Overcoming Fear of Rejection…The Hard Way

We’ve learned before about the importance of verbally confronting clients when psychological barriers are impeding their progress. Unfortunately there are times when you can talk a problem to death with no results. When that happens a client needs to do something to see change. A classic example of this is a common phobia: no matter how much you talk about your fear of flying, until you get on the plane and sit there and feel the anxiety until it subsides not much is going to happen.

This is known as Exposure Therapy and is based on the idea that anxiety is often a physiological reaction to a perceived danger. Through multiple plane rides (called “trials” in the shrink world) the body and mind starts to recognize that inherent danger is not present and the anxiety subsides. When a client can take that final step and begin exposure trials outside the therapy room life often becomes much better because Exposure Therapy has a great track record for treating fears and aversions. When he can’t take that step his therapist has to at least consider the possibility of taking it for him.

Consider my work with Bryan, a young graduate student who was working with me on a variety of dating issues for some time. Bryan put a lot of effort into therapy and we had a very strong working relationship. Most recently Bryan had been grappling with initiating phone contact with women. He could speak with them in person, get their phone numbers and even make tentative plans to go out with them but when the time came to make the call to solidify those plans, he would freeze.

Bryan and I talked about this ad nauseum over many weeks using every therapeutic technique in the book.

“C’mon Bryan, what’s going through your mind right now. I can practically see the wheels spinning in your head. Talk to me.”

“I don’t understand it. The odds of her saying yes are so high. I can’t get a grip on what I’m telling myself that’s making me lock up. Dammit!”

“Are you thinking that she might say no?”

“No. I’m actually thinking how great it will feel to get this call over with no matter what she says. I just want to get over this last damn step.”

“Close your eyes. What do you see when you picture making the call?”

“I see us having a great conversation that ends with a plan for dinner. Possibly seafood.”

“Great,” I said. “I love seafood. Go home, pick up the phone and call.”

“I want to but I know that once I leave here I’ll say ‘screw it’ and be back here complaining about the same shit next week.”

“How about this: call her here, in the office, right now. I’ll go outside so you can have some privacy.”

“I don’t know. That’s so…high school.”

“Maybe so but you’re not getting it done outside of this office.”

“No, I’ll just wait and do it later.”

“Bryan, who are we kidding? You just said that won’t happen. Even though you’ve told me that this date is a slam dunk you’ve got something blocking you. Instead of us analyzing that obstacle until we’re both tired and miserable just call her. It’s going to be fine. Would I ever lead you astray?”

“I think I’ll just wait…”

“Bryan, give me your Goddamn phone!”

“What?”

“You heard me. Give it to me.”

He reached into his pocket and cautiously handed it over.

“The number, please.”

He told it to me.

“It’s ringing. Here. You’re going to be fine. She’ll say yes and you’ll the next thing you know you’ll be at your local eatery hoping they name a fish sandwich after me.”

He took the phone, eyes wide, moved it slowly to his ear. Beads of sweat immediately appeared on his forehead. With his voice initially cracking he got out his name and a reminder on how they met. I stepped outside to give him a little space and when I no longer heard his muted voice and could make-out the snap of his cell phone closing I opened the door.

Ah yes, another successful therapy session as a young man finds true love! Rob, why you aren’t on every magazines’ Best Doctors List is beyond me. In fact you should start your own dating site: DrRobsHotLoveHouse.com.

“So Romeo, how did it go?”

“She said no” he said staring blankly at the wall.

Shit!

“She said no?”

“Right.”

“But…you said that this was probably a no-brainer.”

“Yeah I thought so. Apparently she was really drunk when she gave me her number and doesn’t have much recollection of me.”

Therapist Rule: If you believe you’ve made a clinical error address it head-on.

“I’m sorry about that Bryan. Maybe pushing you like that wasn’t the best idea. Are you angry with me?”

“No not at all. I think I’m still coming down from the anxiety of the phone call.”

“To be honest if you had made that call on your own and this had happened I would have said that while we knew there were no guarantees that she would say yes, you did what you thought was a positive action. And in fact it was positive because you took a crucial step in getting over your fear. I don’t know if that’s what you want to hear right now given that I basically forced you into calling her.”

“I guess that’s all still true, right?” Bryan asked, cracking a smile as the adrenaline began to subside.

“So, um…since we’re on a roll are there any other women you’d like to call during this session?”

Shockingly Bryan was interested in making another call. Exposure Therapy usually requires more than one attempt before the fear is extinguished. Unfortunately the second woman also rejected him, leaving me to wonder where the hell he was getting the idea that all these women were into him. “Is Bryan a Narcissist?” I wondered. “Probably not, just a little too cocksure, so to speak.” We called it a day after that and he spent most of the week making calls to women with varying degrees of success.

The good news however was that Bryan ultimately overcame the phone aversion through Exposure Therapy. Many clinicians might question that choice of treatment claiming that he wasn’t ready and I risked traumatizing him. This is a somewhat fair point although I knew Bryan well and assumed he could handle it. And the reality is that Exposure Therapy rarely goes wrong if the client is motivated and knows that taking that step is in his best interests. It’s also hard to argue with results in this case. Unless I had beaten him with a cane or something until he called that woman. That probably would have worked as well I suppose. Oh well, maybe next time.

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14 Responses to “Overcoming Fear of Rejection…The Hard Way”

  1. Linda says:

    I wish I had therapists (yes plural) that were more helpful. If I ever said “I’m afraid…” I always got the, “let’s talk about that” and well “how do you feel about that”.. blah blah blah. Action-oriented is the way to go! Go Dr. Rob!

