracks went vertical for the occasion. At this point, I thought the failures of the day were comical since the morning of the marathon, I hadn’t signed up for the marathon the night before as I arrived in late, and had paid for breakfast at the start line, but the bus which was supposed to deliver us to the start of the marathon didn’t show. So I made friends with 3 people at the front of the line and they allowed me to join them in their Uber. Luckily I arrived 15 minutes before the marathon, managed to speed eat some food before starting the race.

However, due to the frequent train stops, I missed my connection from Richmond, California to San Francisco International Airport. I started trying to call an UBER after the gang members had left the station because of a police raid. At this moment the mobile data on my phone stopped working. I am standing there with aching legs, no ride to the airport, and the police had gone away. The gangsters started to approach the station again and I was trying to focus on solutions rather than cry and I concluded that my well-being was better served by accepting a shady cab driver offer to take me to the airport for an $80 cash deal (The Uber would have been $40).

“Cash only,” says the driver, whose car he referred to as taxi, despite not having any picture of any license or anything else that I expected in a taxi. I struggle to get into his dirty car as my legs are screaming at me to give them a break. I tell him I will take out cash at the airport. He informs me of the peculiar fact that there are “no ATMs at the airport” in broken English. I try to argue without any luck. He then wastes a precious 10 minutes driving into a shady part of town to get me to withdraw cash.  And he says “you will be at the airport in time”. This statement was truth because after I got the cash, he started speed-driving to San Francisco International Airport. In the seat-belt free backseat I tried to use the United App to check in as my mobile data started working again. The first message I got is that I need to pay a cancellation fee for that UBER driver that had apparently been ordered before my internet connection was lost, and secondly that the app refuses to check me in, but I try at least 8 times, without any luck. I know I need to be at the airport 60 minutes before my departure. Instead of reflecting on how my life was in the hands of this stranger, I decided to focus on the beautiful pink sunset in San Francisco Bay to calm my mind. I don’t know if it was the adrenaline, but it was an incredibly beautiful sunset that day.

The cab driver never intended to stick to our $80 dollar deal and started screaming at me that he had to pay a toll and requested $120 dollars from me when we arrived at the airport. With my surroundings having changed, now we did have airport security and other passengers around rather than some violent gangsters in Richmond. Empowered with my fight or flight response, I tell him (probably rather loudly), a deal is deal and repeated that I only had $80 dollars, as he continued to shout back, I simply walked away with a sense of relief, that I had made it to the airport before the check-in closed.

Despite the traffic jam, and my argument over locations of ATMs, and haggling over how much he was going to overcharge me, I make it in time to the airport on time. I limp over to the United Airlines counter, and the lady asks me for my passport. “You are not on this flight.” the ticket officer says confidently. I felt my heart pumping a bit harder. She continued that it looks like my ticket is a standby ticket and this flight is fully booked. My mind drifted to the incident that became infamous when a United Airlines staff violently forced a passenger out of his seat. “Here is my reservation,” I said. “ And I am DEFINITELY on this flight.” She probably sensed that I was going to cause a fuss, so she kept trying to make it work and had to make at least 3 trips to the back where they try to sort out the situation. After about half an hour of back and forth, she finally has a boarding pass for me.

After this difficult situation, I was exhausted, and went straight to work the next day and got sucked into everyday business. It took weeks for me to tell friends and family in person how this trip went. Life is busy. But I thought this story was the perfect example of the illusion we live every day with FB. The bottom line. I ran another marathon according to Facebook! The rest is the real world, and when you struggle with mental health issues and social anxiety, the comparison to other people’s lives is even a larger illusion.

Fjola  Helgadottir, PhD, MClinPsych, Postgrad Dip, BA is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety. Twitter: @drfjola  is a fully registered clinical psychologist who is running Dr. Fjóla & Kompaní in Iceland and Dr. Fjola Helgadottir Psychology Corp. (R.Psych) in Canada, who has previously worked as a clinical psychologist in Australia and at the University of Oxford in the UK. She has completed 6 marathons and visited 84 countries in the world.

 

You may have noticed that things have been a little quiet on this site lately. That’s because we’ve been very busy collaborating with the University of British Columbia running a Randomized Control Trial. Our work has just been published by the Journal of Medical Internet Research (Impact factor 5.1). It is open access, so you can check it out here:

This is a pretty big deal since the trial shows that AI-Therapy’s Overcome Social Anxiety has approximately triple the mean effect size of 6 stand-alone, internet-based CBT treatments for anxiety and depression (Cohen d=0.24) found in a meta-analysis!

