“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.” Sun Tzu, The Art of War.
Social Anxiety Disorder is an emotional virus which, like other pathogens, lay dormant for years before materializing. It’s likely you were infected during adolescence and the potential disorder lingered in your system for years or decades before making itself known. Any number of situations or events could have triggered the initial contact; it might be hereditary, the result of some traumatic experience, and/or environmental. You could have been subject to bullying or a broken home. Perhaps your parents were overprotective or controlling, or unable to provide emotional validation. What I try to address is the solution before the cause. Get out of the rain first; then look into global warming.
The following email, reproduced verbatim, appeared in my inbox on February 2, 2019. It describes, from a personal perspective, the destructive capabilities of Social Anxiety Disorder.
“I suffer from anxiety to the point that I have know life and am afraid of most everything and really don’t know why? It keeps me from dating and I really want to learn how to have more self confidence and have friends. and a part time job. I’m 48 and the anxiety seems to worsen as I get older. I don’t want to die alone. I have know family, and I’ve only been living in san fran for almost one year, from North Carolina. What I’m trying to say, anxiety has crippled me, locked me in a cage and has become my master. I want to learn how to be free and be and do the things I wan to do without second guessing myself. I want gay friends and to start dating. I want to love and be loved!! I’m not getting any younger and I’m so lonely on so many levels. With that said, please let me know if I can afford this group, please. thanks and have a great day.”
Let’s begin by differentiating common anxiety from Social Anxiety Disorder. Feeling anxious or nervous in certain situations is normal and not indicative of Social Anxiety Disorder. Most individuals are nervous when speaking in front of a group of people, and anxious when their teenager stays out beyond curfew. A “normal” person recognizes the ordinariness of a situation and gives it appropriate attention; the individual experiencing social anxiety disorder takes it personally, dramatizes it, and obsesses on its perceived negative implications.
Published statistics estimate the contagion rate of SAD falls between seventeen and twenty percent of the U.S. adult population. LGBTQ numbers are almost twice that. The National Institute of Mental Health estimates 9.1% of adolescents (ages 10 to 19) experience Social Anxiety Disorder, and 1.3% have severe impairment. These statistics are extremely fluid, however. A high percentage of persons who experience SAD are either unaware or don’t tell anyone, and most remain ignorant of its diagnosis. Statistics for the LGBTQ community are always speculative; 2020 will be the first time that sexual orientation appears on the census form. Numbers for teenagers are even more precarious; while the Conditions for SAD are generally set in adolescence, it can remain latent until adulthood. Let’s settle on a comfortable average of 25 million U.S. adults affected by the disorder.
The logical reaction to mental or physical impairment is to seek awareness and treatment. The commitment-to-remedy rate for those experiencing social anxiety is less than 6%! This is reflective of symptoms which manifest perceptions of worthlessness and futility.
The superficial overview of SAD is intense apprehension—the fear of being judged, negatively evaluated, and/or rejected in social situations. In my experience, a life lived in fear is not a life half lived. It’s no life at all. The overriding characteristic of SAD is acute feelings of incompetence and worthlessness. SAD sustains itself through repression and intractability, impacting our Condition by imposing irrational thought and action. Its dominance is strengthened by our negative dispositions—our anger, our mistrust, agitation, frustration, aggression. Perceptions of personal attractiveness, intelligence, competence, and so on, become distorted and unsound. The SAD individual meticulously avoids situations that might trigger discomfort. Multiple symptoms produce feelings of futility and unworthiness, and the delusion of incompetence is expressed by profound and debilitating shame.
A person with Social Anxiety Disorder experiences symptoms of anxiety or fear in social situations—dating, interviewing for a position, answering a question in class, dealing with authority, and so on. Functioning in perfunctory situations on an interpersonal level—eating or front of others, riding a bus, using a public restroom—can cause undue stress and apprehension to the socially anxious individual. In a nutshell, we are afraid that we will be humiliated, judged, and rejected.
