Social Anxiety Therapy: Helping the Fear of People
Andrew Guthrie, Ph.D.
I am a Toronto therapist who works from a psychodynamic or psychoanalytic background, and this article will outline my findings about social anxiety and therapy for social anxiety. Psychodynamic therapy can be considered to be a general anxiety disorder therapy or anxiety therapy since it is essentially a therapy that uses and explores affect in its theory and manner of practice, and anxiety, or fear, nervousness, and panic, are some of our most basic emotions that have been with us since we were born.
Therapy for social anxiety or general anxiety would begin by looking at the history of the feelings: when they began, in what contexts, what the feelings really feel like, and how one manages the feelings. Exploring the history of a problem is essential to understanding how the problem developed, as every issue has a unique history or place in time. In anxiety therapy, one assumption would be that at some point in our psychological development we learned something that made us afraid or nervous. Likely, we were not able to process, understand or resolve the fear at this time, often because we did not have someone around us that could help us (this is why we can understand psychodynamic therapy to be attachment-based therapy – all experience results from an interaction with another person or the lack of an interaction that was needed or absent).
In my experience with patients with social anxiety, I have been told that being in social contexts makes these people feel overwhelmed. It’s too loud, busy and confusing. The senses get overloaded and one cannot manage the level of stimulation. The may create a feeling of being flooded, which is correlated with feelings of panic and panic disorder. Alternatively, the person may feel vulnerable in open spaces or closed spaces with other people present, afraid of what other people could do or say to them, or be preoccupied with a nameless sense of dread that something horrible is going to occur. The “social” part of social anxiety needs to be understood in more depth, by looking at questions such as, “Why do people evoke fear when ideally they should evoke comfort or pleasure?” “What happened in my history that could lead to my associating people with fear?”
Psychodynamic, or psychoanalytic therapy, is perhaps the most appropriate therapy for anxiety disorder and social anxiety disorder, as this treatment is a) historical, b) contextual, c) based in affect, d) based in attachment and developmental psychology. Developmental problems, or problems that occurred in our development that negatively affected learning or blocked the development of normative learning, requires a “developmental therapy” such as psychodynamic therapy, to understand why and how things went off course. Only then can the developmental course be corrected and room can be made for new learning can take place.
