Structure may reduce social anxiety symptoms
Thinking about past social failures can be less painful in a structured setting for some social phobia sufferers, according to a recent Washington University study that examined current practices in cognitive psychology.
The work addressed a psychological problem that can be especially acute during the college years, when people are exposed to new social situations that are stressful even for those without anxiety problems.
In an experiment conducted by Assistant Professor of Psychology Thomas Rodebaugh, along with Tejal Jakatdar, Anna Rosenberg and Richard Heimberg of Temple University in Philadelphia, 40 undergraduates with social anxiety disorder were asked to write about a recent social situation that caused them distress. The study was published in November in Behavioral Research and Therapy.
As the third most prevalent psychiatric disorder after depression and alcohol dependence, social anxiety disorder affects about five million adults in the U.S. each year. Most patients with the disorder are under 25.
Some subjects wrote freely about a source of anxiety for 25 minutes, while another group had specific prompts to answer. The prompts addressed topics such as what thoughts and emotions they had about the situation and how to determine if any of their thoughts were not true, such as “nobody likes me.”
In the group that free-wrote, some subjects were able to work through their anxiety unaided, while some experienced escalating distress. In the prompted group, however, subjects’ moods did not worsen.
Rodebaugh said that the results show that different people respond better to different techniques.
“Basically it suggests that there are probably ways of talking about and writing about stressful memories and stressful events that are helpful for some people and ways that are not so helpful for some people, at least in the short run,” Rodebaugh said.
Therapy for social phobia sufferers may include talking about past social situations that have posed problems for them. While it is assumed that this practice is helpful, the wrong approach could be counterproductive if a patient experiences escalating distress, according to Rodebaugh.
For some people with social anxiety, according to the study, it is important that the therapist structure a conversation about past perceived failures.
“Hopefully it’ll give people a little more confidence that what therapists are doing will be helpful for people,” Rodebaugh said.
Social situations can be particularly problematic for college students with social anxiety disorder. According to Karolyn Senter, staff counselor at Student Health Services, new faces and new pressures can overwhelm an anxious person.
“I think students with social anxiety have a very difficult time because of the social environment at college—living in dorms, living with peers, even going to classes in large groups,” she said. “I think social anxiety disorder limits them in their experiences. It’s not a full college experience.”
Sophomore Connie Choi said she thought that although freshman floor communities go a long way toward alleviating the stress of meeting new people, freshman year can be socially bewildering.
“Every group bombards you with information,” Choi said.
Rodebaugh stressed that reasonable levels of social anxiety, however, are normal.
“There are situations that tend to bring out social anxiety for most people,” he said. “Anxiety becomes a clinical problem when it poses problems for [people] that they are unwilling to live with.”
The severity of normal anxiety stands in stark contrast to social phobia.
“One thing that is sometimes brought up in the media is people’s concerns that social phobia is a way to pathologize shyness, to make it be bad that people are shy or introverted,” Rodebaugh said.
“We’re talking about people who come in for treatment who can’t do the job they want to do, or can’t have the relationships they want to, or in some cases have abused drugs and alcohol for years because they couldn’t be in certain social situations without being terrified.”