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Script Shrink

@scriptshrink / scriptshrink.tumblr.com

Writing about mental illness? Ask ScriptShrink!
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Reblog if you believe phone call anxiety is real and it isn’t childish bad behavior.

Trying to prove a point to this job helper.

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xubbs

Phone calls can be harder on your anxiety bc you cant pick up on the other persons behavioral cues as you talk with them

^^^^

After 10+ years of psychotherapy, almost all of my social anxiety triggers are now at a manageable level—even academic public speaking, which was my #1 worst trigger for most of my life—except for my phone anxiety. It’s literally the one and only thing I’ve never been able to significantly improve.

I have to talk the whole conversation through with my friends beforehand.

I have to get explicit confirmation from my friends that “yes, you really need to ring that person right now”.

I have to write scripts.

I have to take anti-anxiety meds, or get drunk.

I only ever ring someone as the very last resort, when all other methods are unavailable.

I hyperventilate and cry afterwards.

I’m also a 28-year-old scientist with three degrees and a teaching position. I’m normally a logical (albeit emotional) person. But anxiety is not logical.

Anxiety is due to inability to correctly perceive threats—more specifically, due to both increased expectation and increased frequency of false recognition of threats in response to neutral stimuli (this is called “pessimistic bias”). Social anxiety simply means that this inability to correctly perceive threats is specific to social interactions, rather than generalised to all aspects of life. (For example, a resting facial expression or lack of verbal acknowledgement is more likely to be perceived as anger, disgust or rejection by a socially anxious person than a neurotypical person. But a socially anxious person is not particularly more likely to worry throughout the day that they’ve left their stove on.)

Therefore, socially anxious people learn to cope with this bias by becoming hypervigilant to social cues such as posture, hand gestures, nodding, eye contact, eyebrow position, mouth tightness, tone of voice, talking speed etc., and then using all the available information to attempt to be logical and “talk down the anxiety”. We also learn to be high self-monitors, which means that we closely observe our audience and constantly (subconsciously) monitor their responses in order to ensure that they accept us and deem us “appropriate”.

But non-verbal social cues aren’t available during phone calls!

There isn’t any body language to read, or eyes to look into. You can’t monitor your audience for approval. They don’t follow the script you prepared. All you have is their voice, which is usually masked (everyone seems to have a “phone voice”, “customer service voice” or “professional voice”) and distorted by the phone and is therefore useless. All of a sudden you’re back to relying on a single neutral stimulus, and the pessimistic bias kicks in, and you start to panic because you’re not getting constant feedback.

It’s a Recognised Psychological Thing™.

Phone anxiety (actually, phone phobia) is one of the most common, most recognised and most treated phobias in the world. Social anxiety—of which phone phobia is an extremely prevalent trigger—is one of the most common, most recognised and most treated anxiety disorders in the world.

It’s most definitely real, most definitely not “childish”, and you’re not alone.

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artistmeli

I have this, it is definitely real.

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I'm writing a character who is autistic, and already prone to anxiety. Plot is, put basically, someone is after them and their uncle. Would it be unreasonable to have the MC become more anxious, and how could I portray this properly?

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It seems quite reasonable for your character to become more anxious in this circumstance. In fact, I’d be more surprised if your character didn’t become more anxious.

Escalating anxiety can be shown in a couple different ways, specifically:

  • Developing additional symptoms
  • Amping up the existing symptoms

I’ll go into a little more detail:

Developing additional symptoms:

You can pick a few more symptoms from the criteria of the specific disorder(s) your character is experiencing. Note that it’s rare (but not impossible) to have a character experience every single symptom.

I also suggest considering adding panic attacks (see criteria here), if your character does not already experience them. 

Amping up existing symptoms:

Increase the intensity, frequency, duration, scope, prevalence, and / or consequences of existing symptoms.

Here are a couple examples:

The character has had trouble sleeping due to anxious thoughts keeping them awake. To escalate it, you could have your character double the time it takes for them to fall asleep.

The character has a specific phobia about needles. To escalate it, they might start experiencing phobic reactions to additional stimuli, such as being in a hospital or seeing a doctor.

The character has agoraphobia when in a crowd or in an enclosed space with other people. It can escalate to the point where the character is too anxious to leave their house entirely.

I’m leaving the autistic part aside, as that’s more @scriptautistic​‘s area of expertise. However, I will say that meltdowns are probably more likely to be triggered when your character is in a more anxious state.

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Anonymous asked:

So my character is a man with social anxiety. Would it be realistic for him to fall in love by then break up with his partner because he feels so nervous around him?

