One of the realities that fat persons might have to accept is that the nature of their childhood may
have permanently affected the structure of their brain and its workings. A lifetime of low grade
depression, originally triggered in childhood by excessive shame, stress and fear, may be
permanently set into the way that the brain itself functions. This problem requires a specific
strategy for adjustment and healing. It will entail more than just the dogged and persistent
changes to personality that are required for the healing of the usual personality problems. It
means dealing with the fact that the brain has set itself into a lifetime pattern of producing
low-grade sadness--a loss of energy for living, that reduces the capacity for personal vitality,
resilience, adaptability, pleasure in new experience, and simple joy for living. Reduces. Not
destroys.
There is some scientific knowledge now that excessive stress during childhood alters the way the
brain works, not only how the brain chemicals work, but the way that memory is processed and
thinking occurs.
This is one reason that the concept of Classical Conditioning is so important to people like me.
Just like Pavlov's dog, the brain is "conditioned" to respond in certain ways to certain stimuli.
Therefore the mere presence of certain life situations causes feelings of depression or anxiety.
This conditioned brain, unfortunately, does not need the presence of some specific wrong-doing or
abuse to cause the neverending spate of sadness that we call dysthymia.
The remedy to conditioned anxiety and depression is closely related to Albert Ellis' principles of
Rational Emotive Therapy, and to Aaron Beck's use of Cognitive Therapy.
If we look closely at the childhood of a person like me, we will see that a sad, dysthymic persona
was demanded, required and enforced by the parents. One time, as a therapist, working with a
sixty-year-old woman who was having trouble dealing with constant feelings of sadness, I asked
her the question: "What would your parents have done if you had acted happy?"
This is an important insight. Happy children talk, run, have activities other than those that are
carefully planned and governed by their parents. They forget to follow rules, sometimes they even
disobey out of carelessness. They are, to the selfish parent, a nuisance. Even I have
experienced the wish for peace and calm: one time I joked with a client that I had considered
giving medication to a hyperactive pet, so that I could have some rest!
In my case, my brother and I were taught to "be seen and not heard". If the reader wonders why I
remember so much about my childhood, or how I observed so much about what was going on
around me, it is most likely because I was sitting still, with nothing to do except to observe and
process all their "stuff".
In my family the rules were arbitrarily set, that is, without reference to "golden-rule-based morality",
and they were enforced strictly, without exception (the advantage to this error in parenting was that
the learning was not on a "Partial Reinforcement Schedule", so that an individual like myself could
in fact extinguish the learning over time if willing to work hard and long enough on the task). The
rules were there for the convenience of both of my parents, not just my father. It was the one arena
in which they were totally and continuously united. The rules were for the children, and did not
extend equally to the parents. Thus the parents could deny all forms of self-expression to their
children, while themselves quarreling with each other, telling lies, and belittling their children.
The rules were also based on concern about "what other people think." Well-behaved children
proved the value of the parents. So, for instance, there was a rule that Neil and I walked down the
street in front of my parents, with the males on the outside near the sidewalk, such that there was
a foursome moving down the street as a perfectly square block of four people. There was nothing
intrinsically wrong with this orderly process, as unusual as it was, if it had been part of a greater
code of morality that included a clear statement of how doing this was a benefit to others on the
street, and thus to others in the community. But it was not for the reasons of empathy for others. It
was in order to keep tight control of the children at all times, and to look good to townspeople who
might see us together and be amazed at our discipline.
To this end, my father was good at "snapping his fingers". So that if company was present, he
could snap his fingers and both of his children would get up silently and go to bed.
Both my brother and I had a tendency to reflexively duck our heads if another person moved their
arms. This behavior did not finally extinguish for me until I was past forty years old. It shows how
often as a child a corrective slap to the side of the head was administered.
Then, of course, there was the crushing of skulls together, if Neil and I were making conversational
sounds that were disagreeable to him. We know now that blows to the head during childhood are
a possible cause of Altzeimer's Disease, and this damage is not one that can be controlled by
Behavior Therapy! Any child knows instinctively that he/she is being injured by such punishments.
The constant work that was required of my brother and me as children was not brain-injuring. It
could possibly have increased our competency if it had been otherwise administered. But it was
accompanied always (back to classical conditioning) by criticism, derision and punishment for any
infraction of perfection or speed of delivery. This produced two children who were slow and
anxious, who lacked both spontaneity and the ability to simultaneously socialize while performing
tasks. This made us odd, overly-concerned with detail, slow, and rather obsessive about method.
It did not help us succeed in the workplace. The reader can notice the many references to my
work history being difficult because I was slow at all tasks during my youth and early adulthood.
The degradation was experienced during every imaginable event of childhood. So the pain and
depression and anxiety were relentless and ever-present. Thus two children entered their school
experiences and their later work experiences with negative emotional and mental attachments to
every conceivable situation.
How does one overcome such an obstacle to fulfilling one's God-given abilities, talents and hopes
for the future?
One thing is known about depression that is attached to specific situations. Get out of that
situation. Find situations that do not remind oneself of the painful responses from parents in the
past.
In new situations, one can develop new responses, and new brain activity for the future. Eventually
some of this new learning may be extended to the original parents and home situation. But maybe
not, if the parent is determined to continue the same behavior and attitudes that caused the
original harm. In that case, the child will have to separate from the parent, not just emotionally, but
even more important, environmentally. Because the abused child has become "conditioned" by
thousands of environmental stimuli to feel anxious and depressed.
Such it was my good luck to marry a Texan, who moved me far away from the Pacific Northwest,
where my personality could begin to take its own natural direction. The open skies, with clouds
and sunshine, did not produce that same depression, as the wonderful, salty air of the Pacific
Coast. The decent, orderly, courteous people who frequented Texas required a different response
than did the curt, fiercely independent locals that were attracted to the protection of the Pacific
Northwest forests and mountains. As much as I loved the beauty of the Pacific Northwest, my
brain responds with almost instant low-grade depression the minute that I enter it. This is not a
matter of human will. It is a matter of conditioning.
Regarding anxiety, there is nothing more important to a person like me than simply accepting that
it is ever-present, and to live one's life in it's presence without fear, anger or regret. I was able to
speak about this by the time I was in graduate school when I was about thirty-seven years old. I
had learned to accept the presence of anxiety: feelings that I might throw up or cry, inability to think,
a desperate desire to leave the room, or worst of all, fear of the dreaded childhood "spells" that I
had experienced every year of my youth beginning at age eleven. During these experiences I could
not use language normally, and would eventually experience a severe headache and nausea. I
would be unable to continue with my school activities, would return home, and rest in the dark for
the rest of the day. In my adulthood, when I began to have difficulties with vision, or even when
overhead lighting seemed to bother me, I would immediately take aspirin, drink coffee, lie down in
the dark, until the symptoms passed. When I was 36 years old, a brain specialist told me that my
symptoms indicated that I had gradually learned how to overcome migraine headaches.
But during my childhood these experiences were a nightmare of loss of control of the workings of
my brain and body. They made me feel very helpless and unable to control my own mind and
choices. The anxiety that I lived with is probably very similar to what is experienced by people who
live with asthma, diabetes or epilepsy. Like them, my coping solution had to involve being watchful
for symptoms, and taking immediate actions for remedy of both situation and symptom.
These problems of anxiety made me constantly vulnerable in social situations. Accepting the
reality of anxiety, that is, the presence of unpleasant body sensations during social situations, was
the only way that I could work in my favorite church activities, or attend school. I knew from my
studies in my first year of college, when I first learned about Classical Conditioning, that my brain
had been conditioned to create anxiety any time that I was doing something new, something
without my mother's presence, involvement or blessing.
By now I can realize that the mere presence of anxiety is a signal that I am doing something that I
want to do. It is the price I pay for my independence and personal development. And so now, I
have learned to see anxiety as a painful, but reliable, indicator that I am on the right track, moving
towards personal growth and fulfillment..
Thus, by the time that I was thirty-four I had decided that I would no longer allow anxiety to prevent
me from things I wanted to do. That had included driving and attending Sunday School Classes,
where I would talk and share ideas, then cope with anxiety about it later.
Anxiety can also prevent situations from becoming more disastrous than they already are. During
my stressful visit with my mother in Oregon, depression mounted to an unbearable level for me,
triggered by the constant talk about the past, along with my mother's ever-present domineering
and critical personal style. As anger mounted, there was the real possibility that I might say things
that could never be unsaid, and that would do more damage than was useful or good. Anxiety shut
me down in a bout of crying that prevented an excessive explosion of hostility.
During that event, I was able to state clearly, "Stop arguing with me, stop criticizing me, stop putting
me down. I have just as much right to express my opinions as you do." Those were appropriate
statements for my life and my recovery. But without the anxiety, I might have said things that were
much more intense and aggressive.
So I have this saying, "Fear is your friend." I accept that the anxiety common to the dysthymic brain
is basically unsolvable. It will not go away by any action, except for those that are unacceptable in
terms of morality or good health, such as substance abuse or other addictive behaviors.
Therefore, I choose to accept it and to make the most of it. I find good uses for it.
For instance, if I feel anxiety about some event, then I must ask myself if I should have evaluated
the situation better, and perhaps should have said "No" to activities that were either intrusive or
beyond my interests and abilities. In other words, I made faulty agreements that were not in my
own best interest. Therefore the anxiety informs me that I still need to learn to be more honest,
authentic and responsible for myself and my own choices.
This is not to say that there is not a myriad of methods for minimizing the painful effects of anxiety
at the moment of its occurrence. Skills can be learned that range from deep breathing, to learned
palliative thoughts, to friendly and soothing mental images that can help alleviate the immediate
threat that one might develop feelings of panic that would most certainly require withdrawal from
the situation. In other words, a chronic tendency to anxiety does not have to end up as Panic
Disorder, if its owner decides to accepts its uncomfortable gifts and use it well. There are many
useful books for people like me on the subject of managing anxiety.
The problem with social withdrawal is similar. There is a personality disorder named the
"Avoidant Personality Disorder".15 This disorder begins to develop in early childhood, and is
characterized by fear of being around anyone other than the parent figures who originally caused
the social fear! I wonder if it does not begin in childhood as a form of separation anxiety. The
person who has an avoidant disorder can become very competent at tasks, so long as they do not
involve socializing with others. Recent research indicates the possiblity that this disorder
ameliorates in intensity with age, as the person slowly, but surely, learns that with effort they can
learn to enjoy social situations.
It is also important to note this about disorders. A personality disorder is a part of the personality, it
is not the whole. A disorder is a combination of thoughts, feelings and actions that always occur in
response to a certain type of event. It is learned behavior, developed during childhood, when the
child's options for constructive problem-solving were limited. A person can change his disorder by
either adding or subtracting something from his usual response to that triggering event.
Sometimes we see a person who appears not to have any disorder. It is only in specific situations
that we notice behavior that makes no sense in terms of effectiveness or success, in other words,
that simply does not work in the real world.
To those of us with this problem with "avoidance", the times that workers gather around the
coffeemaker for conversation and gossip are a source of real misery for us, an event that we will
avoid until our coworkers believe that we do not like contact with them, because we are snobs,
because we think we are better than them! At the very least, we definitely are not "cool". This was
a problem that plagued every one of my adulthood jobs. I could not socialize on the job. It was
anathema to me. And I paid a huge price in terms of job success for this personal and social
limitation. Furthermore, to be by nature an extrovert, who simultaneously avoids people, is to add a
lot of confusion to working relationships! How can anyone hope to understand such a person?
In earlier years I had satisfied needs for social contact by organizing small groups. The work kept
me busy, the social interaction was a part of my task, and I did nothing that was not effective in
building group. Doing this contradicted the disorder, as is necessary for all healing, and enabled
me to learn better skills.
Later, this same ability would be used as a therapist. Because my social skills are carefully
governed to assist my clients, they would never imagine that I have very great difficulty managing
any kind of social event.
As with the problem of anxiety, the person like me must learn to deal with it through the use of
careful strategy. One can see from the readings in Section II that I developed skills at music, as
well as involvement in organizational and educational settings that would increase my skills, and
increase a reliable and predictable was to interact socially with people. This is enough to have a
useful and happy life, whether or not the "avoidance" is ever fully defeated.
As with anxiety, avoidance and caution can be useful. A good eye for dangerous people is useful, if
one does not become excessively fearful, angry or otherwise mobilized by this observation.
