Over the years I have worked with many people who suffer from addictions of all sorts –drugs, alcohol, food, sex – you name it. Most were/are in recovery or have attempted to deal with their addictions in other ways. But one thing I’ve noticed that they have in common is that most have Social Anxiety Disorder as an underlying problem. That is not to say that all addicts have this. But when you think about it, for many it makes sense. Addictions mask emotions and help with symptomatology. They initially make things easier – brighter if you will. Drugs & alcohol lower inhibition and can help ease the way for social interaction. For most, alcohol lightens the mood and lowers inhibitions and may make things more pleasant. But social discomfort is major problem for those with Social Anxiety Disorder. People can shake, stutter, withdraw, become mute and can’t make contact even in the seemingly most benign circumstances. Think of Rojesh from TV’s “Big Bang Theory”. He is a caricature for sure, but not so far from hitting the nail on the head. The powerful underlying truth of what many with Social Anxiety Disorder deal with is that their discomfort is so great, they can’t connect. Or they suffer greatly when trying to interact. Drugs or alcohol can produce a major shift for them. It is self-medicating, and many even forget what is lurking underneath – especially if they become chronic users. But when sobriety is achieved it is there – just as it was from the beginning. The trick is to find other ways of dealing that might bring about some real change.
Tag Archives: Social anxiety
How People Deal With Money & Why
Money is not usually a focal point of why people come in for psychotherapy and until recently I never thought about writing about it. But a cousin suggested that it might be an interesting topic and it set me thinking. In my experience money is often an integral part of how people behave, how they judge themselves and others, and has tremendous impact on relationships. It is symbolic on many levels. Everyone has a relationship with money even if they don’t know it. And yet those who see me are reluctant to talk about money. Sex is a less taboo subject. People will reveal their drug or alcohol abuse or their eating disorders sooner than talk about how they deal with money.
Over the years I have seen people who are in constant monetary distress, who have declared bankruptcy, as well as those who have money, but to who continue to strive for acknowledgement through money – as though money would alleviate all anxieties, increase their self-esteem and a validate their lovability & self-worth. It rarely is a solution for any of those things. Focus on money has also destroyed many a relationship. When couples fight about money it is often a cover for other underlying issues having to do with pride, trust, feeling loved, appreciated and desired. That is not to say that money issues aren’t real. Often they are. It is just to say that other problems are usually in that mix.
Now it is impossible to separate some of this from our larger culture which places an enormous value on the trappings of success that money can buy. We see this in all media. We forget that money is a means of survival. And by that I mean food, clothing and shelter. Now there is nothing wrong with enjoying things, and money does cushion people & help them to feel less frightened that they will end up homeless. It makes many of life’s burdens easier. But there are never any guarantees. And that is often why people can be obsessed with money. I think there is nothing more telling about our society’s craziness when it comes to spending and accumulating and the inability of many to deal with money than what happens to many lottery winners. One would think that winning a great deal of money would add to contentment. But too often that is not the case. Many lottery winners end up more miserable and broke. What happens to the concept of saving for the future? It’s almost like money does burn a hole in one’s pocket and it is spent faster than ever. It also makes it clear that money is no panacea for an individual’s well-being. And it is by no means a measure of one’s success as a human being.
People’s attitudes towards money vary as greatly as do their familial experiences. As a child of depression parents, in my family saving was paramount. There were no credit cards and there were envelopes for all the bills & necessities and one for savings if possible. If you didn’t have the cash, you didn’t buy it. Commitment & love were primary values in some families, because they knew what it was like to be hungry and they had their priorities in order. Now others of depression parents had different experiences. They valued money above all else, swearing as did Scarlett O’hara “I will never be hungry again”. They didn’t talk about money and so did not educate their children about how to handle money. Or they spent & were in constant debt, denying the reality of their situation. Shame was a ruling emotion and impacted how they dealt with money & consequently how their children felt about money. Often shame led to avoidance of the whole topic or to knockdown, drag out fights. But as we know, children feel and react to what is not overtly talked about, let alone what they witness. Many children unconsciously or even consciously swore to make up for what their parents lacked.
Money represents many things to people. It can be used as a barometer measuring things like love, self-worth & self-esteem, how others feel about you, and of course power – just to name a few. There are couples I see where money is not a source of conflict. They pull together without a blame game no matter what the circumstances. Then there are others where money becomes the overt reason for conflict, blame, and a means of punishment and revenge.