Another amazing was that comparing AI-Therapy’s Overcome Social Anxiety to 19 therapist assisted computerized intervention, was that AI-Therapy showed comparable results. In other words, even though therapist support appears to contribute substantially to the effectiveness of computer-delivered CBT for anxiety, our findings indicated that Overcome Social Anxiety is comparably effective to therapist-assisted interventions when delivered as a stand-alone treatment.

We have known for a long time that AI-Therapy is highly effective, since the program administers pre-post data for its users. But this trial adds to its credibility, since independent researchers at the University of British Columbia tested the program in a randomized control trial. We have lots more in the works for 2018, so please keep an eye on the site! Also visit our Publication page for more information!

 

fdh2Fjola  Helgadottir, PhD is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety. Twitter: @drfjola. Dr. Helgadottir has worked as a clinical psychologist in Sydney, Australia, Oxford, England and Vancouver, Canada. She will be opening up a new service in Iceland in 2018.

Last week was an interesting one, to say the least. It seems like there was non-stop stories about the havoc in the White House. One story didn’t get as much attention as the others (for obvious reasons), but it caught my eye because it made me think about cognitive behavior theory (CBT). I’m talking about Trump’s theory that the body works like a battery. He believes that people have a fixed amount of energy for their whole life, so we should avoid exercise and not overexert ourselves. To back up his theory, he points to all of his friends who exercise and need to get hip replacements and other medical procedures. Trump believes this theory, and he “feels” it is correct. Therefore, he decides to not exercise himself.

What does this have to do with CBT?

Post-event rumination is a central feature of social anxiety. This means that after a social event someone with social anxiety analyzes the interactions in detail to try figure out if they have done or said anything wrong. The problem with this approach is confirmation bias. If we try to uncover evidence for our “social errors” we will find it. This is not because something bad happened. Often we “feel” like we have said or done something that has upset someone. However, just because we feel or BELIEVE we have done this, it isn’t necessarily true. We are looking for supporting evidence after the fact, just like Trump and his exercise theory.

Evidence, evidence, evidence

What can we do to help make better decisions in life? One of the key ideas behind CBT is to become an evidence based thinker. For the exercise theory, a single google search would find scientific articles contradicting the theory. We don’t need to understand the importance of peer reviewed science to understand the many compelling arguments for cardio exercise, such as longevity, mental health etc. In some situations like this we need to trust our gut instincts less, and our brains more.

The same idea applies to looking at post-event rumination. Rumination can become a habit. One may believe it is a useful strategy to make sure they didn’t “slip up” in a given situation. However, this is not productive, and we need to work out a way to limit the time spent ruminating after social situations. We have to understand that most of the time we simply have no idea what another person is thinking. In other words, when we feel they are thinking poorly of us, this is usually without any direct evidence.  It is just a product of our own minds, and is best ignored, just like Trumps theory on exercise!

 

fdh2Fjola  Helgadottir, PhD is a registered psychologist at the Vancouver CBT Centre, who has previously worked in Australia and at the University of Oxford in the United Kingdom. She is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety. Twitter: @drfjola

The Journal of Abnormal Psychology has just published an interesting study that addresses this very question. The researchers asked people with social anxiety to rate themselves at how good they think they are at being friends. Not surprisingly, most people with social anxiety didn’t rate themselves very highly. However, the study went further and asked people from their social circle to rate the subject’s “performance” as a friend. The result confirmed what psychologist have suspected for a long time: the friends liked them a lot more than those with social anxiety believed.

Woman Looking At Self Reflection In Mirror
People with social anxiety often have a negatively distorted self-image.

Psychologists know that the way people with social anxiety see themselves does not always reflect reality. In particular, they see themselves through the eyes of others in a highly negative way. This is a complex phenomena, but for many learning to correct these biases can lead to a major improvement of life.

This phenomenon is addressed in Part 6 our Overcome Social Anxiety program. Since a distorted self-image is the creation of the mind, it can be modified and replaced with a more positive and accurate representation. This is an important step towards curing social phobia!

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who has worked in Australia and at the University of Oxford in the United Kingdom. She is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety program and the creator of Overcome Fertility Stress. Twitter: @drfjola

Stop mental health stigma, and start seeking help
Stop mental health stigma, and start seeking help

A recent study has shown that living with an untreated mental illness lowers life expectancy. Therefore, not only do suffers get less enjoyment from their day to day life, but their lives are shorter. Why is it that people continue to suffer in silence?

Perhaps the main reason that people do not seek treatment is the stigma surrounding mental health. Sadly, this is widespread in today’s society, and there are several reasons for it. For example, we’ve all seen movies where someone commits a horrific crime, and the text at the end tells us that the person is now seeking therapy. This creates an association between anti-social behavior and therapy. This is outrageous, as the vast majority of people who seek therapy are normal, kind and caring people. Some people are genetically predisposed to having mental health problems, while others struggle with negative life experiences. In both cases, seeking help can be a life changing experience, and in neither case should it be something to be ashamed of.