Rebel

Yes… Your character is avoiding the source of his anxiety (the partner), and avoiding is classic social anxiety (and anxiety in general) behaviour.

barc0de

Damn relatable.  I think every relationship I’ve had I ended because it made my anxiety get so high. I also cant keep up with NT peoples need to communicate every second of the day

Basically anxious people: need a lot of space 

Relationships: much less space

Anon32

Alternatively, social anxiety, need to be reassured constantly that they aren’t a bother and the partner does want them around, but they can’t ask for the reassurance or they will definitely be a bother. So they don’t ever ask for what they need in the relationship. And somehow, those actually go together. I need constant reassurance that I’m not a bother and I am wanted, but I also don’t want to talk all the time. My partner gets upset that I don’t call on breaks or want to talk on the ride home from work, but he also doesn’t understand my desire to have a hand on his leg while in the car or that I ask for hugs a lot when we are home, just random reassuring contact.

Jellyfish

I’ve never been in a romantic relationship but I know with friendships that have been difficult the only thing that is stopping me from ending it is the fear of how they will react when I actually try to end it with them

elizafaraday

Also, some one who is with a person with anxiety has to be really blunt. Like, I love my spouse because he has a way of bringing up issues in a reassuring way or forgetting them. He doesn’t let resentments brew and get worse, so I can just trust him. If he isn’t mentioning it, it isn’t a problem. I couldn’t deal with someone who didn’t say what they meant.

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Anonymous asked:

Would it be realistic for depression to cause someone to not feel hungry? And could social anxiety worry a person so much that they would vomit?

Yes, and yes.

Decrease in appetite is even one of the possible symptoms of depression listed in the DSM-5. 

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I have a ~19yrold who was kept as a food source for vampires until ~2 wks ago. He's now in a safe place where therapy is provided. (Therapist knows about vampires.) He's willing to see the therapist but is passive & nonverbal. He's alert, responsive in small ways (will take handouts and read them, nods sometimes), & very clearly listens, but he doesn't want to talk. At all. What sort of therapeutic approach might a therapist initially take? What might it look like when he starts to thaw? Thanks!

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The Shrink asked some clarifying questions, and this was the response:

They WOULD talk to other peoplesome, but they were basically “rescued” out of the situation and arenow in a situation where he is surrounded by (very kind) strangers, so thatprovokes a kind of reticence, and his recent experiences have left him hesitantto reach out. He would speak to peoplehe knows, but there aren’t any around.
He is placed in therapy by theparty who has chosen to take responsibility for trying to get him back on hisfeet and independent again. It’s … not inpatient, but he’s being put up ina nice hotel suite that he has control over and everything is provided to him. 
He could leave, but where is he gonna go? So like, the guy trying to help himjust basically kind of says “You need therapy, you need help, I’ve gotsomeone who knows the deal and can help you work through this. can I send herto you? You don’t have to talk, you can even turn her away at the door, but Ithink it would be good if you tried.” And he follows through on that. 
D,my character, is not really in a place where he feels like he can refuseanything (kind of learned helplessness, basically, all his needs were providedfor in captivity, he was being kept like a pet, but he had very little choicein anything he did) so he agrees reflexively. (Early on his response to mostthings is just “Okay” and then non-resistance.)
So he’s not being forced togo, the opportunity is just pushed under his nose and he can take it or leaveit. He’s interested, I think, in feeling better? But also just kind of numb,and he definitely doesn’t want to talk about it, or even his feelings about it,since even bringing the subject up in a roundabout way is a major“yuck” thing for him. He doesn’t necessarily trust a stranger NOT totry to make him talk or think about it.

Completely silent clients like your character, D, are some of the most difficult clients for therapists to work with. Therapy is built on interacting with the client and building a relationship - and it’s extraordinarily difficult to do that when the client is essentially a brick wall like you described. Even if a client is yelling and screaming at you, there’s interaction there. You can work with that.

Typically, in scenarios like these, a therapist might try to make small talk or ask about the client’s life (unrelated to the issue that brought them to therapy). Play therapy might be used for kid. Those things would at least give a therapist a foothold to start building a relationship.

However, if your character remains as unresponsive as you describe, therapy is going to stagnate. Sessions would consist of the therapist scrambling to find something to talk about, or ending up with a session filled with long silences. 

He’s interested, I think, in feeling better? But also just kind of numb, and he definitely doesn’t want to talk about it, or even his feelings about it, since even bringing the subject up in a roundabout way is a major “yuck” thing for him. 

