Upcoming appointment causing me alot of distress. Setbacks


This doesnt seem to be a common sympton mentioned in the forum but i have uncontrolable trembling as a side effect to anxiety. I used to put this down to ‘normal’ human reaction. However, about a year ago when trading in a old car and buying a new car I found myself worrying for days before about filling out the paperwork. While at the dealership my anxiety got stronger and stronger to the point that i couldnt think straight. This isnt the thing that worries me, its the physical trembling that makes me feel out of control.

Im sitting at the desk with the salesman and my partner, who calmly completes his part of the paperwork. I know its coming, its my turn. The salesman looks at me and says ok, this one is for you!!! Hands me the form and a pen, well at this point i could have burst into tears! I kept thinking oh my god there is noway i can control this shaking. How do i possibly begin to control this trembling. Turns out i didnt control it, my writing was terrible. Shaky. I had trouble remembering my own information. The form felt like it went on forever.

After this i cried for days. My anxiety was constant for weeks. I kept thinking about all of the future situations i would have to deal with. Right in the middle of this I had to speak to manager in work, who wanted me to travel to London…this tipped me over the edge, how could i possible go, check into hotels! Be around strangers. I broke down in tears right there infront of him and had to explain in emabressing detail why i couldnt go.

At this point i tried hypnotherapy, anti depressants, CBT & now propanolol. I felt better for a while but its back.

I am buying a house. We have been saving for it for years…it should be really exciting. This week i have to go into the bank and close a savings account. Im terrified. I know i have to sign the paperwork. Although this is days away, i cant sleep, my anxiety is extreme, im crying alot, cant concentrate.

I have literally just started this program so not sure i can rely on it to help. So im hoping someone, anyone can relate to this.


I understand your feelings. Sometimes I find myself constantly worrying about the future and sometimes that makes me dwell and overthink everything. I used to cry a lot and have trouble sleeping because I was over analyzing every situation that I could be in and I was picturing how I would feel or how I would look. By starting the series, I’ve realized that this is not helpful. I’ve started the series a little over a month ago and see huge potential!!! You are NOT alone. There are many many people that feel how you feel!! I get the sense that you overthink a lot about your physical symptoms. I do this a lot too. But the series has taught me that thinking too much makes our anxieties even worse. When you focus all of your attention on your physical symptoms, you are essentially bringing them out even more because you are keeping you mind focused just on that one thing. Our mind and our thoughts control our feelings. I strongly suggest you start the series! I wish you the best of luck! And remember that you are not alone !!!


Have the doctor prescribe you a beta blocker. They work! They STOP you shaking. You can then focus on dealing with your anticipatory anxiety by following this program.


Hi @Soccer2000 & @Hammersmith90

Thank you for replying, its really helpful to know we are not alone in this thing. It has to get better for us all & im sure it will. I definetly give my physical symptoms alot of my time & energy. Alot! I just cant understand how i got here, so deep into this issue. I suppose ‘why’ doesnt really matter. How we get out of this place is the most important factor. So, i have started the slow talk (today :laughing:) and i will try to be patient with it.

Did anyone else try hypnosis? The lady i went to look at me with a pretty puzzled face when i told her why i was there, like it was the oddest thing she had every heard.
She just kept getting me to write my name on a peice of paper over & over again :joy::unamused:. Hypnosis is very relaxing but i found it useless for the actual symptoms. So just wondered!

In terms of Beta Blockers, i agree they do help. I have been prescribed 10mg tablets to take as & when. I read in a post by @Dr_Richards that they can prevent the therapy from working? I think for my appointment at the bank this week i will use them because i am so new to the therapy and i have this little 2minute appointment so built up in my head that i can barely face it but, I will.

However, if i want the therapy to work i might need to put myself in these positions without them going forward. That wont be easy.

I know i am new here but by no means new to social anxiety & have tried various things to deal with it. So if i can help at anytime just drop me a message.



In Session 1 trembling is listed as one of the physical symptoms caused by social anxiety, as well as the pattern of anticipatory anxiety (anxiety about future events).

