Monday, August 07, 2006

Do you get nervous in crowds? Social Anxiety

Dr. John Schinnerer,

Social anxiety is the third largest psychological problem in the world today but few understand this.

A young man wastes time sitting in front of the telephone, agonizing because he's afraid to make a call. He's afraid to call a stranger in a business office about the phone bill because he's afraid he'll be imposing and they’ll be mad with him.

A young lady resists going to work since a meeting is scheduled the next day. She knows that such meetings always include her co-workers discussing their current projects. The mere thought of talking in front of her peers spikes her anxiety.

Another individual would like to go to out socially--- and, in fact, he is truly
lonely---yet he never goes out because he gets unbearably nervous when meeting new people. The idea of talking to strangers scares the daylights out of him. He is certain people will stare at him and expose him as an imposter. He is afraid they will reject him and humiliate him. They'll sense his discomfort, mistake it for arrogance and dislike him. He feels he has no way to win. And so he spends the night alone again. He is in his comfort zone at home. Home is the only area in which he feels totally at ease. Home is the only place he can relax.

In public, people with social anxiety feel that everyone is scrutinizing their every move and judging them, despite the rational knowledge that this is not the case. Socially anxious people cannot relax in public. They cannot enjoy themselves when they are out. They can never truly relax when others are around. To them, it always seems like other people are negatively judging them. Regardless of their rational thoughts, they still feel extremely self-consciousness while they are in the presence of others. For many, it is nearly impossible to relax and focus on anything other than the anxiety and the fear. The anxiety is agonizing, making it easier to avoid social situations and other people completely.

Social anxiety is an extreme fear of social situations and conversing with other people which creates feelings of self-consciousness, fear of judgment, evaluation, and criticism. This often leads to feelings of inadequacy, humiliation, and depression.

If you usually become anxious in social settings, but seem fine when you are alone, then "social anxiety" may be the problem.

Social anxiety disorder (or social phobia) causes relationship problems for millions of people all over the world every day of their lives. In the United States, studies have recently shown social anxiety disorder to be the third largest psychological disorder in the country. Such anxiety affects approximately 14-15 million Americans each year. In general, social anxiety is not well understood by the mental health care field. As a result, people with social phobia are frequently misdiagnosed. Socially anxious people have been misdiagnosed as "schizophrenic", "manic-depressive", "clinically depressed", and "personality disordered" to name a few.

An example of a specific social phobia is the fear of speaking in front of groups. On the other hand, generalized social anxiety makes a person anxious, nervous, and uncomfortable in the vast majority of social situations.

People who suffer from social anxiety disorder typically experience considerable emotional distress in situations such as:

Introductions to other people

Criticism and Judgments

Being the center of attention (e.g., birthdays)

Having someone watch while doing something

Talking to people in positions of authority (e.g., doctors, Ph.D.s and police)

Social encounters, especially with strangers

Making "chit-chat" at social engagements

The physiological symptoms that are associated with social anxiety frequently include intense dread, a quickening heart rate, blushing face, dry throat and mouth, shaking, difficulty swallowing, and muscle tension. Constant, pervasive, ongoing and intense anxiety is the most common symptom.

People with social anxiety know that their anxiety does not make rational sense. We know now that each one of us has two “types” of brain – the emotional brain and the thinking brain. These account for our emotional intelligence and traditional intelligence. Therefore, knowing something is not the same is not the same as feeling it. Sometimes we have feelings that are inconsistent with our thoughts. This is frequently the case in anxious people.

They feel anxious despite their rational knowledge that there is nothing of which to be afraid.

On the positive side, cognitive-behavioral therapy for social anxiety disorder has been shown to be highly successful. Individuals with anxiety for years have flourished while in therapy. Due to successful therapy, anxious people have reported a new and improved life -- one that is nearly free of fear and anxiety.

Those who suffer from social anxiety need support, encouragement, and a relaxing environment while they work through therapy. Assuming you do enter therapy, remember that it is your time to heal. You are not putting anyone out. You should not be judged in therapy. You should be supported.