A character gets out of therapy what they put into it. If someone never opens up to their therapist, the things that really bother them will never get addressed.

If D is not willing to even consider talking or thinking about the trauma or his feelings, or even talking at all whatsoever, he’s not putting the effort into therapy that’s needed to start the healing process. He’s not going to get much out of therapy, in my opinion.

He doesn’t necessarily trust a stranger NOT to try to make him talk or think about it.

If D doesn’t trust strangers because they might try to get him to talk about his trauma, seeing a therapist would only make that worse. Because that’s what a therapist does.

I’d recommend that D build some level of trust with the other guy you mentioned first - to the point that D isn’t just complying with what he’s told to do, but actually trusts him enough to believe talking to a therapist will help.

You mentioned “taking and reading handouts,” but that’s probably not a thing that’s going to happen yet - because the therapist doesn’t have any idea what’s going on in your character’s head. You can’t formulate a treatment plan if you don’t even know what you’re treating.

Off the top of my head, some of the things that could theoretically result in the symptoms your character shows:

  • PTSD
  • Selective mutism
  • Social anxiety
  • Avoidant personality disorder
  • Autism spectrum disorder
  • Intellectual disability
  • Major depressive disorder

None of those are treated the same way in therapy.

A therapist might be able to do something if your character is willing to fill out some psychological assessments, but since you said that D isn’t willing to address his feelings, even indirectly, I don’t see him able to fill those out.

Generally, I’d say your character is likely to progress as follows as he begins to get to know and trust others around him:

  1. Entirely nonverbal
  2. Yes or no answers
  3. One word answers
  4. Brief phrases
  5. Short sentences (that don’t describe his feelings / what happened)
  6. Normal speech, where he eventually is able to talk about feelings / trauma

I’d recommend your character be at least at 2 or 3 before entering therapy.

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Anonymous asked:

If it's not too late, this is my experience with social anxiety with a customer service job. I am required to talk to people at my counter all day. Some are upset customers. Although I can keep a light conversation and I am polite, if someone comes at me upset, my mouth gets dry and I am extremely aware of my movements and the way I come across. I also have anger issues so it takes a lot for me to not overreact and be aggressive. I'm more comfortable now due to my job but it's still a struggle

It’s never too late to add your personal experience! Thank you so much for your submission.

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scriptshrink
Anonymous asked:

OMG I was looking for something like this. I need help with a character with depression and social anxiety. The major problem is with the social anxiety... how does someone with this acts??? (Like... can they talk normally to people?? Or like they can't even say a word??) also... how different is having general anxiety and social anxiety??

It depends entirely on the person!  Social anxiety is not necessarily expressed with every single person the character meets.  Usually there are at least one or two people that the person feels safe talking with, typically family members.

Someone could also have the “performance only” specifier, and thus be totally okay with talking to people.  Their anxiety only manifests when they’re doing public speaking or up on a stage.

General anxiety and social anxiety are very different.  Social anxiety is about a fear of being negatively evaluated and judged by others, whereas general anxiety can be about anything and everything.

As for the rest of it, followers with social anxiety, want to help this Anon out? Share your experiences via reblog or submission, and I’ll add it to this post! :)

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Personally for me my main thing is that I can’t start conversations with people without a lot of practicing and scripting in my head. Nowadays this means that I can’t start spontaneous, unscripted conversations - but before I used to not be able to order food or book myself in for appointments. I couldn’t get the bus or train anywhere because the thought of just asking for a ticket was terrifying.

I can’t phone people, like at all. I phone two people, my mum and brother - and that’s been after years of practice. There’s been situations where my safety is in danger and I’ve been unable to phone anyone to get help - like, I’d literally sooner die than phone for help. Apparently this is a fairly common thing with social anxiety, here I just thought I was weird.

I won’t go to events/social gatherings/etc. unless I’m sure I’ll know a few people there.

I’m extremely scared of embarrassing myself or looking weird/stupid, or any kind of negative judgement. Most of my behaviours are based on a fear of negative judgement.

I guess most of my anxiety symptoms are physical though, like a racing heart/sweating/rapid breathing. I shake a lot and my voice trembles, which basically just makes me more scared to talk in case someone can hear that I’m afraid and make fun of me for it.

Anxiety of all sorts is a really broad thing that affects everyone differently and has a whole range of symptoms, ranging from physical, behavioural and emotional. So everyone will be affected very differently.

Thank you for sharing your experiences!

