Need some psychology advice

I started going out with a fantastic girl a couple of weeks ago.  Everything is great, except that whenever I've sent her a text message or email requesting something and haven't received a response yet, I experience significant dysphoric anxiety, fearing that her response will be not just "no" but "no and I don't want to date you any more".  This is due to brain chemistry or personal history, take your pick—either seems like a possible explanation to me.  But there's certainly no evidence supporting the idea that this is likely to happen, nor is the anxiety helping me prevent it or helping me in any other way.

Does anyone have evidence-based advice, or pointers to same, on dealing with this kind of issue?  It is the only splotch on what have otherwise been the best two weeks of my life.

 

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I've found a CBT* technique useful for overcoming that sort of anxiety (it's called catastrophising). I write down the situation and my prediction in a spreadsheet. An example would be: Situation - at work, I emailed [girl]; she hasn't emailed back yet. Prediction - She is going to break up with me.

Then when you receive an email back, you write down the outcome in a third column, e.g. received email back - we are meeting up tonight.

Looking back over the spreadsheet, you can see how accurate your predictions have been. I expect they tend to be too negative.

*CBT (Cognitive Behavioural Therapy) has a strong evidence base.

ETA: I hope that explanation is clear - I'm in a bit of a rush right now! I really wanted to explain it though, as it's had an extremely positive impact on my anxiety levels.

For similar advice, I highly recommend the Feeling Good Handbook for both anxiety and depression.

It has lots of written exercises primarily aimed at contradicting irrational thoughts.

Thanks for this advice.

One reason I've been reluctant in the past to try CBT is that it seems to be predicated on an assumption that I find implausible. The assumption is that, if you actually conform your beliefs to the available evidence, you will no longer feel depressed, or as depressed as you are currently feeling. For example, CBT applied to body dysmorphic disorder proceeds by challenging the beliefs that patients have about their own attractiveness. But what if you are, as you believe, truly unattractive (as most men seem to be)? And what if lack of physical attractiveness has a major impact on most aspects of your life (as seems to be the case for both men and women)? As far as I can see, in these cases CBT would be ineffective at best, and counterproductive at worst, since the beliefs underlying your negative feelings would in fact be true, and supported by the available evidence.

For example, CBT applied to body dysmorphic syndrome proceeds by challenging the beliefs that patients have about their own attractiveness. But what if you are, as you believe, truly unattractive (as most men seem to be)? And what if lack of physical attractiveness has a major impact on most aspects of your life (as seems to be the case for both sexes)?

Assuming both of those are true, CBT isn't be about denying that. The next step would be to ask "why is that bad?" and "exactly how bad is it?" Eventually, if you do it in a precise structured manner, you'll find some irrational thoughts hidden away somewhere (for example, "if I'm physically unattractive I'll never find romantic love" may be one irrational thought, which is easily countered by pointing out that lots of unattractive people are married).

The act of writing it down and following a structured approach is also really important. Even if you know a thought is irrational, it helps to write down all of the reasons it's irrational. I don't know why, but the act of writing it down seems to be important even for things you already "know" in order to believe them on a gut level and actually start to feel better.

All of this is described in the Feeling Good Handbook, which you should be able to find a free pdf of if you can't afford it.

Assuming both of those are true, CBT isn't be about denying that. The next step would be to ask "why is that bad?" and "exactly how bad is it?" Eventually, if you do it in a precise structured manner, you'll find some irrational thoughts hidden away somewhere (for example, "if I'm physically unattractive I'll never find romantic love" may be one irrational thought, which is easily countered by pointing out that lots of unattractive people are married).

I don't want to sound overly negative, but why assume that an honest answer to those questions will make you feel better, rather than worse? People who are deceived about themselves typically suffer from illusory superiority, overestimating their positive qualities. So why think that a therapy that proceeds by correcting these false perceptions will make people feel better about themselves?

The example you mention about romantic love is quite telling. Unattractive people have a much harder time finding romantic partners . And the partners they do find tend themselves to be unattractive. (The issue of physical attractiveness is of course just one example. There are many other cognitions underlying depression and anxiety which may also be rooted in solid evidence.)

All of this is described in the Feeling Good Handbook, which you should be able to find a free pdf of if you can't afford it.

Thanks, I have a pdf of that book, which I intend to read partly on the basis of your recommendation (even though I don't suffer from depression).

But why assume that an honest answer to those questions will make you feel better, rather than worse?

I think it's not that an honest answer will make you feel better. It's that a detailed honest answer is more likely to help you find tools for improving your situation, while a generic honest answer will make you feel bad and very little else. It's really just general steps for solving any problem.