I think it is time to start thinking about mental health problems in the same way as medical problems. If you had a friend or family member who was physically unwell, telling them that “you need help” would be kind and supportive advice. Why doesn’t the same hold for encouraging someone to see a psychologist?

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

A lot has been written about the use of smartphones in social situations – it is the pet peeve of many. People often find it irritating to have a conversation (or eat a meal, watch a film, etc.) with someone who is constantly tapping away at their phone. In this blog I will look at the issue from a slightly different perspective. For those with social anxiety, smartphone use may actually be maintaining their problem.

AI therapy Woman With Smart PhoneA safety behavior is an action taken to manage one’s anxiety by exerting (perceived) control over a social situation. It is a behavior or action that is taken in order to prevent the core fear – being negatively judged by other people. Checking your smartphone is a perfect example that seems to be becoming increasingly common. People may do it to avoid something they fear: uncomfortable conversations, meeting new people, awkward silences, etc. In many cases they are worried that they won’t be able to “perform” in the social situation. In other cases, they may want to look important by being online and connected 24/7.

The problem with safety behaviors is that they tend to make the problem worse. On one hand, since it is an avoidance behavior, anxiety is maintained since it is never challenged. Sometimes uncomfortable conversations turn into interesting ones, sometimes awkward silences are followed by deep and meaningful comments, and sometimes when you meet new people you find a friend for life. Being on a smartphone can take away these opportunities. Also, if the social situation goes well despite being on a smartphone, one might wrongly attribute the positive outcome to the smartphone!

To illustrate another point, consider the following scenario:

Alice goes to a party where she doesn’t know many people. She is very anxious, and is worried that the other people at the party will not like her. She spends a lot of time sending text messages, as she hopes this will demonstrate that she is a social person with a wide group of friends.  The other people at the party make no effort to engage with Alice, as it looks to them like she has no interest in being there.

As you can see, the safety behavior (checking the phone) is the very reason why people are judging Alice negatively.

I should note that not all smartphone use in social situations is a safety behavior, as it depends on the reason why people are using their phone. There are many other reasons why someone may use their phone, such as bad habit or addiction (I will save that for another blog).

Our social anxiety treatment program can help you identify and challenge maladaptive safety behaviors. I encourage you to think about your actions, and try turning your smartphone off next time you are at a party. Not only are you less likely to be perceived as uninterested in the social situation, I guarantee you will have a richer experience, and you are a lot more likely to make a good impression on other people!

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

It seems like every time I open Facebook or LinkedIn I see some tips from celebrities or entrepreneurs how to be more confident or successful. In reality, a little talent, a lot of hard work, and some lucky breaks are the key ingredients to success. Yet, successful people have a tendency to attribute their trajectories to a handful of tricks people “must do” in order to succeed. Unfortunately, these tips aren’t always as helpful as they seem. In fact, they can even lead to safety behaviorsIf social anxiety is a problem for you, it is important to learn about the role of safety behaviors, and see if you are using them to “play it safe” socially.

This blog post is the first in a series where I will give some common tips, and explain why they are actually counterproductive.

Tip 1. Pretend to be interested in other people

The self-improvement writer Dale Carnegie recommends that people pretend to be interested in what others are saying during conversation. While this may sound reasonable when we are trying to impress someone, it can actually backfire. First, the other person might sense a lack of genuine interest in the topic, and find it uncomfortable that the listener is pretending to be interested. Second, if the social interaction results in a positive response, the pretender is likely to attribute the success to their pretense of being interested, not that they were liked for who they are. Third, this sort of behavior can maintain unhelpful thoughts people have about themselves, such as “I’m so plain and boring”. Every social interaction is an opportunity for people to disconfirm these types of unhelpful thoughts. However, every time safety behaviors are used, an opportunity is missed.

Tip 2. Read over your emails at least 5 times

Many of us overemphasize the importance of wording in our emails. Whilst this may seem reasonable, it simply isn’t always helpful. In fact, some of the most successful people I have corresponded with send me emails full of spelling mistakes (probably due to auto spelling) and no formal structure. Life is too short to read emails more than a couple of times. Try sending emails without proofing them: it’s difficult at first, but then it becomes liberating. It becomes easier to respond from your phone or tablet, and can save you from thinking about the emails when you are doing something else!

smart_phone_message_10549

In other news, I just had a peer reviewed paper on safety behaviors accepted in the Journal of Speech, Language and Hearing Research. Once it is in press, I will blog about this as well!

 

Fjola

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety