Assertiveness.

I made it to today's CBT session at Clear Path. I had an opportunity to discuss some fears that have come up lately about the possibility of relapsing. I have made some progress before but it did not last long and I was back to feeling depressed and having panic attacks within a few months. I was reassured by Stephanie today that I am making good progress and that the work that I have done in the past, combined with what I'm doing now, are allowing me to develop the skills needed for long term recovery. 

We also discussed my issues with assertiveness and I was advised to read a chapter on how to properly express anger from the book Your Perfect Right. I have a really hard time with conflict and disagreements because the bodily sensations I get when I'm angry are similar to those feelings I experience when I'm very anxious. When I feel like that, I think that I won't have full control of my emotions and I fear that I will blow up rather than expressing my anger in a healthy way. This fear is what holds me back from confronting someone or expressing my anger and I prefer to avoid conflict whenever possible.

Today was a perfect example of how uncomfortable it is for me to be assertive. In the last ten minutes of my session with Stephanie at Clear Path, Dr. Kelly entered the room to discuss my plans for returning to work. As the conversation progressed I began to feel really anxious to the point where I was sweating heavily and I kept thinking that I'm being judged in a negative way by the very people that are there to help. Obviously they have insight into my condition and understand what I'm going through, but in the heat of the moment I tend to believe the worst. At that time it was difficult for me to pinpoint where all the anxiety and nervousness was coming from. 

As I was walking home I kept going over my thoughts trying to understand why I was so anxious. While I was on the subway I suddenly realized that it was the topic of the conversation that was triggering the anxiety. I was put in a situation where I had to articulate to Dr. Kelly what I wanted. I recall thinking, over and over again, I'm not ready to go back to work yet, I feel that I still have to do the exposure exercises in order to learn to better cope with the physical sensations and the fear. It took a while for me to finally express what I wanted but first I had to get over my fears. I had a fear of my employer not liking the possibility of me taking more time off work. I was also concerned that if I mentioned to Dr. Kelly that I felt like taking some more time off it would reflect negatively on Stephanie. Perhaps Dr. Kelly would think that she wasn't doing a good job or that I wasn't putting in enough effort. The fact that I did see Dr. Kelly as an authority figure also made me feel inferior, as if I had no right to tell him how I felt about my progress or my opinions about returning to work. 

The fear of other people being offended or disapproving of me were so intense that I almost kept my mouth shut despite knowing that I have an opportunity now for me to truly work on myself. I will take whatever time that is needed for me to recover from the panic and anxiety so that I can be productive at work . I'll definitely be reading the entire book on assertiveness and hopefully I'll learn some coping mechanisms that will allow me to be more assertive going forward.