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An expert in social anxiety outlines the techniques that have helped his patients overcome shyness, social phobias, and other problems, focusing on specific social situations
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Jonathan Berent, A.C.S.W, lives in East Hampton, and practices in Great Neck, N.Y. A certified psychotherapist, he has worked with thousands of individuals of all ages in individual, group, and family psychotherapy. He has appeared on "The Oprah Winfrey Show", "Sally Jessy Raphael", "Joan Rivers", "CNN Medical News" and many other TV and radio shows.Excerpt. © Reprinted by permission. All rights reserved.:
Anxiety: Friend or Foe?
Shyness. We've heard this word a lot. At one time or another, all of us have probably thought of ourselves as shy. Indeed, research shows that 93 percent of all people have experienced shyness. What does it mean to be "shy"? For some, it may mean being quiet, reserved, or timid. For others, shyness is a catch-all word to describe what may at first seem like a personality trait, but is in fact a fear response that pervades their lives and prevents them from doing things that they would like to do, such as finding personal fulfillment and achieving career goals.
Over the years, in working with thousands of people who call themselves "shy," I have come to realize that this word is too general to be of much help in identifying a problem and solving it. The actual response to the stress of interaction is called social anxiety. Of course, just as one person might say he is "a little shy around women" and another might say she is "extremely shy about speaking in front of a group," it is also true that there is a wide spectrum of social anxiety, from mild nervousness all the way to social phobia, in which interaction-related anxiety is so extreme that a person actually avoids the specific situations that cause it. Avoidance, too, has its degrees, and can mean anything from being characteristically reserved at work, even though you have an idea or solution to propose, to refusing to attend social gatherings. Social phobia -- commonly defined as performance anxiety in which the individual fears humiliation, embarrassment, or being evaluated -- is quite common, and, according to a November 1991 article in the Journal of Clinical Psychiatry, is an emerging problem that is just beginning to receive attention: "If the 1980s were considered to be the 'decade of anxiety,' most would agree that panic disorder and obsessive-compulsive disorder received the most attention. The 1990s are sure to be another decade of anxiety, but we can expect other anxiety disorders to take the limelight, particularly social phobia." Until now, the article states, social phobia has been "overlooked" as a disorder, and I believe that mental health professionals have often looked at it as part of a general anxiety problem, lumping it together with other conditions. But social anxiety is a very specific problem. As a psychotherapist with more than thirteen years of experience in developing a program for individuals with social anxiety, I have observed that by nature, people with social anxiety are extremely resistant to getting help, so there is much about this population that has not been fully understood or studied. As for the increased awareness of social anxiety, I see it as an indication that technological advances and an increasingly competitive workplace are taking their toll on society. Further, I think families today are less able to "hide" or protect their socially anxious members. People with social anxiety can only benefit from this increased awareness. For some, a little information about how they respond to stress may be enough to minimize the anxiety response; for others, a more detailed application of overall strategies is in order. Whatever your social functioning level, this book can help you to work through your anxiety to be a more productive and fulfilled human being.
As you begin your exploration of social anxiety, it is important to grasp some basic concepts. First, understand that "shyness" and social anxiety are two closely related dynamics: Both terms describe a learned response to social interaction. In unfamiliar situations, or even familiar situations whose outcome may be unknown -- meeting new people, giving a speech, asking someone for a date, negotiating a raise -- a "shy" or socially anxious person may hesitate to pursue the things he or she is interested in, or even begin to avoid situations that cause nervousness or anxiety. For example, if you fear that asking your supervisor to explain a basic point at work will make you appear stupid and you therefore avoid asking questions, you are allowing your social anxiety -- your fear of humiliation or embarrassment -- to control your actions and inhibit your career success. In your personal life, feeling out of place at parties because of anxiety might lead you to decline many social invitations. When you fear rejection, the interactions you do have can become unsatisfying. Your anxiety can prevent you from giving all you can to a conversation and can prevent others from responding fully to all you have to offer.
