Psychiatry & Psychology--General/Empathy Problem


  I think I should start out with my basic info in case you need to know. I will do my best to not ramble on, and most likely some of this wont be relevant, but since I am asking for your advice, and since you have never met me I figured the more insight into my "life" the better.I am  and currently single,have always been a rather shy person(at least until I really get to know people). I have done some drugs in my far past(when a kid) and I use to drink a good amount but I don't have any desire to drink any more(haven't been drunk in like 8 years) and the only drug I do is I occasionally relax at night with a joint. No prescription meds  or medical allergies.I have a few good friends and I am pretty close to my family. I live alone, except for  my cat which is like a child to me. I rarely visit the doctor, in fact last time was about 5 years ago.No matter what, to be honest with you I probably would not go see a doctor about this,I am really just hoping for some insight and maybe something I can do to help. I also understand that you are not an alternative to actually seeing a professional, and I understand that anything you tell me is just your opinion but that's really all I would like at this point. Maybe down the road if things get worse I will see a doctor but right now I am just looking for some educated help or insight.
I have no history of mental health issues, but to be honest I have thought for some time now that I do suffer from some minor problems. I have anxiety, to a degree social anxiety and I do (maybe once a month or so)have what I would consider mid-grade panic attacks. When I do get them the main part usually lasts only about 20 minutes or so but then I feel super tense and on edge for the rest of the day, to the point where I have found the only thing that helps relieve it is if I think about something sad or upsetting and cry good and hard for a few minutes. That seems to help and I have also found, although it may just be a placebo effect, that talking a few Benadyrl helps calm me down as well.. A couple other examples are that I rarely ever call to have food delivered, even when I really want to because #1 making the phone call, for lack of better work "scares" me.I know that sounds silly but, it does. Then even if I do call, order online or have someone else call, I have to go to the door which also causes anxiety. So I just don't order much. The thought of starting a new job, with new people or the thought of being around lots of people I don't really know at a party, etc... makes me very "scared" and makes me very panicky.
Another example is when I am walking down the street. If someone is walking towards me, I will cut down a side street(sometimes going out of my way) or will cross the street because of that awkward moment when you pass each other..."Should I say hi?, what if they don't reply?what if they are a jerk, etc all goes through my mind in a flood of anxiety.If someone screw up such as my food order or a cashier at the grocery store etc, I very rarely say anything because of this anxiety and I dislike going out with my mother or one of my sisters because they are loud and outspoken and tell people exactly what they are thinking and some times its just too much for me.
Now let me clarify, its not in all situations. I go in restaurants, I work, I go in stores and deal with people everyday without much of a problem, but certain things such as described are when it happens the most and worst.
Now  although I do consider those things to be a problem, and unpleasant those tings are not what I feel is the worst thing.I have learned to just deal with those things, at least to where they don't really effect my life much.
However here is what does really bother me and what I would really like to do something about or learn to control. I believe the word is empathy. However I am extremely empathic. and although I always have been to a degree, it has gotten really bad as I have gotten older.
Although in some cases my empathic feelings are directed towards people, it more often is not. I am a HUGE animal lover. To be honest I tend to care more about animals than people, with some exceptions. For example lets say there is a flood. In the flood 10 people die and 3 dogs are killed. Although I do feel bad for the people that dies, especially their families, thinking about the dogs will bring me to tears. If I had to make a choice between donating money to an animal shelter or a cancer society, I would pick the animal shelter in most cases. Again not to say that I don't care about the cancer patients, it is just that for whatever reason the animal cause really tugs at my heart.I have been told by people that I am mean etc.. before because the news will come on and they will tell about a fire and I will seem kind of  cold, however if they next tell about an abused animal I get very upset and it shows.
Last summer I was showing my nephew how to aim and shoot his 22 rifle in their backyard. I was trying to teach him that target shooting can be fun and challenging without killing animals so we were shooting at bottles on a stump. Well one of my shots went through the bottle and suddenly something was thrown into the air behind it. When we looked, I found that what had happened is that there was a mother rabbit and her babies in the tall grass behind the bottles. The bullet had gone through the bottle and hit and killed one of her babies. I was devastated. My day was over.I couldn't continue shooting and honestly cried several times over the next few days.My nephews father, my brother and most people agreed it was sad but I think they felt I overreacted pretty bad., especially when I buried it. However for months and even now thinking about it I get very upset at the thought of the poor mother rabbit losing her little baby because of me and I actually picture the mother rabbit being horribly sad and grief stricken.
Another example is when I watch tv or movies. If a character in the show/movie does something, rude, embarrassing, mean etc..I cant watch it. I either pause it, change the channel or skip over it. It doesn't matter what the subject of the show is, for example lets say the character is about to get exposed as someones secret admirer. I will at the very least pause it and watch it a tiny bit at a time. More often, just skipping over it. One show I really like has many of these situations. In one episode the main character was sent to Hell and the episode ended with him in hell being tortured and hopelessly calling out to his brother. Although I know its just fantasy, and even though I enjoy the show, it not only took me almost 2 weeks to watch the whole episode because I kept pausing it, but the situation described bothered me tremendously for a long long time. I almost felt as if I personally knew the characters and  as if they were real and I felt terrible every time I thought about it.