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aresnergal

Re : Phone stuff, It actually easily becomes a vicious cycle. Even with my family i only feel safe to phone if I’m reasonably sure it won’t entail any arguing/reproaches, but then said family members tend to complain about me being hard to reach almost first thing which doesn’t help

Calling for an appointment or even a dang pizza requires hours of premeditation, thinking about what i’m going to say exactly in what order, and postponing a LOT.

Also my heart jumps like a frightened rabbit every time someone calls me or knocks at my door, unless i’ve been expecting it (and sometimes when something rings in a movie or something i react the same way which is pretty annoying)

Thanks for adding your experience!

Same here. I actually have to prepare myself mentally for social situations, I often wake up earlier than needed for appointments or even going to a contest because I need some time before the fact to just relax and make sure I have everything prepared.

Also, negative social situations can and will leave me a mess. My doctor yelled at me over the phone because I messed up something small and I needed an hour after that to just cry. I literally couldn’t stop crying and was beating myself for the perceived failure.

With people I don’t know that well, I will agonize over conversations after the fact. During conversations I often try to ‘go with the flow’, but afterwards I started going over what I said and analyzing it, trying to weigh in whether I offended them accidentally or not, or whether I said something stupid or not.

And even with people I feel safe around, I’m prone to being paranoid about upsetting them. Meaning if I get a text that’s too vague/short, I will start worrying and thinking about what I’d done that could’ve upset them. And that’s with people I’ve known for 5-10 years. 

And yes, anxiety has physical symptoms for me as well. From increased heartbeat to trembling and stuttering. It all depends on how big or unfamiliar a situation or audience is.

But that doesn’t mean a person with social anxiety can’t be social and/or good at socializing. I was class leader for a while, I took debate classes and got involved in public speaking too. It’s different from one person to another, but I thought I’d maybe share my experiences with it too.

More re: voice on calls. Mine gets quivery and wavers. I can’t control my tonal modulation and end up with this shaky monotone.  Also, I have trouble with my breathing, and sometimes it catches in the middle of a sentence creating this weird break. If it’s an unpleasant phone call (for example, calling a company because they screwed up but they don’t want to admit it and you’ve hit a wall with e-mails)
I will often end up crying. It’s all made worse by the fact that I know the other person can hear my distress. Knowing that they know increases the anxiety.

Thank you both for sharing your experiences!

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reblogged
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scriptshrink
Anonymous asked:

OMG I was looking for something like this. I need help with a character with depression and social anxiety. The major problem is with the social anxiety... how does someone with this acts??? (Like... can they talk normally to people?? Or like they can't even say a word??) also... how different is having general anxiety and social anxiety??

It depends entirely on the person!  Social anxiety is not necessarily expressed with every single person the character meets.  Usually there are at least one or two people that the person feels safe talking with, typically family members.

Someone could also have the “performance only” specifier, and thus be totally okay with talking to people.  Their anxiety only manifests when they’re doing public speaking or up on a stage.

General anxiety and social anxiety are very different.  Social anxiety is about a fear of being negatively evaluated and judged by others, whereas general anxiety can be about anything and everything.

As for the rest of it, followers with social anxiety, want to help this Anon out? Share your experiences via reblog or submission, and I’ll add it to this post! :)

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Personally for me my main thing is that I can’t start conversations with people without a lot of practicing and scripting in my head. Nowadays this means that I can’t start spontaneous, unscripted conversations - but before I used to not be able to order food or book myself in for appointments. I couldn’t get the bus or train anywhere because the thought of just asking for a ticket was terrifying.

I can’t phone people, like at all. I phone two people, my mum and brother - and that’s been after years of practice. There’s been situations where my safety is in danger and I’ve been unable to phone anyone to get help - like, I’d literally sooner die than phone for help. Apparently this is a fairly common thing with social anxiety, here I just thought I was weird.

I won’t go to events/social gatherings/etc. unless I’m sure I’ll know a few people there.

I’m extremely scared of embarrassing myself or looking weird/stupid, or any kind of negative judgement. Most of my behaviours are based on a fear of negative judgement.

I guess most of my anxiety symptoms are physical though, like a racing heart/sweating/rapid breathing. I shake a lot and my voice trembles, which basically just makes me more scared to talk in case someone can hear that I’m afraid and make fun of me for it.

Anxiety of all sorts is a really broad thing that affects everyone differently and has a whole range of symptoms, ranging from physical, behavioural and emotional. So everyone will be affected very differently.

Thank you for sharing your experiences!

