Treat Social Anxiety; Don’t Avoid

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Reader’s Question

My wife and I have been married three years and have two children. She’s a stay-at-home mother who attends college. When I met her she was not comfortable around my friends without me, then it extended to her friends, and now her family. Her discomfort is so bad, she refuses to entertain any friends or family, or attend any friend or family events unless I am there at her side.

My wife is able (though reluctant) to go some places without me (school, store, park, etc.). She says she feels “awkward” and “nervous” around her friends and family when I am not with her. Why? What can we do?

Psychologist’s Reply

Your wife’s experience sounds like social anxiety disorder. Typically, people with social anxiety disorder feel self-conscious when around people who are not well known to them. Often the fear revolves around being judged or criticized, even if other people do not see any reason for such concern. Just as with a phobia, the person experiencing it may recognize that the fear is irrational or without good reason, but that realization doesn’t lessen the anxiety.

Unfortunately, it is not known what causes social anxiety disorder, or why it may appear at some particular point in time. If your wife tends to be an anxious person generally, then social situations may serve as a focus for that anxiety, and she may benefit from medication to treat general anxiety.

From a behavioral standpoint, when we feel uncomfortable or anxious, and something we do helps relieve that anxiety (even a little), we’re more likely to do that same thing again the next time we experience similar anxiety. So, many people with social anxiety simply avoid social situations, and tend to do so more over time. Others with social anxiety disorder learn to rely on the presence of a loved one as a source of security and a way to lessen anxiety. If it seems like your wife has increasingly needed your presence in social settings, that could be the unfortunate result of this behavioral cycle.

Behavioral treatment is based on reversing that cycle. So, as difficult as it may sound, your wife should begin resisting the urge to avoid social situations without you. By consistently doing so, the anxiety should gradually decrease, making it increasingly easier to go out without you. By doing what seems like the answer at the time (having you present), the anxiety when you’re not present actually gets worse. Now that your wife has a label for her situation, she can be assured that at least thousands of other people have a similar problem, and treatment is available.

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