I call this fear response interactive inhibition. How does interactive inhibition affect you? At work, you may stay in a "safe" job, in which all duties are clear and manageable although no longer challenging, rather than ask for more responsibility or look outside your company for a change. In your personal life, you might hesitate to get close to people, although you have friends to socialize with. Your inhibited emotion may inhibit the quality of intimacy.
When your interactions are inhibited by social anxiety, you are unable to get as much out of life as possible, and so a "harmless personality trait" can become a major obstacle that stands in the way of fulfillment and productivity. But this doesn't have to be the case. Social anxiety is a learned response -- habit that can be broken. This book will show you, step by step, how to break the social anxiety cycle that may have caused loneliness in your personal life, decreased productivity in the workplace, and an overall lack of fulfillment. As you begin to understand that social anxiety is a combination of attitudinal, emotional, behavioral, and physical responses, you will see that there is actually no such thing as shyness. Rather, what you may refer to as "shyness" is actually social anxiety, a psychophysiological response that you can learn to control. To recognize social anxiety is to give yourself permission to resolve the issues that cause your symptoms. In working through this self-help program, learn to substitute the phrase "social anxiety" for the vague term "shyness" and you will start to see your response pattern in a different light: as a way of reacting that you have chosen, not some unchangeable instinct that has chosen you.
In more than a decade of psychotherapy practice, I have met thousands of people who refer to themselves as "shy." Often, these people believe shyness is a fait accompli, a matter of genetic predisposition that they must deal with as a fact of life. They say they were "born shy" -- their parents, grandparents, or other relatives are shy too, and it's just in their blood to be timid. Of course, behavior also can be handed down through conditioning -- perhaps your mom always got nervous before a party so you learned to react the same way. Believing that "shyness" is an indelible component of the personality can be a real stumbling block to overcoming social fears. "That's just the way I am" becomes an excuse for not taking responsibility for individual well-being. In order to change this mind-set, it is important to understand that because shyness is learned, it can be unlearned. Anxiety can be controlled.
But there is no pill to cure the problem. As with all aspects of life, if you really want to get the most out of your social interactions on the job and after hours, you have to put a good deal into them. It takes hard work and a genuine commitment to change. If you sit there waiting passively for the day when your "shyness" will disappear, you will miss out on all the things that, deep down, you really want. And I am not just talking about having fun. In our ever-changing economic climate, your job security and career growth depend on your ability to interact productively, to initiate dialogue, stand up for your ideas, and negotiate compromise. Your ability to evaluate the social chemistry of the workplace and to establish and maintain your position on the team may well determine your career success. Not everyone rises to the top, outshining colleagues, but not everyone wants to and that is not always what is required. But most people must work with others, and cooperation demands social skills and confidence.
This reminds me of David, a brilliant young computer programmer whose difficulty in interacting almost cost him an important promotion. Right out of college, he landed an excellent entry-level job with a growing firm. Within nine months, he was promoted to a managerial position -- a real success story. But it was after his promotion that his troubles began.
Although he was fine in front of a computer terminal, David had great difficulty coordinating his work with other members of his department, whether they were his superiors or people who reported to him. Poor communication skills and a tendency to be a perfectionist combined to create a management nightmare: Though it was clear David knew exactly what needed to be done to keep things running smoothly, it seemed he had trouble delegating his duties to subordinates. When a problem arose, he preferred to solve it himself -- even when it took twice as much time -- rather than ask his superiors to jump in and help. At his quarterly review, his boss addressed the department's concerns and offered to extend David's probationary period if he would try harder to interact with others. In working with me, David became aware that he was uncomfortable turning over any aspect of his responsibilities for fear of seeming unable to accomplish his job on his own. After exploring these doubts, he was able to fully utilize his superiors' knowledge, and to rely on his co-workers to get the job done in the most productive and efficient manner. As David learned, if you accept the challenge and take responsibility for your reactions, you will begin to see that you can learn to manage your anxiety and have a healthy, rewarding social life, as well as a more fulfilling career.