  2. Rosie says:

    It’s interesting that you bring up this topic now because my own phobia has been much on my mind as of late. I’m about to enter my 3rd summer living 10 miles from the beach. For the last two summers I’ve lain out on the sand and stared jealously at all the people frolicking in the waves. But each time I tip toe my way to the water’s edge I feel panic coming on. You see, I am deathly afraid of fish. Specifically coming into physical contact with a fish.
    I guess I should start with a dipping my pinky into a goldfish bowl and maybe work my way up to the string ray petting pool at the aquarium (gulp).

  3. Maggy says:

    Great post DocRob! I can totally relate to that guy too. I do the same thing when it comes to calling someone on the phone. Although I have the same problem talking to someone I like in person…maybe Bryan doesn’t realize he has the same problem in person too with how many times he was rejected.

  4. Laren says:

    So that explains why guys ask for my number and then never call!!

  5. Joe says:

    I’ve found that medication usually helps with social phobias. Back in my undergrad days, I usually prescribed Miller Lite. Oh, you can get it in generic form, and it is cheaper, but the generics seem to have more severe side effects, namely bad gas. Especially the doses from the Milwaukee plant.
    I noticed in the story that the girl had been drunk when she gave Bryan her number. Party or bar, maybe? Was he using alcohol to mask anxiety with meeting girls in person?
    I’m not saying that people should mask their symptoms or conditions with alcohol, but it can be useful to get “over the hump” so to speak. And its cheaper than Xanax.

  6. Borderline Betty says:

    I could see how this could backfire, though, especially in the case you linked to, where the guy could not end the relationship he was in w/his girlfriend. You told him: “be a f**king man”! That’s a little disturbing, but hey: I guess it worked. However, what about clients who’d just get defensive…you know what I mean…the BORDERLINE ones. Or, hey, maybe just the Human ones. Having, as you write, a strong alliance w/the client would probably be necessary first. Also, telling a guy to “be a man” could be woefully misconstrued. You refer to your appealing looks, which brings me to another point. If I was that client afraid to make the call, I’d try to undermine you in therapy, if you turned up the heat on me. I’d say: “Hey, Rob, you’re really just a narcissist, Yourself, you know? So, maybe a guy like You, who groves on how Hot he is, doesn’t have trouble calling to make a date. Big-deal! Your ego saves the day for You, but I’m still screwed up on all this!” See, some clients Don’t just roll over and submit, when confronted. Honestly, though, I DO see your point. Sometimes confrontation is extremely necessary. I still think it needs to be done w/compassion, though…and as little ego as possible on the therapist’s part. On the other hand, you sound like a very vital and interestingly creative therapist w/your clients.

  7. Jackmo says:

    Intense. Were you worried he would flip out and blame you? Dr. Rob Note: It crossed my mind but I get blamed for many, many things so I’m kind of used to it.
    Is there much contraversy in the psychological community about exposure therapy? Dr. Rob Note: Not really as long as it’s not completely against a client’s will. If he had rejected giving over the phone and I took it from him…well that would be bad.
    In regards to dog behaviour, Cesar Milan (aka the dog whisperer) is an advocate of exposure therapy (or flooding) for dogs to get over their behaviour issues. However he says many people in the dog community claim that it is cruel and inhumane.
    I’m guessing you don’t think exposure therapy is cruel, but do many other therapists? If so, what are there arguments and what is your view? Dr. Rob Note: I am for it as long as the client is too. The main criticism is that it doesn’t “get to the root of the problem.” I understand that but life is short and I’m not taking 3 years of a person’s time to find that out.
    Oh and re Bryan’s fear of talking to women, instead of a normal session you should just take him out to a bar to witness Dr Robs in action smooth talking the ladiez!”$% :p
    Dr. Rob Note: I don’t think that would be helpful to anyone. Ever.

  8. Grant says:

    Your best post yet in my opinion Dr Rob! I wish I could have seen the look on your face when he told you she said no 😀

  9. Kevin says:

    Isn’t exposure therapy the leading treatment for fear and anxiety disorders? I certainly hope so, because I work in a laboratory where we use extinction of Pavlovian conditioned fear as a model for exposure therapy (in fact, I’m fear-conditioning a rat as I type this…). If it’s not as useful as we eggheads think it is, well, there goes our face validity.
    As for Joe’s suggestion for using alcohol to get over our anxieties, yes it will work. So will Xanax (they bind to the same receptor in the brain, after all). But extinction/exposure learned under a drug state often does not transfer to behavior in a sober state. Might as well do it right by facing the fear and hitting on girls while sober.

  10. Avrila says:

    That reminds me of when I was having issues after a car wreck when I was a teenager (side note: I was a passenger so no making fun of my driving, folks 😛 ). To get over it I forced myself to drive past the corner where it happened every time I went anywhere. I thought of it as fitting into that “desensitization” thing that we’d talked about a little bit in Intro to Psych, but then, I guess it’s pretty much the same thing…push the button and watch stuff *not* blow up and eventually the button is no longer scary.
    Of course if I’d gotten in another wreck on that corner…well…I would’ve probably needed a nice padded room.

  11. Tayler says:

    Dude. You would have a field day with me. I am a case study that is not even funny. I read your stuff all the time hoping you write about a “mess” like me. No such luck though. It’s all good reading nonetheless.

  12. In law school they tell you that you should never ask a question (or do something) without knowing the answer. I wish it was like that in therapy, but sometimes you need to use your best judgment and see how it goes. It seems like you did just that.

  13. Loi says:

    I was thinking… couldn’t exposure therapy further traumatize someone? If they were exposed and had a bad experience. (Example- Person afraid of the dark walks into a room and sees a menacing figure with a triangular head AKA lamp, causing further fear and thus, more resistance to the dark.)

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