Paranoid thinking, that is "motivational thinking" or "mind-reading" must be avoided at all costs,
because it will both paralyze the person, while creating dysfunctional responses as well. One
must learn, with Sargeant Joe Friday, of Dragnet, to say, "Just the facts, ma'am". When one
observes the factual dynamics of a situation, one can spot abusive behavior, and thereby
consiously avoid that situation or person. Excessive fear or defense is not necessary.
Meanwhile, the effective treatment for avoidance involves trying to become aware of the many false
assumptions that people with such afflictions are prone to make. These include negative
assessments of what other people are thinking and feeling, as well as faulty beliefs that one will
not be liked by others.
In my case this problem was intensified by my mother's concern about what "people will think", as
well as my parents' frequent predictions that no one would ever like me for myself. There were
also the unrelenting criticisms by my father of everyone's behavior after every visit with my
grandfather.
This problem I eventually turned around for myself, by learning to enjoy the evaluation with others
of how group meetings or parties had unfolded. What was painful, became a useful way of
evaluating for the purpose of improvement.
The reader can imagine that a problem with social avoidance is very painful. It involves anxiety,
physiological reactions to stress, depression, self-flagellation, and loneliness. In fact, it may never
go away, because the brain was affected by it too early in life. So it must be accepted, adapted to,
and even utilized for good. Trust in God helps.
There is a passage in the book of Romans about people who are like worthless broken dishes, as
compared to others who are like the fine china that is used for meals. I could not understand that
passage until I understood that people who are like broken pottery are people who need and
receive more help from God. Because of grace, they may end up able to fulfill God's will for
themselves, and serving as inspiration to others as well.
People like me are like Barbra Streisand's, "People Who Need People." We have to learn to check
our facts, check our assumptions, soothe our felt pain, and find supportive relationships with
people who understand us. The very act of doing that begins to be the "antidote", the medicine, the
prescription for healing, of this painful mental/emotional/physiological condition.
The other part of recovery, which often again involves faith that a friendly God is helping us do a
good thing, is to take behavioral action always. This means speaking to people, asking them
questions, showing interest in them, no matter how much one believes that they will be offended if
you so much as make eye contact with them! Such is recovery. Deliberate, conscious action that
requires energy, determination and generosity towards others.
And nothing could be more important to recovery than gratitude towards others. One must notice
every kindness, every response, every sign of decency in Disorder hangs as on a thread, a thread
ready to be broken by any person who is ready to change the way they think, and the way they act.
The reader knows before I write it that many fat people deal with the terrors of social anxiety
through both the use of food and the use of fatness. Food helps calm the brain, to help the sad,
dysthymic brain produce seratonin and endorphins. But fatness just prevents recovery from
avoidance. It gives us the reality that we need to explain to ourselves why we have such a fear of
social situations. It is because we are fat, and people do not like fat people! Never mind how
many really charming and happy people are fat. To us, it gives us permission to avoid the very
social contacts that might have helped us make at least a partial recovery from avoidance.
This book from beginning to end has really been the story of my decision to remove the fat, and to
face up to the dynamics, both causes and symptoms, of my own felt inability to function socially.
It has been my effort to define my own faulty responses, but even moreso to define my own faulty
beliefs about myself in interaction with others.
The reader can see that I have come "through" a dangerous passage, and have come out on the
other side. I can now accept and deal with anxiety, the wish to avoid and withdraw, fear of
humiliation, dread of competitive people and situations, fear of other people's anger and rejection,
fear of my own anger, and, most of all, fear that I might just basically be an unlovable person. I
come through it knowing that these things are just a part of my life, and that they define and control
neither me nor the life that I live. I am useful. I am friendly. I am happy. I still dislike meanness
and dishonesty. I use my rather dysthymic brain to attend to the pain of others, even as I use my
ability to persevere in the midst of pain to help clients learn and grow and develop better skills for
building a better life. It is completed.
have permanently affected the structure of their brain and its workings. A lifetime of low grade
depression, originally triggered in childhood by excessive shame, stress and fear, may be
permanently set into the way that the brain itself functions. This problem requires a specific
strategy for adjustment and healing. It will entail more than just the dogged and persistent
changes to personality that are required for the healing of the usual personality problems. It
means dealing with the fact that the brain has set itself into a lifetime pattern of producing
low-grade sadness--a loss of energy for living, that reduces the capacity for personal vitality,
resilience, adaptability, pleasure in new experience, and simple joy for living. Reduces. Not
destroys.
