How Are We Today?

- [Narrator] Major support for this program was provided by Nancy and Nyle Maxwell.

(bright music) Emerson.

(bright music) Kathy and Charlie Izard.

(bright music) Additional support was provided by Amanda Jensen and Scott Bonneau, Amado DeHoyos, Georgetown Health Foundation, Kristen and John Nelson, (bright music) and by, (bright music) And also by... (bright music) For more information and a full list of funders, please visit us at HowAreWeToday.com or AptOnline.org.

The information provided in this program is for general educational purposes only, and is not intended to constitute medical advice.

This is not a replacement for therapy, and does not constitute therapeutic services or a therapeutic relationship.

For personalized medical guidance, or in the case of an emergency, please contact a healthcare provider.

(bright music) (bright music continues) (bright music continues) (bright music continues) (gentle music) (ominous music) - Ah, I got you.

How are we today?

Sorry, I can't help myself because I'm in very high spirits.

It's my favorite day of the year.

Halloween.

- Boo!

(Barry giggling) Gotcha.

- Barry, you sneaky, sneaky monkey.

- Hey, I'm not a monkey!

I'm a dog.

See the ears?

- I see the ears, Barry.

Oh, man.

Dressing up and being silly is one of my favorite things about Halloween.

It's the one time of the year that we all get to cut loose, right?

And just be ridiculous.

Get out of our comfort zone.

Incoming mental health metaphor.

Because even though we all wear masks during Halloween, it's actually a really good time to showcase our personality, right?

We get to share what we think is cool, what we think is interesting, or scary.

Maybe you want to dress up as a character whose qualities you wish you had.

Really, this is just a chance to become more fearless, right?

Because that's the best part.

You get to be anything you want to be.

And it's one of my favorite things about it.

I get to see what everybody comes as.

Yep, we're just a bunch of ghosts, goblins and ghouls bobbing for apples in a judgment-free zone filled with candy, and Barry, what did I tell you about the pumpkins?

We gotta save those for the ladies!

- Ruh-ro!

Sorry, I forgot.

I'll put aside the less nibbled ones for Barbara and Mariel.

(dramatic music) - [Both] Happy Halloween!

Jinxies!

- Hey gang, thanks for bringing over the rest of the sweets and oh, Mariel, can you put the sign on the front of my door?

- You had a whole sign made?

Did you invite the whole block?

- Nah, just the entire building.

And, of course, one bonus Barry beaver.

- Barbara, Mariel.

Oh, you would not believe.

Some costumed fiend started eating all your pumpkins.

But I stopped them.

- It was Barry, wasn't it?

So did everyone RSVP?

Or just us?

- Almost!

Everyone except the tenant down the hallway.

Which come to think of it, I don't even know who lives there.

- Which unit?

- Apartment 13.

(blood-curdling music) - We do not speak of that place.

- What?

Apartment 13?

(scary music) - Ssh!

A lost soul is said to lurk there.

There's all these kind of creepy sounds that come from that apartment, and no one is ever seen coming or going.

- Except the pizza guy.

- And the cable Internet provider who only shows up between 7:00 AM and 6:00 PM, or whenever you're not home.

(creepy music) - Wait, you mean to tell me that no one has ever seen the person in apartment 13?

(creepy music) Oh, are we gonna do this bit every time?

- Okay.

I may have seen someone once.

But it was just a glimpse.

Mariel, do you have any dry ice?

- Oh, yeah.

I snuck in last night and put it in the freezer.

- Oh, come on!

- Perfect.

(cauldron bubbling) Okay, like I was saying, it was just a glimpse.

I'd picked up some groceries after work.

So I'd gotten home a little later than usual.

(tense music) I'd never been to the end of the hallway before, but you could hear noises sometimes at night.

And that night, they seemed especially loud.

So I got curious.

Suddenly the noises stopped.

As if they sensed me.

I was filled with fear.

- [Mariel] Like what they might do to you?

- Worse.

How embarrassed I'd feel if they caught me standing there awkwardly in the hallway.

