THE EXERCISES AND advice in the previous chapters are aimed at those who feel ready to undertake solving issues of shyness that have been hindering their ability to fully and optimistically engage in their lives and achieve their goals. All of the exercises cited are delivered with the confidence that if people are motivated and committed to transforming their shyness from a label of weakness to a trait of strength, they will succeed.
For some, however, shyness is a debilitating experience. If you suffer from extreme panic attacks or agoraphobia, or if you have been diagnosed with obsessive compulsive disorder (OCD), which also makes it virtually impossible to engage in normal daily activities, then you probably are suffering from what is generally termed “social phobia.”
“Social phobia” is an umbrella description that encompasses behaviors that severely restrict and often forbid one to engage in the outside world. For example, if you have social phobia, you probably do not have a job that requires you to interact with others or work outside your home.
This level of painful isolation from society can only be alleviated through professional treatment. It is probably obvious that if you experience extreme social anxiety, the exercises in this book are not possible for you to undertake at this point in time.
“You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, ‘I have lived through this horror. I can take the next thing that comes along.’ You must do the thing you think you cannot do.”
—ELEANOR ROOSEVELT
The hopeful news is that there are ways to manage this disorder, if not cure it. You should seek help from a professional who is trained in this particular area. It might be helpful for you to find someone with extensive training in Rational Emotive Behavior Therapy (REBT).
If the form your social phobia takes is obsessive and compulsive, or if you have a ritual that must be performed repeatedly and leaves little time for going out into the world and also causes you to panic at even the thought of not engaging in this repetitive behavior, you should seek a therapist trained in treating OCD. This therapy will entail a systematic desensitization and involves a gradual process, with steps taken very slowly, to help you connect to the outside environment with more comfort and ease.
Experiencing panic attacks or severe anxiety when in the company of other people can also be reduced and cured through treatment with a professional trained in cognitive behavioral therapy with a specific focus on anxiety or panic disorder.
There are also safe and effective medications that can be extremely helpful in reducing the physical symptoms anxiety causes, which can be frightening and overwhelming. Some of these medications also target the depression that often accompanies social isolation.
The most common treatment for social phobia and extreme social anxiety is a combination of medication and therapeutic intervention with a therapist specifically trained in this area. Most practitioners will refer you to an MD or pharmacologist for a prescription. Be sure to inquire about their experience and expertise in this particular area of social phobia, as well. It is very important that your therapist and medication prescriber are in contact with each other regarding your progress and response to the medication, especially if you experience any side effects. If you find a psychiatrist (who is also an MD) trained in the type of therapy you require, he or she will be able to prescribe medication and you will not need to see any other practitioner.
Medication is mentioned here because we are dealing with a level of suffering that is intolerable and possibly dangerous, since the depression associated with these disorders can be debilitating and can fill one with hopelessness. Please know that this disorder may be related to a chemical imbalance that is creating and exacerbating your symptoms, and there is absolutely nothing wrong with seeking medical attention for it. If you had diabetes you would not hesitate to take insulin if your doctor told you it would save your life. So it is with extreme panic and depression. There is no shame or weakness in seeking to alleviate your distress with an antidepressant or antianxiety medication.
Medication is mentioned in this book because we are talking now about a very extreme condition. The word “shyness” has not been used in this section for a reason. The experience of social phobia is not the same thing as the experience of shyness or timidity/fear in social situations. If you suffer from social phobia, you know that the feelings and emotions you experience are far more painful and destructive than being nervous about going to the office Christmas party, or fearing you will be at a loss for words at a group gathering.
Although medication is a possible treatment for this disorder, it must be strongly stressed here that many, many people are able to overcome extreme social phobia through therapy alone. If you choose to take this route, make sure you find a therapist you feel comfortable with.
For reasons that are obvious, you will need to trust this person if you are to get better. Since your goal is to address this problem, it is important that you talk to as many therapists as it takes (and you can do this over the telephone if you wish) until you find one who sounds as if he or she is the right person for you to work with.
A great many people like you have successfully dealt with the problem of extreme social anxiety and obsessive-compulsive behaviors. You can become engaged with the world of others if you are willing to take the initial step to seek help. You may even join a group of other people like yourself who may have once despaired of ever having a full and rich life. As you hear their stories of hope and success, you will get the courage to ask for and receive the help you need. Please remember, you cannot do this on your own and there is a great deal of help available to you.