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Group therapy helps Gail tackle her anxiety

The 50-year-old knows the skills she learned to overcome her fears have to be continuously practised

Globe and Mail Update

TORONTO — Six months after undergoing group therapy to combat a social anxiety disorder, Gail Andrews has managed to mingle with people in ways she never dared a year ago.

Gail, a senior executive with a major Toronto accounting firm, has suffered all her life from social anxiety, an extreme fear of being negatively judged by others.

It made her fearful of small talk with strangers and colleagues, robbed her of friendships and peace of mind. Three times she turned down partnership offers from the brass at her Bay Street firm, too afraid of the top job's social demands.

But this past spring, a few months after turning 50, Gail finally sought help. She joined a 12-week cognitive-behavioural therapy group and allowed The Globe to follow her progress.

The sessions, run at the Centre for Addiction and Mental Health in Toronto, were designed to teach participants to understand, confront and overcome their fears of social interactions. Each group member had to work their way through a list of the Top 10 social situations they feared most, the kind of encounters that could make them run for a door, hide in their house, or even spark a panic attack.

Their lists included scenarios such as riding the subway while facing another passenger, attending a party, chatting with a coffee shop cashier or eating lunch with colleagues in the cafeteria.

Gail's list included phoning a friend “out of the blue just to chat,” having a conversation with an argumentative colleague, taking an assistant to lunch. Not only did she manage these, but she eventually pulled off even her most feared encounters.

Just a few weeks ago for example, with little time to prepare, Gail led a tutorial workshop for a group of her peers and took questions on the fly.

“I wasn't disastrous,” she said. “I was able to do it … but without having had the therapy I definitely would have declined.”

As well, after years of longing, Gail finally managed to attend the garden party the University of Toronto president holds each summer. This event was especially important to her because she felt it would be a worthwhile networking opportunity for her partner, Gerald, an artist.

“I felt self-conscious and awkward introducing Gerald to potential art lovers … but I had a better time than I thought I would.”

She tried to focus on certain coping behaviours, such as “yanking my mind away” from negative thoughts and remembering to breathe. “The challenge is trying to remind yourself of (the coping tools) in the anxiety-producing situation – easier said than done because the anxiety is such a ‘psychic energy suck'.”

Gail has also made progress on the home front. Even though she and Gerald have been together for a dozen years, Gail, an accomplished musician, never felt comfortable enough to let him listen to her play the cello. She used to make him wear headphones or leave the house.

“Now it's okay if he just stays in the other room – preferably with the door closed, but he doesn't have to leave,” she said.

But Gail never did manage the penultimate challenge of the CBT program – to deliberately draw negative attention to oneself and learn that the world does not end.

CAMH psychologist Lance Hawley, the CBT leader, had described how participants in other groups trailed toilet paper out of their pants, exaggerated sweat stains on their armpits and purposefully mispronounced words.

In the spring group, one young man shaved the hair off the right half of his head, the left half of his moustache and the right half of his beard.

“He got really creative,” Gail said admiringly. “I didn't do anything to make myself look foolish, I thought the exposures were enough.”

Since the cognitive behavioural therapy has ended, Gail has found that the skills she learned to overcome her fears have to be continuously practised – it's not like riding a bike, she can forget. She also intends to continue seeing a professional to discuss her anxiety.

“You have to keep designing exposures for yourself, or you lose the progress that you made,” she said. “The price of freedom is eternal vigilance.”

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