Summary

David, a man with social anxiety and addiction problems, overcomes his fears through exposure therapy and no longer needs anxiety pills.

Abstract

David, a man with a serious addiction problem and extreme social anxiety, decides to seek help and goes to rehab to treat his drug problems. After rehab, he also wants to fix his social anxiety and starts exposure therapy, which involves exposing people to their biggest fear in small and incremental doses. David starts by talking to people at work and making small talk outside work, facing his fears until they stop being afraid. The therapy helps him overcome his anxiety, and he no longer needs anxiety pills.

Opinions

People with social anxiety prefer to stay away from people and hide at home, running away from the pain of talking to others.
Exposure therapy involves exposing people to their biggest fear in small and incremental doses.
Facing your fears is not easy, but it can help you overcome them.
David's doctor encourages him to face his fears, even when he feels like an idiot, until he gets used to them.
The author suggests that facing your fears until they stop being afraid is better than living with them forever.

Running Away From Your Fears Won’t Help You In The Long Run. But This Might

Image created by DALL-E — the author has the provenance and copyright.

Kelly Clarkson famously said:

“What doesn’t kill you makes you stronger”

In the book Dopamine Nation, Dr. Lembke tells a story about a patient called David.

David had a serious addiction problem.

He couldn’t survive without Adderall. On top of his addiction, he also had extreme social anxiety.

He decided it was enough. He went to rehab to treat his drug problems.

Out of rehab, he realized he also wanted to fix his social anxiety.

Usually, people with social anxiety prefer to stay away from people. Hidden at home, popping a pill every day for 30 years for their anxiety.

They run away from the pain of talking to others. And that’s what David was doing before starting exposure therapy.

The goal of this therapy is to expose people to their biggest fear, in small and incremental doses.

For example, if you’re afraid of heights, don’t book a suite on the last floor of the Burj Khalifa. Go to a 2-story house and check out the porch. Start small like David.

He started by talking to people at work. He went to the kitchen 3 times a day and introduced himself to coworkers.

He also had to measure his stress levels before, during, and after, on a scale from 1 (totally cool) to 100 (worst pain you could imagine).

Like most people, David was afraid to talk to others because he thought they’d think he was a loser and a weirdo. So before the interactions, he was at 100. Sweating and afraid of all the things that could go wrong.

Still, he approached people.

I stayed in the moment as long as possible, just letting my anxiety wash over me, while also being respectful of their time. The interactions lasted maybe four minutes. — David

After talking to people, he felt relaxed. A moment of relief after moments of panic. He did this routine for a few months. Then it was time to step up.

He decided to make small talk outside work. He chose Starbucks. Everything was going well for a few weeks until he spilled coffee on the counter. He felt like an idiot. He wanted to hide in a cave and never come out.

He told his doctor what happened. To David’s surprise, his doctor said “Do it again. On purpose”.

The next day he went to Starbucks and did it again. He felt less like an idiot. Eventually, he got used to it.

Facing your fears is not easy.

Even with crippling anxiety, David still ran towards the (small) pain of having to talk to others.

And because of that, now he doesn’t need anxiety pills.

Face your fears until they stop being afraid. Or live with them forever.

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