I could hear my heartbeat in my ears.

I can still hear it now.

(rhythmic beating) - Barry, can you not right now?

- Oh, sorry.

I tail tap when I'm nervous.

- I had to get away before I looked really silly in front of someone.

(tense music) (orange bouncing) (tense music) (tense music continues) (tense music continues) (Barbara screaming) - Wait a second.

You guys mean to tell me you're scared of somebody you've never seen, and they have sounds coming from their apartment?

Guys, that's ridiculous!

I mean, do you remember how we met when I was playing piano all night long?

- Yeah, that was mediocre piano playing.

These are creepy, scary sounds.

- Okay, we're putting a stop to this.

I'm going over there right now to personally invite them because I'm sure they are totally normal and have totally normal hands.

(gentle music) - We're never gonna see him again.

- I'm gonna start writing a eulogy.

- I'm gonna go through his stuff.

(eerie music) (door knocking) - [Sarah] Are you the pizza guy or the Internet guy?

Because I'm hungry and the Internet is still out.

- [Tyler] I'm your neighbor from down the hallway.

The one throwing the Halloween party?

- Oh, right.

I got the invite.

I mean, thanks for the invite.

I was gonna come by, but then my Internet got messed up.

So trying to mix it, I mean, fix it, 'cause I had to Google a costume thing and then I got hungry, ordered pizza, 'cause I need food.

And anyway, I mean, I didn't know if the party would have food.

I mean, I'm sorry, I'm rambling.

- It's okay.

It's totally fine.

I don't have any pizza, but I do know something about fixing Internet modems.

And your place is amazing.

This is incredible!

- Oh!

Yeah.

I mean, thank you.

I mean, sorry.

It's been so long since I've had a visitor.

- It's totally fine.

Look, how about we do intros, yeah?

I'm Tyler.

- I'm Sarah.

It's very nice to meet you.

- It's nice to meet you too.

Where's this Internet modem of yours?

- Oh, the modem's over there.

Do you mind if I finish up something?

- Yeah, totally.

Ah, this is gonna be real easy.

Let me just fix this connectivity issue.

(tense music) - Unhand our friend!

- No, it's not, I'm just... - Guys, guys.

She's just.. - Trying to finish this cosplay costume.

- Is that what all the noises were?

- Was I too loud?

Shoot, I was worried about that.

Sorry!

It's hard to 3D print and fabricate props without making a little bit of noise.

I'll try and be quieter.

- No, that's okay.

I mean, this is amazing.

- Yeah, see?

I think we all just need a little reset right now.

- Hi.

- Hi.

- Oh yeah, sorry.

This is Sarah, by the way.

- Thanks, Tyler.

I work remote full time, so constantly having Internet issues sure does make for longer days.

- Oh, so that's why you never leave your apartment.

- Mariel!

- Oh, sorry.

- You noticed that?

I mean, yeah, I guess that's part of it.

But it wasn't always this way.

I've always had some social anxieties, you know?

But it wasn't always this way.

Sorry, I already said that.

I was pretty functional.

Like, I would take little breaks at work, or quick hangouts with friends.

Just five or 10 minutes to take a breath and recharge.

And I got really into cosplay.

I would go to conventions and make new friends with lots in common.

I think sort of hiding behind my costume helped me be more of myself, you know?

And I feel like I was still awkward and had to work through worries about being embarrassed, but I was happy going to work again, being around friends in social settings without feeling constantly overwhelmed.

And then the pandemic hit.

(traffic noises) Honestly, it was way easier to shelter in my apartment than it ever was interacting with people.

Do my own cosplay shoots at home and work remotely.

But that was the problem.

'Cause I'd worked so hard to get comfortable around people, everything got undone.

Life was easier and more comfortable than it had ever been for me.

And once the world reopened, well, I just didn't know how to come back to it.

(gentle music) (phone buzzing) (gentle music) And then everything got scary.

Every little interaction, it kept building.

The more I stayed home and avoided it all, social events, immersing myself in things I love, being around people.

Every interaction was too much.

I started ordering everything in.

