Social Anxiety

Imagine, if you will, a time before cities, a time before agriculture, a time when it was human versus the untamed world, alone and unsupported. Imagine this is around 50,000 years ago.

 

Imagine you are alone in this part of the world. You are sitting by a river, sorting the plants you have gathered. Some of these plants are edible, some are useful for making tools, some are poisons/medicines and some are just useless to you. You have a few tools, a thumping stick, a spear and a bowl you have carved out of a slab of tree with some stones. You don’t carry the stones, because they are heavy.

 

There are dangers around you. A crocodile in the water, if you get too close, a venomous snake in the tree, and over there on the horizon is a thylacoleo, a nightmare cross of a tiger and marsupial, like a thylacine (Tasmanian Tiger) on steroids. These things could all kill humans and would frequently do so given half a chance. However if you keep on your toes and are ready go hoof it if one gets too interested, you stand a chance.

 

Sooner or later you need to sleep. Different predators come out at different times of the day and night. The average person can stay awake for about 72 hours if necessary, however functional effectiveness usually begins to decline around hour 19. Basically, sleep at your own risk.

 

Time to get an ally. Someone who will watch over you while you sleep in exchange for you watching over them. This won’t work if you don’t actually honour your bargain. If you steal their stuff and leave, or kill them, then you’ve got no one. If they do the same, they have the same problem. Trust is very important. However what choice do you have? You need them and they need you.

 

Having an ally is great. When the Thylacoleo comes a stalking, you can work together to overcome it. Two are more likely to defeat this beast than one is. However if one of you gets seriously hurt during the combat, you are back to being alone. You need a spare.

 

Forming a trusted group of allies is even better than having just one ally. With one ally, someone has to be awake while someone sleeps. The average human needs 8 hours of sleep per 24 hours. This means that 16 hours in the day is spent sleeping for the two of you to remain optimal. With three people this drops down to 12 hours wasted on sleep, which is around the same number of hours as night time. With 5 of you, some people don’t need to interrupt their sleep – that is, every few days everyone gets a full nights un-interrupted sleep.

 

Other benefits of having a group is that you can exchange knowledge. “When I stick my spear in the fire and let it get slightly crispy, the end is harder and penetrates my prey easier”, “oh – that is how you start a fire, that seems really efficient” and so on. Another great advantage is keeping each other awake during wake shifts, collaborating in hunts, working together to build things and so on.

 

There is risk that comes with having a group. I like you, you like Jo, Jo likes Sasha, Sasha likes Alex, Alex likes Lee. But I hate Lee. If I have too much conflict with Lee then the rest of you might think you are better off without me. If a divide happens, and I am split off from the group, I am on my own while there are four of you to watch each others backs. I need the group more than the group needs me. When there were just two of us I had to put up with the irritating things about you and vice versa because we needed each other and we had a lack of choice. As the group expands, the need to put up with someone decreases. They either comply to the group rules or they suffer for it by being kicked out.

 

Often group rules are not explicitly stated. There are a few of them that are – we don’t kill each other, falling asleep during your wake shift is bad, don’t steal and so on. The ones that are really dangerous are less well stated rules, the unspoken rules, the implicit rules, the rules everyone else assumes but no one has told you about. The things you thought were fun but they think are taboo. Each group has them, and no one talks about them. Most people unconsciously adopt these rules and don’t really think about them until one is transgressed. At this point people look to the group to see if they all, or enough of them, agree with you. With support, you will look at the transgressor with disgust and they will either conform or get out. If I think an action should be taboo but no one else agrees, then I will either change my stance, or more likely begin a campaign to get everyone else to agree with me.

 

There are people that don’t pick up on social rules very well, and or miss social cues to say “you crossed a line” or “enough”. When the group recognises this, but sees value in the individual despite the difficulty they have with conformity, allowances can be made for that person. Some transgressions are frownable offenses (they get frowned upon, but tolerated) and some are zero tolerance, leading that person to be exited from the group. It is a sliding scale and not all group members will agree on what that scale is – either specific order or what behaviour crosses this part of the scale from acceptable to not acceptable.

 

Once you are fairly secure in your group, one tends to boundary test a bit. What can I get away with? Sometimes this is a power game – I wonder if I can get away with this… Sometimes it is a side effect of relaxing and being lazy – it’s a lot of effort to conform to that rule, so I’ll let it slide a bit. A consequence to this is risking being kicked out.

 

Once you are out, you need to quickly find another group to join. Humans don’t do well on their own. Once you find a group, you now need to learn their rules, because each group is different, has different goals and grows organically in different ways. Organic growth can look similar, but each is unique. When I hang out with the mercenaries, a certain kind of humour is not only tolerated but is welcomed. When I hang around religious people, that kind of humour is taboo. However there is no list of social rules, I am just supposed to know what these rules are.

