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Recovery: the action or process of regaining possession or control of something stolen or lost.

Empowerment: the process of becoming stronger and more confident in controlling one’s life and claiming one’s rights.

Neuroplasticity: our brain’s ability to form and reorganize synaptic connections in response to learning or experience.

Proactive: controlling a situation by causing something to happen rather than responding to it after it has happened.

Proactive Neuroplasticity: accelerated learning through DRNI – the deliberate, repetitive, neural input of information.

Dr. Mullen’s years of researching and implementing programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives demonstrate the learning effectiveness of proactive neuroplasticity. DRNI – the deliberate, repetitive, neutral input of information dramatically accelerates and consolidates our pursuit of personal goals and objectives—eliminating a bad habit, self-transformation—harnessing our intrinsic aptitude for extraordinary living.

Neuroplasticity is evidence of our brain’s constant adaptation to learning. Scientists refer to the process as structural remodeling of the brain. It is what makes learning and registering new experiences possible. All information notifies our neural network to realign, generating a correlated change in behavior and perspective. 

What is significant is our ability to dramatically accelerate learning by consciously compelling our brain to repattern its neural circuitry. Deliberate, repetitive, neural information (DRNI) empowers us to proactively transform our thoughts and behaviors, creating healthy new mindsets, skills, and abilities. 

See Anatomy of Recovery and Empowerment Workshops 

Reactive neuroplasticity is our brain’s natural adaption to information. Information includes all thought, behavior, experience, and sensation. Active neuroplasticity is cognitive pursuits such as engaging in social interaction, teaching, aerobics, and creating. Proactive neuroplasticity is the most effective means of learning and unlearning because the regimen of deliberate, repetitive neural input of information accelerates and consolidates restructuring. 

Hebbian Learning

Today, we recognize that our neural pathways are not fixed but dynamic and malleable. The human brain retains the capacity to continually reorganize pathways and create new connections and neurons to expedite learning. 

Neurons do not act by themselves but through neural circuits that strengthen or weaken their connections based on electrical activity. The deliberate, repetitious, input of information impels neurons to fire repeatedly, causing them to wire together. The more repetitions, the more robust the new connection. This is Hebbian Learning. DRNI is the most effective way to promote and retain learning and unlearning. 

We not only prompt our neural network to restructure by deliberately inputting information, but through repetition, we cause circuits to strengthen and realign, speeding up the process of learning and unlearning. 

Accelerates and Consolidates Learning

What happens when multiple neurons wire together? Every input of information, intentional or otherwise, causes a receptor neuron to fire. Each time a neuron fires, it reshapes and strengthens the axon connection and the neural bond. Repeated neural input creates multiple connections between receptor, sensory, and relay neurons, attracting other neurons. An increase in learning efficacy arises from the sensory neuron’s repeated and persistent stimulation of the postsynaptic cell. 

Postsynaptic neurons multiply, amplifying the positive or negative energy of the information. Energy is the size, amount, or degree of that which passes from one atom to another. The activity of the axon pathway heightens, urging the synapses to increase and accelerate the release of chemicals and hormones that generate the commitment, persistence, and perseverance useful to recovery or the pursuit of personal goals and objectives. 

The consequence of DRNI over an extended period is obvious. Multiple firings substantially accelerate and consolidate learning. In addition, DRNI activates long-term potentiation, which increases the strength of the nerve impulses along the connecting pathways, generating more energy. Deliberate, repetitive, neural information generates higher levels of BDNF(brain-derived neurotrophic factors) proteins associated with improved cognitive functioning, mental health, and memory. 

PROACTIVE NEUROPLASTICITY YOUTUBE SERIES

We know how challenging it is to change, remove ourselves from hostile environments, and break habits that interfere with our optimum functioning. We are physiologically hard-wired to resist anything that jeopardizes our status quo. Our brain’s inertia senses and repels changes, and our basal ganglia resist any modification in behavior patterns. DRNI empowers us to assume accountability for our emotional well-being and quality of life by proactively controlling the input of information.

Neural Reciprocity

Our brain reciprocates our efforts in abundance because every viable input of information engages millions of neurons with their own energy transmission. DRNI plays a crucial role in reciprocity. The chain reaction generated by a single neural receptor involves millions of neurons that amplify energy on a massive scale. The reciprocating energy from DRNI is vastly more abundant because of the repeated firing by the neuron receptor. Positive energy in, positive energy multiplied millions of times, positive energy reciprocated in abundance. 

Conversely, negative energy in, negative energy multiplied millions of times, negative energy reciprocated in abundance. 

Our brain does not think; it is an organic reciprocator that provides the means for us to think. Its function is the maintenance of our heartbeat, nervous system, and blood flow. It tells us when to breathe, stimulates thirst, and controls our weight and digestion. 

Hormonal Neurotransmissions

Because our brain does not distinguish healthy from toxic information, the natural neurotransmission of pleasurable and motivational hormones happens whether we feed it self-destructive or constructive information. That is one of the reasons breaking a habit, keeping to a resolution, or recovering is challenging. We receive neurotransmissions of GABA for relaxation, dopamine for pleasure and motivation, endorphins for euphoria, and serotonin for a sense of well-being. Acetylcholine supports our positivity, glutamate enhances our memory, and noradrenalin improves concentration. In addition, information impacts the fear and anxiety-provoking hormones, cortisol and adrenaline. When we input positive information, our brain naturally releases neurotransmitters that support that negativity. 

Conversely, every time we provide positive information, our brain releases chemicals and hormones that make us feel viable and productive, subverting the negative energy channeled by the things that impede our potential. 

The power of DRNI is that a regimen of positive, repetitive input can compensate for decades of irrational, self-destructive thoughts and behaviors, and provide the mental and emotional wherewithal to effectively pursue our personal goals and objectives. 

Personal goals and objectives are those things we want to change about ourselves: eliminating a bad habit or behavior, improving life satisfaction, and revitalizing self-esteem and motivation. The deliberate, repetitive, neural input of information significantly improves the probability of recovery. Likewise, it empowers us to pursue those personal goals and objectives that make our lives more viable and productive. 

ReChanneling targets the personality through empathy, collaboration, and program integration, utilizing an integration of science and east-west psychologies. Science gives us proactive neuroplasticity, CBT and positive psychologies are western-oriented, and eastern practices provide the therapeutic aspects of Abhidharma psychology and the overarching truths of ethical behavior. 

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Devising Response Plans for Situations

Dr. Robert F. Mullen
Director/ReChanneling

Numbers generate contributions that support scholarships for workshops.

Dr. Mullen is doing impressive work helping the world. He is the
pioneer of proactive neuroplasticity utilizing DRNI—deliberate,
repetitive, neural information. Alfonso Paredes, CEO, WeVoice.

An essential factor in recovery is learning how to moderate our situational fears and anxieties that precipitate our automatic negative thoughts (ANTs). There are as many different situations as there are persons negatively impacted. They fall into two primary categories: anticipated and unexpected.

Anticipated and Recurring Situations are those we know, in advance, will evoke our fears and corresponding ANTs.

Unexpected Situations

Unexpected Situations are those anxiety-provoking Situations we do not anticipate, and those that suddenly get out of hand.

  • Situation: The set of circumstances ̶ the facts, conditions, and incidents affecting us at a particular time in a particular place. For social anxiety disorder and other emotional dysfunctions, a Situation is an occasion or event that generates anxiety or stress such that it impacts our emotional well-being and quality of life. Examples include restaurants, the classroom, job interviews, speaking in front of a group, and socializing with strangers.
  • Fears and apprehensions: The stress-provoking feelings developed by our life-consistent negative self-beliefs and images. Examples include the fears of saying or doing something stupid; being criticized or rejected; being the center of attention; engaging in conversation.
  • Automatic Negative Thoughts (ANTs): Spontaneous conscious or subconscious expressions of our fears and apprehensions. ANTs are ostensibly irrational and self-defeating. Examples include I am incompetent; I will say or do something stupid; I am unattractive; No one will like me; No one will talk to me.

Anticipated Situations

The following 9-step plan for Moderating our Fear(s) of Situation functions for Anticipated and Recurring Situations. SEE The Trajectroiy of Our Self-Annihilation

  1. Identify the Feared Situation
  2. Identify the Associated Fear(s)
  3. Unmask the Corresponding ANT(s)
  4. Examine and Analyze Our Fear(s) and Corresponding ANT(s)
  5. Generate Rational Responses
  6. Reconstruct Our Thought Patterns
  7. Create a Plan to Challenge Our Feared Situation
  8. Practice the Plan in Non-Threatening Simulated Situations (including Affirmative Visualization)
  9. Expose Ourselves to the Feared Situation

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Coping Skills

In Unexpected Situations, sudden and unpredicted stress can be moderated with certain coping skills. Their primary objective is to reduce the influx of the fear and anxiety-provoking hormones, cortisol and adrenaline, and provide a modicum of control over our fears and corresponding ANTs. It also provides us the opportunity to identify and challenge them going forward.

Not all coping skills provided below work in Unexpected Situations but are better suited for Anticipated and Recurring Situations where we have time to devise a more specific and comprehensive approach.

  • Affirmative Visualization (anticipated/recurring situations)
  • Controlled Breathing (unexpected and anticipated/recurring situations)
  • Deliberate Slow-Talk (unexpected and anticipated/recurring situations)
  • Distractions (unexpected and anticipated/recurring situations)
  • Diversions (anticipated/recurring situations)
  • Objectives (anticipated/recurring situations)
  • Focus (anticipated/recurring situations)
  • Persona (anticipated/recurring situations)
  • Positive Personal Affirmations (unexpected and anticipated/recurring situations)
  • Progressive Muscle Relaxation (unexpected and anticipated/recurring situations)
  • Projected Positive Outcomes (anticipated/recurring situations)
  • Projected SUDS Rating (anticipated/recurring  situations)
  • Rational Response (unexpected and anticipated/recurring situations)
  • Self-Affirmations (unexpected and anticipated/recurring situations)

PROACTIVE NEUROPLASTICITY YOUTUBE SERIES

Affirmative Visualization: By visualizing a positive outcome prior to the Situation, we experience behaving a certain way in a realistic scenario and, through repetition, attain an authentic shift in our behavior and perspective. It is a form of proactive neuroplasticity, and all the neural benefits of that science are accrued by Affirmative Visualization. Just as our neural network cannot distinguish between toxic and healthy information, it also does not distinguish whether we are physically experiencing something or imagining it.

Controlled Breathing: This abbreviated breathing exercise takes roughly a minute. Place one hand on your abdomen, just above your navel, and the other hand in the center of your chest.

  1. Open your mouth and sigh gently, as if mildly irritated. Allow the muscles in your upper body and shoulders to drop down and relax as you gently exhale.
  2. Close your mouth for a few moments.
  3. Slowly inhale through your nose, keeping your lips closed. Push your stomach out as you do this to pull air in.
  4. Pause for a few moments – as long as is comfortable, then open your lips and gently exhale through your mouth while pulling your stomach in.
  5. Repeat several times.

Deliberate Slow-Talk: Speaking slowly and calmly slows our physiological responses, alleviates rapid heartbeat, and lowers blood pressure. It is also helpful to incorporate the 5-second rule, i.e., pause any response for five thoughtful seconds. Not only do these coping skills reduce the flow of cortisol and adrenaline, but it also presents the appearance of someone who is thoughtful and confident.

Distractions: Objects that momentarily rechannel our attention from the emotions of our ANTs.  Examples: a picture on the wall, a vase, a trophy on the bookshelf. When confronted by emotional angst, we turn our attention, momentarily, to a Distraction. Recommendation: Three Distractions.

Diversions: Distractions are objects that momentarily rechannel our attention away from the emotional angst of our ANTs. Diversions are activities that perform the same function. A common Diversion is snapping a rubber band encircling our wrist. Other examples: Carry a pushpin or other physical deterrent in our pocket; character analyze people in the room; place a tiny object in our shoe. Recommendation: Three Diversions.

Objectives  Our Objective(s) support and implement our purpose for exposing ourselves to the Situation. Is it our goal to network, make friends, challenge our dysfunction, or work on a personal concern? What are the steps we plan to take to achieve our goal?

Focus: Focusing on a personal character strength or attribute rechannels our emotional angst to mental deliberation, disrupting our ANTs. It’s also beneficial to work on strengths and attributes that we would like to refine or build upon. A valuable tool in In a recovery workshop is developing our Character Resume – a list of our strengths, virtues, and achievements, recognition of which has been subverted by our social anxiety and lacuna of self-esteem.

Persona: Our Persona is the social face we present to the Situation, designed to make a positive impression while concealing our social anxiety. Our Persona is influenced by how we carry ourselves; the timbre of our voice; the clothes and shoes we wear; the attitude we display. Personas are not other selves but aspects of our personality. We have multiple Personas dependent upon our mood, temperament, and circumstance. Deliberately choosing a Persona can dramatically alter our perspective and presentation.

Actors often determine physical movements as the foundation for their character. Our physical cadence can alter our perspective and emotional state. A walk of rejection is different from one of exuberance. A simple method to change our walk and subsequently our presentation is to attach an imaginary string to different parts of the body. The physical and emotional difference between propelling ourselves with our chest versus our knees or chin can be significant. Try it.

Positive Personal Affirmations: Brief, prepared personal statements that help us focus on goals and objectives. Deliberately repeating PPAs is an extremely valuable asset to our recovery and our neural restructuring. SEE The Science of Positive Personal Affirmations

Progressive Muscle Relaxation (PMR): This quick and discreet process of muscle relation takes roughly a minute. Each component is held for roughly 10 seconds.

  1. Raise your shoulders up toward your ears… tighten the muscles there. Hold. Release.
  2. Tighten your hands into fists. Very, very tight… as if you are squeezing a rubber ball very tightly in each hand. Hold. Release.
  3. Your forehead – Raise your eyebrows, feeling the tight muscles in your forehead. Hold.  Now scrunch your eyes closed. Hold it. Relax.
  4. Your jaw – Tightly close your mouth, clamping your jaw shut. Your lips will also be tight. Hold it. Release
  5. Breathe in deeply through your nose. Hold it. Release the air through your mouth. Repeat at least three times.

Projected Positive Outcome. Because of our years of life-consistent negative self-beliefs and images, we tend to set unreasonable expectations. The key to recovery, however, is progress, not perfection. We already know the projected negative outcome of a Situation is succumbing to our ANTs. Setting moderate expectations can better guarantee a positive outcome. What would be a reasonable expectation for success? What would satisfy our efforts? Our Projected Positive Outcome should be rational, possible, unconditional, problem-focused, and reasonably attainable.

Projected SUDS Rating: The Subjective Units of Distress Scale self-rates our fears and apprehensions on a scale of 0-100. By projecting a moderate success level, you guarantee yourself a Win in any Situation. If our initial fear and apprehension SUDs Rating is at at 70, a reasonable and attainable Projected SUDS Rating would be 65 or 60. Ostensibly, we can achieve that just by showing up.

Rational Responses. It is always prudent to ask ourselves: How logical is my fear? What is the worst that can happen? The answer to that is usually a rational response.

Self-Affirmations: Situationally specific, self-empowering statements designed to improve our self-confidence while fueling our neural network with positive information. Examples: I deserve to be here. I am as significant as anyone else in the room. I am valuable. I will be successful.

Utilizing some or all of these coping skills can provide a dramatic moderation of our fears, apprehensions, and corresponding ANTs. While the process may be challenging due to our life-consistent negative self-beliefs, and images, the scientifically supported power of suggestion tells us that by imitating confidence, competence, and a positive outlook, we can attain an authentic shift in our behavior and perspective. Fake it ’till you make it.

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WHY IS YOUR SUPPORT SO IMPORTANT?  ReChanneling develops and implements programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing scientific and clinically practical methods including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to reinvigorate self-esteem. All donations support scholarships for groups, workshops, and practicums.

Social Anxiety Disorder: A Definitive Guide

Dr. Robert F. Mullen
Director/ReChanneling

Numbers generate contributions that support scholarships for workshops.

Dr. Mullen is doing impressive work helping the world. He is the
pioneer of proactive neuroplasticity utilizing DRNI—deliberate,
repetitive, neural information. — Alfonso Paredes, CEO, WeVoice.  

Social Anxiety Disorder

Social anxiety disorder (SAD) is one of the most common mental disorders, negatively impacting the emotional and mental well-being of roughly 40 million U.S. adults and adolescents who find themselves caught up in a densely interconnected network of fear and avoidance of social situations. As the third-largest mental health care problem in the world, SAD is culturally identifiable by the persistent fear of social and performance situations.

Social anxiety makes us feel helpless and hopeless, trapped in a vicious cycle of fear and anxiety, and restricted from living a ‘normal’ life. We feel alienated and disconnected – loners filled with uncertainty, hesitation, and trepidation. Our fear of criticism, ridicule, and rejection is so severe, that we avoid the life experiences that interconnect us with others and the world. The irony is, that we have far more to fear from our distorted perceptions than the opinions of others. Our imagination takes us to dark and lonely places.

We fear the unknown and unexplored. We obsess about upcoming events and how we will reveal our shortcomings. We experience anticipatory anxiety for weeks before a situation and anticipate the worst. We feel like we are under a microscope, and everyone is judging us negatively. We worry about what we say, how we look, and how we express ourselves. We worry about what we will say, how we will look, and how others perceive us. We feel undesirable and worthless. 

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Roughly 40 million U.S. adults will experience SAD this year. The National Institute of Mental Health estimates that roughly 10% of adolescents currently experience symptoms. Statistics are imperfect for LGBTQ+ persons; the Anxiety and Depression Association of America estimates the community is twice as likely to contract it than their straight or gender-conforming counterparts. Statistics are fluid, however; a high percentage of persons who experience SAD refuse treatment, fail to disclose it, or choose to remain ignorant of its symptoms. 

SAD is ostensibly the most underrated, misunderstood, and misdiagnosed disorder. It is nicknamed the ‘neglected anxiety disorder’ because few therapists want or have the expertise to tackle it, and the massive number of revisions, substitutions, and changes in defining SAD result in the probability of misdiagnosis. Debilitating and chronic, SAD attacks on all fronts, negatively affecting our entire lived-body. It manifests in mental confusion, emotional instability, physical dysfunction, and spiritual malaise. Emotionally, we are depressed and lonely. In social situations, we are subject to unwarranted sweating,  trembling, hyperventilation, nausea, and muscle spasms. Mentally, our thoughts are discordant and irrational. Spiritually, we define ourselves as inadequate and insignificant. 

The commitment-to-remedy rate for those experiencing SAD is unexemplary ― reflective of symptoms that manifest perceptions of worthlessness and futility. SAD’s poor recovery rates mirror a general inability to afford treatment due to employment instability. Over 70% of us are in the lowest economic group.

SAD is a pathological form of everyday anxiety. Feeling anxious or apprehensive in certain situations is normal; most of us are nervous speaking in front of a group and anxious when visiting our dentist. The typical individual recognizes the normality of a situation and accords it with appropriate attention. We anticipate it, personalize it, dramatize it, and obsess about its negative implications. We make mountains out of molehills.

We are inordinately apprehensive others will think us incompetent, stupid, or undesirable. There is persistent anxiety and fear of social situations such as dating, interviewing for a position, answering a question in class, and dealing with authority. Often, mere functionality in perfunctory situations―eating in front of others, riding a bus, using a public restroom—can be unduly stressful. 

The fear that manifests in social situations can seem so fierce that many believe it is beyond our control, which manifests in perceptions of helplessness and hopelessness. Negative self-evaluation interferes with our desire to pursue a goal, attend school, or do anything that might precipitate our anxiety. We often anguish over things for weeks before they happen and negatively predict the outcomes. We avoid situations where there is the potential for embarrassment or ridicule. After a situation, our imagination creates false scenarios, and we obsess about our prior behavior.

The overriding fear of being found wanting manifests in our self-perspectives of inferiority and unattractiveness. We are unduly concerned we will say something that will reveal our ineptitude. We walk on eggshells, supremely conscious of our awkwardness, surrendering to the GAZE―the anxious state of mind that comes with the fear we are the center of attention. Our social interactions are often clumsy, small talk inelegant, and attempts at humor embarrassing. Our anticipation of repudiation motivates us to dismiss relationship overtures to offset any possibility of rejection. SAD is repressive and intractable, imposing self-destructive thoughts and behaviors. SAD establishes its authority through defeatist measures produced by distorted and unsound interpretations of reality that govern our perspectives of attractiveness, intelligence, and desirability. 

Maladaptive Self-Beliefs

Maladaptive is a term created by Aaron Beck, the pioneer of cognitive-behavioral therapy. A unique characteristic of SAD, a maladaptive self-belief is a reaction or perspective unsupported by reality. We can find ourselves in a supportive and approving environment, but SAD tells us we are unwelcome and the subject of ridicule and disparagement. SAD distorts our perception, and we adapt negatively (maladapt) to a positive situation. To analogize, if the room is sunny and welcoming, SAD tells us it is dark and unapproving. 

We circle the block endlessly before entering a situation, then end up avoiding it entirely. We try to hide in the classroom, our hearts pounding, hands sweaty, hoping we will not be asked to contribute. We lie awake at night, consumed by all the stupid things we said and did during the day. We are inordinately concerned about the visibility of our anxiety and are often preoccupied with sexual performance or arousal.

We crave companionship but shun social situations for fear others will find us unattractive or stupid. We avoid speaking in public, expressing opinions, or even fraternizing with peers. We are prone to low self-esteem and high self-criticism due to childhood disturbance which precipitates a disruption in our natural physiological and psychological development, allowing the onset of SAD. 

Then to top it off, we consistently beat ourselves up. We blame ourselves for our lack of social skills. We feel shame for our inadequacies. We guilt ourselves when we avoid getting close to someone, terrified of rejection. We know these feelings are irrational; we know we are not responsible for our emotional dysfunction. But our social anxiety compels us to self-loath and self-destruct. How did this happen to me, we ask ourselves? It originated with our Core Beliefs.

Core and Intermediate Beliefs

Core beliefs are determined by our childhood physiology, heredity, environment, information input, experience, learning, and relationships.

Negative core beliefs are generated by any childhood disturbance that interferes with our optimal physical, cognitive, emotional, and social development. Cumulative evidence that a toxic childhood is a primary causal factor in lifetime emotional instability has been well-established. Any number of things can generate a negative core belief. Our parents are controlling or do not provide emotional validation. Perhaps we were subject to gender bullying or a broken home. The disturbance can be real or imagined, intentional or accidental. A toddler who finds their parental quality time interrupted by a phone call can feel a sense of abandonment, which can generate core beliefs of unworthiness and insignificance. This is important when it comes to attributing blame or accountability for our SAD because of the possibility no one is responsible; certainly not the child. 

SAD senses our vulnerability and onsets in adolescence. A combination of genetic and environmental factors drives SAD. Researchers recently discovered a specific serotonin transporter gene called ‘SLC6A4’ that is strongly correlated with susceptibility to the disorder. SAD can linger in our system for years or even decades before asserting itself. 

Core beliefs remain as our belief system throughout life. They mold the unquestioned underlying themes that govern our perceptions. Even if a core belief is irrational or inaccurate, it still defines how we see the world. When we decline to question our core beliefs, we act upon them as though they are real and true.

Core beliefs are more rigid and exclusive in individuals with social anxiety because we tend to store information consistent with negative beliefs and ignore evidence that contradicts them. SAD generates a cognitive bias—a subconscious error in thinking that leads us to misinterpret information, impacting the rationality and accuracy of our perspectives and decisions. 

Negative core beliefs fall within two categories: self-oriented (I am unlovable, I am stupid) and other-oriented (You are unlovable, you are stupid). Individuals with self-oriented negative core beliefs view themselves in one of four ways: 

  • Helpless (I am weak, I am incompetent)
  • Hopeless (nothing can be done about it)
  • Undesirable (no one will like me)
  • Worthless (I don’t deserve to be happy).

These beliefs can lead to fears of intimacy and commitment, an inability to trust, debilitating anxiety, codependence, aggression, feelings of insecurity, isolation, a lack of control over life, and resistance to new experiences.

We are not defined by our social anxiety,
but by our character strengths, virtues, and attributes.

Individuals expressing other-oriented negative core beliefs view people as demeaning, dismissive, malicious, and manipulative. We tend to blame others for our condition, avoiding personal accountability (I can’t trust anyone). This generates serious anxiety towards situations we perceive as potentially dangerous, causing us to avoid them in anticipation of harm. (A ‘situation’ is defined as the set of circumstances ̶ the facts, conditions, and incidents affecting us at a particular time in a particular place. For social anxiety disorder, situations are the places that generate discomforting anxiety or stress such that it impacts our emotional well-being and quality of life.)

So, we accumulate negative core beliefs due to childhood disturbance and other early-life experiences. They influence our intermediate beliefs which develop our adolescence. The onset of SAD aggravates our negative self-beliefs and images, which generate the fears and anxieties of a situation that form our automatic negative thoughts (ANTs). A corresponding intermediate confirmation of the core belief, I am undesirable, might be,  I am unattractive and fat. A corresponding irrational intermediate resolution might be, If I diet and have my nose fixed, I will be desirable

The negative cycle we are in may have convinced us that there is
something wrong with us. That is untrue. The only thing we may be
doing wrong is viewing ourselves and the world inaccurately.

Intermediate beliefs are the go-between our core beliefs and our automatic negative thoughts (ANTs). Despite similar core beliefs, we have varying intermediate beliefs; they develop by way of ousocial, cultural, and environmental experiences ― the same things that make up our personality.

Intermediate beliefs establish our attitudes, rules, and assumptions. Attitude refers to our emotions, beliefs, and behaviors. Rules are the principles or regulations that influence our behaviors. Our assumptions are what we believe to be true or real which, in SAD, are irrational and cognitively distorted. Dysfunctional assumptions caused by our negative intermediate beliefs, and consequential to our negative core beliefs, generate our ANTs. Even when we know our fears and apprehensions are irrational, their emotional impact is so great, that our dysfunctional assumptions run roughshod over any healthy, rational response. 

Automatic Negative Thoughts

Automatic Negative Thoughts (ANTs) are the involuntary, anxiety-provoking thoughts that occur in anticipation of or reaction to a feared situation. They are unpleasant expressions of our anxieties and apprehensions―manifestations of our irrational self-beliefs about who we are and how we relate to others, the world, and the future. (I am incompetent; No one will talk to me; I’ll say or do something stupid; they’ll reject me.) They are our predetermined assumptions of what will happen in a situation. 

ANTs are the expressions of our dysfunctional assumptions and distorted beliefs about a Situation that we accept as true. For example, the Situational automatic negative thought I am ugly and fat and no one will like me might result from the core belief I am undesirable, and the intermediate belief I am unattractive. This negative self-appraisal can elicit an endless feedback loop of hopelessness, worthlessness, and undesirability, leading to substance abuse, eating disorders, anxiety, depression, and low self-esteem. 

ANTs are cognitively distorted emotions that can lead to maladaptive behaviors. 

Cognitive Distortions

Cognitive distortions are the exaggerated, or irrational thought patterns involved in the onset or perpetuation of anxiety and depression. They are thoughts that cause us to view reality inaccurately. We all engage in cognitive distortions and are usually unaware of doing so. Cognitive distortions reinforce or justify our negative thoughts and behaviors. SAF convinces us these false and inaccurate reactions are the truth of a situation. 

Cognitive distortions define the ANT. I am ugly and fat and no one will like me is a distorted and irrational statement. It is Jumping to Conclusionsassuming we know what another person is feeling and thinking, and why they act the way they do. There is also Personalization, and Labeling-Mislabeling distorting the statement. Cognitive distortions tend to blend and overlap like the symptoms and characteristics of many dysfunctions. 

SEE Thirteen Definitive Cognitive Distortions

Prevalent in social anxiety disorder, ANTs are irrational, perceptual, and self-destructive. To challenge them, we need to interrogate them to understand their structure. Why do we have these self-destructive thoughts and where did they come from? Without a clear inventory of the causes and consequences of our negative thoughts and behaviors, we do not have a chance of defeating them.

Anxiety is an abstraction; it has no power on its own.
We fuel it, giving it strength and power.

Love and Friendship

In unambiguous terms, the desire for love is at the heart of social anxiety disorder because of our inability to establish and maintain healthy relationships. Our fear of rejection makes social interconnectivity challenging. Our compunction to reject to offset the possibility of rejection is borne by our perception of undesirability. We crave companionship but shun the possibility due to the fear of appearing unlikeable, stupid, or annoying, which limits our potential for comradeship. Our low self-esteem and high self-criticism keep us from fraternizing with peers, and this avoidance prevents the enjoyment of being with others who share our hobbies and interests. 

Friendship. Aristotle called philia one of the most indispensable requirements of life. A healthy friendship is a bonding of individuals with mutual experiences―a platonic affection that subsists on shared experience and personal disclosure. A core symptom of SAD is the fear of revealing something that will make us appear stupid or undesirable. Even the anticipation of interaction causes physical and emotional anxiety because of our anticipation of being found wanting.

Physical/Emotional. Eros is reciprocal feelings of shared arousal between people physically attracted to each other, the fulfillment expressed by the sexual act. Our dysfunctional self-image of unlikability, coupled with fears of intimacy and rejection, challenges our ability to establish and maintain romantic relationships. Studies show that, due to our fear of intimacy and sexual incompetence, we experience less sexual satisfaction than non-anxious individuals 

Unconditional. Through the universal mandate to love thy neighbor, the concept of agape embraces unconditional love that transcends and persists regardless of circumstance. To love unequivocally, one must self-love in the same fashion, a quality challenged by our symptomatic self-disparagement and lacuna of self-esteem.

Family. The disruption in our natural human development due to childhood disturbance and subsequent onset impedes satisfaction of physiological safety and belongingness and love. As a result, familial love and protection, vital to the healthy development of the family unit is severely impacted, challenging our ability or willingness to recognize and embrace the family unit. 

Playful and Provocative: Our conflict with the provocative playfulness of ludus is evident in our fears of criticism and rejection. We do not find social interaction pleasurable, always expecting the worst. Our self-perceptions of inadequacy generally manifest in awkward and inappropriate social behavior 

Practical relationships are formed by mutual interests and goals securing a working and endurable partnership. They endure through rational behavior and expectation―a balanced and constructive quality counterintuitive to someone whose modus operandi is discordant thought and behavior. The pragmatic individual deals with relationships sensibly and realistically, conforming to typical standards of conduct. Our symptomatic fears are irrational and cognitively distorted 

There is a large body of research linking healthy relationships with positive mental and physical health outcomes. Productive associations lead us to the recognition of our value to society and motivate us toward building communities for the welfare of others. These relationships are developed through social connectedness ― a central psychological requirement for better emotional development and wellbeing. Social connectedness is strongly associated with our level of self-esteem.

Comorbidity and Misdiagnosis

SAD is routinely comorbid with depression and substance abuse. It shares symptoms and characteristics with avoidant personality, panic, generalized anxiety, bipolar personality, obsessive-compulsive, dependent personality, histrionic personality, post-traumatic stress, and eating disorders.