Groceries, food, left at my door without any interaction.

(tense music) It was much easier to just ghost everything, which I know sounds awful, but I couldn't help it.

And all day, the noises, people coming and going, it filled me with fear that I'd have to face any of them.

I was just so nervous about what would happen if I ran into any people.

Like what if we were both walking down the hallway, and we introduced ourselves, and then they went in for a handshake, and I went in for a hug?

That would be mortifying.

Or what if you thought someone had come to see or tried to talk to you, but really they didn't.

Horrifying, right?

I don't know if I'd ever go outside and be around people again.

And I guess I kind of didn't.

Sorry, I just kind of dumped that all out on you.

I bet you guys think I'm crazy.

The crazy lady of apartment 13.

(dramatic music) - Okay, are we gonna run this gag into the ground?

Who's directing this episode?

Mel Brooks?

- Wait, what?

- Nothing.

- I just, I don't think I could come to the party.

It just feels like it might be too much.

- Sarah.

That's perfectly fine.

We wouldn't want you to be uncomfortable in the first place.

I mean, we know you've been dealing with this I guess for a while now.

- Oh, and thanks for the orange.

- You too!

That is very embarrassing.

You did not give me an orange.

Oh, my God.

- Welcome to my nightmare.

- See, we're breaking the ice here, all right?

Well, Sarah, the invitation's open if you wanna come, but it's totally up to you.

And I do promise you there is nothing scary out there.

(tense music) (all shouting) - Sorry, Barry said y'all were down here.

- And I didn't wanna be all alone.

Started to get the heebie-jeebies!

- Well, you two, this is our neighbor, Sarah.

- It's nice to meet, Sarah.

- You're not that scary after all!

- [All] Barry!

- It's okay.

You guys aren't that scary either.

And by the way, Erin, I love your costume.

- Thanks.

I feel like it might be a little elementary.

But I always wanted to be a detective.

Maybe that's because I get to do a little detecting as a doctor.

- Ooh!

- That reminds me.

I'm seeing my doctor tomorrow.

Well, online, that is, since I switched to telehealth.

Thanks again, Tyler, for fixing the Internet.

And oddly enough, we're working on exposure therapies to help with my social anxieties, though it's pretty difficult to do over a computer.

- Oh, that can happen with telehealth.

I think teletherapy can be so helpful for some people, but other times, it doesn't work quite as well.

It just kind of depends.

But I do find sometimes with social anxiety that the going into the office part can actually be part of the therapy.

It's kind of a shame that modern conveniences can actually encourage avoidance.

Things like delivery apps and email and texting, they make it really easy to avoid any interaction that makes us uncomfortable, which can actually create some bad habits.

- Well, doc, are you saying that the delivery apps have increased Sarah's fear of leaving her house?

- Let's unravel this quandary, shall we?

So it's not the actual apps themselves.

That's not what makes people nervous.

Nor is it doing something against your values or habitually, like how typical bad habits start.

It's really more about the avoidance.

When we avoid things that are scary, they stay scary.

When we avoid things that are new, they stay new.

It's the avoidance that actually builds the fear.

- That's what my doc said.

That's why it was so much easier to go out before the pandemic, when I was doing it often.

The more I went out, the easier it was.

Now it's the opposite.

The more I stay in, the harder it is to go out.

- So I guess you're worried about being outside?

Or is it just being around people?

- It's more like I'm scared of anything embarrassing happening.

- Yeah, with social anxiety, it's actually more like a fear of unexpected social behavior.

At its root, it's really more like a fear of being laughed at or judged, or doing something embarrassing.

So with exposures then, it's all about building tolerance to those feelings, and we really take it one step at a time.

And each step gets a little bit easier as we go.

- And Sarah, you can come over right now if you want to.

There's nobody there except for us.

So if you wanna come over early, kind of check out the place.

But, no pressure.

- That sounds a lot like what I used to do with my therapist.

Little steps, practice being out with people, practice my bravery.

- Yeah, that's exactly how exposures work.