 

Often it is easier for me to conform to the group than it is to get the group to conform to me. This works well when the new group is, for the most part, right. Or at least not blatantly wrong. They are a compatible level of right. 6 + 3 = 9 for my old group. This group prefers 3 + 6 = 9. Meh, close enough. However if they insist that 5 + 5 = 9, well that is just wrong. Now I need to work out – do I try to correct the group, put up with the wrong thing, or leave the group? If I try to correct the group, I may get kicked out of the group. If I put up with the wrong, I may become complicit with the wrong. If I leave the group, I’m on my own again – will the next group be equally wrong?

 

Conformity is a big thing in humans. We are biologically driven to conform or leave. Often, though, we aren’t conforming to the group per se. We are conforming to the leader of the group, who through strength of charisma, defines the explicit and implicit rules of the group. If they are good enough, they stay the leader. If they underperform, either the group suffers or the leader is replaced. If you cross the leader, you place yourself in quite a bit of danger. Non-conforming behaviour automatically brings you into conflict with that leader.

 

In this modern time, I live in a city with millions of people. Most of them are strangers. I have a few small groups that work with me, or perhaps, allow me to work with them, to survive. I have my family group, most of whom are allies, and some are Lee. I have my work, most of whom are friends of Lee – that is, associated and acquaintances – not friends, but not enemies either. I have social groups, the people I prefer to hang around with, but it is with a purpose.

 

For each of these I am expected to behave in a certain way to conform to their explicit and implicit rules. Behind these behaviours I need to hold on to who I am – me. If that “me” conflicts with a group, or where a group is going, I need to either decide to correct that group, correct me, or leave the group.

 

The thing I fear is discovering that I have transgressed a groups rules too late to correct and stay. That isn’t me choosing to leave a group, that is me being kicked out of a group. That lack of choice is a real kicker. Often I will feel like an imposter in the group while I try to figure out what enough of the rules are to survive.

 

Once I seem a bit more comfortable with the group, I can start to express my true nature a bit more. This has risk, but it also helps me to become a unique part of that group, where the good that I bring outweighs the odd that I bring, where odd is pushing that rule boundary a bit in non-conformity. After all, if there are multiple wood carvers and food is scarce, get rid of a surplus carver. However if I am the only one that makes high quality spears, then they don’t dare get rid of me. I need to find my niche in the group and make my “me” needed, yet at the same time, don’t cross enough rules that it is cheaper for the group to lose that niche than to keep me.

 

Social is complex. Social anxiety is the fear that we will be judged as not worthy of the group and we will be kicked out and end up on our own. We would often rather take on the isolated role through our own choice than risk being excommunicated by the group for transgressing some rule we didn’t know about, or some rule that doesn’t make sense. The danger of being rejected is real and the consequences can be devastating to the ego. Each rejection indicates that you failed to find a niche that was valued, and by simple logic it seems that there is nothing about you that is valued, that is, you think you are worthless. It is very hard to balance that role of being a conformed part of the group and being unique enough to be a niche filler. After all, if you are yet another woodcarver, what value are you? If your niche is rejected, again, what value are you?

 

The person working through social anxiety is hypervigilant to any signs of transgression – one’s own or that of others. Suggestions of rejection by group members will be klaxxon clarion bells warning you to comply, comply, comply, or run, run, run. Other people’s transgressions are used to try to understand the implicit rules better, or to work out which explicit rules are not as rigid as one was led to believe. It becomes baffling when Lee can transgress a rule and you get punished, and that is because part of the implicit rules is a scale of acceptance based on your perceived value to the group – a placement in hierarchy.

 

Hierarchy is often mistaken as a linear scale from least important to most important, when really it is more like a branching tree. The leader may be at the top of the hierarchy, but often they are actually the second top and the true power lies in the person behind the scenes. Or there isn’t so much a second in charge as there are several second in charges. Or George provides unique X so we allow them to get away with various Y, and since you don’t, you can’t.

 

I’ve covered here the basic biological establishment of groups and built up to some of the complexity of group engagement. This is just an introduction to some of the issues faced by people with social anxiety – the fear of people in groups and your place in them. It is distinct in many aspect to agoraphobia, which is the fear of being in a crowd [of strangers] and/or open space. I might cover that one in the future at some point.

Schizophrenia

All people have behavioural and psychological traits, such as being happy, being sad, being angry, having belief in a thing, being talkative, flinching from danger, being self centred and so on. The list is very long and changes subtly from culture to culture. When one of these becomes dominant they can progress into a disorder and then into a mental illness.

 

Frequently these disorders and mental illnesses can be managed by treatment, which can  include therapy, lifestyle changes and possibly medication. Most of these disorders are where there is an over expression or under expression of a normal human trait, possibly due to a chemical/hormone imbalance or a behavioural trait that is learned and can be unlearned.

