Understanding Social Anxiety: A Recovery Guide for Sufferers, Family, and Friends

282 Pages·2017·1.54 MB·English

by  Vera Sonja Maass Ph.D.

Understanding Social Anxiety
A Recovery Guide for Sufferers,
Family, and Friends
Vera Sonja Maass
Copyright © 2017 by Vera Sonja Maass All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior
permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data Names: Maass, Vera Sonja, author.
Title: Understanding social anxiety : a recovery guide for sufferers, family, and friends / Vera Sonja Maass.
Description: Santa Barbara, California : Praeger, an Imprint of ABC-CLIO, LLC, [2017] | Includes
bibliographical references and index.
Identifiers: LCCN 2016040338 (print) | LCCN 2016042933 (ebook) | ISBN 9781440841958 (hardcopy :
alk. paper) | ISBN 9781440841965 (ebook) Subjects: LCSH: Social phobia—Handbooks, manuals, etc. |
Anxiety—Handbooks, manuals, etc.
Classification: LCC RC552.S62 M33 2017 (print) | LCC RC552.S62 (ebook) | DDC 616.85/22—dc23
LC record available at https://lccn.loc.gov/2016040338
ISBN: 978-1-44084195-8
EISBN: 978-1-44084196-5
21 20 19 18 17 1 2 3 4 5
This book is also available as an eBook.
Praeger
An Imprint of ABC-CLIO, LLC
ABC-CLIO, LLC
130 Cremona Drive, P.O. Box 1911
Santa Barbara, California 93116-1911
www.abc-clio.com
This book is printed on acid-free paper
Manufactured in the United States of America This book discusses treatments (including types of
medication and mental health therapies), diagnostic tests for various symptoms and mental health disorders,
and organizations. The author has made every effort to present accurate and up-to-date information.
However, the information in this book is not intended to recommend or endorse particular treatments or
organizations, or substitute for the care or medical advice of a qualified health professional, or be used to
alter any medical therapy without a medical doctor’s advice. Specific situations may require specific
therapeutic approaches not included in this book. For those reasons, we recommend that readers follow the
advice of qualified health care professionals directly involved in their care. Readers who suspect they may
have specific medical problems should consult a physician about any suggestions made in this book.
Contents
Preface
Acknowledgments
Chapter 1 Overview
Chapter 2 Cultural Institutions: A Breeding Ground for Social Anxiety
Chapter 3 Coping Mechanisms—Avoid, Avoid, Avoid
Chapter 4 Technology Obscuring the Problem
Chapter 5 Self-Help Remedies—Medication, Alcohol, Street Drugs, Food,
and More
Chapter 6 Approaching the Possibility of Change: Medical versus Mental
Health
Chapter 7 We Act as If Our Beliefs Are True
Chapter 8 Process of Change: Recognizing the Illogical Logic of Social
Anxiety
Chapter 9 Reconstructing One’s Life
Notes
Resources
Bibliography
Index
Preface
Although social anxiety disorder is currently receiving increased public
attention, it is by no means a new problem, as is outlined in this book. Sadly, the
rekindled attention is due to an increase of occurrence of the problem and the
growing use of prescription drugs for it—along with increased medication abuse
and deaths due to overdose.
When, why, and how does social anxiety develop, and who is prone to suffer
from it? Experts during the “decade of anxiety” in the 1980s searched for the
answers. Arriving at a lack of self-esteem for an answer, they made valiant
efforts to correct for this apparent shortage. Self-esteem was considered to be the
solution for social problems. However, as is discussed in this book, the forces
operating within the disorder of social anxiety are complex and complicated,
requiring exploration deeply beyond the surface.
Many research workers agree that there is no single factor that determines the
development of social anxiety; rather there seems to be a multitude of factors.
Other experts in the field point to general vulnerabilities as the core of anxiety
disorders.
Some experts believe that the roots of social anxiety are to be found in one’s
childhood, and while this seems to be true in many cases, having passed the
childhood years does not mean that one will not develop the difficulty later in
response to future events and experiences. There is no vaccination available to
prevent its occurrence, but changes in one’s brain activities when forming beliefs
and developing thoughts regarding certain disturbing situations could lead to
resolution and relief.
The author’s past training with Albert Ellis, PhD, founder of Rational
Emotive Behavior Therapy (REBT), and Maxie C. Maultsby Jr., MD, founder of
Rational Behavior Therapy (RBT), has provided an appreciation for research and
theory-building but also for the power of people’s thoughts and beliefs and the
impact those thoughts and deeply entrenched beliefs have on people’s quality of
life, their happiness, and their distress.
As can be observed from the case histories described in this book, patience
and intense focus are required from both the client and the therapist as they delve
deeply below the surface in their efforts to reach the core of the impairment and
explore the implications for achieving relief and healing.
Acknowledgments
My special thanks are deserved by the brave individuals in the community at
large who so graciously consented to disclose their life stories and past
experiences to the general public. They were generous with their time and the
information they shared; it is greatly appreciated.
My appreciation for the clients who allowed me to incorporate their case
histories is limitless. Their stories have become a significant part of this book.
For reasons of confidentiality their names have been changed, and some of their
circumstances have been disguised. Some of their stories have been combined to
form composite characters. Although I cannot disclose their identities, they
know who they are, and they know the impact of their generosity on this book.
My deepest gratitude belongs to Debbie Carvalko, Senior Acquisitions
Editor, Psychology and Health, not only for her expert professional guidance but
for the caring recognition that I needed work to help me adjust to and heal over
the biggest loss in my life. Debbie, I treasure the experience of working with you
on our previous books, and I am deeply indebted to you for the coming to life of
this book.
Finally, I want to dedicate this book to the memory of my husband, H.
Gordon Featherstonaugh, PhD, who had so much looked forward to seeing this
book’s completion. Sadly, my psychologist-colleague and life partner’s wish
was not granted.
CHAPTER ONE
Overview
“It seems so ridiculous, but the whole idea of going to church suddenly frightens
me. This started shortly after my divorce. Last Sunday, as we were getting ready
for church, the anxiety became so strong, like something awful was going to
happen. My heart was racing, my hands became clammy with cold sweat, and I
had difficulty breathing. My oldest son saw me tremble and asked me if I was
sick. We decided not to go to church.”
Those were the words spoken in a barely audible voice by Gina, a 34-year-old
woman, divorced mother of two sons, in her first therapy session. At the end of
the session, the preliminary diagnosis in her chart read “social anxiety disorder.”
According to the current edition of The Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), the essential feature of social anxiety disorder is a
marked, or intense, fear or anxiety of social situations in which the individual
may be scrutinized by others. And when exposed to such social situations, the
individual fears that he or she will be negatively evaluated. The prevalence
estimate for social anxiety disorder in the United States is around 7 percent. In
general, rates of the disorder have been higher for females than for males. This
gender difference tends to be more pronounced in adolescents and young adults.
The median age at onset of social anxiety disorder in the United States is 13
years old; about 75 percent of people with social anxiety experienced an initial
onset between the ages of 8 and 15.
Self-medication with substances such as drugs or alcohol is common. But
despite the distress associated with social anxiety disorder, only about half of
individuals with the disorder in Western societies ever seek treatment, and they
tend to do so only after 15–20 years of experiencing symptoms.1
Apparently, the term phobie des situations socials was first introduced in
1903 by Pierre Janet, a French doctor, practitioner of hypnosis, and mentor of
Charcot, who used the concept of a fixed idea, suggesting that some people
dissociate an idea and then this fixed idea operates on its own, independent of
the individual’s consciousness.2 Sigmund Freud may have been influenced by
the French and their notion of the fixed idea; however, his concept added the