There is some scientific knowledge now that excessive stress during childhood alters the way the
brain works, not only how the brain chemicals work, but the way that memory is processed and
thinking occurs.
This is one reason that the concept of Classical Conditioning is so important to people like me.
Just like Pavlov's dog, the brain is "conditioned" to respond in certain ways to certain stimuli.
Therefore the mere presence of certain life situations causes feelings of depression or anxiety.
This conditioned brain, unfortunately, does not need the presence of some specific wrong-doing or
abuse to cause the neverending spate of sadness that we call dysthymia.
The remedy to conditioned anxiety and depression is closely related to Albert Ellis' principles of
Rational Emotive Therapy, and to Aaron Beck's use of Cognitive Therapy.
If we look closely at the childhood of a person like me, we will see that a sad, dysthymic persona
was demanded, required and enforced by the parents. One time, as a therapist, working with a
sixty-year-old woman who was having trouble dealing with constant feelings of sadness, I asked
her the question: "What would your parents have done if you had acted happy?"
This is an important insight. Happy children talk, run, have activities other than those that are
carefully planned and governed by their parents. They forget to follow rules, sometimes they even
disobey out of carelessness. They are, to the selfish parent, a nuisance. Even I have
experienced the wish for peace and calm: one time I joked with a client that I had considered
giving medication to a hyperactive pet, so that I could have some rest!
In my case, my brother and I were taught to "be seen and not heard". If the reader wonders why I
remember so much about my childhood, or how I observed so much about what was going on
around me, it is most likely because I was sitting still, with nothing to do except to observe and
process all their "stuff".
In my family the rules were arbitrarily set, that is, without reference to "golden-rule-based morality",
and they were enforced strictly, without exception (the advantage to this error in parenting was that
the learning was not on a "Partial Reinforcement Schedule", so that an individual like myself could
in fact extinguish the learning over time if willing to work hard and long enough on the task). The
rules were there for the convenience of both of my parents, not just my father. It was the one arena
in which they were totally and continuously united. The rules were for the children, and did not
extend equally to the parents. Thus the parents could deny all forms of self-expression to their
children, while themselves quarreling with each other, telling lies, and belittling their children.
The rules were also based on concern about "what other people think." Well-behaved children
proved the value of the parents. So, for instance, there was a rule that Neil and I walked down the
street in front of my parents, with the males on the outside near the sidewalk, such that there was
a foursome moving down the street as a perfectly square block of four people. There was nothing
intrinsically wrong with this orderly process, as unusual as it was, if it had been part of a greater
code of morality that included a clear statement of how doing this was a benefit to others on the
street, and thus to others in the community. But it was not for the reasons of empathy for others. It
was in order to keep tight control of the children at all times, and to look good to townspeople who
might see us together and be amazed at our discipline.
To this end, my father was good at "snapping his fingers". So that if company was present, he
could snap his fingers and both of his children would get up silently and go to bed.
Both my brother and I had a tendency to reflexively duck our heads if another person moved their
arms. This behavior did not finally extinguish for me until I was past forty years old. It shows how
often as a child a corrective slap to the side of the head was administered.
Then, of course, there was the crushing of skulls together, if Neil and I were making conversational
sounds that were disagreeable to him. We know now that blows to the head during childhood are
a possible cause of Altzeimer's Disease, and this damage is not one that can be controlled by
Behavior Therapy! Any child knows instinctively that he/she is being injured by such punishments.
The constant work that was required of my brother and me as children was not brain-injuring. It
could possibly have increased our competency if it had been otherwise administered. But it was
accompanied always (back to classical conditioning) by criticism, derision and punishment for any
infraction of perfection or speed of delivery. This produced two children who were slow and
anxious, who lacked both spontaneity and the ability to simultaneously socialize while performing
tasks. This made us odd, overly-concerned with detail, slow, and rather obsessive about method.
It did not help us succeed in the workplace. The reader can notice the many references to my
work history being difficult because I was slow at all tasks during my youth and early adulthood.