If we're avoiding things that are scary, especially in situations where it could be important to us, or that would lead to a more meaningful values-based life, we wanna take steps to build tolerance of those feelings and build that bravery.

Instead of letting the anxiety get in the way, we really wanna face those fears and build up that bravery.

Sometimes it's kind of like climbing a ladder, but you don't wanna jump to the top step of the ladder, or the scariest thing.

That's too overwhelming.

We have to climb the steps that we're on, so we just take it one step at a time.

- So if I were afraid of spiders, rather than going straight to holding my friend's pet spider, I could just start with looking at a picture of a spider?

- [Tyler] Like this one?

- Ah!

Tyler, I wasn't ready for that!

- Why do you have a picture of a spider saved on your phone?

- Don't worry about it.

- Aside from that, yes Barry, that's exactly how it works.

- Except with my social anxiety, it's not a spider that I'm scared of.

It's the idea that I could do something embarrassing, or someone could judge me.

So it's not like I can look at a picture of that.

So I have to practice going out, and sort of risk that embarrassment.

- That can be the hardest part.

We want to make sure that nothing awkward ever happens, but we can't actually guarantee that.

So we go out anyways, because usually at the end of the day, it ends up being worth it.

- I do miss people.

I miss my friends.

I do want things to be easier, and I think I'll come to the party, if that's okay everyone?

- I think that's a great idea.

But, question, do you have a costume you can wear?

- Yeah, I think I could find something.

Let me get something on and I'll head over.

- Sounds good.

Guys, let's get out of her hair.

- See you soon.

(jaunty music) - Okay, gang, remember, let's let her acclimate, okay?

When she first gets over here, it's all about baby steps.

- Exactly.

Bravery is all about approach.

And this could be a really scary step because even just wearing a costume at all could be risking looking silly or embarrassing.

So let's just be really supportive no matter what she shows up in.

(door knocking) (drumroll thumping) - [All] Whoa!

- [Barbara] Sick costume!

- [Mariel] You look incredible!

- The Caped Crusader!

- Thanks, everyone.

Figured I dress as someone who faces and embraces their fears.

- That's the perfect costume.

- Your place looks great, Tyler.

- Oh, thanks.

Yeah, I mean, I love going all out, and we have so much to do tonight.

We have bobbing for apples, I got karaoke, I have a pumpkin carving contest we're gonna do- - And we can take it one step at a time.

Because sometimes just showing up is the biggest exposure.

It's all about leaning into this scary thought, right?

And really risking the scary thing happening.

So we wanna have those thoughts show up.

Like what if I am laughed at?

Or what if I do something embarrassing?

Or what if I do something silly?

If the fear is doing something embarrassing or silly or weird, really what's happening is that the anxiety is trying to trick you into thinking that you can't handle it if that's happened.

But we've all had times where we felt embarrassed before, right?

- Mm hmm.

- The key is that it's probably not as bad as your anxiety makes you think that it is.

Or even if it is really bad and embarrassing, we can handle that.

Again, we've handled it before.

- Hey real quick, gang.

This is one that you definitely wanna do with your medical provider.

Okay.

- Okay, so you want us to actually do something weird or embarrassing?

- Yes, I do.

So with anxiety, remember how anxiety really wants us to hide or avoid.

Instead, what we're gonna do is we're gonna play a game called Pause and Play.

(jaunty music) This is a game that's all about exposures.

It's sort of like hide and seek.

So for the pause part, what we're gonna do is we're gonna pause, and really notice the feelings that are showing up, but more importantly, we're gonna notice the thought that's showing up.

Sometimes it's really easy to identify what the thought is.

Other times it's a little trickier.

So we wanna pause and see if we can notice what thought is showing up.

For example, if I'm bobbing for apples, am I worried about snot dripping all down my face and looking gross?

- Oh, gross!

- No.

- Or is the worry actually just that you'd be bad at bobbing for apples?

- I mean, the snot is pretty gross, but that kind of comes with putting your head into a bucket of water, right?

- Exactly.

So once we've noticed what the worry is, then we wanna pause, and the second step is actually just noticing what our values are, what's important to us?