The fear that we have in social situations is so fierce we conclude it’s beyond our ability to control it, which manifests in perceptions of incompetence and futility. This interferes with our desire to pursue a goal, attend school, or do anything that might trigger anxiety. Often we worry about things for weeks before they could possibly happen. Invariably, we avoid places or events or situations where there is any potential threat of embarrassment or ridicule.
In my twenties and thirties, there was no such thing as Social Anxiety Disorder; it was recognized in 1994. Due to my errant behavior, I was told I wouldn’t amount to anything. No matter the situation or circumstance, I was the outsider who didn’t fit in. I had no identity except as someone who took advantage, and no goal beyond self-aggrandizement. I relied on alcohol and pharmaceuticals as mind-numbing alternatives to facing my social ineptitude. I would go to extreme lengths to blind myself to my Condition. I consulted with psychiatrists, psychologists, mental health experts, and attended multiple self-help seminars. I was diagnosed with some form of depression (situational, atypical, dysthymia, chronic major, manic-depressive) or told I was shiftless, lazy, opportunistic, amoral, a freeloader—the list goes on.
Even today, about 90% of individuals experiencing SAD are misdiagnosed. According to The Social Anxiety Institute, individuals with “diagnosable [DSM-V] Social Anxiety Disorder” are declared “schizophrenic,” “manic-depressive,” “clinically depressed.” “panic disordered,” “personality disordered,” and so on.
The key to SAD’s success is its uncanny ability to detect weakness, to instinctively sense vulnerability. It swoops in to fill the void, taking control, telling us how to think and act. SAD is the like the man who came to dinner—that annoying houseguest you can’t get rid of. We feed him with our irrationality and detachment; we allow him to crash on our couch, surrounded by empty beer cans once filled with hope and prosperity. He takes over the bathroom, making us miss opportunities. He even opens our mail. So why do we allow him to take advantage like that? It seems incomprehensible but, after a while, we grow accustomed to having him around. Perhaps we felt lonely and SAD was someone in which to confide. Perhaps we were angry at some perceived injustice and wanted someone to take our side. It’s extremely difficult to throw him out of the house after he’s become the predominate fixture in our life. We have become dependent on his companionship.
In many ways, interpersonal relationships are at the heart of SAD. We find it difficult to make new friends or have any at all. Intimacy is special, almost indefinable, and you can’t be intimate with just anyone. Intimacy demands that we emerge from our protective environment and take risks—not an easy commitment for someone resistant to change. A relationship brings new ideas and concepts. We abhor change. That’s where the risk factor comes in; we have to take chances and be willing to lose—traits peculiar to a SAD person. SAD attacks the entire body complex, bringing intellectual confusion and irrationality. emotional instability, physical dysfunction, and spiritual malaise. Emotionally we feel melancholic, heartbroken, and useless. Under duress, we are subject to unwarranted sweating and trembling, hyperventilation, nausea and cramps, dizziness, lightheadedness, muscle spasms, and tension, to name a few. Spiritually we perceive ourselves as unworthy, insignificant, and incapable.
You’re all familiar with the free association test. The person in the white coat tosses words at you and you respond with the first reactive word that comes to mind. So here’s a list of words. I want you to verbalize each one and then associate it to the first thing that flashes before your conscious. Useless, incompetent, timid, ineffectual, chicken, insignificant, stupid, (fill in your own blanks).
Has anyone used those words to describe you? Do you use any of those words to describe yourself? When you break a dish do you blurt out the word, stupid? When you can’t figure the right driver to remove a screw do you feel useless? When you forget to pay a bill, do you think, what an idiot? Most people toss out these pejoratives on a daily basis but few take them to heart like the SAD individual who believes every word. These are the automatic negative thoughts (ANT’s) we’ve implanted in our neural network. They determine our initial reactions to situations or circumstances. They tell us how to think and feel and act. Our ANT voice exaggerates, catastrophizes, and distorts. It demeans us, denigrates our abilities, makes us feel inept, robs us of our dignity and self-esteem, and makes our future seem hopeless. SAD thrives on the pessimism of our old thoughts and feelings. They’re part of our Condition and they’re extremely unhealthy. We have to stop giving in to them.
