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Self-Assessment
– How often do you experience general anxiety?
– Not at all/a little/some of the time/a lot of the time/all of the time
– Do you find it difficult to control your anxiety and worry?
– Not at all/a little/some of the time/a lot of the time/all of the time
– On a scale of one to 10, how much do you suffer the symptoms of general anxiety in your life today?
(0–1 = none, 2–3 = slight worry and anxiety, 4–6 = moderate anxiety, 7–8 = marked worry and anxiety, 9–10 = chronic worry and anxiety)
CASE STUDY for GAD
Ross, an attractive 24-year-old Australian, was on a travelling trip around the world. Whilst in London, he found himself suffering from severe bouts of anxiety and worry that appeared to be causing on-going migraines and stomach cramps. Ross had a belief that he couldn’t cope. These disempowering thoughts were the result of consistently failing exams in childhood and the learning disability dyslexia. When he was in Australia, he was supported by his mother and sister and felt able to manage his life. However, when abroad, he found it very difficult to communicate his fears and anxieties for fear of ridicule. He seemed to suffer from worry and anxiety about absolutely everything and the slightest thing would cause a negative spiral. He worried about getting a job then he worried about the people around him. He worried that he couldn’t get a girlfriend; he worried about his health.
Underlying Ross’s worry was a belief that he couldn’t cope, so we worked to change this by using some of the beliefs exercises featured in this book. I also used the TFT algorithm for anxiety (see chapter five), and exercises on worry, which allowed him to put his problems into perspective. Ross returned to Australia feeling a lot better.
Social Anxiety
A large number of people have suffered from social anxiety at some point in their lives. Think back over your own experiences and I’m pretty sure you’ll be able to recall a period when you were shy and anxious with particular people or groups, or in certain social settings.
To a certain extent, we are born with our personality already mapped out and with an ‘emotional’ biology that is thought to determine our temperament. Consider babies for a moment – they all have such different personalities. Children born to the same parents also usually have characters that are completely different: one child may have a placid temperament, while another is more robust.
Of course, there is little doubt we are affected by our environment and social anxiety often has its roots in childhood experiences. However, studies examining whether the temperaments of young children changed in social situations over time found that the robust, confident individuals stayed that way in groups of people. The children who were fearful and nervy at an earlier age were more likely to be anxious in social situations, though some did improve.
It is perhaps during adolescence that social phobias and anxieties really begin to manifest and become most apparent. At this stage, children may be breaking some of the bonds with their parents and becoming more aware of themselves as individuals, but they have a strong need to fit in with their peers. As a result, anxieties emerge about being judged or rejected – or indeed doing anything that might conceivably lead to embarrassment or humiliation.
Social anxiety can occur on many different levels. When it is mild, the sufferer usually experiences discomfort and anxiety in particular situations. In cases of extreme anxiety, the individual is consumed by thoughts of their inadequacies and feels quite overwhelmed and panicky. Following a stressful event they will spend hours obsessing about how they could have behaved differently. It is also possible to have phobic reaction in social situations (see here).
While the lucky ones grow out of their anxiety, others simply learn to manage it. For some, however, it can stick, causing them to become fixated with self-doubts about social situations. Patterns like this can run the whole of a lifespan and can have an incredibly negative effect on a person’s life, making it difficult for them to make friends and get on in social situations. For an unlucky minority, this becomes so fraught with anxiety that they will avoid such situations and hence become reclusive and lonely.
High-tech, Low-value Communication
The computer has patently not helped us to interact with others. Instead of communicating face to face and developing relationships within the family and at work, many of us – kids, teenagers and adults – spend hours in front of the computer, cut off from genuine human contact. Today, you can, if you choose, virtually lead your life via the Internet – you can do your shopping, click on to chat rooms for conversations and even have a relationship over the net. Dating anxiety is very common, as the insecurities we have about ourselves can negatively affect the way we communicate. Using the Internet can make the initial process less stressful, but of course it throws up many other problems, not least of which are the expectations both parties have built up before they meet.
Social anxiety is often based on perception rather than feedback from others. People with social anxiety become very conscious of the signals that they are giving out and can easily find themselves blushing, tongue-tied or unable to eat, drink or talk; or the opposite – eating or drinking too much to cope with the situation. And, not surprisingly, this can often exacerbate an already difficult situation.
Social Phobia
Social phobia is an extreme type of anxiety (see phobias page 35) in which a phobic reaction can occur at even the thought of being in a social situation. This can escalate into chronic, excessive fear that is deeply distressing to the individual – especially as they are aware at a rational level that the very thing that is making them anxious is harmless. To be diagnosed as a social phobic you must have had the problem for at least six months and the phobia must interfere with your life.
Men and women can suffer equally from social
