The Premier Resource for Resolving Social Anxiety Disorder
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Social Anxiety Treatment
While there are numerous manifestations of social anxiety, including performance anxiety, fear of public speaking, selective mutism, erythrophobia (fear of blushing), hyperhidrosis, fear of being noticeably nervous, school phobia, dependent personality, and pervasive social avoidance, there are two basic types of individuals who have the problem: These are people with “initiative” and those without “initiative”. Initiative does not mean ability. It means the motivation to start up or motivation to get help. When an individual of any age does not have initiative, treatment begins with parents, given the avoidance-dependence dynamic.
The dynamic that distinguishes social anxiety from other anxiety disorders is the element of performance. That said, social anxiety is commonly co-morbid with other anxiety symptomatology; especially Obsessive-Compulsive Personality Disorder, which includes perfectionism and Obsessive-Compulsive Disorder.
Jonathan’s book Beyond Shyness: How to Conquer Social Anxieties (Simon & Schuster) was so named because “shyness” is too abstract and nonfunctional a term. The reality is that shyness is social anxiety. The question is, to what degree is it present? To really understand the phenomenon, it is important to understand its components. Think of F.A.T.E. (See Figure 1).
Any treatment modality that does not integrate this architecture is, in essence, trivializing the problem.
The biggest confusion that people experience when starting treatment is understanding how ingrained the problem can become. That’s the reason intervention as early as possible will facilitate high performance treatment.
Each individual has their own learning curve. The primary variables for this include length of the problem, severity of the problem, motivation, expressive ability, ability to integrate new concepts, readiness to face fear, and degree of obsessive worry and panic.
Think you may have social anxiety?
Jonathan Berent Announces First of Its Kind Library of Clinical Interviews on Public Speaking and Fear of Being Noticeably Nervous
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The most evidence based clinical success for social anxiety since 1978.
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Jonathan Berent, L.C.S.W., A.C.S.W., is a psychotherapist who has been practicing since 1978. He has created the Berent Treatment Method for Social Anxiety, which is the result of his clinical work with thousands of individuals of all ages with social anxiety since 1978. He is the author of Work Makes Me Nervous: Overcome Anxiety and Build the Confidence to Succeed (Wiley, 2010), Beyond Shyness: How to Conquer Social Anxieties (Simon & Schuster, 1992), and Social Anxiety: The Untold Story, which is an accredited course for mental health professionals in using the Berent Method to treat social anxiety. (Andrew Kukes Foundation, 2011).
Socialanxiety.com, has served millions of unique visitors as a multimedia clearinghouse for patients, parents, and fellow mental health professionals in search of articles, educational materials, and books on social anxiety and related subjects. His library of clinical interviews appears to be the most documented clinical success with social anxiety.
During my forty plus years of clinical experience with social anxiety I’ve worked directly with, and supervised treatment for, approximately ten thousand individuals between the ages of four and seventy from many cultures. The clinical spectrum has ranged from public speaking anxiety and erythrophobia to pervasive social avoidance and adult selective mutism. Functioning levels have ranged from C suite executives with seven figure salaries to adults who have isolated themselves in their homes for years. I’ve spent literally a few hundred thousand hours on the clinical front line. Treatment has included individual, family, group and special needs therapeutic communities. I’ve seen everything from a cure to the problem remaining permanent, and everything in between. Many of my patients who have done well in treatment have said about therapy “this is the hardest thing I’ve ever done”.
This is in direct contrast to the statements by the CBT community where positive results are promised within a short-term context of approximately 10-15 sessions. Now, something is very wrong here. While I believe that CBT can help many, it’s claims regarding social anxiety are grossly misleading and flawed. These claims are a significant component of the greater common misunderstanding of the disorder. CBT offers social anxiety sufferers the belief that the disorder can be resolved via behavioral and cognitive technique. This is simply not true. It puts the consumer at risk for unrealistic expectations regarding treatment. The reality is that while technique can help immensely with self-regulation; it does not touch the core emotionality that causes and drives the problem!
The reality is that social anxiety is an assault on personhood concurrent with nervous system overload. CBT claims make a mockery of this dynamic and the fact that social anxiety is the “quintessential disease of resistance”.
Having reached my breaking point with CBT claims I decided to channel the energy of my anger, which is a dynamic I try to teach my patients, into research which has never been done; researching the research on CBT and social anxiety. The following are my conclusions.
- None of the research identifies differences in the functioning levels of participants. There is no differentiation between subjects with and without initiative for treatment. There is minimal understanding of social anxiety as a spectrum disorder.
- There is little differentiation of social anxiety symptoms.
- The vast majority of research has taken place in university settings. This is going to limit greatly the type of profile of participants. This is putting it mildly.
- The statements regarding short term treatment success are in direct conflict with my clinical experience which leads me to conclude that inherent in this research is a basic misunderstanding of the core psycho-pathology at play.