CBT for social anxiety?

Discussion in 'Medical Topics' started by S_Tharp, Jul 10, 2018.

  1. S_Tharp

    S_Tharp Filing Flight Plan

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    I would like to work with a CBT therapist on my social anxiety, but I am not sure if that will affect my medical certificate. I am fine with ATC control and instructing. In fact, I just got a teaching award in other fields this year. I struggle mostly in parties or big conferences. Any idea?
     
    Last edited: Jul 10, 2018
  2. Rushie

    Rushie Cleared for Takeoff

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    I'm thinking "CBT for social anxiety" on your next medical might be a problem. You sure you aren't just an introvert? Or a nerd? I hate parties too. I park myself in a corner and get into deep discussions with one person only, for the whole party. Doesn't matter who, just can't do the group thing. But I can get up in front of a room full of colleagues and give a paper.

    On the other hand if this affects your daily functioning you may indeed have a disorder that would benefit from treatment and sometimes we have to choose between our health and happiness, and medical certification if it comes to that.

    I'm not an AME but as far as I know, only marriage counseling, or short term help for a temporary circumstantial problem, are the only forms of psychological therapy the FAA won't care too much about. Even those have to be reported, is my understanding, but hopefully others will be along to clarify.
     
  3. bbchien

    bbchien Touchdown! Greaser!

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    So long as it does not rise to the level of medication, FAA will review the record will likely approve. MUCH much better than doing Celexa and the SSRI protocol. Rushie's commentary is spot on, thank you Agatha.
     
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  4. S_Tharp

    S_Tharp Filing Flight Plan

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    Thanks Rushie and Dr. Bruce. I guess I can call myself shy and a nerd. It doesn't affect my daily functioning but sometimes I wish I could enjoy life a little more like a lot of other people. Maybe I should try a workbook by myself first.
     
  5. steingar

    steingar Taxi to Parking

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    You have to be the person you are, which may not always be the person you want to be. You cannot be anyone else. Why you should want to enjoy life like others is a bit of a mystery, I would think it better to enjoy life like yourself.
     
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  6. S_Tharp

    S_Tharp Filing Flight Plan

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    Good point. I do enjoy my life and who I am. But maybe some self improvement? I just feel I lack some social life and I wanna make it up. It's not always easy for everyone but well I am not ashamed of speaking it up
     
  7. steingar

    steingar Taxi to Parking

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    There should be some means for you to develop of the social interaction you seek without altering your basic body chemistry, which is what pharmacological agents do. I'll go farther, if you use some sort of medication to ease your social anxiety you're not being true to yourself.

    Says me find a small group of like minded people (like at the FBO of your airport?) and have at it. Groups can certainly increase over time.

    Of course, I could also say not to let your anxieties rule you. I had anxiety plenty learning to fly, and even more transitioning into the aircraft I fly now. I had a bad accident in that aircraft, and had anxiety further in coming back. But I will not be ruled by fear, it isn't who I want to be.
     
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  8. hotprops

    hotprops Line Up and Wait

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    i am glad this thread is not what I first thought it might be;)
     
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  9. benyflyguy

    benyflyguy Pre-takeoff checklist

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    Profound!!!
     
  10. steingar

    steingar Taxi to Parking

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    I get lucky sometimes.
     
  11. Rushie

    Rushie Cleared for Takeoff

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    Very true. I don't know your age, OP, but some of us are late bloomers, blooming only when we find that small group of like minded people. My youngest daughter had a hard time in school. Her first year of college she was miserable in the freshman dorm, no friends at all. They partied all the time and weren't very studious. Her sophomore year she moved to the other side of the campus, into the dorms of grad students and the engineering "nerds", and she absolutely bloomed. Made several friends and even found the guy she eventually married. It was a matter of her needing to be swimming in the right pool.
     
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  12. CC268

    CC268 En-Route

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    You mean like CBD?
     
  13. Van Johnston

    Van Johnston Line Up and Wait

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    Someone help me out with the acronym please. CBT means computer-based training to me. I gather from the context it means something else.

    Yeah, it's ok to be an introvert.
     
  14. S_Tharp

    S_Tharp Filing Flight Plan

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    It stands for cognitive behavioral therapy. It teaches you ways to react/cope with your feelings. Some people use it for pain management
     
  15. Rushie

    Rushie Cleared for Takeoff

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    To me it's a fancy term for "mind over matter"; age-old advice, but in many cases totally inappropriate. You can't "think" your way out of major depression for example. But in terms of learning tools and coping strategies it can sometimes be extremely helpful, especially if you want to avoid medication, or is very helpful as an adjunct to medication.

