What Anxiety Does to Your Brain and What You Can Do About It


What Anxiety Does to Your Brain and What You Can Do About It


One therapists’ ongoing fight with shame


Sometimes I can be my own worst enemy.

*Shaking my head* So, I bought a concert ticket to go see a show about two hours from my house. The ticket was $50. As someone who still struggles with social anxiety it is not uncommon for me to make plans and then rationalize not going. It was a big deal to buy one ticket and know that I was going alone, but I was really looking forward to this show.

I woke up feeling happy anticipation and put their music on my ipod as I started getting ready. Now, this is Los Angeles and it’s Thanksgiving week and President Obama was in town (for those of us with anxiety, all of these factors build up into a big deal). I decided to leave early in the day and get past all of the traffic traps on the 405 before rush hour started.

I walked out to my car and it wouldn’t start. If you have never experienced shame anxiety, I cannot possibly describe the heart-wrenching feeling that came next. In that moment I did not experience just the car not starting. I experienced every loss and every failure I had ever had in my whole life…in one moment. I quickly thought that I could call roadside assistance or I could call a cab to a rental car company. However, I also figured how much that would cost and could not justify spending more on a cab and a rental car than I did for the cost of the ticket. I came back in the house defeated and overwhelmed.

Initially I tried to call my husband who seems to be a magician in situations like these, but my unwillingness to spend more on transportation trumped my knowledge that he would insist I get in a cab and go to a rental car company. Instead I became my own worst enemy. I stopped functioning and just thought about NOTHING ever works out for me and how EVERYTHING always goes wrong. Even though I knew it was true, I allowed myself to go down the “Everything is bad” Highway. Nothing good ever comes from this, ha ha. 🙂

After my self-induced pity party I called my husband, the magician. He immediately sprung into action, but with Los Angeles traffic I could not meet his enthusiasm. I was in full eyeore mode. My husband’s compromise was to buy another ticket for tonight’s show over in Las Vegas. Now I have $90 ticket for a show 5 hours away and still no transportation, ha ha ha. As I write this my mind is computing 10 hours worth of gas, the cost of a cab to get a car, plus the cost of a rental car the day before Thanksgiving and making a five-hour drive from Vegas to LA in the middle night. Man, that’s worse than yesterday’s problem. But that is the way shame and social anxiety work.

Shame convinces us that we aren’t worth it and that our lives are crap and that the problems aren’t fixable. The anxiety that comes with shame prevents us from reaching out to others who could help us. The anxiety silences us because even to talk about shame hurts and talking about anxiety hurts. Then we feel isolated and alone, which hurts even more. We do not have to suffer in silence. There are others out there who would care about us if we let them.

If only I had moved into action earlier in the day while I still had time to fix the situation.

If only I believed I was worth the cost of a silly rental car.

If only ______________________.

I’m tired of saying, “if only”, how about you?

Yes. Sometimes it IS best to ignore your kids ;-)


Ignoring petty misbehavior is something a lot of parents struggle with. Many parents want to correct each and every misbehavior each and every time. However, much to annoyance of parents, children’s jobs are to grow up and become independent from their well-intentioned parents. The older a child gets the more independent he or she should become and the more freedoms he or she should receive.


Think for a moment when people tell us every mistake we make and remind us how we are not living up to their expectations. A lot of us either become angry and argumentative, or we become sad and resentful. Neither of these makes us want to continue trying. Most of us, deep down, really do want approval from others. Rather than getting locked into endless arguments with your children, your sanity may benefit from learning how to ignore the little things.


When we get annoyed we tend to notice more things which also annoy us. This could lead to the illusion just can’t do anything correctly. Instead of harping on the stuff we do not like, we would all be better off ignoring the sighs and eye rolls and instead offering praise and encouragement for what we do like. If we are happy and looking to praise, we will find more things to praise.


A word of caution: this does not apply if your child is engaged in behavior that will cause him or her danger.

