Social anxiety is the third largest psychological problem in the United States today. This type of anxiety affects 15 million Americans in any given year. Unlike some other psychological problems, social anxiety is not well understood by the general public or by medical and mental health care professionals, such as doctors, psychiatrists, psychologists, therapists, social workers, and counselors. In fact, people with social anxiety are misdiagnosed almost 90% of the time. People with social phobia come to our anxiety clinic labeled as "schizophrenic", "manic-depressive", "clinically depressed", "panic disordered", and "personality disordered", among other damaging misdiagnoses.
Because few socially-anxious people have heard of their own problem, and have never seen it discussed on any media, such as the television talk shows, they think they are the only ones in the whole world who have these terrible symptoms. Therefore, they must keep quiet about them. It would be awful if everyone realized how much anxiety they experienced in daily life. Then what would people think about them? Unfortunately, without some kind of education, knowledge, and appropriate treatment, social phobia/social anxiety continues to wreak havoc throughout their lives. Adding to the dilemma, when a person with social anxiety finally gets up the nerve to seek help, the chances that they can find it are very, very slim.
Making the situation more difficult is that social anxiety does not come and go like some other physical and psychological problems. If you have social anxiety one day......you have it every day for the rest of your life.....
The feelings I described to you at the beginning of the article are those of people with social anxiety disorder. That is, their symptoms apply to most social events and functions in almost every area of life. I suffered from social anxiety myself for twenty years before I ever saw the term or read about its symptoms in a book. (The first book that specifically dealt with social phobia was not published until the 1990's.)
As with all problems, everyone with social anxiety has slightly different secondary symptoms. Some people, for example, cannot write in public because they fear people are watching and their hand will shake. Others are very introverted and they find it too difficult to hold down a job. Still others have severe anxiety about eating or drinking in the presence of other people. Some people with social anxiety feel that a certain part of their body (such as the face or neck) are particularly "strange looking" and vulnerable to being stared at. Others experience a muscle spasm (usually around the neck and shoulders) and it becomes the center of their focus ---"it's so embarrassing that if someone sees it I will be humiliated forever!"
One thing that all socially anxious people share is the knowledge that their thoughts and fears are basically irrational. That is, people with social anxiety know that others are really not critically judging or evaluating them all the time. They understand that people are not trying to embarrass or humiliate them. They realize that their thoughts and feelings are somewhat exaggerated and irrational. Yet, despite this rational knowledge, they still continue to feel differently.
It is these automatic "feelings" and thoughts that occur around social situations that must be met and conquered in therapy. Usually these anxious feelings are tied to thoughts that are entwined in a vicious cycle of negative expectations and negative appraisals. It is a catch-22 situation: there is no way out without the appropriate therapy.
Here comes the good part.
How can social anxiety be treated? Many therapeutic methods have been studied, but cognitive-behavioral therapy is the only modality that has been shown to work effectively. In fact, treatment of social anxiety through cognitive-behavioral methods has the capacity to produce long-lasting, permanent relief from the anxiety-laden world of social anxiety.
Social anxiety responds to relatively short-term therapy, depending on the severity of the condition. I have seen significant progress in just twelve individual sessions, although most people respond better with sixteen to twenty-four meetings. To overcome social anxiety, completion of a behavioral therapy group is also essential (when people feel ready for this and not before).
What socially anxious people do not need is years and years of therapy or counseling. You can't be "counseled" out of social phobia. In fact, socially anxious people who are taught to "analyze" and "ruminate" over their problems usually make their social anxiety and fears much worse, which in turn leads to depression, which just reinforces the fact that "I will never get better". (Shudder...this statement does NOT have to be true.)
THERE IS A BETTER LIFE FOR ALL PEOPLE WITH SOCIAL ANXIETY. Without treatment, social anxiety is a torturous and horrible emotional problem; with treatment, its bark is worse than its bite. Add to this that current research is clear that cognitive-behavioral therapy is highly successful in the treatment of social anxiety. In fact, the people who are unsuccessful are the ones who are not persistent in their practice and who won't stick with simple methods and techniques at home. They are the ones who give up.
If a person is motivated to end the years and years of crippling anxiety, then cognitive-behavioral treatment provides the methods, techniques, and strategies that come together to lessen the anxiety and make the world a much more enjoyable place.
Many of us have been through the crippling fears and constant anxiety that social phobia produces -- and have come out healthier and happier on the other side. You can too.
---Thomas A. Richards, Ph.D.Psychologist