ANXIETY DISORDER very long

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Social Anxiety Disorder/Social Phobia:

THE LEAST UNDERSTOOD
ANXIETY DISORDER



Social anxiety is the fear of social situations and the interaction
with other people that can automatically bring on feelings of
self-consciousness, judgment, evaluation, and criticism. Put another way,
social anxiety is the fear and anxiety of being judged and evaluated
negatively by other people, leading to feelings of inadequacy,
embarrassment, humiliation, and depression. If a person usually becomes
anxious in social situations, but seems fine when they are alone, then
"social anxiety" may be the problem.

Social anxiety disorder (social phobia) is a much more common problem
than past estimates have led us to believe. Millions of people all over the
world suffer from this devastating and traumatic problem every day of their
lives, either from a specific social phobia or from a more generalized
social phobia. In the United States, epidemiological studies have recently
pegged social anxiety disorder as the third largest psychological disorder
in the country.

A specific social phobia would be the fear of speaking in front of
groups, whereas generalized social anxiety indicates that the person is
anxious, nervous, and uncomfortable in almost all (or the majority of)
social situations.

People with social anxiety disorder usually experience significant
emotional distress in the following situations:

Being introduced to other people

Being teased or criticized

Being the center of attention

Being watched while doing something

Meeting people in authority ("important people")

Most social encounters, particularly with strangers

Making "small talk" at parties

Going around the room in a circle and having to say something

This list is certainly not a complete list of symptoms -- other
feelings may be associated with social anxiety as well.

The physiological manifestations that accompany social anxiety may
include intense fear, racing heart, turning red or blushing, dry throat and
mouth, trembling, swallowing with difficulty, and muscle twitches. Constant,
intense anxiety that does not go away is the most common feature.

People with social anxiety disorder know that their anxiety is
irrational and does not make "head" sense. Nevertheless, "knowing" something
is never the same as "believing" and "feeling" something. Thus, in people
with social anxiety, thoughts and feelings of anxiety persist and show no
signs of going away.

The good news is that cognitive-behavioral therapy for social anxiety
disorder has been markedly successful. People who have had this anxiety
problem for long periods of time have blossomed while in therapy. After
therapy, people with this problem report a changed life -- one that is no
longer totally controlled by fear and anxiety.

Social anxiety, as well as the other anxiety problems, can be
successfully treated. It always bothers me when I read that a person with
social phobia is just going to "learn to live with it". I want to scream.
"No! You don't have to live that way!"

But in seeking help for this problem, search for a specialist --
someone who understands this problem well and knows how to treat it. Become
an informed client and ask questions. Do they understand that you feel very
self-conscious, that others are watching and forming a negative evaluation
about you - or do they minimize what you're saying and just say, "No, No,
No, you're exaggerating...." Now it is true that we who have gone through
social phobia do realize our mind is overexaggerating, but it still FEELS
like others are watching and judging us. Our self-consciousness is very
real. If your psychologist/mental health care worker does not understand
this, YOU KNOW MORE THAN THEY DO ABOUT SOCIAL ANXIETY. It is very doubtful
they will be able to help you.

Also, remember that the true professional will always welcome your
questions. If they seem stand-offish and unfriendly, they should not be your
choice of a therapist. Those of us who have or have had social anxiety need
support, encouragement, and a relatively stress-free environment while we
progress through therapy. Remember: This is YOUR time to get better and
heal. This is YOUR time to move forward away from the effects of anxiety,
fear, and avoidance.

Does your therapist say, "Face your fears and they'll go away?" Sorry,
but this therapist does not understand the dynamics of social anxiety. We
have constantly faced our fears ever since birth - we've HAD TO - and we
feel more fearful now than we did in the past. Seek another therapist. It is
imperative you find a psychologist who understands social anxiety
completely - because if they don't even know what it is - how will they know
what to do to help you overcome it?

Do they run a behavioral therapy group just for people with social
phobia? This is essential. If there is no social phobia therapy group
involved, seek treatment elsewhere. A behavioral therapy group is essential
to your ultimate success. (Note: We are not talking about a "support"
group -- what are we supporting anyway? The continuance of social phobia?
Support groups for people with social phobia do not help people overcome
this anxiety disorder. In fact, they may actually prevent progress.

Secondly, the group should not be a mixed anxiety group. Although the
anxiety experienced by all people with anxiety disorders is somewhat
similar, people with social phobia need precise, custom-tailored group
activities run by a specialist in this area. A social phobia therapy group
should only be for people with social phobia.

Getting over social anxiety disorder is not an easy task; yet many
thousands have already done it. While you're in the middle of the problem,
it feels hopeless - that you'll never ever get better. Life is just one
gut-wrenching anxiety problem after another. But this can be stopped,
quenched, and reduced in a relatively short period of time - but you must
find a cognitive-behavioral therapist who understands and specializes in the
treatment of social anxiety.

The most important elements in conquering social phobia are:

1. An understanding and awareness of the problem,

2. A commitment to carry through with cognitive-behavioral therapy
even when it seems difficult,

3. Practice, practice, practice to get that information deep down into
your brain so that it becomes automatic.

4. Participation in a social anxiety therapy group in which you can
slowly and gradually work on problems that cause you anxiety in the real
world. That is, the person who feels anxious while reading in public uses
specific strategies to meet his goal, whereas the person who wants to learn
how to make anxiety-free introductions and engage in small talk during
social activities slowly works toward her goals. We use role-plays, acting,
the tape recorder and video camera, question and answer periods, mock job
interviews, and doing foolish things deliberately as part of our behavioral
therapy group for people with social anxiety.

Note: We use a ladder or "hierarchy" as a flexible guide in our
planning. We want to practice, meet our goals, move up our expectations,
meet our goals, move up our expectations, until our goal is finally met. WE
DO NOT PRESSURE, PUSH, or CAJOLE. NO NEGATIVE tactic is employed because the
individual must choose to participate at her own pace. If she wants to sit
there in group and not say a word, that's O.K. No one will ever force her to
do or say a thing. But here's the secret: This has never happened! Everyone
in the group understands why they are there and, despite an amount of
anxiety that is present, they voluntarily choose to work on their specific
anxieties. This is much more practical and real-life than being forced to do
something in a group. While the therapist and the group should be
encouraging and motivating, the ultimate decision on progress resides within
the person himself.

Therapy groups should always be encouraging, positive, and supportive.
Social anxiety people are among the nicest people in the world. Go to a
meeting and find out......

It is impossible to stop a motivated person who refuses to give up
practicing. The role of the therapist is to know specifically what to do and
how quickly to do it. This sounds easy, but it is not. You must be
practicing the right material and you must proceed at the correct pace for
your own anxieties. You are more in control of this than your therapist.

Today, cognitive-behavioral therapy is used to treat both forms of
social anxiety. With cognitive-behavioral therapy, we do not wallow in the
past and continually bring it up --- because it doesn't do us any good.
Instead, we focus on present-day problems and symptoms and use many small
techniques and methods to eradicate anxiety thinking.

Here's where motivation and practice come in. The more you can
practice these small techniques at home, the quicker anxiety can be reduced
and social anxiety can be conquered.

-- Thomas A. Richards, Ph.D.,
Psychologist