Hypnotherapy In Adelaide

 

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​Stages

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Child development

Social anxiety first occurs in infancy and is said to be a normal and necessary emotion for effective social functioning and developmental growth. Cognitive advances and increased pressures in late childhood and early adolescence result in repeated social anxiety. Adolescents have identified their most common anxieties as focused on relationships with peers to whom they are attracted, peer rejection, public speaking, blushing, self consciousness, and past behavior. Most adolescents progress through their fears and meet the developmental demands placed on them. More and more children are being diagnosed with social anxiety and this can lead to problems with education if not closely monitored. Part of social anxiety is fear of being criticized by others, and in children social anxiety causes extreme distress over everyday activities such as playing with other kids, reading in class, or speaking to adults. On the other hand some children with social anxiety will act out because of their fear. The problem with identifying social anxiety disorder in children is that it can be difficult to determine the difference between social anxiety and basic shyness.

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Adults

It can be easier to identify social anxiety within adults because they tend to shy away from any social situation and keep to themselves. Common adult forms of social anxiety include shyness, performance anxiety, public speaking anxiety, stage fright, timidness, etc. All of these may also assume clinical forms, i.e., become anxiety disorders

Criteria that distinguish between clinical and nonclinical forms of social anxiety include the intensity and level of behavioral and psychosomatic disruption (discomfort) in addition to the anticipatory nature of the fear. Social anxieties may also be classified according to the broadness of triggering social situations. For example, fear of eating in public has a very narrow situational scope (eating in public), while shyness may have a wide scope (a person may be shy of doing many things in various circumstances). The clinical (disorder) forms are also divided into general social phobia (i.e., social anxiety disorder) and specific social phobia.

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Disorder

Extreme, persistent and disabling social anxiety may be diagnosed as social anxiety disorder. The experience is commonly described as having physiological components (e.g., sweating, blushing), cognitive/perceptual components (e.g., belief that one may be judged negatively or looking for signs of disapproval), and behavioural components (e.g. avoiding a situation).

The essence of social anxiety has been said to be an irrational or unreasonable expectation of negative evaluation by others. One theory is that social anxiety occurs when there is motivation to make a desired impression along with doubt about having the ability to do so. Although the "official" clinical name for the disorder, as listed in the DSM and  ICD, is Social Phobia or Social Anxiety Disorder, support groups for people who have the disorder (whether through clinical diagnosis or self-diagnosis) often refer to it as simply "social anxiety" or even "SA".

Criteria in the DSM and ICD attempt to distinguish clinical versus nonclinical forms of social anxiety, including by intensity and levels of behavioral and psychosomatic disruption: The validity of the "disorder" diagnosis has been challenged, however, on scientific and political grounds; people satisfying DSM social phobia criteria may simply be temperamentally high in social anxiety rather than suffering from a disorder, although such problems in living in society may still deserve attention as a matter of social justice.

Standardized rating scales such as Social Phobia Inventory can be used for screening social anxiety disorder and measuring severity of social phobia.

Clinicians and researchers continue to struggle with definitional problems regarding the constructs of shyness, social anxiety, and social anxiety disorder. Each shares similarities, yet each has been used to define distinct aspects of psychological life as it relates to interpersonal functioning and how easy or difficult different cases of social anxiety are to overcome. A continuum describes some of the distinctions yet there is no absolute consensus yet as to where one disorder begins and another ends, although it is widely agreed that there are differences.

Social anxiety disorder may sometimes be symptomatic of an underlying medical disorder, such as hyperthyroidism.

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Prevalence

According to the US National Comorbidity Survey, social anxiety has a 12-month prevalence rate of 6.8%, placing it as the third most common mental disorder in the U.S. An estimated 19.2 million Americans suffer from social anxiety disorder and it can occur at any time but most often presents in adolescence, early adulthood, or even early childhood. Statistically it is also more common in women than in men.

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Causes

The exact causes of social anxiety are still contested. Ongoing research on the genetic roots of physical and mental health suggests that the tendency toward feelings of anxiety, in social situations in particular, has a moderate probability of inheritance.

Another potential cause of social anxiety can be found in the nervous system. Medications that are prescribed to treat social anxiety affect the levels of neurotransmitters, chemical messengers that are responsible for transmitting signals in the brain. However, researchers are still unsure if the differences in these chemicals cause social anxiety. Several studies have found that certain areas of the brain, such as the amygdala, can be more active in individuals with social phobia.

Also, life experiences can be another cause of social anxiety. Negative experiences in life, and the way one handles and reacts to them, can also lead to the development of social anxiety. If one is consistently put in situations that make him or her feel inferior or fear the judgment of other people, he or she can begin to develop negative beliefs about himself or herself and the world that can cause social anxiety. This then promotes avoidance of situations that may provoke anxiety, which causes one to miss the opportunity to prove their negative assumptions about themselves wrong.

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Low self-esteem

Self-esteem is how a person evaluates their self based on the qualities they possess. Children with low self-esteem tend to dwell on unfavorable attributes, rather than focusing on their strengths. The evaluation children have of themselves can have a huge impact on their psychological well-being and their actions, thus leading to disorders like social anxiety. A child that has insecure attachments to their caregiver can also develop low self-esteem. These attachment problems can have a bigger influence on the child when they grow up as well. At around 8 years old, the child's self judgements start reflecting what other people think of them. Social anxiety can develop from other's perceptions of one's self; thus having peer groups, caregivers and influential people around can impact the thoughts individuals have about themselves.

