How I Vaccinated Mike Against Anxiety
Sitting in front of me, sweating profusely with dried saliva in the corners of his mouth, Mike said, “I’m afraid of talking about my fears”. He apologized again and again for being nervous but he could not sit still. He told me that he had read one of my books and driven 250 kilometers to ask for my help.
Mike said that he suffered from anxiety, fear and obsessive thoughts. He was afraid of saying something “obnoxious” when he was talking with people. He was also unsure if he had just said something inappropriate without noticing it. Being a school teacher he was constantly on guard, watching his words in order not to make any mistake and say something inappropriate in front of his students. This constant effort exhausted him which wouldn’t let him sleep well at night. He didn’t dare ask people he didn’t know well but he did feel at ease with friends and relatives. So he would ask them if he had said something wrong and obnoxious. Several times he apologized to me just in case if he had already or was going to say something inappropriate to me.
Unfortunately Mike had suffered from this condition for 25 years. His first psychiatrist had made a gloomy prognosis: “Your fears and obsessions would never be cured.” Other psychiatrists weren’t as negative as the first one but neither could they help to solve his problems. They had prescribed multiple medications which Mike was taking regularly.
First, I asked him what he did to calm himself when he doubted himself or had anxiety. He informed me that when he felt anxious, to feel better he would ask his relatives for reassurance. They would reassure him that he didn’t say any inappropriate word. This feedback would calm him.
I pointed out to Mike that although seeking reassurance from others gave him temporary peace of mind, in the long run, it didn’t help in eliminating his doubts. He agreed that seeking reassurance from others wasn’t the definitive solution to get rid of his anxiety. He also realized that his mental control over his words in order not to make mistakes actually made him more nervous, which in turn made him more prone to make mistakes.
I told him, “As you have also realized, you cannot escape from doubts and obsessive questions by trying to find the correct answer or reassurance. Trying to answer these doubts with convincing answers or with logical arguments actually feeds the vicious circle of these obsessive doubts. Instead of trying to stop these perturbing doubts, you can shift your attention to the answers you seek. After all, you have little control over the doubts and obsessive questions that pop into your head. However, you do have the power over your own answers. Perhaps a good analogy is that to get rid of weeds in a garden one can avoid watering it. Likewise, in order to eliminate these doubts and obsessive questions you ought to avoid answering them. As Sherlock Holmes once said, ‘I will not honor a stupid question with an intelligent answer.'” I asked Mike to repeat this sentence as a mantra whenever he had doubts or obsessive questions.
Two weeks later Mike said that the battle with his fears and doubts hadn’t been easy. He didn’t always remembered to repeat his mantra. I guided him to continue practicing it and gave him a new task:
“You say that you are afraid of saying something obnoxious by mistake. This would embarrass you greatly and you are in constant fear of making mistakes. You can do an experiment and apply the same principle as vaccination.”
I explained to Mike that introducing a weakened or dead micro-organism stimulates the immune system to develop adaptive immunity to that particular pathogen. Likewise, he could purposefully administer to himself small doses of what he feared. He could choose the people and the situation that were less stressful and insert a small mistake in his speech on purpose. But the mistake had to be so small that only he would notice it.
I saw Mike a few weeks later and was happy to hear that he felt better. He had used the mantra and by blocking his own answers to the questions he had curbed his anxiety. The intensity of his obsessive doubts had decreased significantly as well. So much so that for two consecutive weeks he hadn’t sought reassurances from his family. He also recounted to me that he felt a strange sensation of elation and surprise when he had made his little mistakes in front of people on purpose. I asked him to keep practicing his mantra for a few more weeks and gave him a new task.
I asked Mike to practice what I call a mechanical smile – he had but to lift both corners of his mouth. Several studies have shown that artificially induced smiles affect our mood. Paul Ekman, a pioneer in the study of emotions and their relation to facial expressions has conducted studies in this field and discovered that people can access pleasant emotions by mechanically activating the right facial muscle patterns. My instructions to Mike was to carry out on his own personal experiment. Three times a day, in the morning, at noon and in the afternoon, he was to smile for exactly 5 minutes.
One month later Mike said that he was feeling much better. His experiment with artificially smiling three times a day had improved his mood. Many days he didn’t have any obsessive questions and when any doubt popped in his head he was able to eliminate it by repeating his mantra. I told him that according to the Norwegian social scientists, Jon Elster, responding to doubts may sound a rational procedure. However, due to its negative consequences, it becomes an illogical strategy. Three months later I was ecstatic to learn that after 25 years of suffering and hardship, Mike was happy. As a result of applying these new strategies he had eliminated his obsessive self-doubts and overcome his anxiety.
Mike thanked me but it wasn’t necessary. It is always immensely gratifying for me to be able to help people and seeing them lead a better, happier life is thanks enough.