Unattractive people have a much harder time finding romantic partners.

Much harder doesn't mean impossible! How much harder is it? How many people that look [a certain way] have partners and how many don't? Where did the ones that do have partners find their partner? Maybe you could look there. What other personality traits did they develop that helped them succeed at dating while looking [that way]? Maybe you could work on those!

And the partners they do find tend themselves to be unattractive.

This statement really requires data. Unattractive to whom? Probably not to them.

I don't want to sound overly negative, but why assume that an honest answer to those questions will make you feel better, rather than worse?

It's not an assumption; four weeks of bibliotherapy in the form of reading Feeling Good and doing the exercises has been shown in experiments to be superior to a placebo book for treating depression (75% of patients no longer qualified for DSM criteria of major depressive disorder afterwards), and the improvements were sustained at 3-month and 3-year followup.

Of course, you could then argue that the book doesn't actually make you evaluate your situation honestly and is just mindless positive thinking, but I don't think that'd be a fair assessment of the book.

The example you mention about romantic love is quite telling. Unattractive people have a much harder time finding romantic partners . And the partners they do find tend themselves to be unattractive. (The issue of physical attractiveness is of course just one example. There are many other cognitions underlying depression and anxiety which may also be rooted in solid evidence.)

Sure, but my example was "if I'm physically unattractive I'll never find romantic love" not " "if I'm physically unattractive I'll have a much harder time finding romantic love."

This review of the Feeling Good Handbook, which I just found, makes essentially the same point:

It really disturbs me that an entire school of thought has developed around the idea that nobody needs to be depressed, and that if they are, it is simply because they are not being "rational". For many people this is true. [...] But for many of the rest of us, being depressed is simply being realistic. [...]

It is almost a scientific fact that people need to be acknowledged. When a baby is ignored by its mother, very often it will get sick and die, even if it gets plenty of food and water. I believe that there is a biological need for love, no matter how old we are. Humans also have a variety of other needs, as discovered by Abraham Maslow in his heirarchy of needs. People who are mentally or biologically inferior have more difficulty in getting these needs met, and to me it is a mistake to label these people as "irrational". We are, indeed, not created equal, nor are we equally capable of being happy. In many cases it will be possible to feel "better", but it may never be possible to feel "good".

That's not quite how it works. Sometimes rational people get depressed and they can tell that their thinking is distorted and un-distorting it doesn't make them feel better. They just feel bad. Meanwhile, some depressed people contribute to their depression through cognitive distortions, such as all-or-nothing thinking and catastrophizing that PECOS-9 pointed out, and CBT can help (though not necessarily cure) that subset of people.

But for many of the rest of us, being depressed is simply being realistic.

Feeling bad about a problem is only useful if it helps motivate you to do something about it. If you can't completely fix a problem, then once you've done everything you can about it, feeling bad becomes useless and you shouldn't feel bad anymore.

A recent study in the American Journal of Psychiatry found that CBT was no better than psychoanalysis. On the plausible assumption that psychoanalysis doesn't work (better than a placebo), it follows that CBT doesn't work either.

For discussion, see this post by Scott Alexander (Yvain).

Please edit the above to read "by Scott Alexander" - the blog doesn't carry his name for patient privacy reasons.

"Oh no, what if X happens, what'll I do? I might lose Y!"

I find that asking and answering a couple different question helps.

"What'll I do if I lose Y?" Not gnashing your teeth over losing Y, but actually answering the question. "If I lose Y I will ..."
"What's my best strategy here?"

One claim in some depression book - catastrophizing is at bottom a worry that you won't be able to handle the loss. It's a boogeyman in the closet, and you're too scared to open the closet and check, so live in fear, night after night, that the boogeyman will jump out and get you.

Open the closet and look. The boogeyman is there or he is not. Do you think he won't come out and kill you just because you refused to look to see if he was there? Buck up and look. What you'll likely find is that the boogeyman really isn't so fearsome, and your fear of the boogeyman is more crippling than anything he might do to you.

Either you'll spend from here to eternity with this fantastic girl, or you won't. Likely not. Someday you'll lose her. You'll weep and moan and move on to some other girl in a few weeks. Or maybe you'll dump her. You'll look back on your time together fondly, perhaps guiltily, when you're with someone else. Or perhaps 5 years from now you'll be struggling to remember her name.

Closet opened. Boogeyman faced. Situation handled.

Now, you look at your options in a game theoretic sense.

She's on the verge of dumping you, or not. You can fret about, or blithely go on as if nothing is wrong. Fretting makes either situation worse. Dominated strategy. Do not do.

