October - December 2008

Treating Stress and Anxiety: A Practitioner's Guide to Evidence-Based Approaches, Lillian Nejad, Ph.D. & Katerina Volny, BSc (188 pages, paperback), New York: Crown, 2008. In this straight-forward, well-organized handbook, health professionals can have confidence that the techniques suggested are well-supported by clinical research. The book structures topics so that you can rapidly organize treatment interventions and support them by ready-made handouts and worksheets. A great teaching tool for the new clinician in this field and an efficient time-saver for the seasoned anxiety specialist. Bonus: An included CD provides reproducible handouts and worksheets for clients and relaxation tracks. Table of Contents Chapter 1 - A brief overview of anxiety and stress Chapter 2 - Identifying presenting problems Chapter 3 - Treatment of anxiety disorders Chapter 4 - Maintaining emotional health Chapter 5 - Relaxation and breathing exercises Chapter 6 - The impact of thoughts on stress and anxiety Chapter 7 - Facing Fears Chapter 8 - Relapse Prevention Chapter 9 - Other issues related to stress and anxiety Chapter 10 - Group programmes to reduce anxiety and enhance wellbeing

Self-Help Update:
Moving Past Shyness

In the last issue I reviewed Dr. Bernardo Carducci’s excellent self-help book, Shyness: A Bold New Approach (1999, Quill). As promised, here are some tips from the book. Many of these are used by socially confident people and can be used to strengthen the skills of shy people. I’ll start with the section called “Using Social Skills to Solve Social Problems” (p 124-126).

FORGETTING NAMES – Introduce yourself first (it puts you in control).  When you hear the person’s name, repeat it and then comment on it. “Nice to meet you, Rosanna.  My best friend in grade school was named Rosanna.” That will help you remember it later, and it shows your interest.

MAKING SMALL TALK – Move quickly through the clichés like comments on the weather.  Instead, take an interest in your companion. Comment on a book he is holding; compliment a piece of jewelry. 

GETTING THE BRUSH-OFF – If this happens at a party, decide not to take it personally, since it may have nothing to do with you. Increase your chances of success by seeking out another potential companion. If your boss often implies that she doesn’t have time for you, then when you approach her in the future, ask, “this is a good time to talk?” If not, arrange a mutually acceptable time.

CIRCULATING – If you are in a crowded social situation where you know no one, then look for others who appear alone. Who’s standing by themselves near the door or at the buffet table?  By strategically targeting a few people who appear available, you increase your chances of success.

ENDING A CONVERSATION – If someone is dominating the interaction because of your polite silence or shyness, then allow yourself to interrupt their monologue: “I really enjoyed speaking with you, but there are some other folks here that I have to say hello to before they leave.  Can we talk again later?” Interrupting someone takes courage, but it’s good to practice being courageous.

Two consistent points to notice in this advice… First, you still have to assert yourself, which means you still have to feel somewhat uncomfortable in order to break out of your old pattern. That comes with the territory of behavior change.  Tricks of the trade won’t allow you to sidestep your nervousness.  You must tolerate some degree of anxiety and learn to handle it. And second, you need to focus your attention outward instead of inward.  Continually monitoring and judging yourself wastes valuable mental resources that are best applied to the task at hand: interacting with your environment.

In chapter 12, Carducci continues with his advice-giving. Starting on page 257, he writes of “The Art and Craft of Making Small Talk” by reviewing research on the distinctions of confident people’s small talk.  Here’s how they do it, in a nutshell:

1. Setting talk.  They take a few moments (only) to comment on their surroundings. “It’s stuffy in here, isn’t it?” This can be an ice breaker, enabling them to move to the next comment if they choose, or move on to the next person if they don’t sense receptivity in the other.
2. Name exchange. They exchange names early to show their interest and to help establish comfort.
3. Pre-topical sequence. They fish around for mutually interesting topics. If one question doesn’t pan out, they might search around for a second try. This is just a warm-up period. The rules here are:
1. Relevance. The comment fits the circumstances.
2. Sensitivity. They look for shared experience or knowledge without being too personal.
3. Balance.  They don’t act like know-it-alls or as though they are desperate for companionship.
4. Taking turns. They give and read cues (eye contact, pausing, etc.)
5. Banishing silences. They play host within the conversation. They pose questions at times, and at other times they jump in with a new topic.
6. Self-disclosure. They work to match their partner’s degree of self-disclosure, whether moving into more personal sharing or backing off.

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