Written by: Megan Smith / Treatment / May 2020

Anxiety is a useful tool that we picked up somewhere along our evolutionary history. A long time ago, if a hungry tiger was lurking around us, it was worthwhile to be constantly assessing our behaviour and analysing the things that we are doing that could be harmful. Controlling our circumstances and our behaviour may have made the difference between hiding or escaping from the tiger and being caught and eaten. When danger was present, it made the difference between life and death. Unfortunately, this response is less functional when we perceive a constant threat, and when the actions required to save ourselves lie outside of our control.

With the emergence of COVID-19 in recent months, and the many dramatic lifestyle changes that have come with the disease, many of us are learning ways to manage our mental health that we had not needed to rely on before, partially in order to appease the parts of our minds that are hyper focused on the threat that we perceive all around us. Living in this state of constant stress has caused many people to feel unproductive, distracted, and anxious, after only a few months of exposure to this threat. Every decision that we make (e.g., to go out for a socially distant walk or to stay home; to get groceries today because it has been a week or to try to hold out one more day) carries this threat.

Unlike this imagined tiger, SARS-CoV2 is unlikely to wander away overnight. With an invisible and ever-present threat, our minds will not allow us to return to our normal, less biased thinking pattern. We do not get a reprieve from our stress that would allow us to recharge and be ready for our next dangerous situation. On Maslow’s hierarchy of needs, we are focused on the most basic: survival. Self-actualization (even including doing good work), socialization, even finding basic comfort at home are more difficult in this state.

Now, imagine that you are constantly perceiving communication as a threat. For years, not months, each time you interact with someone, there is a part of your mind alerting you at full volume to the fact that there is a chance for danger. Something about the way you communicate is risking the dissolution of this social connection, permanently. It could be your stutter, your lisp, your accent, or your inability to assert yourself, but whatever it is feels too risky to attempt. Your need to belong and experience love is challenged each time you open your mouth to speak, and so you cannot focus on building your own self-esteem or on self-actualization (in this case, maybe providing the best possible ideas at your team meeting at work). Until you resolve the more fundamental threat, you are stuck. Clients in this scenario will do anything they can think of to avoid this threat. And yet, much of this threat exists in their own thinking.

The thought “I could be exposed to COVID-19 if I stand too close to someone when I go outdoors,” is a true circumstance. There is external evidence for this belief in research and from experts in their fields. Behaving in a certain way (washing hands often, not touching our faces, keeping 2m apart in public spaces) will reduce our risk of catching the disease, and is also acting in alignment with our values (improving public health, self-care, protecting loved ones).

Contrast this with the thought “this relationship is currently under threat because of the way that I communicate.” Depending on your history, this thought may have evidence too. It is possible that in the past, or even in the present, you have been judged for your speech or communication. But the thought “I can [lisp, stutter, sound accented, say the wrong thing, etc.] in this conversation and still retain a strong social connection with this person,” also has evidence, if you look for it. And of these two thoughts with evidence supporting them, one thought promotes your mental well-being and helps you move towards your values by communicating genuinely and creating opportunities for success and connection. The other reinforces a fearful pattern of behaviour that pulls us farther from our values in order to avoid a perceived negative outcome.

In Acceptance and Commitment Therapy (ACT), two major acronyms are used to understand a person’s negative thoughts and feelings (in this case, about communication). One describes the areas in which people can become stuck:

F – Fusion of their thoughts and the world (e.g. having the thought that “my accent will cause people to think I am unintelligent,” and accepting that as a fact about the world rather than a thought in the mind);

E – Excessively difficult goals (e.g. “I will consider myself to be a successful communicator only if I never stutter again”);

A – Avoiding discomfort rather than allowing it (e.g., thinking the thought that “My colleague’s suggestion will not work, but if I tell him about the mistake he could become upset with me,” and choosing not to speak);

R – Remoteness of their choices from their true wants and values (e.g. knowing in a conversation that I want to share something genuine about myself to promote social closeness but ignoring my values and choosing not to do so).

When we act in these ways, we often feel frustration (that we cannot meet our own standards), guilt and shame (for failure to act based on our values) and increased anxiety the next time we enter the situation.

Another acronym describes the actions we can take to become “unstuck” and move on more freely in our lives:

A – Accepting our discomfort for what it truly is (not what our minds convince us that it is);

C – Choosing to move through that discomfort rather than struggling with it; and then,

T – Taking Actions that are consistent with our values rather than avoiding our fears.

For many of the clients we have work with, applying strategies within this framework and helping them ACT to replace FEAR helps them stop struggling against their thoughts, and instead work towards the things that they want from communication: success at work, stronger relationships, or better social connections.

One way to tell whether these strategies would be helpful is to determine whether your mind has fused to a story about your communication. Here is an example of a fused mind, locked in a negative thought spiral:

• I need to control this situation and not make mistakes.

• I am going to make a mistake.

• I should not have made that mistake.

• My lack of control makes me a bad person.

• The person I am speaking with is judging me right now.

• I need to get control of this situation and not make any more mistakes…

If this thinking spiral is familiar to you, and you find yourself with ever-increasing anxiety caused by these thoughts when communicating with others, you may be a candidate for this type of therapy approach.

At Well Said: Toronto Speech Therapy, we use a holistic approach to communication therapy and training that incorporates managing communication-related anxiety, regardless of its cause! To book an initial consultation with one of our registered speech-language pathologists, you can call our clinic at 697-795-5277 or book an appointment using the link below.