The degradation was experienced during every imaginable event of childhood. So the pain and
depression and anxiety were relentless and ever-present. Thus two children entered their school
experiences and their later work experiences with negative emotional and mental attachments to
every conceivable situation.
How does one overcome such an obstacle to fulfilling one's God-given abilities, talents and hopes
for the future?
One thing is known about depression that is attached to specific situations. Get out of that
situation. Find situations that do not remind oneself of the painful responses from parents in the
past.
In new situations, one can develop new responses, and new brain activity for the future. Eventually
some of this new learning may be extended to the original parents and home situation. But maybe
not, if the parent is determined to continue the same behavior and attitudes that caused the
original harm. In that case, the child will have to separate from the parent, not just emotionally, but
even more important, environmentally. Because the abused child has become "conditioned" by
thousands of environmental stimuli to feel anxious and depressed.
Such it was my good luck to marry a Texan, who moved me far away from the Pacific Northwest,
where my personality could begin to take its own natural direction. The open skies, with clouds
and sunshine, did not produce that same depression, as the wonderful, salty air of the Pacific
Coast. The decent, orderly, courteous people who frequented Texas required a different response
than did the curt, fiercely independent locals that were attracted to the protection of the Pacific
Northwest forests and mountains. As much as I loved the beauty of the Pacific Northwest, my
brain responds with almost instant low-grade depression the minute that I enter it. This is not a
matter of human will. It is a matter of conditioning.
Regarding anxiety, there is nothing more important to a person like me than simply accepting that
it is ever-present, and to live one's life in it's presence without fear, anger or regret. I was able to
speak about this by the time I was in graduate school when I was about thirty-seven years old. I
had learned to accept the presence of anxiety: feelings that I might throw up or cry, inability to think,
a desperate desire to leave the room, or worst of all, fear of the dreaded childhood "spells" that I
had experienced every year of my youth beginning at age eleven. During these experiences I could
not use language normally, and would eventually experience a severe headache and nausea. I
would be unable to continue with my school activities, would return home, and rest in the dark for
the rest of the day. In my adulthood, when I began to have difficulties with vision, or even when
overhead lighting seemed to bother me, I would immediately take aspirin, drink coffee, lie down in
the dark, until the symptoms passed. When I was 36 years old, a brain specialist told me that my
symptoms indicated that I had gradually learned how to overcome migraine headaches.
But during my childhood these experiences were a nightmare of loss of control of the workings of
my brain and body. They made me feel very helpless and unable to control my own mind and
choices. The anxiety that I lived with is probably very similar to what is experienced by people who
live with asthma, diabetes or epilepsy. Like them, my coping solution had to involve being watchful
for symptoms, and taking immediate actions for remedy of both situation and symptom.
These problems of anxiety made me constantly vulnerable in social situations. Accepting the
reality of anxiety, that is, the presence of unpleasant body sensations during social situations, was
the only way that I could work in my favorite church activities, or attend school. I knew from my
studies in my first year of college, when I first learned about Classical Conditioning, that my brain
had been conditioned to create anxiety any time that I was doing something new, something
without my mother's presence, involvement or blessing.
By now I can realize that the mere presence of anxiety is a signal that I am doing something that I
want to do. It is the price I pay for my independence and personal development. And so now, I
have learned to see anxiety as a painful, but reliable, indicator that I am on the right track, moving
towards personal growth and fulfillment..
Thus, by the time that I was thirty-four I had decided that I would no longer allow anxiety to prevent
me from things I wanted to do. That had included driving and attending Sunday School Classes,
where I would talk and share ideas, then cope with anxiety about it later.
Anxiety can also prevent situations from becoming more disastrous than they already are. During
my stressful visit with my mother in Oregon, depression mounted to an unbearable level for me,
triggered by the constant talk about the past, along with my mother's ever-present domineering
and critical personal style. As anger mounted, there was the real possibility that I might say things
that could never be unsaid, and that would do more damage than was useful or good. Anxiety shut
me down in a bout of crying that prevented an excessive explosion of hostility.
