Social Anxiety
For millions of Americans, every day is a struggle with debilitating shyness
Social phobia affects about half of its victims by age 8, and many others during adolescence, when social fears are more pronounced. Others live with an undetected problem that surfaces when facing a new public arena (college, a new job) that over whelms them. Grace Dailey, who had man aged to suffer quietly through high school, was seized with sudden panic attacks in her college classes. The episodes were so distressing that she would race out of lecture halls, and she considered dropping out. She did graduate, with the help of thoughtful professors who let her take tests by herself and who kept classroom doors open so that she didn't feel so trapped.
More women than men are thought to suffer social anxiety, but because shyness and demureness are smiled upon in females and less acceptable in males, more men turn to professionals for help. Roland Bar don, 27, knew he needed to see a psychologist after becoming too anxious to drive a car. "I worry about making other drivers mad," he says. "When people honk, that kind of criticism drives me crazy." He still avoids taking the wheel whenever he can.
Talking to strangers. It's Friday night at the Shyness Clinic in Menlo Park, Calif., time for this week's social phobia information session. But in the tiny room dec orated haphazardly with fake flowers, only one man has shown up. The very nature of their disorder often causes social phobics to hide, and revealing themselves to a stranger is the last thing they want to do. Tonight's newcomer put off coming for two months. Clinic patients attend group meetings once a week, but some cannot even bring themselves to show up at all.
When the socially anxious do make it into clinics, they usually start with a few months of cognitive behavioral therapy. The cognitive element fights what psychiatrist Isaac Tylim of the Maimonides Medical Center in Brooklyn calls the intellectual core of social phobia: the belief that others will pass negative judgments on you and that unbearable humiliation will result. "I turn down invitations to go to lunch with people I really admire, even though I desperately want to go," says a Kentucky housewife and mother of two girls who exhibit a similar timidity. "I assume that as soon as we get together, they'll regret having asked and want to get away from me as soon as possible." These distortions cause an emotional reaction that sends social phobics running away from even the most promising friendships. Through cognitive restructuring--a fancy term for replacing faulty thoughts with realistic ones--many social phobics learn to question the insidious fears that, no matter how irrational, paralyze them in their everyday lives.
Perhaps the most salient feature of social anxiety is what is known as flooding: the sensation of being so overwhelmed that panic sets in. Almost everyone feels mild flooding at the podium during the first minute or so of an important speech, but for most people the discomfort soon subsides. A social phobic can suffer such agony for more than an hour. But even in social phobics, flooding will eventually subside, if only because of sheer exhaustion. That is why behavioral therapists coach social phobics to remain in terrifying situations until the symptoms abate and it becomes clear that nothing bad is going to happen.
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