Coupled with the discrepancies and disparity in SADs definition, epidemiology, assessment, and treatment, mainstream medical authorities point to the poor reliability of conventional psychiatric diagnosis. A recent Canadian study reported, that of 289 participants in sixty-seven clinics meeting DSM-IV criteria for SAD, 76.4% were misdiagnosed. The Anxiety Institute in Phoenix reports an estimated 8.2% of clients had generalized anxiety, but just 0.5% were correctly diagnosed. Experts cite the mental health community’s difficulty distinguishing the symptoms and traits of dysfunctions or identifying specific etiological risk factors due to the DSM’s failing reliability statistics. 

The DSM changes drastically from one edition to the next, while the American Psychiatric Association swears by its credibility. Criteria change with each edition, often without evidence that the new approach is better than the prior one. The abundant revisions, substitutions, and changes from one edition to the next is never universally accepted. Psychiatrists, psychologists, and researchers who specialize in or survive by funding are justifiably protective of their territory. Even under the best circumstance with a knowledgeable and caring clinician, it is difficult to get a proper diagnosis. 

But there is hope. We can learn to moderate those fears and anxieties that impact our emotional wellbeing and quality of life. A comprehensive recovery program guides us through the process of proactive neuroplasticity to restructure our neural network from the years of negative self-beliefs to an appreciation of our value and significance. An integration of science and east-west psychologies is necessary to capture the diversity of human thought and experience in recovery. Science gives us proactive neuroplasticity and psychobiography; cognitive-behavioral self-modification and positive psychology’s optimal functioning are western-oriented; eastern practices provide the therapeutic benefits of Abhidharma psychology and the overarching truths of ethical behavior. Included are targeted approaches to help us rediscover and reinvigorate our self-esteem.

Recovery takes persistence and perseverance to endure the deliberate, repetitive input of information necessary to compensate for years of negative core and intermediate self-beliefs. However, once we begin the process, progress is exponential. It is physiologically and psychologically felt as we implement and experience the tools and techniques of recovery.

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WHY IS YOUR SUPPORT SO IMPORTANT?  ReChanneling develops and implements programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing scientific and clinically practical methods including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to reinvigorate self-esteem. All donations support scholarships for groups, workshops, and practicums.  

Affirmative Visualization

Dr. Robert F. Mullen
Director/ReChanneling

Numbers generate contributions that support scholarships for workshops.

Dr. Mullen is doing impressive work helping the world. He is the
pioneer of proactive neuroplasticity utilizing DRNI—deliberate,
repetitive, neural information. — WeVoice

Affirmative Visualization

Affirmative Visualization is another viable tool in recovery from social anxiety and its common comorbidities, including depression and substance abuse. The neural benefits of visualization are scientifically supported through studies and the neuroscientific understanding of neuroplasticity. Like positive personal affirmations (PPAs), the graded exposure or systematic desensitization of Affirmative Visualization (some experts call it imaginal exposure) alleviates anxiety in a structured, unthreatening environment. PPAs are concise, predetermined, positive statements. Affirmative Visualizations are positive outcome scenarios that we mentally recreate by imagining or visualizing them. Both are underscored by the Laws of Learning, which explain what conditions must be present for learning (or unlearning) to occur and how to accelerate and consolidate the process through proactive neuroplasticity

PROACTIVE NEUROPLASTICITY YOUTUBE SERIES

We label the process as Affirmative to emphasize the positivity of the visualizations to counteract our natural negative bias and the predisposition of the emotionally dysfunctional to set negative outcome scenarios due to life-consistent negative self-beliefs and images.

Through Affirmative Visualization, we envision behaving a certain way in a realistic scenario and, through deliberate repetition, attain an authentic shift in our behavior and perspective. It is a form of proactive neuroplasticity, and all the neural benefits of that science are accrued by visualization.

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As we know, our brain is in a constant mode of learning; it never stops realigning to information. It forms a million new connections for every input. Information includes experience, muscle movement, a decision, a memory, emotion, reaction, noise, tactile impression, a twitch. With each input, connections strengthen and weaken, neurons atrophy and others are born, learning replaces unlearning, energy dissipates and expands, beneficial hormones are neurally transmitted, and functions shift from one region to another. Proactively stimulating our brain with deliberate, repetitive neural information utilizing Affirmative Visualization accelerates and consolidates learning (and unlearning), producing a correlated change in thought, behavior, and perspective. These changes become habitual and spontaneous over time.

Our brain provides the same neural restructuring when we visualize doing something or when we actually do it; the same regions of our brain are stimulated. Just as our neural network cannot distinguish between toxic and productive information, it also does not distinguish whether we are physically experiencing something or imagining it.

The thalamus is the small structure within our brain located just above the stem between the cerebral cortex and the midbrain. It has extensive nerve connections to both. All information passes through the thalamus and onto the millions of participating neurons. By visualizing an idea or performance repeatedly for an extended period, we increase activity in the thalamus and our brain responds as though the idea is a real object or actually happening.

Our thalamus makes no distinction between inner and outer realities. It does not distinguish whether we are imagining something or experiencing it. Thus, any idea, if contemplated long enough, will take on a semblance of reality. If we visualize a solution to a problem, the problem is systemically resolved because visualizing activates the cognitive circuits involved with our working memory.

Research reveals that visualizing an event in advance improves our mental and physical performance. When we visualize what we want to achieve, we consciously source information that will improve our performance outcomes, dramatically improving the likelihood of success in the real situation.

We can visualize mitigating anxiety and comfortably interacting, or we can envision being a more empathetic or competent individual. Our neural repatterning will help us achieve those goals. The more we visualize with clear intent, the more focused we become and the higher the probability of achieving our goal. It activates our dopaminergic-reward system, decreasing the neurotransmissions of anxiety and fear-provoking hormones, and accelerating and consolidating those that make learning more accessible. In addition, when we visualize, our brain generates alpha waves which, neuroscientists have discovered, can dramatically reduce the symptoms of anxiety and depression.

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WHY IS YOUR SUPPORT SO IMPORTANT?  ReChanneling develops and implements programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing scientific and clinically practical methods including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to reinvigorate self-esteem. All donations support scholarships for groups, workshops, and practicums.  

DRNI: Proactively Restructuring Our Neural Network

Dr. Robert F. Mullen
Director/ReChanneling

Numbers generate contributions that support scholarships for workshops.

Dr. Mullen is doing impressive work helping the world. He is the
pioneer of proactive neuroplasticity utilizing DRNI—deliberate,
repetitive, neural information. WeVoice

DRNI: The deliberate, repetitive neural input of information

Neuroplasticity is scientific evidence of our neural network’s constant adaptation to learning. Neuroscientists refer to the process as structural remodeling of the brain. It is what makes learning and registering new experiences possible. All information notifies our neural circuits to realign, generating a correlated change in behavior and perspective. 

What is significant is our ability to dramatically accelerate learning by consciously compelling our brain to repattern its neural circuitry. Deliberate, repetitive, neural information (DRNI) empowers us to proactively transform our thoughts and behaviors, creating healthy new mindsets, skills, and abilities. It is the most effective means of learning and unlearning.

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Reactive neuroplasticity is our brain’s natural adaption to information. Information includes thought, behavior, experience, sensation, etc. Active neuroplasticity is cognitive pursuits such as engaging in social interaction, teaching, aerobics, and creating. Proactive neuroplasticity is the most effective means of learning and unlearning because the regimen of deliberate, repetitive, neural input of information accelerates and consolidates restructuring. 

Neurons do not act by themselves but through neural circuits that strengthen or weaken their connections based on electrical activity. The deliberate, repetitious, input of information impels neurons to fire repeatedly, causing them to wire together. The more repetitions, the more robust the new connection. This is Hebbian Learning.

Hebbian Learning

Hebbian Learning

Synaptic connections consolidate when two or more neurons activate contiguously. Neural circuits are like muscles, the more repetitions, the more durable the connection. Hebb’s rule of neuroplasticity states neurons that fire together wire together. When multiple neurons wire together, they create more pre- and post-synaptic neurons. Repeated firing strengthens and solidifies the pathways between neurons. The activity of the axon pathway heightens, causing the synapses to accelerate the release of hormones that generate the commitment, persistence, and perseverance useful to recovery or the pursuit of personal goals and objectives.

We not only prompt our neural network to restructure by deliberately inputting information, but through repetition, we cause circuits to strengthen and realign, speeding up the process of learning and unlearning. 

What happens when multiple neurons wire together? Every input of information, intentional or otherwise, causes a receptor neuron to fire. Each time a neuron fires, it reshapes and strengthens the axon connection and the neural bond. Repeated neural input creates multiple connections between receptor, sensory, and relay neurons, attracting other neurons. An increase in learning efficacy arises from the sensory neuron’s repeated and persistent stimulation of the postsynaptic cell. Postsynaptic neurons multiply, amplifying the positive or negative energy of the information.

The consequence of DRNI over a long period is obvious. Multiple firings accelerate and consolidate learning. In addition, DRNI activates long-term potentiation, which increases the strength of the nerve impulses along the connecting pathways, generating more energy. Deliberate, repetitive, neural information generates higher levels of BDNF (brain-derived neurotrophic factors) proteins associated with improved cognitive functioning, mental health, and memory. 

PROACTIVE NEUROPLASTICITY YOUTUBE SERIES

We know how challenging it is to change, to remove ourselves from hostile environments, to break habits that interfere with our optimum functioning. We are physiologically hard-wired to resist anything that jeopardizes our status quo. Our brain’s inertia senses and repels changes, and our basal ganglia resist any modification in behavior patterns. DRNI empowers us to assume accountability for our emotional well-being and quality of life by proactively controlling the input of information.

Neural Reciprocity

Neural restructuring does not happen overnight. Recovery-remission is a year or more in recovery utilizing appropriate tools and techniques. Meeting personal goals and objectives takes persistence, perseverance, and patience. Substance abuse programs recommend nurturing a plant or tropical fish during the first year before contemplating a personal relationship. The successful pursuit of any ambition varies by individual and is subject to multiple factors. However, once we begin the process of DRNI, progress is exponential. Our brain reciprocates the positivity of our efforts in abundance because every viable input of information engages millions of neurons with their own energy transmission. 

DRNI plays a crucial role in reciprocity. The chain reaction generated by a single neural receptor involves millions of neurons that amplify energy on a massive scale. The reciprocating energy from DRNI is vastly more abundant because of the repeated firing by the neuron receptor. Positive energy in, positive energy multiplied millions of times, positive energy reciprocated in abundance. 