So is it about being here with friends, being creative, being adventurous, having fun, playing games?

We wanna notice what the fear is, notice what our values are, and maybe notice how the fear is getting in the way of the values.

Then we wanna do the play part, which is where this gets really fun.

- You ready, Barry?

- Yeah, this is the part I'm interested in.

- Me too, Barry.

- So the play part is the exposure.

So remember that the fear in this case is all about doing something silly or embarrassing or being laughed at, right?

With an exposure, we wanna lean into that fear, or face it by actually doing something silly or weird or embarrassing.

So in this case, with play, we wanna actually take one tiny step towards being brave by doing something that might risk those feelings.

So we might actually do something silly or weird or embarrassing.

- Do you mean like slipping on an icy patch and a squirrel seeing and laughing at you?

- Well, hopefully not if you get hurt, actually.

- No, no, no, no.

- [Mariel] Very specific.

Has that happened before, Barry?

- No, no, no, no, no, no.

This is hypothetical.

- But remember that it can be kind of fun.

- [Sarah] Okay.

(all laughing) - Yeah, gonna need you to play with us and you can do it.

Just hang with me.

See if you can challenge yourself to sit with those thoughts and feelings and do the play part anyways, okay?

I'll jumpstart you with some examples.

Like make a weird noise.

Make a weird face like Dr.

Erin did.

Do a dance move on the spot, sing a song.

You get the idea.

We're gonna go first and then you're up next.

You got this.

All right gang, we're about to do this.

Sarah, you're gonna be first up.

You ready?

- I think so.

- Okay guys, let's do this.

- Okay, so we're gonna pause.

Notice any thoughts or feelings that are showing up, notice what's important to us, and then play!

(Barbara cawing) - Whee hee!

- Ready?

You're gonna do this with us.

Pause and play!

(Barbara cawing) (Tyler yelling) (Erin sighing) - That was great everyone.

- It was fun.

- And did we do it right, Dr.

Erin?

Does it have to be a funny face?

- No, it can be anything small that helps you feel brave when you're feeling worried.

- About doing something unexpected, like wearing sunglasses inside.

- Oh, crazy, Barbara!

What about wearing your hair in an unusual way?

- Oh, even wilder.

- Or say something awkward, like talk in a different accent around your friends.

(Barry giggling) - Barry!

- That was a funny voice.

- That was really good!

- Thanks.

- That is all perfect.

Anything that helps you hold those thoughts and feelings and do something brave so you can take a little bit of power away from the anxiety.

- Hey, great job everybody, seriously.

And Sarah, I'd love for you to stay if you'd like to.

- Sure, I think I can handle it, especially with my new friends.

And I never said thank you for everything, Tyler.

Everyone, really.

- And you never have to.

- That's Batman's line, Barry.

But being weird is the name of the game today.

So you know what?

Keep being weird.

Well, gang, mystery solved.

Remember, it's baby steps.

The slower you go, the faster you grow.

In the meantime, stay weird and take heart and take care.

- Why so serious, Tyler?

- That's not Batman, that's Joker.

- You know, Tyler, you either die a hero, or you live long enough to become the villain.

I always say that.

- [Tyler] That's Harvey Dent.

What are we doing?

Are we doing all the Batman characters?

- [Barry] Wow, Tyler, you need to chill.

Maybe put it on ice.

- [Tyler] Is that Arnold?

- [Barry] Yeah!

- [Barbara] So you're a movie star?

- [Barry] Yeah, but my TV's made of wood.

(bright music) (bright music continues) - [Narrator] Major support for this program was provided by Nancy and Nyle Maxwell.

(bright music) Emerson.

(bright music) Kathy and Charlie Izard.

(bright music) Additional support was provided by Amanda Jensen and Scott Bonneau, Amado DeHoyos, Georgetown Health Foundation, Kristen and John Nelson.

(bright music) And by, (bright music) And also by... (bright music) For more information and a full list of funders, please visit us at HowAreWeToday.com or AptOnline.org.