Patient x was an intelligent, attractive, athletic 20 year old college student who had recently been in a carjacking where he had been shot and almost killed. When he entered therapy with me it was absolutely incredible that this incident was hardly on his mind; what dominated his psyche was his uncontrollable blushing. This blushing, which had been present for many years, caused severe humiliation, shame, embarrassment, and depression. In addition it created substantial social avoidance, and relationship problems. X was very motivated in treatment. We were able to do core work on self-esteem. Concurrent to this, we worked on the technique of adrenaline acceptance, which is a paradoxical mode of thinking to anxiety sufferers. X adapted the thinking that he was quarterbacking or piloting decision making and began to re-structure the defensive positioning associated with his anxiety.
One day in college when he was presenting a report in front of his class, he started by saying “guys; in a minute you will see a magic trick; my face is going to change color”. Guess what? He did not blush. Why; you are probably asking. The answer is because he went on offense (psychologically and behaviorally) instead of playing defense. By doing this he de-activated his psychological internal critical script that activated his autonomic hyper-sensitivity and the horrific visceral response associated with blushing. Now don’t think that I suggest everyone implement this technique. It takes tremendous courage and substantial emotional work. The pathology of blushing is based on the sufferer’s belief that the blush is a character flaw and that when a blush occurs the flaw is revealed.
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