Conversely, negative energy in, negative energy multiplied millions of times, negative energy is reciprocated in abundance. 

Neurotransmissions

Our brain does not think; it is an organic reciprocator that provides the means for us to think. Its function is the maintenance of our heartbeat, nervous system, blood flow, etc. It tells us when to breathe, stimulates thirst, and controls our weight and digestion.

Because our brain does not distinguish healthy from toxic information, the natural neurotransmission of pleasurable and motivational hormones happens whether we feed it self-destructive or constructive information. That is one of the reasons breaking a habit, keeping to a resolution, or recovering is challenging. The power of DRNI is that a regimen of positive, repetitive input can compensate for decades of irrational, self-destructive thoughts and behaviors, and provide the mental and emotional wherewithal to effectively pursue our personal goals and objectives. 

We receive neurotransmissions of GABA for relaxation, dopamine for pleasure and motivation, endorphins to boost our self-esteem, and serotonin for a sense of well-being. Acetylcholine supports neuroplasticity, glutamate enhances our memory, and noradrenalin improves concentration. In addition, information reduces the impact of the fear and anxiety-provoking hormones, cortisol and adrenaline. When we input negative information, our brain naturally releases neurotransmitters that support that negativity. 

Conversely, every time we provide positive information, our brain releases hormones that make us feel viable and productive, subverting the negative energy channeled by the things that impede our potential. 

Definitions

Dysfunction and discomfort are conditions that can result in functional impairment and impact our quality of life. The difference is in severity. A dysfunction is a diagnosable condition that psychiatrists label a mental illness or disorder. Discomfort does not rise to the level of diagnosability but is holistically disruptive, nonetheless.

Personal goals and objectives are those things we want to change about ourselves: eliminating a bad habit or behavior, improving life satisfaction, and revitalizing self-esteem. The deliberate, repetitive, neural input of information significantly improves the probability of recovery. Likewise, it empowers us to pursue those personal goals and objectives that make our lives more viable and productive. 

Constructing the Information

Deliberate neural, information is structured by context, content, and intention, which determine the integrity of the information and its correlation to durability and learning efficacy. The most effective information is calculated and specific to our intention. Are we challenging the negative thoughts and behaviors of our dysfunction? Are we reaffirming the character strengths and virtues that support recovery and transformation? Are we focused on a specific challenge? What is our end goal – the personal milestone we want to achieve? Content is the actual phrasing of our intent; words have meaning.

The process is theoretically simple but challenging, due to the commitment and endurance required for the long-term, repetitive process. We do not put on tennis shorts and advance to Wimbledon without decades of practice with racket and balls; philharmonics cater to pianists who have spent years at the keyboard. DRNI requires a calculated regimen of deliberate, repetitive, neural information that is not only tedious but also fails to deliver immediate tangible results, causing us to readily concede defeat and abandon hope in this era of instant gratification. Fortunately, the universal law of compensation anticipates this. The positive impact of proactive neuroplasticity is exponential due to the abundant reciprocation of positive energy and the neurotransmission of hormones that generate motivation, persistence, and perseverance. Proactive neuroplasticity utilizing DRNI dramatically mitigates symptoms of physiological dysfunction and discomfort and advances the pursuit of goals and objectives. 

*          *          *     

WHY IS YOUR SUPPORT SO IMPORTANT?  ReChanneling develops and implements programs to (1) moderate symptoms of emotional dysfunction and (2) pursue personal goals and objectives – harnessing our intrinsic aptitude for extraordinary living. Our paradigmatic approach targets the personality through empathy, collaboration, and program integration utilizing scientific and clinically practical methods including proactive neuroplasticity, cognitive-behavioral modification, positive psychology, and techniques designed to reinvigorate self-esteem. All donations support scholarships for groups, workshops, and practicums.

Social Anxiety Disorder and Relationships.

Numbers generate contributions that support scholarships for workshops.

Enlisting Positive Psychologies to Challenge Love Within SAD’s Culture of Maladaptive Self-Beliefs.

in C.-E. Mayer and E. Vanderheiden (eds.) International Handbook of Love. Transcultural and Transdisciplinary Perspectives, Springer Publications, 2021.

Robert F. Mullen, Ph.D.

Social anxiety disorder (SAD) is one of the most common psychophysiological malfunctions, affecting the emotional and mental well-being of over 15 million U.S. adults who find themselves caught up in a densely interconnected network of fear and avoidance of social situations. These observations provide insight into the relationship deficits experienced by people with SAD. Their innate need-for-intimacy is no less dynamic than that of any individual, but their impairment disrupts the ability (means-of-acquisition) to establish affectional bonds in almost any capacity. The spirit is willing, but competence is insubstantial. It is the means of acquisition and how they are symptomatically challenged by SAD that is the context of this research.

Notwithstanding overwhelming evidence of social incompatibility, there is hope for the startlingly few SAD persons who commit to recovery. A psychobiographical approach integrating positive psychology’s optimum human functioning with CBT’s behavior modification, neuroscience’s network restructuring, and other supported and non-traditional approaches can establish a working platform for discovery, opening the bridge to the procurement of forms of intimacy previously inaccessible. It is an arduous and measured crossing that only 5% of the afflicted will even attempt in the first year of onset.

Keywords: Love. Social anxiety disorder. Intimacy. Philautia. Means-of-acquisition.

59.0 Social Anxiety Disorder

Social anxiety disorder (SAD) is the second most commonly diagnosed form of anxiety in the United States (MHA, 2019). The Anxiety and Depression Association of America (ADAA, 2019a) estimate that nearly 15 million (7%) American adults experience its symptoms. Ritchie and Roser (2018) report 284 million SAD persons, worldwide, and the National Institute of Mental Health (NIMH, 2017) reports 31.1% of U.S. adults experience some anxiety disorder at some time in their lives, Global statistics are subject to “differences in the classification criteria, culture, and gender” (Tsitsas & Paschali, 2014), and “in the instruments used to ascertain diagnosis”(NCCMH, 2013).

Studies in other western nations (e.g., Australia, Canada, Sweden) note similar prevalence rates as in the USA, as do those in culturally westernized nations such as Israel. Even countries with strikingly different cultures (e.g., Iran) note evidence of social anxiety disorder (albeit at lower rates) among their populace. (Stein & Stein, 2008)

SAD is the most common psychiatric disorder in the U.S. after major depression and alcohol abuse (Heshmat, 2014). It is also arguably the most underrated and misunderstood. A “debilitating and chronic” psychophysiological affliction (Castella et al., 2014), SAD “wreaks havoc on the lives of those who suffer from it” (ADAA, 2019a). SAD attacks all fronts, negatively affecting the entire body complex, delivering mental confusion (Mayoclinic, 2017b), emotional instability (Castella et al., 2014; Yeilding, 2017), physical dysfunction (NIMH, 2017; Richards, 2019), and spiritual malaise (Mullen, 2018). Emotionally, persons experiencing SAD feel depressed and lonely (Jazaieri, Morrison, & Gross, 2015). Physically, they are subject to unwarranted sweating and trembling, hyperventilation, nausea, cramps, dizziness, and muscle spasms (ADAA, 2019a; NIMH, 2017). Mentally, thoughts are discordant and irrational (Felman, 2018; Richards, 2014). Spiritually, they define themselves as inadequate and insignificant (Mullen, 2018).

SAD is randomly misdiagnosed (Richards, 2019), and the low commitment to recovery (Shelton, 2018) suggests a reticence by those infected to recognize and or challenge their malfunction. Approximately 5% of SAD persons commit to early recovery, reflective of symptoms that manifest maladaptive self-beliefs of insignificance and futility. Grant et al. (2005) state, “about half of adults with the disorder seek treatment,” but that is after 15–20 years of suffering from the malfunction (Ades & Dias, 2013). Resistance to new ideas and concepts transcends those of other mental complications and is justified by, among other attributions:

  • 1. general public cynicism
  • 2. self-contempt of the afflicted, generated by maladaptive self-beliefs
  • ignorance or ineptitude of mental health professionals
  • real or perceived social and mental health stigma
  • the natural physiological aversion to change

Many motivated towards recovery are unable to afford treatment due to SAD-induced “impairments in financial and employment stability” (Gregory, Wong, Craig, Marker, & Peters, 2018). The high percentage of jobless people experiencing social anxiety disorder in the U.S. is related to “job inefficiency and instability” (Felman, 2018), greater absenteeism, job dissatisfaction, and frequent job changes. “More than 70% of social anxiety disorder patients are in the lowest economic group” (Nardi, 2003).

According to leading experts, the high percentage of SAD misdiagnoses are due to “substantial discrepancies and variation in definition, epidemiology, assessment, and treatment” (Nagata, Suzuki, & Teo, 2015). The Social Anxiety Institute (Richards, 2019) reports that, among patients with generalized anxiety, an estimated 8.2% had the condition, but just 0.5% were correctly diagnosed. A recent Canadian study by Chapdelaine, Carrier, Fournier, Duhoux, and Roberge (2018) reported, of 289 participants in 67 clinics meeting the criteria for social anxiety disorder outlined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), 76.4% were improperly diagnosed.

Social anxiety disorder is a pathological form of everyday anxiety. The clinical term “disorder” identifies extreme or excessive impairment that negatively affects functionality. Feeling anxious or apprehensive in certain situations is normal; most individuals are nervous speaking in front of a group and anxious when pulled over on the freeway. The typical individual recognizes the ordinariness of a situation and accords it appropriate attention. The SAD person anticipates it, takes it personally, dramatizes it, and obsesses on its negative implications (Richards, 2014).

SAD’s culture of maladaptive self-beliefs (Ritter, Ertel, Beil, Steffens, & Stangier, 2013) and negative self-evaluations (Castella et al., 2014) aggravate anxiety and impede social performance (Hulme, Hirsch, & Stopa, 2012). “Patients with SAD often believe they lack the necessary social skills to interact normally with others” (Gaudiano & Herbert, 2003). Maladaptive self-beliefs are distorted reflections of a situation, often accepted as accurate. The co-founder of CBT, Aaron Beck provides three types of maladaptive self-beliefs responsible for persistent social anxiety. Core beliefs are enduring fundamental understandings, often formed in childhood and solidified over time. Because SAD persons “tend to store information consistent with negative beliefs but ignore evidence that contradicts them, [their] core beliefs tend to be rigid and pervasive” (Beck, 2011). Core beliefs influence the development of intermediate beliefs―attitudes, rules, and assumptions that influence one’s overall perspective, which, in turn, influences thought and behavior. Automatic thoughts and behaviors (ANTs) are real-time manifestations of maladaptive self-beliefs, dysfunctional in their irrationality (Richards, 2014; Wong, Moulds, & Rapee, 2013).