Social anxiety, and depression, have been linked to one's explicit and implicit self-esteem. "Explicit self-esteem would reflect deliberate self-evaluate processes whereas implicit self-esteem would reflect simple associations in memory."  An experiment using Implicit Association Tests, Child Anxiety and Depression scales, and the Rosenberg Self-esteem Scale was done on adolescent teenagers, and found that self-evaluative thoughts and actions can come from a person's self-esteem level. The findings show that one's explicit self-esteem can be the factor leading to social anxiety and depression. The negative judgement that a person has towards themselves can be linked to unstable cognitive behavior that they posses. In this experiment it was also found that girls, rather than boys, were more likely to have symptoms of social anxiety and depression. This in turn leads to them having lower explicit self-esteem.

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In children

For children the exact cause of social anxiety is unknown. However, there is a growing consensus towards an integrated, multifactor model, in which biological, genetic, and environmental factors contribute to the development and intensification of maladaptive anxiety. Genetic vulnerabilities and/or a biological predisposition, including a temperamental style of behavioral inhibition and a family history of anxiety, may place individuals at increased risk for anxiety. Such individuals are more inclined to develop a diagnosable anxiety disorder, particularly when faced with stressful or aversive situations (e.g., peer-related difficulties, strained family relations). Also family variables such as parenting style and parent–child interaction have received increasing attention and may be particularly relevant in the development of childhood social anxiety, especially parental styles characterized by rejection and overprotection.

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Prevention

Use of CBT in a universal prevention program has been found to significantly reduce social anxiety prevalence.

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Communication apprehension

Social anxiety causes communication apprehension, which can be thought of as an "internally experienced feeling of discomfort", in turn causes ineffective communication when in a social or public situation. “Communication apprehension is the level of fear or anxiety associated with either real or anticipated communication with another person”. Early communication researchers described physiological sensations experienced while giving a public speech as "profound discomfort". Patients with social anxiety typically experience embarrassment, distressing panic attacks, and self-consciousness impairing their speech. According to a study done by Robin and Mills, children experiencing social anxiety show issues in social perspective-taking ability, fewer successful problem solving skills, and use less interpersonal problem solutions. The feelings of embarrassment, inferiority, and shame inhibit the ability to seek help.

Imagined interactions (IIs) refer to the cognitive process of individuals indirectly experiencing themselves in anticipated future communication interactions with others through the process of imagination. IIs have their theoretical roots in symbolic interactions. The functions of IIs is to put into practice the phrase "practice makes perfect". When using IIs you can try to anticipate what is going to happen, and by doing this people with low communication skills can try and account for what is going to happen in the upcoming interaction. According to the article "Communication Apprehension and Imagined Interactions", people who practiced IIs were less likely to have nonverbal displays of apprehension. e.g. fewer silent pauses, shorter speech on set latencies, and fewer object adapters. IIs are said to increase the readiness to communicate and decrease the apprehension associated with a communication episode.

One thing that increases communication apprehension is if the partner is unknown. Some things that can reduce communication apprehension is if someone is extroverted, has good self-control, high levels of self-esteem, and has high willingness to disclose information. These are all things that contribute to helping reduce communication apprehension.

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Diagnosis

This disorder can be difficult to diagnose because it is easily confused with general shyness or paranoia in both children and adults. The underlying factors that cause symptoms of social anxiety are also hard to determine. It can be a combination of life, stress, drugs, and various other factors

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Treatment

It is not very difficult to treat social anxiety and the treatment needed varies case to case. It is claimed that the most effective treatment available is cognitive behavioural therapy (CBT), improving symptoms in up to 75 percent of people with social anxiety disorder according to the Mayo Clinic website. The goal of CBT is to guide the patient's thoughts in a more rational direction when faced with anxiety; it helps the person to stop avoiding situations that once caused anxiety and teaches people to react differently to the situations that trigger their anxiety. Cognitive behavior therapy may include systematic desensitization or controlled exposure to the feared situation. With systematic desensitization, the person imagines the anxious social situation and works through their fears in a safe and controlled environment. CBT may also include role-playing to practice social skills and gain the comfort and confidence in order to relate to others. Relaxation or stress management techniques may be included in a treatment plan.

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Relaxation techniques

Relaxation techniques include breathing methods and muscle relaxation strategies. Calm breathing or 'diaphragmatic breathing' is a breathing technique used to slow down and control one's breathing when they start to feel anxious or even stressed. When one begins to feel anxious, breathing rhythms change from slow constant breaths to quick, short breaths (also known as hyperventilating). Overbreathing (quick short breaths) can lead to feeling more anxious and can lead to a rapid heart beat, dizziness and headaches. Calm breathing requires practice but can be very helpful in controlling anxiety.

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Medication and other therapies

For some patients medication might be used along with CBT. There are several different types of medications used to treat social anxiety disorder, such as antidepressants like Paxil or benzodiazepines such as Xanax, Librium, Valium, and Ativan. Beta-blockers, which are often used to treat heart conditions, may be used to mitigate some of the physical symptoms of social anxiety, such as reducing heart rate or blood pressure.

Another more time-consuming approach is psychoanalytic therapy. This can be helpful in identifying the sources of anxiety in childhood, and may also be combined with medication.

Changing one's diet may also be of benefit; drinking less caffeine may help reduce some of the symptoms, because caffeine is a stimulant which increases the heart rate

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