Anxiety · Recovery · Therapy

Exposed: facing anxiety head on

Yesterday I popped into work with momma to buy a few bits. At the tills I got chatting to one of my colleagues, and when we left, mum asked if it had gotten easier for me to do stuff like that- small talk, social stuff.

I am diagnosed with generalised anxiety, my new consultant explaining I experience facets of several anxiety disorders. Over the past 10 months or so, I have made huge progress with the social aspect, for 2 reasons:

  1. An anxiety medication called buspirone, which I was prescribed last March, and helped take the edge off
  2. Exposure to things that make me anxious, possible because the edge had been taken off

Last September, I started working for one of the UK’s biggest retailers, which invariably meant meeting 110+ new work colleagues and dealing with thousands of customers a week. This was the exposure bit. As part of our training, we had to work all the ‘stations’- tills, fitting rooms, shop floor…and the customer service desk. I was dreading the desk. The desk meant interacting with sometimes irate customers, making tannoy announcements, and making and answering phonecalls. All of which sounded thoroughly anxiety inducing. The service desk proved to be the ultimate ‘exposure therapy’.

Exposure therapy is a type of therapy directed at helping people control their fears through exposure to the things that make them anxious, usually in a safe environment. Exposure therapy can be graded (or gradual), where ‘smaller’ fears are tackled before moving on to ‘bigger’ fears, or flooded, with the biggest fear being addressed first. With anxiety, people tend to avoid the things or situations that they fear, and while this helps alleviate the anxiety in the short term, long term it exacerbates the fear. So you might need to make an important phonecall, and feel anxious about doing so, so you put it off. And temporarily that works- you don’t have to make the phonecall. But hours or days or weeks might pass and you still need to make the important phonecall, but by putting it off, you create more anxiety around it, build it up to be a hugely scary task and it becomes more and more difficult to do it.

So working for one of the biggest retailers in the UK has been damn good exposure- I couldn’t continue avoiding the things I feared. On the service desk, I was forced to speak to customers. I was forced to be assertive if someone was being difficult. I was forced to speak over the tannoy, for the whole shop to hear. I was forced to answer the phone. And I was forced to make phonecalls. Phonecalls were something I struggled with- like, really struggled with. Mum was pretty much the only person whose calls I would- could- answer. If my best friends rang, I’d wait til it went to voicemail, then text them to see what they wanted. Unknown or unrecognised numbers were a complete no. For years, mum had to make my doctors appointments, call CAMHS or the CMHT or the dentist or school or extended relatives or the pharmacy or whoever else. On the rare occasions I did make phonecalls, it would require days of preparation and psyching myself up. One time, after several days of working up the courage to do so, I managed to ring the CMHT, only for the line to drop halfway through the conversation. Mortified, embarrassed, broke, I cried for 45 minutes. I made my mum ring back afterwards.

So I remember that first time I had to make a phonecall at work. I shook. I panicked. I squeaked to my supervisor that I couldn’t do it, that I was really scared. Secretly, I was hoping she’d snatch the phone off me in frustration and do it for me, save me from dithering there in front of her while the customer stood waiting. She told me I would be ok, to take a deep breath. So I swallowed the fear and did it. Because I had to. Because my supervisor was standing next to me expecting me to, and because there was a customer standing waiting for me to find out a price for her. 

Every day at work is exposure. Every day at work I have to do things that make me feel uncomfortable. Some days I still have panic attacks at the tills, or have to leave the shop floor to take something to calm down. On bad days I won’t be able to talk to customers at the tills, my heart will sink when the phone rings, and weaving in and out of prams and people gathered in the aisles will make my heart thump and I’ll start to sweat and tears will prick my eyes. But on the good days, I can laugh and joke as I serve people, make phonecalls with relative ease, deal with irate customers and everyone says I make the best tannoy announcements. The service desk is my favourite station to work.

First line treatment for anxiety disorders is often CBT (cognitive behavioural therapy), which aims to change the way you think, and therefore behave and feel. Last year, my CPN worked through a series of anxiety booklets with me, which had similar aims- recognising ‘hot thoughts’ and learning about the different types of thinking patterns associated with anxiety. And it was helpful, in that it made me aware of when I was being irrational, but being aware didn’t stop me from being irrational. Exposing myself to my fears, making phonecalls and smalltalk with strangers and working in a crowded, busy, messy store- facing some of my fears, has made them less scary. Made me realise there is little to be scared about. Sure, exposure is uncomfortable. Sure, every day I breathe a sigh of relief when I clock out because I don’t have to deal with situations that make me feel horrible. But if I wasn’t exposing myself to things, if I wasn’t challenging my anxiety, where would I be?

I spent my final year of university shackled in my room. I was too afraid to go out and make a cup of tea, or make dinner when I was hungry or go to the bathroom when I needed to because my flatmates were around. In class, I sat in the corner, next to the door, or at the edge of the row in lecture theatres. I didn’t go to the society meetings I wanted to, or to events on campus. I had panic attacks on public transport, would arrive at the bus station in tears after pushing my way through the busy city centre. Scared of people, scared of being raped, mugged, attacked on my way through the streets. I start to drive to uni. I don’t go into the city for weeks at a time. I move from my car to my apartment to class and back again. Head down, eyes fixed to the floor. I live a life constrained by anxiety.

It seems cruel, is very much uncomfortable and painful and distressing, and while there is an element of ‘just getting on with it’ involved, I still think it’s a viable approach. I’ve never had ‘formal’ exposure therapy- in fact, bar the odd trip out with the OT during my first admission, I don’t think I’ve ever done it with a professional, but exposure has always been something encouraged by the professionals I’ve worked with (CAMHS therapists would set me small ‘challenges’ like going swimming or meeting up with a friend between sessions, for example). So despite never having formal exposure therapy, I’ve still found it to be the most helpful thing I’ve done to treat my anxiety.

Anxiety as a whole is still very much an issue for me, but I am trying not to let it have the same hold over me. I am trying every day to ‘expose’ myself to the things that scare me, to do things that I wouldn’t have dared do even a year ago- some days it is easier to do than others. Some days, I can’t manage to challenge myself at all- and that’s ok. But bit by bit, day by day, things are getting easier. I am facing anxiety head on, and I am winning.

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