I also see individuals living on credit, even though they make a good living. They live and spend beyond their means. Buying becomes a sort of drug to help ease other emotional problems. It becomes a means to escape, a way to ease a greater pain – somewhat like drugs or alcohol. Now buying an extra lipstick or a pair of socks is one thing, but several cars or homes, expensive vacations & clothes and electronic toys that one really can’t afford, is a totally different thing. Living on credit is dangerous and in spite of debit cards which ostensibly help people not live beyond their income, debt in this country has reached all-time highs. It seems that living within one’s means is a disappearing value.
Now there are organizations that will help people budget and learn to live within their means, but they are sorely underfunded and underutilized. Often by the time people consult them they are in such a deep hole that little can be done. When I ask people about a budget, they often look at me either ashamedly or blankly as though the concept is prehistoric. I don’t know. Maybe it is.
There is an important question as to whether this society just pays lip service to the idea of not living on credit. We certainly seem schizophrenic on the subject. On the one hand we extoll the virtues of saving and not using money as a measure of success or how we judge ourselves and others. But just look at the values we place on society’s commodities. What does that say about us?
Now little I have said about the societal aspect of money is new. It goes back to the Romans & before. It just seems wider spread. But if you judge yourself by money, you are missing the point. You don’t need labels or an image or an accumulation of ‘toys’ to feel successful. That should be an inner definition having to do with the kind of person you are.
The Prevalence of Social Anxiety
Scratch the surface and there it is. Social anxiety is much more prevalent than people realize. I hesitate to use the word ‘disorder’ because many people who suffer from it don’t meet the DSM criteria. In more lay man’s terms they would be considered painfully shy. Saying one is very shy seems more acceptable than saying they have ‘social anxiety disorder’. Severe shyness is often something that’s been there since childhood.
In my practice over the years, I would say that more than a third of those I see have social anxiety in varying degrees, even if never diagnosed. Many are able to hide it so well, no one would ever know. They are good actors & often that helps. But more often they are avoiders, afraid to deal with the world. Then there are those with more overt symptomatology who suffer from panic attacks, are almost are unable to speak, shake visibly, and will actually faint if the stress is enough. Medication has been very helpful for some as well as psychotherapy along with the use of CBT. In my practice I have noticed it gets significantly better but it rarely goes away completely.
Most people have a certain amount of anxiety in obvious situations like making a speech or meeting new people or confronting a difficult situation. But for people who have social anxiety, the triggers are not necessarily visible. They can be afraid to make phone calls, get on a bus or walk down the street for fear they may meet someone, talk with shop clerks, have difficulty going out in general, and without a drink or two, barely function in social situations. It may not always be apparent, but inside they are struggling. They are severely self-conscious. I believe that many alcoholics suffer from social anxiety and that that may be a contributing factor to their disease. Intimacy and social anxiety is another difficult combination. Meeting people is hard enough for those who suffer from it, but add the pressure of relationship, and the situation can become impossible. Loneliness and social anxiety are not strangers.
Over the years I have noticed that not only is the anxiety itself dehabilitating, but the shame and judgments that accompany it make it much more painful and problematic. Often those who suffer from it consider themselves, wimps, cowards and just plain stupid for not being able to do things that seem to come so easily for others. Self-hatred & self-criticism are very common. They are aware that most of the fear is irrational and hate themselves for not being able to overcome it. It constricts their lives and they feel they are at fault. Consequently the self-hatred is continually reinforced, and that makes the anxiety even worse. It’s bad enough to have it to begin with, but with the added constant erosion of self-image, the pain is that much greater.
Unfortunately, like most things, intellectual knowledge does not always help with how one feels. Most social phobics have been chipping away at their self- esteem for a long time. These judgments about themselves can feel like a religion. In their core they know how bad they are. It’s a long standing belief system that has offered a certain amount of protection & explanation for their plight. That makes it harder to help alleviate the anxiety. Acceptance is the friend of someone with social anxiety. It takes away the added burden of self-hatred which in turn makes life easier. Getting to a place of acceptance is very difficult for most. There are usually some very unrealistic fantasies about what they would be like if they weren’t so shy. But it is the first step in the healing process. Liking oneself better usually is.
Related articles
- Social Anxiety Disorder (annadeedslpc.com)
Paula Zuckerman, LCSW. Random thoughts on a 30+ year psychotherapy practice 