    Most, I dare say all, psycho-active meds do nothing to cure the problem, only treat the symptoms, and often involve increasing tolerance and resulting ineffectiveness over time. Witness the TV commercial: "If your anti-depressant doesn't seem to be working anymore, try adding a second one! Ask your doctor about Abilify."

    In my SGOTI opinion meds are appropriate in only these scenarios: to help get through a temporary crisis, or one-time doses for infrequent use, and in severe psychosis or other disorder where normal functioning is impossible without them, or you have a physical disorder being treated with psychoactive drugs. Lifelong reliance in the latter cases needs to be very carefully managed. In the first two cases, short term or occasional use will avoid the tolerance issue. Other than that, IMHO, these meds do more harm than good, therefore CBT is the only professional alternative.

    I might suggest non-professional alternatives, such as online support groups, self help books, and journaling. Or talking to the bartender... :D

    We are a long way from having a good understanding of and a fix for, the causes of psychological disorders. In the meantime, we have to be on guard for a growing $$industry increasingly redefining what used to be considered normal if imperfect states of being, as abnormal to the point of disease. (It's not just being shy anymore, it's "social anxiety disorder" emphasis on disorder.)

    We've been over the subject of this lowering the bar for disorder in other threads. There's one where the OP wanted to get talk therapy to resolve feelings about his childhood - something probably 100% of us could use help with - but unless you're a victim of severe and sustained abuse, you likely do not have a "disorder" because mommy and daddy got divorced. But you might benefit from some help sorting your feelings. And the last thing you need is that sort of thing hurting your FAA medical.
     
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  16. CC268

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    So...just out of curiosity. If you are a career pilot (1st class medical), you can't go to a counselor without it being deemed some sort of depression/psychological issue and possibly getting your medical revoked? I sure hope not, if so, that is incredibly screwed up. Lots of folks who have gone/go to a counselor for normal life issues - I would consider that to be A LOT more healthy than someone who doesn't seek any outside help.
     
  17. steingar

    steingar Taxi to Parking

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    With respect, I vehemently disagree with most of this. First, the most common form of psychoactive medication that most people will encounter will be monamine uptake inhibitors. They are very effective in dealing with clinical depression. What they are ineffective at dealing with is a temporary crisis. Clinical depression is caused by changes in brain chemistry that can be counteracted by monamine uptake inhibitors. A temporary crisis often causes unhappiness, which cannot be treated with monoamine uptake inhibitors. The only medication I've ever heard of to counteract unhappiness is alcohol, though it does have side effects and isn't universally beneficial. I've heard that the love a good man or woman can also be efficacious toward the treatment of unhappiness, but again there's the whole thing about side effects and unintended consequences. The biggest thing about taking medication to bridge one through a tough situation is their use will set off huge alarm bells with our friends at the FAA and could muck up our flight plans.

    Severe psychosis is a world away from what we're discussing here. I do agree that medication should be a last resort, especially in the sort of situation we're discussing here.
     
  18. SkyDog58

    SkyDog58 Final Approach

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    So what?! If you are otherwise a well adjusted and successful person, who gives a damn about parties and other big events? You’ll find those have little to do with a happy and successful life.
     
  19. dtuuri

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    Pshh.. go roller skating. Meet some chicks, get some exercise, listen to some music, improve your coordination. After that, go have a beer, dance a little. Fly the next morning.
     
  20. Rushie

    Rushie Cleared for Takeoff

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    Re-read what I wrote: "severe psychosis or other disorder where normal functioning is impossible without them". Clinical depression fits the bolded part. Agree 100% about changes in brain chemistry, which is why you cannot "think" your way out of it. I define normal functioning as being reasonably happy, not just dragging yourself around yet managing to get through the day.

    I don't disagree about whether or not monoamine uptake inhibitors are effective for short term. Not sure why you're bringing that up; I am not just talking about depression and not just about anti-depressants.
     
  21. steingar

    steingar Taxi to Parking

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    Like I said, a world away from the problem at hand. Yes, things are done very differently for victims of psychosis.
     
  22. Rushie

    Rushie Cleared for Takeoff

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    I think the tricky part is what the counselor is going to put into your record, especially if you use insurance to pay for sessions. Insurance does not want to pay unless you have a "disorder". Psychologist/counselor/therapist wants to get paid, counselee doesn't want to pay out of pocket. Hence, disorder codes sneak into your record.
     
  23. 1RTK1

    1RTK1 Line Up and Wait

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    Agreed Rushie, One of the most important aspects of any medical office is proper billing codes, sometimes they are abused or used incorrectly