That is just an example but that's how it is with all or at least most things I watch. I love the show Game of Thrones but cant really watch it because each episode takes me a month to watch. I cant watch suspenseful movies, scary movies are out entirely even though they look good and I want to watch them.  If the character is embarrassed, so am I. If sad, so am I,if they are being rude I cant watch because I feel ashamed and embarrassed for them and it bothers me.Sometimes not just in the moment, but also long afterwords if I think of it. It really stinks when I am watching a movie with someone because then I have to "suffer" through the difficult part. Or when watching tv, if say its an embarrassing scene, its even worse than normal for me because not only do I have to watch it but watching it with someone makes me even more embarrassed or whatever feeling it is. Now it also happens outside of TV and the movies and such but not as much and actually not as bad. And to be honest the tv and movie part of it is a large part of the problem, at least its the part I dislike the most. Sometimes I have to just turn the tv off and read or something because it seems like everything on at that time, makes me feel the ways I described.
I understand that empathy is a normal emotion, it just seems like my "empathy button" in my brain is stuck down and on overload.The situations and examples I mentioned are just some of the times where it creates "problems" for me but I think you can get-an idea of what I am saying.
Like I said, I do realize that I have some issues, and I know the best thing to do would be to go to the DR but#1 I have no insurance and I make just a bit too much for medicaid. I live in a very small rural town where there are no hospitals, clinics psychiatrists etc..The nearest ones are almost 30 miles away and not really accessible to me unless of an emergency.Actually about 6 years ago I went down to the County Mental Health Department and asked about getting some help. My dog I had  for the previous 13 years died and I was a wreck. I was horribly upset, I couldn't eat, I couldn't sleep because after that I was terrified I was gonna loose my other pet or a family member. In fact as silly as it sounds I pretty much watched nothing but the cartoon spongebob squarepants for almost 2 months because it was the only thing that wouldnt make me sad in some way and made me laugh a little bit. So anyway I went and explained that to them and asked if I could talk to someone. They told me first to apply for medicaid. So I did that and spent several hours dealing with Social services who eventually informed me that I was denied because even though I don't make enough to pay for my own insurance or to pay a doctor, I make $ more a week than the amount that would qualify me for medicaid.I then informed the County Mental health Department who sent me to medicaid of that and they said, "Sorry we cant help you". They did give me the phone number of two psychiatrists that were about 15 miles away.I drive a motorcycle as my only transportation but it was winter so I had no way to get to the Dr as well as the fact that I had no clue how I would pay for it. However I did call both Dr's. I was told from both Dr.s that they could not see me without a referral. So I found a way to get to the hospital and the emergency room since I don't have a regular Dr. Well after almost 4 hours of explaining my issues to about 5 nurses and several Dr's in training(which in itself was embarrassing and difficult to do)and stressing that I didn't really need anything from them just a referral, I was told I would need to make an appointment with a general practitioner who after examining me would give me a referral if he thought it was necessary, but they either could.'t or wouldn't give me one.When I went out to make the appointment I was told the soonest the "general practitioner" could see me was almost 2 months away so I  said forget it and left. So after wasting the day and almost $200 bucks for the visit I was no  closer to getting some help and allot more frustrated. So as I said unless I am having an emergency I probably wont be seeing a Dr anytime soon.
Now let me close with this. I know that nothing is going to solve my issue(s) overnight and that naturally the best course of action would be to seek the help of a professional. However I have explained why that's not really an option and I also have never really been depressed, have never been a danger to myself or anyone else,I have never tried suicide  and although these mentioned issues are aggravating, unpleasant, uncomfortable and problematic, they are not in my opinion major or very serious. Although they do make things "difficult" for me on a pretty regular basis and although I would love to end them, or at least control them at least to some degree, I still lead a relatively happy and decent life. Most people who aren't close to me don't even realize the majority of the issues I have because I either have learned to cover them up or fight through them. However as I get older, even though the problems have not really gotten worse, they seem to bother me and get to me more.
Lastly I just want to say thanks for taking the time to read through my ramblings, however irrelevant some of it may be. I understand that in your response you most likely will mention that I should see a Professional locally, but please do not just tell me that and leave it there.I would like your opinion or advice, not just a textbook stamped out form type letter even if my issues arent specifically your area of expertise.I am not looking for you to tell me that I don't have to go to a Dr. or that I can cure myself easily overnight, just your opinion, insight and hopefully recommendations that can help me to deal with things a bit. At the very least I would appreciate some specific suggestions of what to look up and read about on my own.I am not afraid to research things  on my own and consider myself a relatively intelligent person so please feel free to recommenced things for me to read.(as long as they arent super technical medical jargon).Right now it is a bit difficult to do that because I don't really know what to look up or look for.So pointing me in the right direction would be appreciated.
Thank You very Much


You have written a thoughtful and excellently detailed letter describing your, social anxiety.  I understand your problem because I consider people like yourself to be the type of person I most like to help.