Negative self-images reported by patients with social anxiety disorder reflect a working self that is retrieved in response to social threat and which is characterized by low self-esteem, uncertainty about the self, and fear of negative evaluation by others. (Hulme et al., 2012)

Halloran and Kashima (2006) define culture as “an interrelated set of values, tools, and practices that is shared among a group of people who possess a common social identity.” As the third-largest mental health care problem in the world (Richards, 2019), social anxiety disorder is culturally identifiable by the victims’ “marked and persistent fear of social and performance situations in which embarrassment may occur,” and the anticipation “others will judge [them] to be anxious, weak, crazy, or stupid” (APA, 2017). Although studies evidence “culture-specific expression of social anxiety” (Hoffman, Asnaani, & Hinton, 2010), SAD “is a pervasive disorder and causes anxiety and fear in almost all areas of a person’s life” (Richards, 2019). SAD affects the “perceptual, cognitive, personality, and social processes” of the afflicted who find themselves caught up in “a densely interconnected network of fear and avoidance of social situations” (Heeren & McNally, 2018).

The superficial overview of SAD is intense apprehension—the fear of being judged, negatively evaluated, and ridiculed (Bosche, 2019). There is persistent anxiety or fear of social situations such as dating, interviewing for a position, answering a question in class, or dealing with authority (ADAA, 2019a; Castella et al., 2014). Often, mere functionality in perfunctory situations―eating in front of others, riding a bus, using a public restroom—can be unduly stressful (ADAA, 2019a; Mayoclinic, 2017b). This overriding fear of being found wanting manifests in perspectives of incompetence and worthlessness (Richards, 2019).

SAD persons are unduly concerned they will say something that will reveal their ignorance, real or otherwise (Ades & Dias, 2013). They walk on eggshells, supremely conscious of their awkwardness, surrendering to the GAZE―the anxious state of mind that comes with the maladaptive self-belief they are the center of attention (Felman, 2018; Lacan, 1978). Their movements can appear hesitant and awkward, small talk clumsy, attempts at humor embarrassing, and every situation reactive to negative self-evaluation (ADAA, 2019a; Bosche, 2019). They are apprehensive of potential “negative evaluation by others” (Hulme et al., 2012), and concerned about “the visibility of anxiety, and preoccupation with performance or arousal” (Tsitsas & Paschali, 2014). SAD persons frequently generate images of themselves performing poorly in feared social situations (Hirsch & Clark, 2004; Hulme et al., 2012) and their anticipation of repudiation motivates them to dismiss overtures to offset any possibility of rejection (Tsitsas & Paschali, 2014). SAD is repressive and intractable, imposing irrational thought and behavior (Richards, 2014; Zimmerman, Dalrymple, Chelminski, Young, & Galione, 2010). It establishes its authority through its subjects’ defeatist measures produced by distorted and unsound interpretations of actuality that govern perspectives of personal attractiveness, intelligence, competence, and other errant beliefs (Ades & Dias, 2013).

We are all familiar with the free association test. The person in the white coat tosses out seemingly random words and the recipient responds with the first word that comes to mind. Consider the following reactions: boring, stupid, worthless, incompetent, disliked, ridiculous, inferior (Hulme et al., 2012). Most people use personal pejoratives daily, but few personalize and take them to heart like a SAD person. These maladaptive self-beliefs, over time, become automatic negative thoughts (Amen, 1998) implanted on the neural network (Richards, 2014). They determine initial reactions to situations or circumstances. They inform how to think and feel and act. The ANT voice exaggerates, catastrophizes, and distorts. SAD persons crave the company of others but shun social situations for fear of being found out as unlikeable, stupid, or annoying. Accordingly, they avoid speaking in public, expressing opinions, or even fraternizing with peers … People with social anxiety disorder are typified by low self-esteem and high self-criticism. (Stein & Stein, 2008)

Anxiety and other personality disorders are branches of the same tree. “There is a significant degree of comorbidity between social anxiety disorder and other mental health problems, most notably depression (19%), substance-abuse disorder (17%), GAD [generalized anxiety disorder] (5%), panic disorder (6%), and PTSD (3%)” (Tsitsas & Paschali, 2014). The Anxiety and Depression Association of America (ADAA, 2019a) includes many emotional and mental disorders related to, components of, or a consequence of social anxiety disorder including avoidant personality disorder, panic disorder, generalized anxiety disorder, depression, substance abuse, eating disorders, OCD, and schizophrenia.

Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. (UNLM, 2018)

Personality reflects deep-seated patterns of behavior affecting how individuals “perceive, relate to, and think about themselves and their world” (HPD, 2019). A personality disorder denotes a “rigid and unhealthy pattern[s] of thinking, functioning and behaving,” which potentially leads to “significant problems and limitations in relationships, social activities, work and school” (Castella et al., 2014). A recent article in Scientific American speculates that “mental illnesses are so common that almost everyone will develop at least one diagnosable mental disorder at some point in their life” (Reuben & Schaefer, 2017).

59.1.1. SAD and Interpersonal Love

In unambiguous terms, the desire-for-love is at the heart of social anxiety disorder (Alden, Buhr, Robichaud, Trew, & Plasencia, 2018). Interpersonal love relates to communications or relationships of love between or among people. The diagnostic criteria for SAD, outlined in the DSM-V (APA, 2017), include: “Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.” SAD persons find it inordinately difficult to establish close, productive relationships (Castella et al., 2014; Fatima, Naizi, & Gayas, 2018). Their avoidance of social activities limits the potential for comradeship (Desnoyers, Kocovski, Fleming, & Antony, 2017; Tsitsas & Paschali, 2014), and their inability to interact rationally and productively (Richards, 2014; Zimmerman et al., 2010) makes long-term, healthy relationships unlikely. SAD persons frequently demonstrate significant impairments in friendships and intimate relationships (Castella et al., 2014). According to Whitbourne (2018), SAD persons’ avoidance of other people puts them at risk of feeling lonely, having fewer friendships, and being unable to take advantage of the enjoyment of being with people who share their hobbies and interests.

There is a death of research directly investigating the relationship between SAD and interpersonal love (Montesi, Conner, Gordon, & Fauber, 2013; Read, Clark, Rock, & Coventry, 2018). A study on friendship quality and social anxiety by Rodebaugh, Lim, Shumaker, Levinson, and Thompson (2015) notes the lack of relative quality studies; Alden et al. (2018) report on the lack of attention paid to the SAD person’s inability or refusal to function in close relationships. The few studies that do exist report that the SAD person exhibits inhibited social behavior, shyness, lack of assertion in group conversations, and feelings of inadequacy while in social situations (Darcy, Davila, & Beck, 2005). This dominant culture of maladaptive self-beliefs results in the tendency to avoid new people and experiences, making the development of “adequate and close relationships (e.g., family, friends, and romantic relationships)” extremely challenging (Cuming & Rapee, 2010). Experiencing social anxiety disorder translates to less trust and perceived support from close interpersonal relationships (Topaz, 2018).

Although intimately related, the desire-for-love and the means-of-acquisition are binary operations. Most forms of interpersonal love require the successful collaboration of wanting and obtaining. The desire-for-love is the non-consummatory component of Freud’s eros life instinct (Abel-Hirsch, 2010). The means-of-acquisition are the methods and skills required to complete the transaction―techniques that vary depending upon the type of love in the offing. Let us visualize love as a bridge, with desire (thought) at one end and acquisition at the other; the span is the means-of-acquisition (behavior). The SAD person cannot get from one side to the other because the means of acquisition are structurally deficient (Desnoyers et al., 2017; Tsitsas & Paschali, 2014). They grasp the fundamental concepts of interpersonal love and are presented with opportunities but lack the skills to close the deal. Painfully aware of the tools of acquisition, they cannot seem to operate them.

59.2. Cognitive-Behavioral Therapy

CBT purposed for SAD is typically conceptualized as a short-term, skills-oriented approach aimed at exploring relationships among a person’s thoughts, feelings, and behaviors while changing the culture of maladaptive self-beliefs into productive, rational thought and behavior (Richards, 2019). CBT focuses on “developing more helpful and balanced perspectives of oneself and social interactions while learning and practicing approaching one’s feared and avoided social situations over time” (Yeilding, 2017). Almost 90% of the approaches empirically supported by the “American Psychological Association’s Division 12 Task Force on Psychological Interventions” involve cognitive-behavioral treatments, according to Lyford (2017). “Individuals who undergo CBT show changes in brain activity, suggesting that this therapy improves your brain functioning as well” (NAMI, 2019).

Recent meta-analytic evidence suggests that CBT as an effective treatment for SAD compares favorably with other psychological and pharmacological treatment programs (Cuijpers, Cristea, Karyotaki, Reijnders, & Huibers, 2016). There is no guarantee of success, however, and standard CBT is imperfect (David, Cristea, & Hoffman, 2018; Mullen, 2018). The best outcome a SAD sufferer can hope for is mitigation of symptoms through thought and behavior modification and the simultaneous restructuring of the neural network, along with other supported and non-traditional treatments..

“[M]any patients, although being under drug therapy, remain symptomatic and have a recurrence of symptoms,” according to the Brazilian Journal of Psychiatry. “40–50% are better but still symptomatic, and 20–30% remain the same or worse.” (Manfro, Heldt, Cordiol, & Otto, 2008)

Behavioral and cognitive treatments are globally proven methodologies. There are multiple associations worldwide, “devoted to research, education, and training in cognitive and behavioral therapies” (McGinn, 2019). CBT Conferences (2019) are offered across the globe, “where knowledge transfer takes place through debates, round table discussions, poster presentations, workshops, symposia, and exhibitions.” David et al. (2018) credit CBT as the best standard we have in the field currently available—for the following reasons: (1) CBT is the most researched form of psychotherapy. (2) No other form of psychotherapy is systematically superior to CBT in the treatment of anxiety, depression, and other disorders; if there are systematic differences between psychotherapies, they typically favor CBT. (3) Moreover, the CBT theoretical models/mechanisms of change have been the most researched and are in line with the current mainstream paradigms of the human mind and behavior (e.g., information processing).