 

Then there is schizophrenia. Schizophrenia is defined by positive and negative traits. Positive traits are behaviours and experiences that most people don’t have while negative traits are an absence of traits most people do have. An example of a positive trait is the soft drink dispenser asking you about your day where no one else hears it or experiences it (this excludes pranks or “smart dispensers” that talk to everyone), while an example of a negative trait is an absence of joy.

 

Along with positive and negative traits there is frequently a cognitive dysfunction. To a mainstream person, a person with schizophrenia will use chains of logic that almost make sense, but don’t. Dysfunction can also be lost memories, lost skill sets (I use to be able to do this, but now I can’t) and strange beliefs.

 

As with all conditions, schizophrenia presents on a spectrum. Simplistically we can look at a simple linear functionality spectrum, from managing fine in the community without medication, managing with medication and treatment, to not managing. However the reality is that the spectrum is multi-axial. That is based on how much of each of the above signs and symptoms are present and how capable is the person experiencing this is able to compensate and manage.

 

Schizoaffective disorder is a combination of Schizophrenia and Affective (mood) Disorder, where both symptoms of schizophrenia and mood disorder are present, but not quite enough of either to diagnose the person in either category. Often people will receive this diagnosis before being upgrade, if necessary, to the schizophrenia diagnosis later.

 

Please note that this is all a simplified version of what schizophrenia is and is not a diagnostic guideline.

 

Often people diagnosed with schizophrenia will be referred to, or refer to themselves, as schizophrenic. This is very common in mental illnesses and some other illnesses – to mistake oneself for the diagnosis. I am schizophrenic, I am autistic, I am diabetic, I am broken armian, I am chronic pain, I am momentary headache. The fact is, you are a person first, diagnosed with one or more of these issues as a description – not an identity.

 

Highly creative people are able to look at disparate information and make sense out of it. Examples of some of these creative people are artists and scientists. This ability is all about making unusual links and then testing to see if it is feasible and doable. Uncreative people are not able to make these links and follow more traditional means of connecting information together. People diagnosed with schizophrenia are thought to lack the second part of this ability – testing. That is, reality testing to check if it is feasible and doable. The hypothesis is that people with schizophrenia lack the important reality testing part that rejects ideas, thoughts and visions that shouldn’t work and/or exist and instead assume that these ideas are real and accurate.

 

Another angle on this hypothesis is that the brain misfires certain inputs (stimuli from outside the body, such as sight, touch, smell etc) or the processing of internal inputs (memories, thoughts) and ends up with a bizarre result. This bizarre result is then accepted as accurate rather than rejected before the conscious mind is aware of it. All brains misfire and come up with unusual result, but generally these ideas are rejected before much attention is given to them. A hypothesis about schizophrenia is that either this rejection isn’t very good, or that there are so many misfires that the brain assumes it must be true. Any lie told often enough takes on a hint of truth, so enough repeats of the wrong idea will start to seem right.

 

Schizophrenia seems to have a genetic component. If you have a family member with schizophrenia traits, then it is more likely that you will inherit it. This isn’t much of an increase though. Instead of it being about 1 in 200 people, you are now 1 in 100 people – which is not much of a shift. It can also be spontaneous, with no family history of schizophrenia. Most often it is developed during the early to mid teens. Some mind altering substances are thought to cause schizophrenia in some people, but the evidence for this is weak. Did the drug cause schizophrenia, or was the person already experiencing some symptoms that they were trying to treat with illicit drugs? Which was first? Or even if there were no preceding symptoms of schizophrenia, was the person going to develop them anyway, and drugs were a correlation rather than a causation? What has been evidenced is that some illicit drugs have a higher correlation with schizophrenia diagnosis than others.

 

Not all people with schizophrenia need treatment. It is estimated that roughly 1 in 3 people who experience these symptoms manage themselves without input from mental health teams and or medication. They experience full and generally happy lives. Another 1 in 3 of these people respond well to treatment, where they find the skills learned through therapy and or antipsychotic medication mean they can lead a fairly high quality community life. Unfortunately it is estimated that roughly 1 in 3 people don’t respond well to medication or therapeutic input, struggling to find meaning and quality in their life. The exact statistics are difficult to get as not all people who experience symptoms are diagnosed or have any interaction with mental health.

 

If you are in the last of these 3 subcategories, take heart. Many people who didn’t respond well to the medical model of treatment found good support from peers (those with similar experiences) via the Hearing Voices Network – a worldwide organisation. Even those in the first two categories have frequently found positive value in connecting to others. It isn’t for everyone, but it does exist and can help.

 

Another thing to look into is the recovery model. The idea here is that you have a thing, and it is big and somewhat disruptive. How can you manage that big and disruptive thing, minimising its impact? And wherever that big thing doesn’t disrupt your life, how much comfort and meaning can you get? Recovery is about recognising that this diagnosis is about a thing you have, it isn’t defining you. I have an arm – does that make me an arm? No. I am a person who is more than my arm. You have schizophrenia, that doesn’t make you schizophrenia.