So yes, this symptom is coming from anxiety, in every way, shape and form, and in every way you’ve described it. It’s the speed up hormones - adrenaline and cortisol - which are very much at the heart of speeding up the body, mind, our thinking, racing heart beats, blushing, sweating, trembling. Thus the therapy immediately goes into the strategies to first start slowing down. Slow Talk and Slow Thinking in Session 2. Throughout the entire series, loosening up and relaxing is emphasized in different ways and with different strategies. We do not need to know everything at the beginning of therapy, nor could we. Nor could we even begin to allow the CBT to get into our brains unless we somehow find a way to begin slowing down, even at home, in relative peace, while doing the therapy. So, Slow Talk will become a major tool in all of this therapy, but for now, all you need to know is that this is the first step.

People with more worries about the physical symptoms naturally want answers to those physical symptoms questions first. Or sometimes they see the symptom as the problem, not anxiety - they may want to jump straight to answers for the symptom. But, that won’t be effective. This is why some people might feel we don’t discuss symptom issues enough early on - although it is stated right there in Session 1. It’s just that the answer will not be reached by directly going to physical symptoms specific therapy. This speeding up is central, and we must start by slowing down. Our thoughts are making us speed up and thus leading to these physical symptoms, so we must ultimately get at the thoughts by slowing down now and slowly turning around those thoughts. Often people focused on the symptoms don’t see at first that it is the thoughts. It’s very good if you understand this now - that the symptoms are just that - symptoms of the underlying social anxiety, and that you are doing the right thing for truly overcoming social anxiety (and the related symptoms) by doing the therapy in the manner it’s laid out. There aren’t quick fixes, ultimately, when talking about overcoming this.

About medication, Dr. Richards makes the point that medication, in the right way, and for the right reason - if used correctly - then yes, if it allows the person to approach the therapy and do it, if the anxiety is so high that someone cannot even, say, start. It would not be helpful if it’s inappropriate medication, or if the medication drowns out or numbs you out so completely that you do not feel anything at all. One has to be somewhat conscious and still in touch with thoughts and feelings, working somewhere near where we would want to be, so that we have a chance to work on the true thoughts and feelings as they come up while doing the therapy. The point is that medication is not a solution, either, but can be a temporary aid in helping one do the therapy.

We’re all going to have events in our lives happen before we feel ready. Those events often prompt people to start therapy, something that might happen in a few weeks encourages someone to start therapy now. You maybe can’t avoid that upcoming thing, and naturally you’re still more on the anxious side than the rational side at this stage. You can only use what you’ve gained so far, what you’ve learned so far. Just be as rational as you can. From Session 2, you’re using Slow Talk. From Session 3, you’re already learning about stopping ANTs and how not to dwell on them. So that’s what you can use at this point, and that would be the right way to handle this and all anxiety causing situations anyway. You’ll get through this thing now. You won’t die. As much as we worry now, we rationally know that you will survive, and you apply slowing down and stopping ANTs to this thing now, as much as you can, and, as much as you can, you stay away from anticipatory anxiety over this.

This is one thing now, but you’re here for the longer, healthier, permanent change in your life.


Thank You @Mateo for your reply and support. I appreciate the time you took to do that.
I wasnt clear earlier when i mentioned that trembling isnt a common theme. I didnt necessarily mean that the therapy doesnt address this. I see that it is mentioned as a symptom. I have came to understand it is a side effect of the bigger picture of social anxiety.

I meant more that from what i have read, writing (which i find most difficult) isnt mentioned by people who access the therapy very often. So i wondered if this perhaps is less common. I guess it doesnt matter, this is my reality and i am working on it now. It was simply a wondering.

I am dedicated as us everyone here im sure at beating this thing. We can do it. With time & effort. I am so grateful this platform exists. I feel better already just to know there are people here who understand. I will update on my progress, ask questions as i go & offer any advice i can for anyone who needs it.

Best wishes. X


People here in the therapy groups - both International and Local - over the many years of my experience with them, have quite often discussed each and every physical symptom on that list or others that you wouldn’t dream up. Trembling comes up often. It’s natural that it would, because again, when we get all hyped up on those speedy hormones, your body is going to react that way. Shaking hands when trying to hold something or when writing (holding a pen) especially while people might be watching, holding papers. Holding utensils while eating. The examples go on on on there, with the shaking, and the shaking doesn’t contain itself to hands. Shaking trembling voices, shaking/twitching heads or other body parts, even facial twitches.