The Association for Behavioral and Cognitive Therapies (ABCT) is “a worldwide humanitarian organization,” fostering the “dissemination of evidence-based prevention and treatments through collaborations with the World Health Organization (WHO) and the United Nations Educational, Scientific and Cultural Organization (UNESCO)” (McGinn, 2019). The World Confederation of Cognitive and Behavioural Therapies (WCCBT) is a global multidisciplinary organization promoting health and well-being through the scientific development and implementation of “evidence-based cognitive-behavioral strategies designed to evaluate, prevent, and treat mental conditions and illnesses” (ACBT, 2019).

Cognitive-behavioral therapy is arguably the gold standard of the psychotherapy field. David et al. (2018) maintain, “there are no other psychological treatments with more research support to validate.” Studies of CBT have shown it to be an effective treatment for a wide variety of mental illnesses including depression, SAD, generalized anxiety disorders, bipolar disorder, eating disorders, PTSD, OCD, panic disorder, and schizophrenia (Kaczkurkin & Foa, 2015; NAMI, 2019). However, David et al. (2018) suggest if the gold standard of psychotherapy defines itself as the best in the field, then CBT is not the gold standard. There is clearly room for further improvement, “both in terms of CBT’s efficacy/effectiveness and its underlying theories/mechanisms of change.”

Lyford (2017) provides two examples of criticism. A 2013 meta-analysis published in Clinical Psychology Review comparing CBT to other therapies, failed to “provide corroborative evidence for the conjecture that CBT is superior to bona fide non-CBT treatments.” An 8-week clinical study by Sweden’s Lund University in 2013, concluded that “CBT was no more effective than mindfulness-based therapy for those suffering from depression and anxiety.”

Another meta-analysis conducted by psychologists Johnsen and Friborg (2015) tracked 70 CBT outcome studies conducted between 1977 and 2014 and concluded that “the effects of CBT have declined linearly and steadily since its introduction, as measured by patient self-reports, clinician ratings, and rates of remission.” According to the authors, “Just seeing a decrease in symptoms,” he says, “doesn’t translate into greater well-being.” This is reflective of most one-size-fits-all approaches.

While this study recognizes CBT as the best foundation for addressing the SAD culture of maladaptive self-beliefs, it makes the point standard CBT, alone is not necessarily the most productive course of treatment. New and innovative methodologies supported by a collaboration of theoretical construct and integrated scientific psychotherapy are needed to address mental illness as represented in this era of advanced complexity. A SAD person subsisting on paranoia sustained by negative self-evaluation is better served by multiple non-traditional and supported approaches, including those defined as new (third) wave (generation) therapies, developed through client trust, cultural assimilation, and therapeutic innovation with CBT and positive psychology serving as the foundational platform for integration.

59.3. Categories of Interpersonal Love

In Nicomachean Ethics, Aristotle (1999) encapsulates love as “a sort of excess of feeling.” Utilizing the classic Greek categories of interpersonal love is vital to this study; each classification illustrates how SAD symptoms thwart the subject’s means-of-acquisition in seven of eight categories (with the notable exception of healthy philautia). The three primary categories: (1) philia (comradeship), (2) eros (sexual), and (3) agape (selfless and unconditional), are followed by (4) storge (family), (5) Ludus (provocative), (6) pragma (practical), and the two extremes of philautia: (7) narcissistic and, (8) positive self-qualities. Forms of inanimate love are excluded from this study, “including love for experiences (meraki), objects (érōs), and places (chōros)” (Lomas, 2017).

1. Aristotle called philia “one of the most indispensable requirements of life” (Grewal, 2016). Philia is a bonding of individuals with mutual experiences―a “warm affection in intimate friendship” (Helm, 2017). This platonic love subsists on shared experience and personal disclosure. A core symptom of a SAD person is the fear of revealing something that will make them appear “boring, stupid or incompetent” (Ades & Dias, 2013). Even the anticipation of interaction causes “significant anxiety, fear, self-consciousness, and embarrassment” (Richards, 2014) because of the fear of being scrutinized or judged by others (Mayoclinic, 2017b).

2. Eros is reciprocal feelings of shared arousal between people physically attracted to each other, the fulfillment declared by the sexual act. The SAD person’s self-image of unlikability (Stein & Stein, 2008) coupled with the fear of intimacy (Montesi et al., 2013) and rejection (Tsitsas & Paschali, 2014) has significant consequences in terms of acquiring a sexual partner, and satisfaction of the sexual act (Montesi et al., 2013). SAD’s culture of maladaptive self-beliefs poses severe challenges to their ability to establish, develop, and maintain romantic relationships (Cuncic, 2018; Topaz, 2018). A study by Montesi et al. (2013), examining the SAD’s person’s symptomatic fear of intimacy and sexual communication concluded, “socially anxious individuals experience less sexual satisfaction in their intimate partnerships than nonanxious individuals, a relationship that has been well documented in previous research.” The study reported a lacuna of literature, however, examining the sexual communication of SAD persons.

3. Through the universal mandate to love thy neighbor, the concept of agape embraces unconditional love that transcends and persists regardless of circumstance (Helm, 2017). SAD generally infects adolescents who have experienced detachment, exploitation, and or neglect (Steele, 1995). This form of love characterizes itself through unselfish giving; the SAD person’s maladaptive self-belief that she or he is the constant focus-of-attention is a form of self-centeredness bordering on narcissism (Mayoclinic, 2017a).

4. Again, the primary cause of SAD stems from childhood hereditary, environmental (Felman, 2018; NAMI, 2019), or traumatic events (Mayoclinic, 2017b). In each case, the SAD person is exploited (unconsciously or otherwise) in the formative stages of human motivational development: those of physiological safety and belongingness, and love (Maslow, 1943). As a result, storge or familial love and protection, vital to the healthy development of the family unit, is severely affected. The exploited adolescent (Steele, 1995) faces serious challenges recognizing or embracing familial love as an adolescent or adult.

5. A SAD person’s conflict with the provocative playfulness of Ludus is evident by the fear of being judged and negatively evaluated by others (Mayoclinic, 2017b) as well as themselves (Hulme et al., 2012; Ritter et al., 2013). Persons experiencing SAD do not find social interaction pleasurable (Richards, 2019) and have limited expectations things will work out advantageously (Mayoclinic, 2017b). Finally, SAD persons’ maladaptive self-beliefs generally result in inappropriate behavior in social situations (Kampmann, Emmelkamp, & Morina, 2019).

6. The obvious synonym for pragma is practicality―a balanced and constructive quality counterintuitive to someone whose modus operandi is discordant thought and behavior (Richards, 2014; Zimmerman et al., 2010). Pragma is mutual interests and goals securing a working and endurable partnership, facilitated by rational behavior and expectation. The SAD personality sustains itself through irrationality (Felman, 2018) and maladaptive self-beliefs (Hulme et al., 2012; Ritter et al., 2013). The pragmatic individual deals with relationships sensibly and realistically, conforming to standards considered typical. The overriding objective of a SAD person is to “avoid situations that most people consider “’normal’ ” (WebMD, 2019).

The onset of SAD is a consequence of early psychophysiological disturbance (Felman, 2018; Mayclinic, 2019a). The receptive juvenile might be the product of bullying (Felman, 2018), abuse (NAMI, 2019), or a broken home. Perhaps parental behaviors are overprotective or controlling or do not provide emotional validation (Cuncic, 2018). Subsequently, the SAD person finds it difficult to let his or her guard down and express vulnerability, even with someone they love and trust (Cuncic, 2018). Alden et al. (2018) note that SAD persons “find it difficult, in their intimate relationships, to be able to self-disclose, to reciprocate the affection others show toward them.”

There is a large body of research linking love with positive mental and physical health outcomes (Rodebaugh et al., 2015). Relationships, love, and associations with others lead one to recognition of their value to society “and motivates them towards building communities, culture and work for the welfare of others” (Capon & Blakely, 2007). Love is developed through social connectedness. Social connectedness, essential to personal development, is one of the central psychological needs “required for better psychological development and well-being” (Deci & Ryan, 2000). Social connectedness plays a significant role as mediator in the relationship between SAD and interpersonal love (Lee, Dean, & Jung, 2008) and is strongly associated with the level of self-esteem (Fatima et al., 2018).

59.4. Philautia

The seventh and eighth categories of interpersonal love are the two extremes of philautia: narcissism and positive self-qualities. To Aristotle, healthy philautia is vigorous “in both its orientation to self and to others” due to its inherent virtue (Grewal, 2016). “By contrast, its darker variant encompasses notions such as narcissism, arrogance and egotism” (Lomas, 2017). In its positive aspect, any interactivity “has beneficial consequences, whereas in the latter case, philautia will have disastrous consequences” (Fialho, 2007).

The good man should be a lover of self (for he will both himself profit by doing noble acts, and will benefit his fellows), but the wicked man should not; for he will hurt both himself and his neighbors, following as he does evil passions. (Grewal, 2016)

59.4.1. Unhealthy Philautia

Unhealthy philautia is akin to clinical narcissism―a mental condition in which people function with an “inflated sense of their own importance [and a] deep need for excessive attention and admiration.” Behind this mask of extreme confidence, the Mayoclinic report (2017a) states, “lies a fragile self-esteem that’s vulnerable to the slightest criticism.” SAD persons live on the periphery of morbid self-absorption through their self-centeredness. Their obsession with excessive attention (ADAA, 2019b) mirrors that of unhealthy philautia. In Classical Greece, persons could be accused of unhealthy philautia if they placed themselves above the greater good. Today, hubris has come to mean “an inflated sense of one’s status, abilities, or accomplishments, especially when accompanied by haughtiness or arrogance” (Burton, 2016). The self-centeredness and self-absorption of a SAD person often present themselves as arrogance; in fact, the words are synonymous. The critical difference is that SAD persons do not possess an inflated sense of their own importance but one of insignificance.

59.4.2. Healthy Philautia

Aquinas’ (1981) response to demons and disorder states, “evil cannot exist without good.” The Greeks believed that the narcissism of unhealthy philautia would not exist without its complementary opposition of healthy philautia, which is commonly interpreted as the self-esteeming virtue―an unfortunate and wholly incomplete definition. Rather than self-esteem only, philautia incorporates the broader spectrum of all positive self-qualities.

