The earthquake of September 4th 2010 and again on February 22nd 2011 have had a significant effect on most people living in Canterbury. Our reactions to the earthquakes are not universal, but are as individual as we are. One person’s reactions and coping styles might be completely different to the next person’s. We know that allowing ourselves time to grieve and process what has happened, in our own way, is essential to the recovery process.

Most people are affected by further aftershocks, images, sounds, or movements that remind us of the earthquakes. Usually our reactions to these reminders will fade after time. However, some people may continue to experience very high levels of anxiety which impacts on their quality of life. They may feel unable to return to activities they engaged in prior to the earthquakes and may find themselves ‘stuck’ in unhelpful thinking.

An example may be “Lydia” who avoids going anywhere without her handbag, in particular her cellphone, and refuses to go into multi-storey buildings. This is causing her problems as her work place is on the fourth floor. In addition to this, she takes very short showers for fear that another earthquake could occur while she is in the shower and she would be unable to seek help. Lydia also spends a great deal of her day worrying about the possibility of another earthquake and what she would do if this happened. She reports a lot of “what if” thinking and she tends to ignore any information that does not support her worries.

People experiencing on-going high levels of anxiety, which negatively impact on their ability to return to life as normal may benefit from Cognitive Behavior Therapy (CBT). CBT is a time limited, skilled based therapy, which helps people recognise and manage unhelpful thoughts and behaviors.

Using CBT, Lydia firstly explored her beliefs about the earthquake. The concept of uncertainty was explored – whereby she recognised that a lot of her anxiety stemmed from the need to gain certainty about the next earthquake. She recognised that no-one is able to be certain about when earthquakes occur. Specific techniques were taught to allow Lydia to ‘sit with’ her uncertainty, instead of struggling against it. She also recognised that she had been ignoring a lot of information that contradicted her worries. For example, Lydia remembered that during the February earthquake, she did not have a mobile phone and she managed extremely well.

A number of behavioral experiments were established to help Lydia test out her fears. For example, she agreed to walk around the block without her handbag or mobile, to test out her fear that “there could be another earthquake and I wouldn’t be able to get help”. She also decided to have showers for increasingly longer periods of time to test out her same fear. Lydia started to go into multi-story buildings to test out her fear that there could be another earthquake, but also her fear that she would become overwhelmed with anxiety and have to leave.

As a result of engaging in these experiments, Lydia noticed that her anxious predictions did not occur and her anxiety reduced. A big step for Lydia was recognizing that her anxiety had no impact on when another earthquake might occur, nor did it help her to cope in any way. In fact, she realised that instead of helping her, her anxiety was holding her back from re-building her life after the earthquake.

As a result of engaging in CBT, Lydia reported that her anxiety had significantly reduced and that she was starting to enjoy activities that she used to engage in before the earthquake (including going back to work) – as a result, she noticed her mood improved, too. She gained a sense of control of her feelings about the earthquake and said that she no longer felt terrified.

If you are noticing recurrent unhelpful thoughts, avoiding things you used to do, and feel that this is negatively impacting on your quality of life, seeing a CBT therapist may be of benefit to you.

Essentially, social anxiety is driven by beliefs the person holds, such as they will say or do something embarrassing or make a fool of themselves; that others are thinking about or judging them negatively; or that there is something wrong with their appearance. Understandably, such beliefs lead to the person focusing on themselves in social situations rather than on the person they’re talking to. This increased self-consciousness increases feelings of anxiety and embarrassment, and unpleasant, but harmless, physical responses such as feeling hot, sweaty, shaky, and blushing. Naturally, when people fear the worst in social situations they tend to avoid those situations. Alternatively, they may face the social situation but do things to prevent their worst-case scenarios from occurring. This might include avoiding eye contact by looking away or wearing sunglasses, rehearsing what they are going to say, using alcohol for “Dutch courage”, wearing make-up to hide blushing, and doing things to make them feel less obvious like sitting in a corner or not asking questions. While these behaviours may seem helpful at the time, they actually maintain social anxiety rather than reducing it. For example, try rehearsing what you are going to say to someone while you are talking to them – we become distracted and in turn give the impression that we are not interested in the other person. Similarly, avoiding eye contact may give the impression that we are rude. Simply avoiding social situations means that you don’t get to find out that things can go well!

Fortunately, there is an effective treatment for Social Phobia. Cognitive Behaviour Therapy (CBT) has been found to be effective in treating and reducing social anxiety. CBT is a practical therapy that focuses on the here and now and encourages people to gradually let go of behaviours that are maintaining anxiety. This includes decreasing avoidance and reducing unhelpful behaviours such as limited eye contact, and adapting the way we think about social situations and ourselves. Further, CBT aims to reduce self-consciousness by developing the ability to focus on the person you are talking with and losing yourself in conversation, rather than being focused on focused on the impression you believe you are giving.