During that event, I was able to state clearly, "Stop arguing with me, stop criticizing me, stop putting
me down. I have just as much right to express my opinions as you do." Those were appropriate
statements for my life and my recovery. But without the anxiety, I might have said things that were
much more intense and aggressive.
So I have this saying, "Fear is your friend." I accept that the anxiety common to the dysthymic brain
is basically unsolvable. It will not go away by any action, except for those that are unacceptable in
terms of morality or good health, such as substance abuse or other addictive behaviors.
Therefore, I choose to accept it and to make the most of it. I find good uses for it.
For instance, if I feel anxiety about some event, then I must ask myself if I should have evaluated
the situation better, and perhaps should have said "No" to activities that were either intrusive or
beyond my interests and abilities. In other words, I made faulty agreements that were not in my
own best interest. Therefore the anxiety informs me that I still need to learn to be more honest,
authentic and responsible for myself and my own choices.
This is not to say that there is not a myriad of methods for minimizing the painful effects of anxiety
at the moment of its occurrence. Skills can be learned that range from deep breathing, to learned
palliative thoughts, to friendly and soothing mental images that can help alleviate the immediate
threat that one might develop feelings of panic that would most certainly require withdrawal from
the situation. In other words, a chronic tendency to anxiety does not have to end up as Panic
Disorder, if its owner decides to accepts its uncomfortable gifts and use it well. There are many
useful books for people like me on the subject of managing anxiety.
The problem with social withdrawal is similar. There is a personality disorder named the
"Avoidant Personality Disorder".15 This disorder begins to develop in early childhood, and is
characterized by fear of being around anyone other than the parent figures who originally caused
the social fear! I wonder if it does not begin in childhood as a form of separation anxiety. The
person who has an avoidant disorder can become very competent at tasks, so long as they do not
involve socializing with others. Recent research indicates the possiblity that this disorder
ameliorates in intensity with age, as the person slowly, but surely, learns that with effort they can
learn to enjoy social situations.
It is also important to note this about disorders. A personality disorder is a part of the personality, it
is not the whole. A disorder is a combination of thoughts, feelings and actions that always occur in
response to a certain type of event. It is learned behavior, developed during childhood, when the
child's options for constructive problem-solving were limited. A person can change his disorder by
either adding or subtracting something from his usual response to that triggering event.
Sometimes we see a person who appears not to have any disorder. It is only in specific situations
that we notice behavior that makes no sense in terms of effectiveness or success, in other words,
that simply does not work in the real world.
To those of us with this problem with "avoidance", the times that workers gather around the
coffeemaker for conversation and gossip are a source of real misery for us, an event that we will
avoid until our coworkers believe that we do not like contact with them, because we are snobs,
because we think we are better than them! At the very least, we definitely are not "cool". This was
a problem that plagued every one of my adulthood jobs. I could not socialize on the job. It was
anathema to me. And I paid a huge price in terms of job success for this personal and social
limitation. Furthermore, to be by nature an extrovert, who simultaneously avoids people, is to add a
lot of confusion to working relationships! How can anyone hope to understand such a person?
In earlier years I had satisfied needs for social contact by organizing small groups. The work kept
me busy, the social interaction was a part of my task, and I did nothing that was not effective in
building group. Doing this contradicted the disorder, as is necessary for all healing, and enabled
me to learn better skills.
Later, this same ability would be used as a therapist. Because my social skills are carefully
governed to assist my clients, they would never imagine that I have very great difficulty managing
any kind of social event.
As with the problem of anxiety, the person like me must learn to deal with it through the use of
careful strategy. One can see from the readings in Section II that I developed skills at music, as
well as involvement in organizational and educational settings that would increase my skills, and
increase a reliable and predictable was to interact socially with people. This is enough to have a
useful and happy life, whether or not the "avoidance" is ever fully defeated.
As with anxiety, avoidance and caution can be useful. A good eye for dangerous people is useful, if
one does not become excessively fearful, angry or otherwise mobilized by this observation.
Paranoid thinking, that is "motivational thinking" or "mind-reading" must be avoided at all costs,
because it will both paralyze the person, while creating dysfunctional responses as well. One
must learn, with Sargeant Joe Friday, of Dragnet, to say, "Just the facts, ma'am". When one
observes the factual dynamics of a situation, one can spot abusive behavior, and thereby
consiously avoid that situation or person. Excessive fear or defense is not necessary.
