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Social Anxiety

Social AnxietySocial anxiety disorder, previously referred to as social phobia, has been redefined in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).  Social phobia referred to a fear of performing or public speaking. However, researchers have come to realize that this definition was too narrow.  A person can experience extreme discomfort or fear when socializing, performing, working or even eating in public.

Social anxiety disorder is essentially brought on by any activity in which a person feels they are being watched and criticized. Furthermore, the person may go to great lengths to avoid feared social or performance situations, which may negatively impact their occupational, academic or daily functioning.  Additionally, the impacts of social anxiety disorder make it difficult to create or maintain healthy personal relationships.

For example:

A woman is fearful of attending a team meeting because she knows she’ll have to discuss her project in front of all of her coworkers, so she calls in sick to avoid the situation and sends her boss an email update on her project.

A man is meeting a friend at a new bar up the street.  The man gets there first and is flooded with anxiety because he feels everyone else at the bar is judging him.  He knows this is irrational, but the fear begins to mount.  His heart is racing and he is paralyzed unable to give the bartender his drink order.

Diagnosis of Social Anxiety Disorder

According to the DSM-5, the criteria for being diagnosed with social anxiety require a person’s anxiety level to be disproportionate to the situation and the symptoms must be persistent over the span of six months or more.  Social anxiety disorder is not to be confused with panic disorders.  A person experiencing a panic attack fears that what they are experiencing is indicative of a physical ailment, such as a heart attack.  A person experiencing an anxiety attack is aware that their symptoms are a result of their anxiety.

Treatment for Social Anxiety Disorder

Traditionally, Cognitive Behavior Therapy (CBT) has been a proven treatment modality for anxiety disorder. CBT addresses and corrects maladaptive thoughts and behaviors that are often associated with anxiety disorders.  For example, CBT addresses thoughts such as, “everyone thinks I’m stupid” or behaviors such as avoiding social gatherings due to anxiety by providing techniques and strategies to lessen anxiety.  CBT focused support groups are particularly helpful for social anxiety disorders because it aids in developing coping strategies for social interactions in a therapeutic environment. One’s success with CBT therapeutic technique requires practicing coping strategies both in session and at home.

Emotion-focused therapy (EFT) is a recent humanistic approach to therapy that incorporates structured techniques with unconditional positive regard and empathy to address a client’s issues.  Although EFT was developed for the treatment of depression it has been applied to trauma and anxiety over the last 20 years.  Whereas CBT focuses on correcting maladaptive thoughts and behaviors, EFT addresses the emotional process behind those thoughts and behaviors.  For example, addressing childhood trauma that has led to the dysfunctional thoughts and behaviors that cause anxiety.

Regardless of the therapeutic model used, social anxiety disorder will not right itself or dissipate with time.  In fact, anxiety disorders have been proven to worsen overtime if not addressed.  Reaching out to a mental health professional and committing to utilizing appropriate strategies and techniques are the best way to combat social anxiety.

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