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Feeling Anxious? Treatment Shows Promise for Social Anxiety Disorder
The worst fear of people suffering from social anxiety disorder is that they will move through life alone, never connecting with anyone. Cognitive behavior therapy can help in treating those afflicted with what is recognized as the third most common mental disorder, behind depression and alcoholism.
For millions of Americans suffering from social anxiety disorder, it can mean avoiding job interviews or squirming out of presentations at work, shunning the dating scene or even trying to calm a racing heartbeat in casual social interactions.
Social anxiety disorder, also known as social phobia, can seriously impede people’s lives, interfering with their ability to work, have interpersonal relationships or simply take part in a one-on-one conversation, says Temple University psychologist Richard Heimberg.
“People with social anxiety disorder are afraid of embarrassment, humiliation and negative evaluation by others in one or more situations, such as speaking or eating in public, talking to authority figures or attending social gatherings,” he says. “And they’ll do whatever they have to do to avoid the risk of a social calamity.”
Social anxiety is now recognized as the third most common mental disorder — behind depression and alcoholism, according to Heimberg, who has studied the disorder for two decades and is the author of Social Phobia: Diagnosis, Assessment, and Treatment, the first comprehensive research book on the subject.
With a $1.2 million grant from the National Institute of Mental Health, Heimberg and researchers in Temple’s Adult Anxiety Clinic are helping people with social anxiety deal with their feelings of inadequacy and fear.
“Many people with social anxiety have been afflicted for years: The average length of the disorder is 20 to 25 years,” he notes. “Research shows that these are people who are more likely to drop out of high school and end up on welfare, and to have depression and alcohol problems, and they are less likely to get married and have children.
“A client’s worst fear,” Heimberg continues, “is that he will move through life alone, never connecting with anyone.”
The research study, which utilizes psychotherapy and medication treatments to treat the disorder, is assessing the effectiveness of a program of therapy in combination with anti-depressant medication. More specifically, the researchers hope to determine if the therapy augments the effects of the medication and makes it more likely a person will continue to do well after stopping the medication.
The therapy regimen, a treatment designed by Heimberg that is a form of cognitive behavior therapy (CBT), helps clients manage their feelings by more scientifically examining the thought processes that trigger them.
“When a client is thinking ‘I look stupid, I don’t know what to say, that person doesn’t like me,’ she can learn how to process these thoughts differently.
“Instead of a cycle of failure, the client learns how to institute a cycle of success.”
In therapy sessions, clients identify situations in which they experience social anxiety. Then, through role playing, analyzing their thought processes and practicing cognitive skills, they are encouraged to “talk back” to their negative thinking and realize their fears are not supported by most of the evidence.
For people with social anxiety, the impairment tends to run broad as well as deep, affecting multiple aspects of their lives, Heimberg points out.
“People who have more severe forms of social anxiety disorder may not have any social support at all. They may be fearful of talking to other human beings at work or school, as well as in more personal social situations.
“A person with social anxiety may retreat to her apartment on Friday and not come out until Monday morning.”
And people are generally reluctant to seek treatment, Heimberg says, noting that they find it difficult to understand what is troubling them.
“The percentage of people who need treatment and get it is very small. Many assume they’re simply shy and convince themselves ‘that’s just the way I am.’ They may get medication for ‘having a case of nerves’ and not fully recognize the scope of their difficulties.”
Initial findings of the study suggest encouraging outcomes. “Three-quarters of the people who have come through the study have gotten substantial benefit from the treatment. We see them doing things they had shunned before and starting to put their lives together.”
For Heimberg, who joined Temple’s psychology department in 1996, the results are particularly gratifying. “Everything in life is interpersonal — whether it’s school, job, relationships, even going to the supermarket. People who go through treatment are opting into life, instead of opting out.”
Before coming to Temple, Heimberg did research on social phobia at the State University of New York at Albany for 18 years. He earned his doctorate in psychology from Florida State University.
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