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Overcoming fear important factor in controlling social anxiety

Millions of Americans suffer from social anxiety disorder, an extreme fear of being judged by others in social situations. Lorraine Rapp and Linda Lowen, hosts of WRVO's health and wellness show Take Care, recently spoke with doctor Robin Zasio, a nationally known clinical psychologist and author about what social anxiety disorder is and how to treat it.

Lorraine Rapp: would you explain the difference between just being shy and actual social anxiety?

Dr. Robin Zasio: Absolutely. People who are shy can still go to parties, can still engage in social conversations, they go out, they can still go to class, they can still raise their hand while they’re in class. They just might be a little more reserved. But it doesn’t necessarily interfere in a clinical way in their lives and prevent them from doing the things that they want to do. People with social anxiety in terms of a clinical diagnosis have a very, very difficult time going out in public. The primary symptoms include being fearful of what people think about them. Fearful of being judged, fearful of being criticized, fearful that they’re gonna do something that’s embarrassing or humiliating, so much so that they will avoid situations so that they’re not in, what they might expect, a predicament where that feared situation would happen. And, that being said, what happens is, is their world becomes smaller and smaller because they begin to isolate and withdraw because they are so extremely fearful of having these kinds of what might be expected confrontations.

Lorraine Rapp: what is the treatment? How do you help these people that come to you?

Dr. Zasio: Social anxiety is about fear of being in situations where they’re gonna be scrutinized, judged, humiliated, do something that draws negative attention to themselves. That being said, as people we can all relate to fear; everybody’s afraid of something. If I can identify what my fear is and I approach it in a very systematic way, it’s quite likely I could get to a place where I could not be so scared. With social anxiety disorder, basically what we are doing is we’re identifying what the feared situations are.  And so what we do is we then have that person go into those situations and have them confront them repeatedly. And this is the key—over and over again. And what happens is, is you’re telling that part of your brain, your fear center, ‘there is no danger.’ That what you fear, the person might get mad at you, or otherwise, is not going to happen.

Linda Lowen: How long is the process of overcoming this fear? Because I imagine it did not come on quickly, so it’s not going to go away quickly.

Dr. Zasio: Oftentimes what happens is, someone will come in and they’ll say ‘as far back as I can remember I was worried about what people would think about me. So I’m now 26, it took me this long to seek treatment. Is it gonna take me another 20 years to get over it?’ Absolutely not, because through the behavioral therapy, which is what the exposure therapy process is about, your brain changes very quickly. It learns by confronting fear and seeing, literally experiencing, that the feared consequence doesn’t happen. It changes and it adjusts to what you’re trying to show it, if you will. So exposure therapy is about exposing yourself to the feared consequence to see what you fear is not going to happen. And it’s amazing how quickly that will happen.

More of this interview can be heard on Take Care, WRVO's health and wellness show Sunday at 6:30 p.m. Support for this story comes from the Health Foundation for Western and Central New York.