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Social Anxiety as Self Stigmatization

answered 10:37 PM EST, Wed December 16, 2015
Dr Schultz, I've been trying to get help, first I have to apologize for the English, it's not my first language. I moved to other countries for two years now, about 1 month ago, I'm having a presentation in class, I'm well prepared, but when it was my turn, I got really panic and can't speak, I still get upset by thinking about it, I feel like everyone remembers it and secretly making fun of me. At first I thought it was because English is not my first language that's why I get nervous, but I still remember before I moved, I was like this too. In every presentation I would sweat and blush, my palms are cold and sweaty sometime I even got upset stomach before or during a presentation, my face would be hot and red to the point that steam would form on my glasses , which makes me more nervous because everyone will see how nervous I'm. Not only a presentation, I would blush when I'm talking to strangers,but only when I messed up, I'm usually ok in a 1 on 1 conversation. I'm afraid to tell my parents, especially my mother, I haven't seen her for 5 years, and she wasn't around me too much when I'm younger, I asked her why and she said because she doesn't like babies, I always feel nervous and stressed infront of her because she always judge my behavior, for example how I dress, the way I walk and the way I speak, I was never a loud person or get excited easily and my mother hates it and tell me no one would like me and I will never get married, She often asked me why she have a child like me, I try not to cry infront of her because she hates when I cry and she always said I deserve it, sometimes I get depressed because I have no one to talk to, my family is too complicated and I don't want any of my friends to know. When I was in kindergarten, I lived at neighbors house, I've been at 2 different neighbors house, when I'm 6 my father and mother divorced, than my mother got herself a boyfriend, so all three of us lived together, my mother usually come home late. When I'm 11 she left to and go to other country, so I was living with her boyfriend for 4 years, it was fine but I just don't like it. Now I moved and living with my mother and her new boyfriend i don't know is it because all the changes or what causes me to behave this way today, I'm not able to go to mall by myself, I can't speak loud and my voice is always like mumble, I have few friends in school and I'm keeping contact with my friends that are in my back home, even now, my hands are cold because I'm afraid to send my problem to someone, I haven't go to a professional doctor to diagnose any mental problems, I get nervous when I have to make a phone call, I don't know what to do. I just want to know what can make me feel better, I still laugh when I'm with friends, but get sad when I was alone. My concern are, base on what I describe, should I go find a doctor or it is completely normal?I don't know why I have such a hard time and behave this way, I've been worrying bout this for a while and I still avoid going to parties or mall, but thanks for taking your time to read this .

Dr. Richard Schultz Says...

Hello, and thank you very much for consulting me about your struggles with anxiety.

Although you may not be aware of this, the symptoms and challenges you have described are quite common within the human population.

In the United States, we refer to this syndrome as "social anxiety disorder," and it is typically characterized by a fearful preoccupation with others' critical or negative evaluations, judgments, or disapproval. I understand that, in your situation, the condition was exacerbated once you moved to a new country, yet it is also clear that the condition existed prior to that. It is quite common for signs of the condition to be present in childhood, manifesting as shyness, social ambivalence, or attachment problems. So, these symptoms begin as a temperamentally driven tendency toward shyness. Thereafter, any challenging social or interpersonal situations come to be avoided because they are experienced as somehow unpleasant. This avoidance behavior becomes quite instrumental in the further worsening and persistence of the anxiety.  The relief one experiences after avoiding a fear triggering situation is part of the process of "Negative Reinforcement;" the behavior leads to very short term reduction of anxiety, and is therefore repeated, however, continued avoidance prevents one from improving their ability to cope with the aversive stimulus. Thus, the condition worsens, as the sequence of symptomatic behaviors is repeated and strengthened in a cyclical and habitual manner.

Further, as anxiety is a typically progressive condition, and via the process of generalization, more and more people, feelings, and situations will come to be avoided across time, due to their paired association with the worry about experiencing anxiety. This illustrates the true definition of anxiety as "fear of fear." During this process, the anxious person is quite aware that they are "on the run" from their fears, and this observation of one's own avoidance leads one to make negative judgments about the self. This is a common pathway for the development of symptoms of depression.

As you noted, physiological symptoms of panic can also exacerbate social anxiety in a variety of ways. It can manifest as gastrointestinal distress, hot or cold sweats, blushing, or muscular tension, as many of these symptoms are common reactions of the central nervous system to the possibility of danger. So, the fact that these symptoms are occurring actually means that your equipment is working correctly.

Another aspect of what you described that is common among individuals with social anxiety, is that you were frequently exposed to a caregiver (your mother) who was herself averse to, and critical of, the idea of expressing or showing emotions in front of others, or feeling or appearing out of control in front of anyone. You may have not only learned to adopt your mother's perspective, via modelling, but you may also have developed a strong motivation to suppress or hide your own vulnerable or overtly emotional feelings or behaviors, given that any manifestation of them was not likely to bring your mother closer to you.

I hope the preceding material has provided you with a good basic explanation of how you got to where you are. Now, let us address the issue of healing and growth.

You will be glad to know that the pathway to change in your situation will not be particularly complicated or difficult. It will, however, require that you agree to tolerate the distress that will naturally result from implementing your choice to leave the comfort zone. If you are willing to face, and even embrace the frightened parts of you, and to do so with a strong motivation, you'll find that your distress will dissipate rather quickly as you learn to live with an expanded repertoire of social behaviors, coping abilities, and confidence.

 

Although I note that the method of change here will not be all that complex, it will be much easier and more efficient if you employ the resources of a qualified therapist who can guide you through the process.  In addition to providing basic support and encouragement, a mental health professional trained in cognitive-behavioral technique will be able to help you better understand the mechanisms underlying your current state, and help you develop a cohesive plan for making change. This will involve re-evaluating some of your well-established patterns of thinking and behaving, learning how to increase your ability to master your physiological and emotional discomfort, and executing a series of graded behavioral experiments, also known as "exposures."  The therapist will focus on the interpersonal and intrapersonal challenges you face across all settings in your life, and help you develop an even better understanding of the environmental or developmental factors that led to your developing these protective techniques in the first place. CBT for social anxiety is time-limited, carries no side effects, and will lead to a greater sense of overall well-being and confidence.

If you would like to try and take a few steps on your own before seeing a therapist, you can certainly do so, however, as Albert Einstein wrote, "It is impossible to solve a problem with the same thinking that created it."  That is why having an objective and trained professional at your side will optimize this process.  A few non-therapy activities that might steer you in the right direction are reading and working your way through a good book on social anxiety, or joining an organization designed to help individuals build their social confidence.

As far as reading, I recommend you consult "Managing Social Anxiety" By Heimburg and Turk. As far as groups go, "Toastmasters" is an international organization that has been helping improve their social confidence since 1924. Find out more about them at www.toastmasters.org.

I hope this reply has been of some use to you, and I invite you to let me know of your progress and to direct any further questions to me.

Sincerely,

Richard E. Schultz, Ph.D.

 

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