Simple positive reinforcement ideas


There are lots of ways of “doing” positive reinforcement. They can all work if applied consistently; the trick is to find one that you like and sticking with it. If the parent will not follow through, the child certainly will not follow through. Some examples of positive reinforcement:


Develop a list of family rules (some prefer the term expectations because it is less confrontational) and write them out together as a family. Every family member gets to contribute to this list. A note here, all expectations should be written as a thing to do and not as things to not do. For example, you would not say, “no yelling” be cause that does not teach what you do expect…it only lists one thing to not do. To re-word it as a positive, the expectation should read, (depending on the age of your child) “talk nicely” or “always use inside voices”. When you have created your list of family expectations, post or hang them somewhere everyone will see them on a daily basis.


There are two ways parents can now use this list: to use positive praise only, acknowledge or praise when you notice your child meeting an expectation on the list


using tokens, change, or a checkbook register (depending on age of child) give them tokens or change for positive behaviors and have child give you token or change for significant negative behaviors. It works best if parent and child develop how much change or how many tokens should represent behaviors so that rewards and punishments and will be seen as fair and expected. This also helps keep the parent honest by not punishing out of anger, which never works.


Parents can also develop a to-do list with their child and assign a point value to item. When child completes items on list they are rewarded with points which can be turned in for a variety of activities. If parents choose to use money instead of points for their older children, it can also help teach them the value of money and the importance of saving money for more expensive desired items. This is great because a side effect is teaching patience instead of instant gratification.

Reward, Ignore, or Punish?


As a parent you have three main choices regarding discipline:

1. Reward the behaviors you want to see more of

2. Ignore the annoying behaviors if there are no safety concerns

3. Punish the negative behaviors that, due to safety concerns, need to stop


Today’s post will focus on rewards. I will follow up with a post for ignoring and for punishing.

When you use rewards, they should “fit” the behavior you are rewarding. The way to make rewards meaningful is to have your child assist in developing the rewards master list. In other words, have them write a list of all the things they enjoy and would like to receive more of. There should be a range of free to moderate items on the list. This is where I noted yesterday that it can feel like you are bribing your child to do what is already expected of them. The idea here is to start with external motivation and move toward internal motivation. 

Many parents have a hard time properly following with this approach because it adds to their to-do list and let’s face it, most parents do not need one more stinking thing to do, right? However, the research in undeniable: this approach does work best if used systematically. 

Kids always want to put big-ticket items on their weekly reward list. I would too if I could get away with it. Usually you will not be working with big-ticket items. Think more in terms of: picking a dvd from Redbox, renting a video game, letting them pick what to have for dinner one night a week,”coupons” to turn in for a desired item, going to a skate park or roller rink once a week…this list truly could be endless based on the age of your child. What will make this list work is to determine what will motivate your child and give them the ability to earn  rewards THAT THEY FIND REWARDING. If your child does not to read, adding story time as a reward will not work. 

It is no secret that children do not like to do chores. I know that I did not like having to do chores and chances are, you probably didn’t either. We all need a little external motivation to get us going. To put it into adult perspective, if most of us were not “rewarded” with a paycheck, most of us would stop going to work. It is the same for children. None of us REALLY want to work for free.

As you fall into a routine, it becomes easier to switch to less obvious rewards and motivators like very specific praise (please avoid “good job” as that loses all meaning when applied to everything). Smiles, high-fives, and never under-estimate the impact of a parent saying thank you to their child. Encouraging words, head pats, and acknowledgement of a job well done become motivating and helps children internalize their sense of pride. Self-pride, a sense of accomplishment, and self esteem become the reward.

The positive reinforcement trap


As a family therapist, one of the common complaints I hear is how to motivate children to do their chores. At this point therapists normally encourage parents to use “positive reinforcement”. You know the drill, reward them when they do well or offer rewards to get the minimum done.