So you can imagine how each one of these people (and the few I’ve described above is by no means a full list of everything people discuss here) - you can imagine how each person is looking for the solution to that single physical symptom. But now you also know how the adrenaline and cortisol plays into each one of these, AND that we get to the solution here not by designing a program based around eye twitching or blushing, but one for social anxiety.

One might not think so at first, but the cognitive therapy, the stuff we are learning about our thoughts and attitudes - as this stuff becomes stronger and gets deeper into your belief system, it will also have a huge impact then on your behavioral responses. If someone is changing their habits so that they are not dwelling on ANTs and not dwelling on anticipatory anxiety, and if that same person is starting to turn their belief system around not to care or worry about behavioral symptoms indicating something negative about them as a human being - then of course their mind would more automatically be saying something like “ah, who cares if I blush/tremble - that doesn’t matter and I’m going to be all right” instead of saying “oh my god, I know I’m going to blush or shake again and then everyone will see it and think I’m a loser, what will I do?” - well these are two very different cognitive thinking reactions and patterns to go through. The first pattern ends up with less anxiety and worry over the whole thing and the result is less anxiety and, thus, fewer symptoms of anxiety in the moment. The latter is what we know now - all that worry just feeding the fire of anxiety and its symptoms.

But to get to the first cogntive way of looking at it takes this time with the therapy to build that new neural, rational pathway, and time then to start believing it more and more.

This will be your future, the way that you overcome social anxiety. You’ll get there through this repetition of the therapy and its application to your daily activities. And some days will still be a bit down, but overall they’ll keep getting better. You’ll get to some point where you may even be very rational about it all and you might suddenly be surprised how far you’ve come and how much you’ve changed, because it is a gradual process, and you notice, “wow, I don’t even worry about that stuff anymore! I hadn’t noticed that in such a long time!” It might not be one “aha!” moment where you feel over this, but more of a longer process that once you are more or less “over this” you’ll not feel like it’s a a singular point in time where everything went from suffering to being fine. That was my experience.


Hi @Mateo

Your prompt response is the reason I know I am in the right place. Thank you so much. So, I knew i had to go to the bank today, I woke up early and set time aside to go over my ‘slow talk’. I then read over your email again on my way to the bank and read it in ‘slow talk’ to give myself the best chance of feeling ok. I went into work feeling pretty positive and chatty.

About 15mins before I was leaving for the appointment a colleague came to me unexpectedly and asked me to sign something. Well, it didn’t go very well, my heart felt like it was pounding out of my chest and my hands felt like they were weak! Luckily it was just initials required which I managed. So, I know I am early on in this therapy but I was so annoyed with myself!

The closer the time came to leave work and walk over to the bank the tighter my chest got, so I thought just get up and go, get it over with. On the way there I tried telling myself to ‘slow down’ - I have to say my heart was beating extremely fast (even with Propranolol) but I kept talking to myself anyway. I told myself I should be proud that I am making myself go in and face it regardless of how I feel! I was at the desk for about 10minutes, every time the printer went off I could feel my chest getting tighter because ‘I knew’ I would have to pick up the pen. The moment never came! I didn’t have to sign anything. Now, I am relieved its over but a little annoyed that I worried so much for nothing. I also I feel like it was a wasted chance to see how I would handle it. What I will try to take from this is anticipatory anxiety is a waste of energy, time and frankly my weekend!

I faced it head on & I tried to apply what I have learned so far. I will keep trying. So one day i can post a more positive & encouraging story!