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aresnergal

Re : Phone stuff, It actually easily becomes a vicious cycle. Even with my family i only feel safe to phone if I’m reasonably sure it won’t entail any arguing/reproaches, but then said family members tend to complain about me being hard to reach almost first thing which doesn’t help

Calling for an appointment or even a dang pizza requires hours of premeditation, thinking about what i’m going to say exactly in what order, and postponing a LOT.

Also my heart jumps like a frightened rabbit every time someone calls me or knocks at my door, unless i’ve been expecting it (and sometimes when something rings in a movie or something i react the same way which is pretty annoying)

Thanks for adding your experience!

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scriptshrink
Anonymous asked:

OMG I was looking for something like this. I need help with a character with depression and social anxiety. The major problem is with the social anxiety... how does someone with this acts??? (Like... can they talk normally to people?? Or like they can't even say a word??) also... how different is having general anxiety and social anxiety??

It depends entirely on the person!  Social anxiety is not necessarily expressed with every single person the character meets.  Usually there are at least one or two people that the person feels safe talking with, typically family members.

Someone could also have the “performance only” specifier, and thus be totally okay with talking to people.  Their anxiety only manifests when they’re doing public speaking or up on a stage.

General anxiety and social anxiety are very different.  Social anxiety is about a fear of being negatively evaluated and judged by others, whereas general anxiety can be about anything and everything.

As for the rest of it, followers with social anxiety, want to help this Anon out? Share your experiences via reblog or submission, and I’ll add it to this post! :)

Avatar

Personally for me my main thing is that I can’t start conversations with people without a lot of practicing and scripting in my head. Nowadays this means that I can’t start spontaneous, unscripted conversations - but before I used to not be able to order food or book myself in for appointments. I couldn’t get the bus or train anywhere because the thought of just asking for a ticket was terrifying.

I can’t phone people, like at all. I phone two people, my mum and brother - and that’s been after years of practice. There’s been situations where my safety is in danger and I’ve been unable to phone anyone to get help - like, I’d literally sooner die than phone for help. Apparently this is a fairly common thing with social anxiety, here I just thought I was weird.

I won’t go to events/social gatherings/etc. unless I’m sure I’ll know a few people there.

I’m extremely scared of embarrassing myself or looking weird/stupid, or any kind of negative judgement. Most of my behaviours are based on a fear of negative judgement.

I guess most of my anxiety symptoms are physical though, like a racing heart/sweating/rapid breathing. I shake a lot and my voice trembles, which basically just makes me more scared to talk in case someone can hear that I’m afraid and make fun of me for it.

Anxiety of all sorts is a really broad thing that affects everyone differently and has a whole range of symptoms, ranging from physical, behavioural and emotional. So everyone will be affected very differently.

Thank you for sharing your experiences!

Avatar
Anonymous asked:

OMG I was looking for something like this. I need help with a character with depression and social anxiety. The major problem is with the social anxiety... how does someone with this acts??? (Like... can they talk normally to people?? Or like they can't even say a word??) also... how different is having general anxiety and social anxiety??

It depends entirely on the person!  Social anxiety is not necessarily expressed with every single person the character meets.  Usually there are at least one or two people that the person feels safe talking with, typically family members.

Someone could also have the “performance only” specifier, and thus be totally okay with talking to people.  Their anxiety only manifests when they’re doing public speaking or up on a stage.

General anxiety and social anxiety are very different.  Social anxiety is about a fear of being negatively evaluated and judged by others, whereas general anxiety can be about anything and everything.

As for the rest of it, followers with social anxiety, want to help this Anon out? Share your experiences via reblog or submission, and I’ll add it to this post! :)

Avatar

Social Anxiety Disorder - Demystifying the DSM-V

This isn’t the same as only being scared of talking to other people.  There’s a crucial background motivation that is required.

The character needs to have notable fear / anxiety about being in one or more social situations where the character thinks they will be judged or criticized. For children, they need to be anxious both with peers and adults, not just one or the other.

Some examples of situations that characters may fear:

  • Meeting new people
  • Having conversations
  • Being watched
  • Performing (especially when giving a speech)

The character is scared they’ll act in some way, or show how anxious they are, and that will result in being humiliated and embarrassed.

The character is virtually always terrified when in these social situations.

The character would avoid (or at least try to avoid) these situations, or endure the situations while feeling intensely scared and anxious.

The fear / anxiety is out of proportion to the actual danger these situations potentially pose to the character and to the cultural context.

It has to be persistent, and last more than 6 months.

The fear and anxiety need to make the character stressed out, or severely make their life more difficult.

It’s not better explained by another mental disorder, drug, or medical condition.

Note – if a character is only anxious when speaking or performing, they have the Performance Only specifier.

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