The first step in overcoming your problem is to acknowledge that what you call shyness is anxiety, a very specific kind of anxiety. As you begin to understand this concept, you will be able to make use of the strategies and techniques I have developed to solve the problem. Remember, to use the word "shy" to describe yourself is to give up control of your life and your ability to improve it. Call yourself "shy," and that's the end of the story. Admit you have social anxiety, however, and you are on your way to a more relaxed, fulfilling life in which you are in control. Shyness, after all, means many things to many people. But anxiety is more concrete -- I usually describe it as an attitudinal, emotional, behavioral, and physical response to stress, although not necessarily a negative response.
Picture the athlete at the starting line of a race -- adrenaline pumping, energy flowing, muscles tightening, skin aglow with anticipatory perspiration, heart beating faster and faster, the mind focused on only one thing: the starter's gun and the race. Now, picture the person about to enter a social gathering. He or she approaches the door, behind which a number of people are talking, laughing, having fun -- adrenaline pumping, energy flowing, pulse beginning to quicken, the mind focused on anticipation: "What will happen when I enter the room?" "Will I see anyone I know?" "What will they think of me?"
What do these situations have in common? The answer is anxiety. For the athlete, anxiety is channeled into energy that just may win the race. By allowing the anxiety to play a role in gearing him or her up for the race, the athlete is making good use of the natural fight-or-flight response. For the partygoer, it is not so clear. If that person is willing to let being "keyed up" or "excited" be a positive kind of energy flow, then any initial nervousness or uncertainty will remain manageable and nonthreatening. But if the physical sensations of anxiety become distracting and the thoughts obsessive, the party guest is in for a difficult time. Similarly, a person who prepares for an important meeting may feel a kind of nervous energy in gearing up for negotiations. But if that same person, although well prepared, allows interactive inhibition to keep him from suggesting a solution, questioning a point, or voicing an opinion, he will feel a real letdown. When holding back becomes a habit, the pervasive feeling of "Oh no, I did it again" may lead to a lack of enthusiasm that interferes with productivity and job satisfaction. The truth is, we all want to be heard without -- if we can reasonably avoid it -- being rejected or embarrassed. How to resolve this dilemma? First, by understanding anxiety in its simplest terms. The more you understand about anxiety, the more you will be able to control it. Remember, social anxiety is not some abstract phenomenon or indelible personality trait. It is an explainable dynamic that you can choose to control.
Let's look more closely at the athlete. For that person, in that situation, anxiety is normal and appropriate. In fact, it is crucial to effective performance. Without it, the physiological workings of the body would fall short of what is required. In the second example, anxiety is also appropriate. But it can become negative if the person begins to worry about what is going on inside the room: "What are they laughing about?" "Will anyone talk to me?" "Am I dressed right?" "Will I seem nervous?" At that point it's the degree of incapacity -- the extent to which the anxious feelings and thoughts prevent interacting -- that becomes the most important issue. (In the workplace, these thoughts may run to "Have I done enough research?" "What if I can't answer my boss's questions?" "Can they tell I'm anxious?")
Anxiety is a fact of life! Everyone experiences it. It began in our cave-dweller days as a fight-or-flight response. Think of it this way: If you were walking through the woods and you ran into a bear, it would be normal for your body to activate the fight-or-flight response. Your heart would race, your muscles would tense up, your pupils would dilate, you would breathe more rapidly. The same thing would happen today if you were walking down the street and ran into a mugger. There is a simple, scientific explanation of this response: Your mind and body are preparing to protect you -whether you can feel it happening or not.
Let us briefly examine this process. Your nervous system is divided into two basic parts: The voluntary nervous system controls actions that require thought, such as using the different parts of your body to drive a car; the autonomic nervous system, among its many functions, suspends all nonessential activity of the body and increases the physiological activity needed to confront the situation -- either by fighting or by fleeing the external threat. Here is what it is responsible for:
* increased muscle tension
* accelerated heartbeat
* rapid breathing
* constriction of peripheral blood vessels (this is what causes cold hands)
* dilation of the pupils
* suspension of the digestive process
* dry mouth
* a voiding of bladder and bowels
In addition, the fight-or-flight response causes a marked increase in the flow of ...
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