Best Wishes,


Hi overit anxiety destroyed alot of my life. Please don’t let it destroy yours.
The therapy does work. You just have to put in the work. And it’s repetition, reprogramming and practice, practice. It’s when you get the strategies. Statements deep down into your brain. So you won’t forget it even if you try.
Overit I had all physical symptoms, so I know what your going through my voice would shake, my hands would tremble, my legs would shake.
I couldn’t make eye contact. My face would twich.
Like everything I was doing to help my anxiety, was making it worse,
First you must stop thinking of your shaking.and stop the anticipatory anxiety. Stop fighting it. And accept it. Accept yourself. And work on relaxation exercises, and really work on the therapy, believe me it works. You will feel little changes taken place in your head. You will make progress. I only wish the therapy had of been around years ago. Good luck you can beat this. And live a happy life


Hi @Pinetree
Thank You for the message. Where are you now in terms of your SA? I am doing ok. Doing the therapy everyday for 30 minutes, currently on session 4. Ive started to write down key bits i feel might help. Like most people it seems im not entirely sure what my ANTS are. I only become aware that ive had an ANT when i feel the anxiety. So from this point i say Stop! This feeling is a liar (because i dont recall any thought) it has no real power over me & i move on from it. Try to ignore it. I can see that this will help with time. As i just bought a house, there is alot of appointments, paperwork & just the overall stress of moving going on for me just now. So, im not hoping for any miracles and just trying to stay rational and accept i will feel more anxious in the next few weeks. (Sounds so easy when i type it :joy:)

Its really nice to hear from people who understand it. Im glad that you feel the therapy helped you @Pinetree , even though we dont know each other i am so happy for anyone who can over come this & live happy :blush:

Any advice along the way is helpful & I appreciate it.

Thank You


Hi Overit,
It’s good to hear that you are trying to stop the ANTS!! They are only there to try to scare you and make you fearful. Don’t let the ANTS thoughts take over your mind. You are the one in control of your thoughts so don’t allow your mind to be consumed with negativity. You will just trap yourself and make yourself even more anxious. Our anxious feelings are just a reflection on our thoughts. If we are thinking negatively and if we are believe false things about ourselves, it is likely that we intensify our anxieties even more. There are times when I feel anxious and the first thought that comes in my mind is “Oh my god. I don’t want people to think I look anxious. I don’t want people to see me blushing. I probably look like a mess right now. There’s not enough time for me to calm down. What am I going to do.”
If you noticed, my ANTS thoughts were all based on me worrying about what other people would think of me. I made myself more nervous and anxious because I was afraid about how others would view me. I was FIGHTING the anxiety. This DOES NOT work. Instead, I needed to focus on the solutions, the calming down strategies, slow talk and slow think. Think of it this way, if we live life always looking behind us, on our mistakes, negative experiences, and our embarrassments, we are just trapping ourselves in a bubble. We are not letting ourselves move forward. But rationally, how we view ourselves is most important. Just accept and love yourself. Everyone in life experiences these symptoms at some point (blushing, shaking,trembling, sweating) but it seems like they move forward and don’t pay attention to it. So can we!! Don’t let the symptoms make you feel ashamed or embaresssed. Just accept yourself! The moment you think rational, you will feel much better. I still have a long way to go and so do you! But don’t give up and just keeping going. Don’t let the ANTS win. Because they really have no power over us anyway!!!


Hi Overit I’ve made a lot of progress, and do have a way to go, but I can go for lunch, to events, meet up with friends, arrange meetings with bank manager ( I dreaded all this before) I can go shopping now and go to supermarkets, ( this was all so hard for me before, I was so self conscious, I felt everyone was looking at me, I was always hiding my face, behind my hands, hair, couldn’t make eye contact, if I saw someone that I new, I would practically run out of shop, I would be trembling and couldn’t hold my basket and i have left my basket on floor of supermarket, I would run out of shop, it was like a panic attack.
Slow talk is so powerful, it really helps you relax,
Like soccer said in his email, a lot of people have anxiety about lots of things, but they don’t over think like we do,
We are perfectionists, we can’t bear to make a mistake, so we keep thinking of our faults, we think people are looking at us and judging us, but this is not happening, it’s the ants,
You learn a lot about yourself when your doing the therapy, like years ago I bought some of those self help books, about been positive, I thought saying positive things to yourself was rubbish, but how wrong I was, because that’s how we got this way, by repeating negative things to ourselfs.
Because I’ve made a lot of progress, when I read emails of people suffering like you, it makes me upset, because I suffered, I feel for people tgat are going through this now, like I don’t know you, but I feel I do. we are all the same in our suffering, and I just want to let people know how I’ve made progress, if it worked for me it has to work for you, ( I went down the road of medication it didn’t work for me, it actually made me worse.
As I said its repetition, repetition, practice, practice, BECAUSE you are changing your brain pathways,
SLOW TALK, read in SLOW TALK (practice this)
Tease it out for example ( when I was going to meet friends for lunch, I would have anticipatory anxiety, I would go over things a hundred times in my head, So I started to do the opposite to what I normally did, I had go with the anxiety, accept it, accept myself, like myself, accept that I am nervous, and I probably will make mistakes, but that’s ok, so what? who cares? It’s no BIG DEAL ( use attitude statements ) ( have a talk with yourself, and say things like!!
IM GOING OUT FOR LUNCH WITH FRIENDS, THEY ARE NOT GOING TO JUDGE ME, ( there not my ennimies) there no perfect conversation? I will use slow talk, relax,
There no rational or logical reason why I should feel anxious.
That’s when I felt little changes take place in my head, the anticipatory anxiety started to get less and less. I do hope this helps, and good luck with your house as this can be stressful