A lot of parents resent this advice because they say they should not have to “bribe” their children to do what is expected of them. I find this argument comes up a lot for children who are oppositional and argumentative. These children have already worn out their parents good nature and attempts at compromise. These parents, whether they realize it or not, often are angry at their children and just cannot justify rewarding them one more time. They want their children to listen and they want their children to listen now.

I couldn’t agree more. No one wants to feel manipulated and taken advantage of by their child. However, positive reinforcement does not have to be that way. In fact, if you’re doing it correctly, no one needs to feel manipulated. Positive reinforcement is not just throwing toys, treats, and allowances at children. Often when starting a new positive reinforcement program from scratch it can feel that way, though. It is common to take a child who is not motivated at all and first make then externally motivated and then develop their internal motivation.

Coming up: How to do “positive reinforcement” better.



Social Anxiety treatment options


There are three main approaches therapists currently use in treatment: Dynamic, Behavioral, and Cognitive. 

The Dynamic approach explores underlying issues, childhood experiences, and attempts to make the unconscious conscious. Perhaps someone picked on you or teased you as a small child. As a result you may feel that world is not a safe place although you cannot put your finger on why it isn’t safe.

The Behavioral approach looks at how we learn and develop behaviors over time. Such as, if someone teases us or bullies us, we learn to associate people with shame and then we do everything that we can to avoid being teased, bullied, or shamed. We allow ourselves to develop a fear of other people and expect that because one person teased us, everyone will tease us.

The Cognitive approach focuses on what we think about our situation, sometimes before we even realize that we have had a thought. So when I think I have to go to work or I would like to go to the mall, the first thing I think is, “ugh, the people” and I immediately have a sense of fear or foreboding. Even if it is an activity that I want to do (gym, yoga, shopping, movies, etc) I will not allow myself to go because I think other people are not safe.

Treatment for Social Anxiety is often behavioral in nature, with the therapist guiding the client through exercises more closely resembling the feared object or situation. I start someplace (online or in the person’s home) that the person feels safe. Then, through behavioral, and sometimes cognitive exercises, we help people face their fears and behaviorally learn new associations in a safe and fun way. Exploring underlying issues can also be beneficial, if the client wants to understand the root of their problem, but it is not necessary for successful treatment.

Prognosis for Social Anxiety is very good if treated effectively.


Social Anxiety


Social anxiety is more than just shyness. Social anxiety interferes with a person’s ability to fully function in society and have the life that they want. I have been encountering more and more people suffering from this fear or discomfort of others. The sad thing is that most people think that they are alone and that they are the only one who is sensitive and worried about what others will think of them (or say about them), or how others will treat them. Many people fear that they will be bullied or socially rejected and as a result they either act harsh to defend themselves against perceived attacks before they happen, or they just stay home all together…even though they are bored and want to go out and enjoy life.

The symptoms of social anxiety are divided in three groups – physical symptoms, cognitive symptoms, and personality traits.

Physical symptoms: 
-A tendency to blush
-Shaky voice and trembling of hands and feet
-Sweaty or cold hands
-Intense sweating
-Panic attacks (one of the main indicators)
-Muscular tension
-Shortness of breath or breathing difficulties
-Pain or pressure on the thorax
-Difficulty making eye contact

Cognitive symptoms:
-Fear of being judged or criticized
-Anxiety or fear of being in the spotlight
-Fear of showing symptoms of distress
-The belief that others see you as anxious, weak, crazy or stupid
-Fear of meeting strangers
-Fear of authority figures
-Anxiety that is so strong it disrupts routine daily activities

Personality traits:
-Low self-confidence and self-esteem
-Difficulty with being assertive
-Negative thought patterns – “I’ll appear stupid”, “They’re not interested in what I’ve got to say”, etc
-Undeveloped social skills
-Excessive sensitivity to criticism

The good news is that psychotherapy is very effective at treating social anxiety. There are also medications which are very good at reducing anxiety. There is hope.