Meanwhile, the effective treatment for avoidance involves trying to become aware of the many false
assumptions that people with such afflictions are prone to make. These include negative
assessments of what other people are thinking and feeling, as well as faulty beliefs that one will
not be liked by others.
In my case this problem was intensified by my mother's concern about what "people will think", as
well as my parents' frequent predictions that no one would ever like me for myself. There were
also the unrelenting criticisms by my father of everyone's behavior after every visit with my
grandfather.
This problem I eventually turned around for myself, by learning to enjoy the evaluation with others
of how group meetings or parties had unfolded. What was painful, became a useful way of
evaluating for the purpose of improvement.
The reader can imagine that a problem with social avoidance is very painful. It involves anxiety,
physiological reactions to stress, depression, self-flagellation, and loneliness. In fact, it may never
go away, because the brain was affected by it too early in life. So it must be accepted, adapted to,
and even utilized for good. Trust in God helps.
There is a passage in the book of Romans about people who are like worthless broken dishes, as
compared to others who are like the fine china that is used for meals. I could not understand that
passage until I understood that people who are like broken pottery are people who need and
receive more help from God. Because of grace, they may end up able to fulfill God's will for
themselves, and serving as inspiration to others as well.
People like me are like Barbra Streisand's, "People Who Need People." We have to learn to check
our facts, check our assumptions, soothe our felt pain, and find supportive relationships with
people who understand us. The very act of doing that begins to be the "antidote", the medicine, the
prescription for healing, of this painful mental/emotional/physiological condition.
The other part of recovery, which often again involves faith that a friendly God is helping us do a
good thing, is to take behavioral action always. This means speaking to people, asking them
questions, showing interest in them, no matter how much one believes that they will be offended if
you so much as make eye contact with them! Such is recovery. Deliberate, conscious action that
requires energy, determination and generosity towards others.
And nothing could be more important to recovery than gratitude towards others. One must notice
every kindness, every response, every sign of decency in Disorder hangs as on a thread, a thread
ready to be broken by any person who is ready to change the way they think, and the way they act.
The reader knows before I write it that many fat people deal with the terrors of social anxiety
through both the use of food and the use of fatness. Food helps calm the brain, to help the sad,
dysthymic brain produce seratonin and endorphins. But fatness just prevents recovery from
avoidance. It gives us the reality that we need to explain to ourselves why we have such a fear of
social situations. It is because we are fat, and people do not like fat people! Never mind how
many really charming and happy people are fat. To us, it gives us permission to avoid the very
social contacts that might have helped us make at least a partial recovery from avoidance.
This book from beginning to end has really been the story of my decision to remove the fat, and to
face up to the dynamics, both causes and symptoms, of my own felt inability to function socially.
It has been my effort to define my own faulty responses, but even moreso to define my own faulty
beliefs about myself in interaction with others.
The reader can see that I have come "through" a dangerous passage, and have come out on the
other side. I can now accept and deal with anxiety, the wish to avoid and withdraw, fear of
humiliation, dread of competitive people and situations, fear of other people's anger and rejection,
fear of my own anger, and, most of all, fear that I might just basically be an unlovable person. I
come through it knowing that these things are just a part of my life, and that they define and control
neither me nor the life that I live. I am useful. I am friendly. I am happy. I still dislike meanness
and dishonesty. I use my rather dysthymic brain to attend to the pain of others, even as I use my
ability to persevere in the midst of pain to help clients learn and grow and develop better skills for
building a better life. It is completed.
| But who are you, O man, to talk back to God? "Shall what is formed say to him who formed it, 'Why did you make me like this?' Does not the potter have the right to make out of the same lump of clay some pottery for noble purposes and some for common use? What if God, choosing to show his wrath and make his power known, bore with great patience the objects of his wrath--prepared for destruction? What if he did this to make the riches of his glory known to the objects of his mercy,whom he prepared in advance for glory.... Romans 9:20-23 NIV But he said to me, My grace is sufficient for you, for my power is made perfect in weakness. 2 Corinthians 12:9a NIV |
© Copyright by Nancy Carter, LCSW, ACSW
Dealing With the Sad and Dysthymic Brain
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