What a great response, Pinetree. Thank you for taking the time to write this.


Hi, @Pinetree, @Soccer2000

Thank you for the responses and support. You are exactly right @Soccer2000 people without SA can move forward and not constantly pay attention to physical symptoms, I am determined to learn to do this, to train my brain to care less about this. You are also right that these physical symptoms at the moment do make me feel embarrassed, I can see that its possible to ignore this but its still just a little out of reach for me.

@Pinetree Like @Mateo said thank you for taking the time to respond its very helpful. Sounds like you are doing great with therapy and making great strides. These types of positive messages helps us all here keep going. I went back to the slow talk handout today and read it out loud to myself, I then read the ANTS handout again, out loud in slow talk. I have to start working on accepting when I have anxiety, like you and going with it, accepting it. Its natural to want to shut it down completely and that’s what I kept trying to do. This is because I feel like I cant be in control of these physical symptoms with adrenaline coursing through my body.

I’m a few weeks in to the therapy and I know it takes time, but one of these days I hope to be at a place where I can give others advice and success stories too! Just like you @Soccer2000 @Pinetree.

I am a working progress! :slight_smile:

Best Wishes


Hi again, thanks you for your lovely response,
I just thought of something, that I like to add,
It was like I carried around this huge weight, because I had myself under Huge pressure to behave in a certain way,
I had all physical symptoms, ( voice would shake, couldn’t make eye contact, face twitching, hands would tremble, It was hard standing cause my legs would shake,
The point I’m trying to make is,
I fought these feelings every time I went out, but it just made it worse,
Like I would come home, feeling depressed, angry with myself,
So it’s when you don’t fight it, just accept it,
Like when you accept yourself and this anxiety,
You feel this BIG WEIGHT has been lifted, and the PRESSURE is off.
And you see the little changes taking place, they are slow, but worth it, and you start to get excited ( well I did )
Have a rational talk with yourself everyday, I realize you are a bit early into the therapy, I know it can seem so hard, ( cause I know I nearly gave up cause I didn’t feel I was making progress) BUT IT IS SO EASY, just don’t rush it, changes happen slowly,
The next time you have a meeting where papers need to be signed,
Have a rational talk with yourself and say! ( IN SLOW TALK this is so powerful, it was for me. )
I probably will be a bit nervous and my hands might tremble, but everybody in the entire world has some sort of anxiety, I will calm down, stop thinking about it, think of something nice ( like a holiday you were on ) accept yourself and the situation. (cause this is a positive thought)
( cause when I got angry it brought on my anxiety) so work on the positive, turn a negative thought into a positive thought, hope this helps.


Thank You so much @Pinetree I will try that!
You have done so well, you should be proud of yourself.


thanks for your response Mateo, no problem if I can help in anyway, I’m happy to. You are helping so many out there, and it’s brilliant.


So, today in work decided I would go for it and put myself in a situation where I would have to sign something. Trembling hands is my biggest symptom as I’ve said, I am lucky I guess that this is the only real symptom I get. My day was going ok and I knew one of our temporary staff would need her timesheet authorised so I just said ‘hey if you print it off I will do it’. I could have left this for my boss to do but instead I told her to print it off and I would sign it for her! then I regretted it.