You can handle it if she dumps you. Trying to read the tea leaves for the impending dump only makes you look and feel insecure. Do not. She'll eventually let you know if she wants to dump you. Until then, you're seeing a fantastic girl. Make hay while the sun is shining.

I'm a worrier. I'm trying to get over it. Part of it seems like fear is a response to uncertainty. Remove the uncertainty. Face the issue, pick a strategy, and move on.

Either you'll spend from here to eternity with this fantastic girl, or you won't.

Fallacy of grey. The “you won't” possibility includes them breaking up tomorrow, them breaking up next year, or either of them dying in thirty years, among others.

Have you dated before?

It sounds like these contact points are natural accumulation points for your anxiety - not so much that you're specially anxious about them.

That said, what sorts of things are you requesting? I'd recommend a shift to make suggestions, or invitations where a 'no' answer can very clearly (even to you) be accompanied by 'It's sweet of you to offer, though' rather than 'GTFO'. If requesting something comes up so often that you've noticed the pattern, and they cause an aversion, perhaps you should avoid making so many requests per se?

I have dated before, but not much. The most significant relationship I've had, I sort of begged her to go out with me (to be fair to myself, I was pretty convincing), moved to another city to be with her, and was "contracting" as a job which really meant sitting around websurfing all day. There was no structure in my life and I couldn't hold things together, and after a few months she decided to break up with me and move 1000+ miles to go back to school. This was a formative experience for me and I'm sure it's related to my current anxieties.

Omigosh, that sounds awful. I'm sorry you had to go through that. Internet hugs!

You've already recognized the pattern. Now, when you send her an email, before anxiety kicks in, plan out a realistic anxiety schedule. You tell yourself, "I am sending this now, and I recognize that she might not respond tonight. Or tomorrow. But she usually replies within three days. If she hasn't written back in four days I'll be justified in feeling anxious." Precommit so you're not constantly thinking, "It's been 7 hours. That probably means it's anxiety time, right?"

I think that CBT techniques could be helpful. They tend to be about reasoning things out on paper in a structured manner.

You could work on realistically assessing how likely the feared result is, and on assuring yourself that, even if it happened, you could cope with it.

I'm resisting the urge just post a one line comment saying #humblebrags by posting the comment anyway and giving some advice :)

Below Joshua mentioned studying PUA and I agree. One method that works for me that I learned from PUA is to try to convince yourself that you don't care if she breaks up with you. Tell yourself "she's just a girl" or "there's plenty of fish in the sea" or whatever motivates you. I also combine this with a "just fuck it" attitude. If I find myself worrying about something like this, I'll say either in my head or out loud "fuck it. If she doesn't want to respond I don't care. I'm going to go play video games/exercise/whatever." (The "just fuck it" attitude only seems to work specifically with social interactions, in my experience. If I have reservations about other things, typically it's for a good reason)

Typical mind fallacy applies here - what works for me might not work for you or might have negative side effects, but you don't really know until you try.

So I think a variant of this approach is useful and a variant of this approach is really harmful. If you say "fuck it, she's not important," you'll be conditioning yourself not to care about her or even actively resent her for "making" you anxious. That way lies a lot of badness.

Nevertheless, I do think it's handy to come to terms with the idea that if she decides to break up with you, then it's not the worst thing in the world. It's an admittedly sucky but manageable state of affairs. You will be a finite amount sadder than you were when you were single! And although you have some influence on her decisions, you have no control over them. So think "I have done everything in my control in this situation. Now I will go play video games/exercise/whatever." This is a more detailed, more accurate, healthier variant of "fuck it, she's just a girl."

Fantastic girls are important! But they're not your whole life! But they are also not unimportant! There's a large range in between those two!

But there's certainly no evidence supporting the idea that this is likely to happen, nor is the anxiety helping me prevent it or helping me in any other way.

A simple way to put that anxiety to use would be whenever you feel that anxiety, to do 10 pushups. Becoming more fit makes you more attractive, so it's not irrational to start doing more sport to increase your chances with woman.

Channel the anxiety into some useful activity.

From personal experience the best advice is to date a lot and get hurt a lot and build up a thick enough skin to where you don't care anymore about the rejections.

Worrying about the rejection will only make rejection more likely.

Act as if you are a confident person, then other people think you are confident, and you'll become more confident. While of course actually trying to do things to actually become more capable too, since that improves your confidence as well.

The other ideas here also are good techniques too, but what I found is that when I had been burned enough to stop caring about rejection was when I suddenly became successful at dating. The main thing that had changed was not worrying about it.