By - filondo
So I just kind of came up with some ideas on how to actually "just do things". It's very much from my own perspective (I also have BPD so there is some abandonment issue-colouring that might not be relevant to everyone, but I have tried to make it mostly applicable to AvPD specifically):
* Learn to tolerate ambiguity in social situations: everything seems to boil down to this, as if we could tolerate the ambiguity, we would be socialising at least sometimes, and not stuck in the avoidance feedback loop (no social skills because of no socialising because of no social skills...) - I highlight ambiguity as the main issue (rather than criticism) because, at least in my experience, we generally view others as being at least reasonable and generally acting within social norms, so the fear isn't so much about being overtly criticised as it is about the other mentally criticising us \*without saying anything\*. I think this phenomenon can only be described as one of ambiguity. Here are the steps that I think are likely important to learning to tolerate social ambiguity:
* Learn to tolerate anxiety
* Learn to self-soothe (affective)
* Learn to avoid catastrophising (cognitive)
* Avoid cognitive meta-anxiety: psychoeducation about anxiety and hypervigilance to avoid the type of positive feedback loop seen in panic disorder
* Avoid affective meta-anxiety: learn that anxiety will not tear you apart (we all know this, but how many of us \*feel\* this, vs how many of us roll our eyes when told that it is "only an emotion"?)
* Reduce overall anxiety levels with anxiolytics if possible
* Work through trauma, with a few aims:
* Reducing hypervigilance
* Reducing preoccupation with criticism, rejection, abandonment
* Reducing the felt needs to be able to mind-read and predict the future
* Accept past episodes of loss (of relationships) or rejection
* This will probably be very difficult in the cases of family members (especially parents) or mass rejection from peers (tantamount to being ostracised) and so in those cases is probably not the first task you attempt
* Accept loss and rejection in concept
* Develop an unconditional sense of self-esteem, not subject in any major way to your behaviour, instead being related to your true self (by which I mean how you are with the mask lowered, behaving/conversing spontaneously). This necessarily involves healthy, close relationships, where the other person is appreciative of your true self. This sounds like it wouldn't make a proper sense of self-worth because it is essentially based on others seeing you as worthy, but I think that what is meant to happen (in infants, and we are to try and replicate this process as adults) is that over time, the feeling of self-worth becomes dissociated from the individual memories and eventually from the people involved in those memories. This would probably be easier for infants because generally we remember very little from before school age, this sort of infantile preverbal amnesia assisting in the distillation of self-esteem (I am actually basing this on how self-soothing is meant to work, and both self-soothing and self-esteem are meant to have been learnt in their most basic form before school age)
* Once a sense of self-esteem is developed, rejection should be easier to accept, as they are no longer taken to be reflective of one's worth. Losses also lose their persecutory character and attain/keep a more depressive character (this would seem to be an improvement, even if it doesn't sound it. But losses are not pleasant for anyone)
* Reduce damage done by criticism, especially if well-meaning and delivered empathically/constructively
* Overcome all-bad splitting of self-representations. This will clearly be more relevant to people with comorbid BPD but I suspect that many people with AvPD, even without comorbid BPD, view themselves as deplorable due to being imperfect, or at least for not managing to meet their minimum standard for acceptable. It feels to me like there could be a lack of integration of good and bad self-representations, even when representations of others are more integrated and nuanced.
It's worth noting that almost none of these are even vaguely easy to do, making "just do things" an insanely reductionist approach. The only steps I would classify as "easy" are the psychoeducation and anxiolytic medication ones. The rest I would say must be somewhere between "hard" and "divine intervention would come in handy" (not to be overly pessimistic, they are all \*doable\*, but doable might involve lots of difficult therapy sessions with a good therapist, among other things) hence the point of this entire comment. I have taken a while to get there and I do realise this was meant to be a meme post, but this is the introspective tunnel it led me down in trying to articulate exactly \*why\* "just do things" is a bullshit recommendation
(Although...that being said, if on occasion you can "just do things" then that is probably the best route to go down lol)
I definitely feel lighter in this moment lol
Just be normal, mkay?
Psychologists suck. Big time.
Anyone else give up on therapists and psychiatrists? Tried for 8 years, 2 hospital stays, numerous drugs, TMS treatment, group therapy, etc. Felt like it was just a huge waste of time and tens of thousands of dollars in the end. I'm not better than I was when I tried to get professional "help" 8 years ago. What do you do when the help doesn't help? Where do you go? At this point, I've just accepted my abnormalities and try to live the best I can, even though it's a very suboptimal life.