Rather, we are concerned here with various positive qualities prefixed by the term self, including -esteem, -efficacy, -reliance, -compassion, and -resilience. Aristotle argued in Nichomachean Ethics that self-love is a  precondition for all other forms of love. (Lomas, 2017)

Positive self-qualities determine one’s relation to self, to others, and the world. They provide the recognition that one is of value, consequential, and worthy of love. “Philautia is important in every sphere of life and can be considered a basic human need” (Sharma, 2014). To the Greeks, philautia “is the root of the heart of all the other loves” (Jericho, 2015). Gadamer (2009) writes of philautia: “Thus it is; in self-love one becomes aware of the true ground and the condition for all possible bonds with others and commitment to oneself.” Healthy philautia is the love that is within oneself. It is not, explains Jericho (2015) “the desire for self and the root of selfishness.” Ethicist John Deigh (2001) writes:

Accordingly, when Aristotle remarks that a man’s friendly relations with others come from his relations with himself … he is making the point that self-love (philautia), as the best exemplar of love … is the standard by which to judge the friendliness of the man’s relations with others.

Positive self-qualities are obscured by SAD’s culture of maladaptive self-beliefs and the interruption of the normal course of natural motivational development. Positive psychology embraces “a variety of beliefs about yourself, such as the appraisal of your own appearance, beliefs, emotions, and behaviors” Cherry, 2019). It points to measures “of how much a person values, approves of, appreciates, prizes, or likes him or herself” (Blascovich & Tomaka, 1991). Ritter et al. (2013) conducted a study on the relationship between SAD and self-esteem. The research concluded that SAD persons have significantly lower implicit and explicit self-esteem relative to healthy controls, which manifest in maladaptive self-beliefs of incompetence, unattractiveness, unworthiness, and other irrational self-evaluations.

Healthy philautia is essential for any relationship; it is easy to recognize how the continuous infusion of healthy philautia into a SAD person supports self-positivity and interconnectedness with all aspects of interpersonal love. “One sees in self-love the defining marks of friendship, which one then extends to a man’s friendships with others” (Deigh, 2001). Self-worthiness and self-respect improve self-confidence, which allows the individual to overcome fears of criticism and rejection. Risk becomes less potentially consequential, and the playful aspects of Ludus less threatening. Self-assuredness opens the door to traits commonly associated with successful interpersonal connectivity―persistence and persuasiveness, optimism of engagement, a willingness to vulnerability. A SAD person’s recognition of her or his inherent value generates the realization that they “are a good person who deserves to be treated with respect” (Ackerman, 2019). A good person is, spiritually, one that is loved by God; reciprocation is instinctive and effortless. “To feel joy and fulfillment at being you is the experience of philautia” (Jericho, 2015). The philautia described by Aristotle, “is a necessary condition to achieve happiness” (Arreguín, 2009) which, as we continue down the classical Greek path, is eudemonic. In the words of positive psychologist Stephen (2019), eudaimonia

describes the notion that living in accordance with one’s daimon, which we take to mean ‘character and virtue,’ leads to the renewed awareness of one’s ‘meaning and purpose in life’.

Aristotle touted the striving for excellence as humanity’s inherent aspiration (Kraut, 2018). He described eudaimonia as “activity in accordance with virtue” (Shields, 2015). Eudaimonia reflects the best activities of which man is capable. The word eudaimonia reflects personal and societal well-being as the chief good for man. “The eudaimonic approach … focuses on meaning and self-realization and defines well-being in terms of the degree to which a person is fully functioning” (Ryan & Deci, 2001). It is through recognition of one’s positive self-qualities and potential productive contribution to the general welfare that one rediscovers the intrinsic capacity for love. Let us view this through the symbolism of Socrates’ tale of the Cave (Plato, 1992). In it, we discover SAD persons chained to the wall. Their perspectives generate from the shadows projected by the unapproachable light outside the cave. They name these maladaptive self-beliefs: useless, incompetent, timid, ineffectual, ugly, insignificant, and stupid. The prisoners have formed a subordinate dependency on their surroundings and resist any other reality until, one day, they find themselves loosed from their bondage and emerge into the light. Like the cave dwellers, the SAD person breaks away from maladaptive self-beliefs into healthy philautia’s positive self-qualities, which encourage and support connectivity to all forms of interpersonal love.

A study published in Cognitive Behaviour Therapy (Hulme et al., 2012) looked at the effect of positive self-images on self-esteem in the SAD person. Eighty-eight students were screened with the Social Interaction Anxiety Scale (SIAS) and divided between the low self-esteem group or the high self-esteem group. The study had two visions. The first was to study the effect of positive and negative self-beliefs on implicit and explicit self-esteem. The second was to investigate how positive self-beliefs would affect the negative impact of social exclusion on explicit self-esteem, and whether high socially anxious participants would benefit as much as low socially anxious participants. The researchers used a variety of measures and instruments. The Social Interaction Anxiety Scale is standard in SAD therapy and CBT workshops; the Implicit Association Test (IAT) reveals the strength of the association between two different concepts. The Rosenberg Self-Esteem Scale (RSES) is a 10-item self-report measure of explicit self-esteem; the State-Trait Anxiety Inventory-Trait (STAI-T) is a 20-item scale that measures trait anxiety; and the Depression Anxiety Stress Scale-21 (DASS-21) is a self-report scale measuring depression, anxiety, and general distress.

Social exclusion is inherently aversive and reduces explicit self-esteem in healthy individuals … the effect of exclusion has been measured in terms of its impact on positive affect and on four fundamental need scores (self-esteem, control, belonging, and meaningful existence) which contribute to psychological well-being. (Hulme et al., 2012)

The study’s results were consistent with evidence-based on implicit self-esteem in other disorders; it found that negative self-imagery reduces positive implicit self-esteem in both high and low socially anxious participants. It provided supporting evidence of the effectiveness of promoting positive self-beliefs over negative ones, “because these techniques help patients to access a more positive working self” (Hulme et al., 2012). It also demonstrated that positive self-imagery maintained explicit self-esteem even in the face of social exclusion.

59.5. Conclusion

For 25 years, since the appearance of SAD in DSM-IV, the cognitive-behavioral approach has reportedly been effective in addressing social anxiety disorder. It is structurally sound and would conceivably remain the foundation for future programs, however, it is not the therapeutic gestalt it claims to be. Productive cognitive-behavioral approaches emphasize the replacement of SAD’s automatic negative thoughts and behaviors (ANTs) with automatic rational ones (ARTs). As defined by UCLA psychologists Hazlett-Stevens and Craske (2002), CBT approaches treatment with the assumption that a specific central or core feature is responsible for the observed symptoms and behavior patterns experienced (i.e., lawful relationships exist between this core feature and the maladaptive symptoms that result). Therefore, once the central feature is identified, targeted in treatment, and changed, the resulting maladaptive thoughts, symptoms, and behaviors will also change.

Clinicians and researchers have reported the lack of a clear diagnostic definition for social anxiety disorder; features overlap and are comorbid with other mental health problems (ADAA, 2019a; Tsitsas & Paschali, 2014). Experts cite substantial discrepancies and disparities in the definition, epidemiology, assessment, and treatment of SAD (Nagata et al., 2015). More specifically, according to a study published in the Journal of Consulting and Clinical Psychology (Alden et al., 2018), “there is not enough attention paid in the literature to the ability to function in the close relationships” required for interpersonal love.

Standard CBT also lacks methodological clarity. Johnsen and Friborg (2018) cite the varying forms of CBT used in study and therapy over the years. Experts point to two predominant types of CBT: “the unadulterated CBT created by Beck and Ellis, which reflects the protocol-driven, highly goal-oriented, more standardized approach they first popularized,” and the more integrative and collaborative approaches of “modern” CBT (Wong et al., 2013). This study maintains neither faction should be ignored if we are to effectively challenge the evolving complexities of positive self-qualities and their importance to the individual’s psychological well-being.

The deficit of positive self-qualities in individuals impaired by SAD’s symptomatic culture of maladaptive self-beliefs combined with the interruption of the natural course of human motivational development is a new psychological concept in our evolving conscious complexity. Cognitive-behavioral therapies focus on resolving negative self-imaging and irrationality through programs of thought and behavioral modification.  Positive self-qualities in healthy philautia is not a new concept; it was being discussed in symposia almost two-and-a-half centuries ago. The psychological ramifications and methods to address it, however, are in their formative stages. There is a need for innovative psychological and philosophical research to address the broader implications of healthy philautia’s positive self-qualities, which could deliver the potential for self-love and societal concern to the SAD person, opening the bridge to the procurement of all forms of interpersonal love.

Kashdan, Weeks, and Savostyanova (2011) cite the “evidence that social anxiety is associated with diminished positive experiences, infrequent positive events, an absence of positive inferential biases in social situations, fear responses to overtly positive events, and poor quality of life.” Models of CBT that attempt only to reduce the individual’s avoidance behaviors would benefit from addressing more specifically the relational deficits that such people experience, as well as positive psychological measures to counter SAD’s culture of maladaptive self-beliefs. Non-traditional and supported approaches, including those defined as new (third) wave (generation) therapies, with CBT serving as the foundational platform for integration, would widen the scope and perspective in comprehending SAD’s evolving intricacies.

One such step is the integration of positive psychology within the cognitive behavioral therapy model which, “despite recent scientific attention to the positive spectrum of psychological functioning and social anxiety/SAD … has yet to be integrated into mainstream accounts of assessment, theory, phenomenology, course, and treatment” (Kashdan et al., 2011). CBT would continue to modify automatic maladaptive self-beliefs, thoughts, and behaviors, and positive psychology would replace them with positive self-qualities.

Training in prosocial behavior and emotional literacy might be useful supplements to typical interventions. Behavioral exercises can be used to practice the execution of considerate and generous social skills. Positive affirmations have enormous subjective value as well. Data provide evidence for mindfulness and acceptance-based interventions, where the goal is not only to respond to the negativity of maladaptive self-beliefs but to pursue positive self-qualities despite the presence of unwanted negative thoughts, feelings, images, or memories. Castella et al. (2014) suggest motivational enhancement strategies to help clients overcome their resistance to new ideas and concepts. Ritter et al. (2013) tout the benefits of positive autobiography to counter SAD’s association with negative experiences, and self-monitoring helps  SAD persons to recognize and anticipate their maladaptive self-beliefs (Tsitsas & Paschali, 2014). Finally, the importance of considering the “nuanced and unique dynamics inherent in the relationships among emotional expression, intimacy, and overall relationship satisfaction for socially anxious individuals” should be thoroughly considered (Montesi et al., 2013). As positive psychology turns its attention to the broader spectrum of philautia’s positive self-qualities, integration with CBT’s behavior modification, neuroscience’s network restructuring, and other non-traditional and supported approaches would establish a working platform for discovery.

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