Another avenue to successfully triumphing over anxiety is a behavioral therapy group solely for those with social phobia. This is necessary. If there is no social phobia therapy group offered, you may want to seek therapy somewhere else. A behavioral therapy group is essential to your ultimate success. Please realize that this does not mean a “support group.” Support groups frequently lead to a worsening of anxiety symptoms.

In addition, the anxiety group should be focused solely on socially anxiety. It
should not be a mixed anxiety group. Although anxiety is similar across anxiety disorders, social phobia sufferers need specific, customized activities run by a specialist in this area. A social phobia behavioral therapy group should only be for those with social anxiety.

While it is not easy to overcome social anxiety, it can be done. I have done it myself. I suffered from social anxiety while I was a Ph.D. candidate in educational psychology at U.C. Berkeley. I felt like an impostor. Being around my professors made me break a sweat. My brain froze when put on the spot.

While it may feel hopeless when you are smack dab in the middle of the problem, keep in mind that there is a light at the end of the tunnel. It may feel as if you’ll never get better. However, your anxiety can be overcome with the help of a skilled therapist.

The key components to vanquishing social anxiety are:

1. A knowledge and awareness of the situation,

2. A vow to carry through with therapy even when it provokes your anxiety,

3. Practice changing the “tapes” in your head so that your inner voices
become positive and automatic.

4. Sharing in a social anxiety therapy group in which you can work on anxiety-provoking situations at your own pace. In other words, the individual who feels nervous while speaking in public uses certain strategies to meet his or her goals, whereas the person who wants to learn how to make anxiety free small talk at parties slowly works toward his or her goals. The means by which this is done includes role-playing, acting, using a tape recorder and video camera, question and answer periods, and purposefully doing foolish acts as part of a behavioral therapy group focused on social anxiety.

Don’t give up. A better life is waiting for you. If you are motivated to end your lifetime of anxiety, then cognitive-behavioral therapy has the methods, techniques, and strategies to alleviate your anxiety and make the world a much more relaxing place.

Many of us have suffered through the life-altering fears and pervasive anxiety that social anxiety causes and have come out healthier and happier on the other side. You can too. Seek out a professional therapist today for a happier, more fulfilling life.


Dr. John Schinnerer

Guide To Self(C) All rights reserved 2005-2006.


At 1:20 PM, Anonymous Anonymous said...

i am an LPC clincian in CT ans i was wondering waht is the "cutting edge" and most breakthru treatment for social phobia is it a new med or new intervention like your approach? Please let me know!
Louis Delegan, LPC

At 6:09 AM, Anonymous Anonymous said...

Where in CT are you located?

At 3:34 AM, Anonymous Anonymous said...

Anxiety disorders, in addition to generalized anxiety, include phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. For millions of sufferers anxiety disorders are disruptive, debilitating and often the reason for loss of job and serious problems in family relationships.

At 10:33 PM, Anonymous Anonymous said...

If you find that you are constantly stressed out about something or worrying for no reason, then you might be suffering from a panic attack. They can happen to anyone, but seeking out a therapist is good especially for those who experience panic attacks frequently.

At 5:51 AM, Anonymous Anonymous said...

I had anxiety before, but I got a lot better now, thanks to I HIGHLY recommend ordering from them, they have a section on their website for anxiety pills and the best part there is no prescription required!!! uc

At 9:27 AM, Anonymous Anonymous said...

If you are depending on drugs to get over your anxiety then you are not seeking long term help and are only causing a second issue to address at a later date. :(

At 8:34 AM, Anonymous Anonymous said...

I agree with the previous post. Medication can mask symptoms, but does not address the underlying cause. Currently, the best known treatment for long-term improvements to social phobia and social anxiety is a technique known as cognitive behaviour therapy (CBT). CBT can be effectively delivered through online treatment programs, such as AI-Therapy

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