While there are many different manifestations of social anxiety, there are basically two types of people who have the problem; one is the person who is capable of “initiative”; the other is not capable. “Initiative” does not mean ability. It means to "start up". When the social anxiety sufferer is not capable of initiative, that person will be driven by intense and often primal dynamics to avoid anything that is threatening. This includes talking about the situation and identifying pertinent issues for healing, in addition to the threatening situations and people.

In order for the person to be good at avoiding, dependence has to be present. Dependency can take financial, emotional, and practical forms. If the people who are depended upon do not learn a functional game plan to empower their dependent, it is extremely difficult to achieve any therapeutic success.

At one time in my practice two individuals in their mid-30s came to me from the same inpatient program at a well-known Midwest clinic. Both were intelligent individuals whose lifestyle was totally enabled by their parents. Both did not work and had limited social lives. Both sets of parents were paying around $50-$60k a year to enable their dependents' lifestyles. Both were overly medicated. Both would respond with suicidal threats if their parents tried to stop their enabling behavior. These threats paralyzed the parents.

The fact that these parents were not involved at all in the intensive inpatient program demonstrated to me the total confusion of the professional staff at that facility. In order for there to be success, parents have to learn how to manage their own anxiety along with developing a productive therapeutic blueprint. If this is not the case chaos, distress will be the status quo!

School phobia and selective mutism are examples of social anxieties that personify the avoidance-dependency dynamic. In these cases, most of productive treatment is based on corrective parenting. The same is the case for the "adult child" with social anxiety - a person who lives at home, does not socialize, and does not work.

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1. Free video of Sally Raphael Show featuring a number of Jonathan's patients. ($10.95 postage in U.S. $19.95 outside U.S.)
2. Free Introductory CD
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5. Free "Parent Addiction" quiz
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9. The book, "Beyond Shyness: How to Conquer Social Anxieties" (Simon & Schuster)
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