You have a choice of how you think and react. Why choose to be bitter and angry when you can be good natured? Why choose to beat yourself up? It’s not your fault you have SAD; you’re only to blame if you choose to remain in its control. The positive option is not only the right choice, to a rational person, it’s the only choice. The choice that is kind and beneficial and makes you feel good—that’s the right choice. I’ve placed two items on the table. One is a rusty, iron trap capable of crushing the leg of a wild animal; the other is a plate of warm brownies. Choose wisely.
Overall, we worry too much about what someone else thinks of us. In the film Bridge of Spies, Rudolf Abel, the Soviet agent faces the possibility of the death penalty. His lawyer, befuddled by Rudolf’s impassive demeanor, whispers, “Aren’t you at all worried?” The convict shrugs. “Would it help?” Everyone makes errors-in-judgment, says something inappropriate, tells a bad joke. We’re not stupid or an idiot or a jerk―we’re human!
We constantly feel like we are being evaluated and judged. We’re overly concerned we’re going to say or do something that will reveal our incompetence or ignorance. We walk on eggshells, conscious of every eye in the room because we feel like we’re the center of attention and everyone is judging us. Our movements are awkward, and our attempts at humor embarrassing. We try to make conversation but we don’t know what to say. When someone asks us a question we look away rather than directly at them, our mind goes blank, and our response is so soft and timid, we end up having to repeat ourselves.
Many of us drink or rely on alcohol and pharmaceuticals. Substance abuse dulls the pain of our Condition, and it gives us false confidence. It disrupts our normal personality allowing us to be someone else for a while; someone who doesn’t suffer from SAD. We’re not as addicted to the substance as we are to the momentary serenity and sense of belonging.
People ask how long it took for me to beat my social anxiety. You don’t cure social anxiety–you outsmart it. Old perceptions of inadequacy, recollections of isolation, irrational fears, and other consequences of SAD are indelibly ingrained into our psyche. They’re a component of who we once were and who we are today. We outsmart SAD by overwhelming it with positive affirmation, and an appreciation of our value. What is irrational? Anything we do, think, or say detrimental to our well–being and happiness is irrational.
SAD closes the door on alternatives and shuts the windows to possibility. As water is one thing that can destroy the Wicked Witch, SAD can only be defeated by rational thought and action. The singular theory proven effective at outsmarting SAD is Cognitive Behavioral Therapy. CBT is designed to help you counter decades of wrong–thinking and false perception. Only by recognition of your inherent strength and determination can you overwhelm a lifetime of propaganda designed to keep you from that to which you’re inherently entitled. Only by commitment and practice can you reclaim what SAD has taken from you.
This is how you outsmart Social Anxiety Disorder. You revolt. You refute its power over you. You not only oppose what it stands for, but you also use every opportunity to challenge its legitimacy. You stop feeding it with your negative self–perceptions. You reclaim the qualities that celebrate your uniqueness and rechannel your self–destructive, false perceptions into pride of your individuality. You consider the value and wisdom of anything and everything counterintuitive to your current Condition because every belief, concept, thought, and action you held or acted upon under the domination of Social Anxiety Disorder is wrong! If they held any logic or validity you wouldn’t still be suffering!
I lived the earlier part of my life with SAD; I’ve spent years counseling and developing treatments to more efficiently address all aspects of SAD—and I have arrived at this conclusion. You are better than this. I hear your stories and I am impressed by your courage, and I know what SAD has taken from you. Let me reassure you: it’s not your fault, and it doesn’t have to continue.
© 2019. Robert F. Mullen, Ph.D.
Director, ReChanneling Inc,
COGNITIVE BEHAVIORAL RESTRUCTURING
LI: Robert F. Mullen, Ph.D.
A Brief History of SAD
CBR, CBT and Other Treatments
What Steps to Take