While I can neither diagnose or professionally treat you in this limited forum, I will do my best to provide you with some useful information.

You, like most good people, have a sensitive nervous system.  The means you feel things emotionally much more strongly than most people.  You are not crazy in any way, because the feeling that you have a real and normal, just stronger and more intense than average.  It makes you feel weird and sometimes act weird, but that is only because such strong feelings are hard to understand and deal with.

The way you can help yourself not suffer from these feelings is to work to overcome their ability to make you act in odd or self defeating ways.  They way to do that is to imagine that you can rank order the avoidance activities that you described from the least strong to the worst.  Then very gradually work to overcome the least strong by forcing yourself, gently but steadily,  not to avoid the situation that causes them.  It is obviously more complicated than strengthening  muscles, but the metaphor is basically the same...start small and increase slowly and steadily, building up to the most difficult situations as you get stronger.


Dr. Elmore  

Psychiatry & Psychology--General

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Andrew M. Elmore, Ph.D.


I can answer questions about: Stress. Headaches. Stress-related Disorders. Anxiety/Panic Disorder. Depression. Psychopathology. Cognitive Behavioral Therapy. Personal Problem Solving. Life in General. Relationships: Love, Friendship, Business Partner, Coworker, Family,Child/Parent. What makes us tick. The use of psycho-pharmacological agents in combination with psychological treatment. How to deal with evil people in your life. How to improve your outlook under duress. How to control stress. How to control mood. How to control headaches. I cannot answer: Questions about Eating Disorders. Questions about computers.


30 years in private practice as a psychologist in Manhattan. Dealing with people from almost every conceivable ethnic and socioeconomic backgrounds, and as many character types as exist in this country. Dealing with patients from 8 years old to 90 years old. Pioneer in biofeedback and the treatment of stress-related disorders. Assistant Clinical Professor of Psychiatry at the Mount Sinai School of Medicine since 1982. Treatment of stress-related, anxiety and depressive disorders with biofeedback and cognitive behavioral therapy. Developed personal problem solving, an extremely precise form of psychotherapy. Relationship therapy for couples, families, parent/child issues, business partners, coworkers, employers, and dealing with psychopathic individuals in your life.

American Psychological Association. Association for Applied Psychophysiology and Biofeedback. Biofeedback Certification Institute of America. New York Academy of Sciences.

The journal, Psychophysiology. The book, Expanding Dimensions of Consciousness. The journal, Headache. The journal, Biofeedback and Self-Regulation. The journal Psychiatry Digest. The book, The TMJ Book. The book, Dental Phobia. The network, CNN. Parade Magazine. The newspaper, Newsday. The Manhattan TV station, WCBS. The national news program, The CBS Evening News. The newspaper, The New York Post. The national TV program, The Phil Donohue Show. The magazine, The New Yorker. The magazine, Glamor. The magazine, Redbook. The magazine, Health. The magazine, Bottom Line Personal. Web MD. The website, Healthology. The magazine, Newsweek.

Ph.D. SUNY at Stony Brook, 1979. B.A., magna cum laude with Honors in Psychology, Illinois Wesleyan University, 1974.

Awards and Honors
Who’s Who in Medicine and Healthcare, First, Second and Third Editions, 1997-2000. Appointed to the Training Faculty of the Biofeedback Certification Institute of America (BCIA), 1993. Senior Fellow BCIA. New York Academy of Sciences, 1987. Who’s Who in the East, 1983-present. Who’s Who in Frontier Science and Technology, First Edition. Citation Paper Author. Eleventh Annual Meeting of the Biofeedback Society of America, Colorado Springs, Colorado, 1980. Biofeedback Society of America Scholar, 1979. Co-author, USVA Grant, “Variables Affecting the Experience of Pain in Migraine,” USVA Medical Center, Northport, New York, 1977-1979. Biomedical Research Fellow, Department of Biomedical Engineering, SUNY at Stony Brook, Stony Brook, New York, 1978. NIMH Predoctoral Fellowship, 1976. BA, Magna cum laude, with Honors in Psychology, 1974. Danforth Fellowship Nominee, Illinois Wesleyan University, Bloomington, Illinois, 1973.

Past/Present Clients
Most of my clients are my private patients. However I have provided many seminars, lectures and workshops for: Columbia University. The Mount Sinai School of Medicine. The Metropolitan Museum of Art. The Museum of Natural History. The UJA Federation. The university, CW Post. The College of New Rochelle. Equinox Fitness. Travelers Insurance. AutoOne Insurance. Chubb Insurance. Metropolitan Life. Allstate Insurance. State Farm Insurance. Encompass Insurance. The public relations firm, Porter Novelli. The investment firm, Capital Re:. The Estee Lauder corporation. The law firm of Irwin Abrams. The National Insurance Crime Bureau. GEICO Insruance. Beth Israel Hospital.

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