While I was waiting for her to print this off a colleague was talking to me & I noticed that I started to zone out of what she was saying and kept focusing on signing this timesheet. I was saying to myself, calm down, be rational, no one is watching you, its easy you have done this many times. By the time she came over with the sheet, it felt like an hour had past & the same old feelings came back and I felt like I couldn’t control it. I tried to pinpoint the thoughts behind it but I couldn’t. It was just the physical reaction and its overwhelming!

I am not going to beat myself up over this for days like I normally would (this just happened) but right now It just feels so ridiculous that my body reacts so strongly to something so mundane and simple. I know that this is something I will have to do every week, more than once per week for the foreseeable future. So I have to get it together!

Luckily she had pre-filled my name in it so it was just a squiggle of a signature I had to do because honestly, there is no way I wouldn’t been able to print my name!
I realise I have been pretty upbeat on this thread and positive about it all being ok but in this moment I am definitely not. I am sitting at my desk and should actually be pretty busy with work but I had to just take sometime to post this because, well, im hoping it makes me feel better.


Hi Overit I do know how you feel, be patient it’s repetition, repetition,
Like I nearly gave up with therapy in the beginning, because I felt I was making no progress, and I really didn’t have a lot of patience, I want it to work immediately,:rage: But it takes time,
I couldn’t read in front of anyone or write in front of anyone, I hated the sound of my own voice, so I know what it’s like,
The attitude statements I found these helpful, you might not have come to them yet, I would stand in front of a mirror and practice these attitudes, say them with real meaning, say them with a sense of real conviction. So they get deep down into your brain.
I just think you have to say things to your brain with real meaning, for your brain to believe it, if you know what I mean. ( it takes practice )
Having anticipatory anxiety about signing papers, just have a ralional talk with yourself and say! Yes I’m having a little problem now but it’s going to get better, I will use slow talk, this will slow my thinking down, and relax. It just takes a little time for your brain to process all this new therapy,


@Pinetree: I thank you so much for your responses! I feel they are so helpful and inspirational for everyone who is reading them! I’m so happy to hear all of the progress you’ve made and I wake up everyday feeling motivated to overcome SA! I truly appreciate hearing your stories!

@Overit: You are still very early in the therapy and so it’s totally okay to still feel a lot of anxiety in certain situations. But trust me, just continue on with the therapy and keep moving forward despite the anxieties you feel. You will soon learn new strategies that will build upon the strategies you’ve already learned. Don’t get upset or angry about feeling your anxious symptoms because this will just continue on that negative thought cycle that has become a habit for us for so long. We are trying to end this vicious cycle. SA is something we can overcome with practice and persistence! Something I struggle with is overthinking situations and rehashing events. I spend too much time on thinking about social events and what I will say and how I will look… But as I’m continuing on with the therapy, I am learning to be more rational with myself and I’m questioning my irrational thoughts and beliefs. I don’t think too much about past events because it’s over and done with and there’s nothing you can do about it now. I tell myself that everyday is a new day and we can start in a clean slate. I am starting to realize that they are just lies and I’ve made myself believe them and have became a victim to them for so long. SA is all in our head! Once we realize that the anxiety monster has no real power over us, we will be able to stop it completely!! I am starting session 8 and so I’m not that far along into the therapy but you can already see how much progress I’ve made and how I view differently on things!! You will feel this way too!! Don’t give up. Anxiety wants you to give up so that it can maintain its power. But don’t let it win over you! Don’t run from anxiety but don’t hide either. Just tell yourself that you choose to stay calm and will not give anxiety attention. Just accept that you feel anxious and let the anxiety pass on it’s own. Don’t fight it because it will just continue. Just ignore the feeling (even though I know how bad anxiety feels) and it will pass!!!
Today I went on a field trip to the city with my class, and I had really bo anxiety at all. I didn’t even think about my anxiety. I was able to be myself and I was so happy! I accept that soon I may have a bad day ( a setback) but that’s okay! It is what it is! Life is not perfect because if it was, no one would ever have anxiety to begin with… Keep continuing on with therapy. The good moments will come soon!:-):slightly_smiling_face: