Causes of Social Phobias

Escaping from family trauma: is it difficult to let it go?

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Can one ever escape from past family trauma? Parents divorcing? Abuse? Loss of a loved one? Moving? Blended families? Whatever consists of trauma within the individual? I believe that they can. It’s all about what you want as an individual. Do you want to move on from family trauma? What are you doing about it? Are you seeking a healer? a psychologist? someone to support you? I think anything is possible. For me, writing my own narrative is one way to let go of the past and move forward. And, so here my story goes. 

This song makes me think of my siblings; mostly my sister. When we were younger we used to go on many crazy adventures. My sister had this friend. She had this green Jeep. It had tan leather interior and we used to ride with the windows down with the wind blowing in our hair. My sister’s friend was called Julie. I am unsure where they met, but I used to tag along. We used to drive, smoke and go from Canton, Ohio to Columbus chasing parties. We used to play this game called Radish, Radish. That game always made me laugh. Tears would pour out of my eyes with utter content. My sister was younger than me. But she was always more advanced than me in everything. She was always partying before me. She knew the best parties, the best festivals and the knew where to get the coolest clothes.

The irony of it all… she probably thought the same about me. She probably looked at me and thought, ‘Jessica had it all’ or ‘has it all’. It’s funny how people’s perspective vary. It’s that whole the grass is greener syndrome. For me, I always felt I could never keep up. I don’t mean keep up with my sister, but just people in general. It was easier to be different, to be odd, to cut my hair shorter than everyone before it was the ‘in thing’ to do and to slide on those leather pants knowing people probably judged me and at that time in my life didn’t give a rats ass who judged. I naturally escaped from the whole conformity of society. I think nowadays there would be words for me: bohemian, hedonist, neurodiverse. But, do labels help? What do you think? In the past, I didn’t care what people thought of me. But, I guess as one matures, gets married, has children, gets divorced, raises kids… one starts to develop a different view on things in life. For me, I don’t really care what people think of me. It’s just sort of like I don’t want any ill will or bad vibes in my life or on my journey. But as you get older you realise that this is all part of growing up and maturing, unfortunately.

SEEING THINGS IN A DIFFERENT PERSPECTIVE always matter!

My youngest just asked me about the moon. She said ‘how does the moon stay up in the sky?’ I said ‘due to gravitational force’. She said, so I could be upside down right now? as she puts her hands upside down along side of her hands to display exactly what she is verbalizing. I responded, yes. She stood still. Posed while hanging upside down, her hair falling loose. She said as a matter of factly, I feel better upside down. And, I replied- so do I sometimes! We giggled. Funny how when you are a child your view on life is so clear. And, sometimes we as adults tend to mess everything up.

When I was younger, my sister and I were very close. We used to stay up late and giggle. We used to see the world upside down.

When I hear Tracy Chapman’s Fast Car, nostalgia dances to me like a wave that has just hit me unexpectedly. It always makes me think of my sister and myself escaping the world together. It makes me think about just me being part of her world and being so excited about it all. It was high school. It was a long time ago. But, that is when I felt most close to her; the times when we would stay up late in bed and talk and laugh. Exactly like my very own children do now.

That doesn’t mean I leave my brother out of the equation. He and I were the dynamic duo when we used to work together. People came to see us behind the bar. We had charisma, we had something that many people didn’t have working behind the bar. We just didn’t care. We laughed, we drank, we created some of the best parties when we worked together. Those were the days.

But things evolve. We get older, get married, have children, develop something that is called ‘responsibility’ and there the story goes.

We grow, we change, we love. But one thing remains constant. The love and affection I have for my siblings. It is a continuum.

 

A letter of Goodbye

I am sorry for leaving
I am sorry for not leading
I am sorry for escaping
I am sorry for not mothering
I am sorry I had my own issues
I am sorry for being selfish
I am sorry for leaving you behind
I am sorry for not protecting you
Mostly
My travels are coming to end
I am now in my 40’s
And, that is when you learn
You learn when you have your own kids
You learn when you fail
I am the oldest
I should have known better
I should have been there when she wasn’t
When he wasn’t
I should have been there
I am sorry for failing you
I am sorry for letting you down
I am sorry for misleading you

 

www.brightonwellnesscentre.co.uk
www.onlinetherapyhelps.com

from Memoires across the Pond

Five Ways to Make Your House Accessible for Your Disabled Child

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Unfortunately, today’s society is not geared toward making the lives of those with disabilities easier. Ramps are not as common as they should be. Movies aren’t shown with subtitles often enough. Bathrooms, at the best of times, are hazardous. If your child has a disability, they should not have to face such difficulties at home. There are numerous things you can do to transform your home into the sanctuary your child needs, many within a reasonable budget.

Threshold

Let’s start with the beginning, when your child will be entering the home. If your child uses a wheelchair, forearm crutches, a cane, or any implement to help movement, stairs are a nightmare. According to Angie’s List, “A threshold ramp in a doorway could cost as little as $100, but larger ramps, depending on material and size, can cost $1,000 to $15,000.” A hundred dollars is a completely affordable way to help your child navigate in and out of the home while maintaining independence.

The Bathroom

The restroom is possibly the most difficult room of the home to navigate when you have limited mobility. You need to consider access to the sink, the toilet, and the tub/shower, and you need to be sure your child has room to maneuver easily. You may need to expand the doorway so your child can comfortably access the room alone. Depending on what machinery your child uses, you also might need to raise or lower the sink. You can add grab bars and handrails for your child to be able to easily use the toilet and the bathtub, or you can opt for a door-access tub or a wheelchair-friendly shower.

Flooring

You will have to consider every room your child is going to access. If you currently have flooring that is not smooth, that can bunch, has gaps or is porous, moving about the home is going to be difficult, and potentially dangerous, for your child. It needs to be durable and slip resistant to help your child. If your child uses a wheelchair, then it will require extra resilience, as the wheels may cause deterioration or grooves in the surface over time.

The Kitchen

If your child is young, it may seem easier to simply make sure the kitchen is off-limits for their own protection. But, as your child ages, it may become important to them to have access to the kitchen, such as to get a snack, a drink, or make themselves a meal. If you can aid their independence, you should strive to do so. Again, you will need to make sure pathways are wide enough for your child to easily navigate. Like with the bathroom, you might consider adjusting the height of the sink to be at the level your child can best access. It is often easier to use a sliding cabinet door than one that pulls open, simply because the open door may force the user to move to make room for it. Make sure your counter-tops do not have dangerous edges, as they can easily cause injury.

Stairways

If you live in a two-story home, it will be imperative to render the staircase manageable for your child. Depending on mobility, handrails on both sides of the stairs may be beneficial. If there is carpet, ensure that it is properly tucked and stapled down to minimize the risk of trips and falls. Non-slip adhesive can be applied to further aid stability. If your child has a wheelchair, you should consider installing a stair lift, as doing so is much more reasonably priced than installing an elevator.

The world is not made to accommodate disabilities, but that doesn’t mean our homes can’t be fitted to help those with disabilities flourish. Times are changing, but it remains a slow process. You can help your child feel at home, safe and encourage their independence by making your house into the sanctuary it should be.

Why Do I Have Social Anxiety? Can Social Anxiety be Treated?

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by Holly Woodley

Social anxiety is an intense fear or worry over social situations and is surprisingly common in the general population, although rarely reported unless severe.

One of the most influential explanations of the onset of social anxiety disorder is the cognitive model:

  • Faulty cognitions in the individual manifest during social situations that possess them to believe that they are in danger of being seen as inept, boring or stupid, which could lead to people disliking them or ignoring them.
  • The model begins with the social situation, which activates the assumptions of perceived social danger, and in turn, the processing of the self as a social object.
  • These cognitive processes can lead to behavioural symptoms, for example the patients’ avoidance behaviour, or somatic and cognitive symptoms, such as the intrusive thoughts of what others may think.
  • The theory proposes that people don’t initially possess the symptoms of social anxiety disorder, they simply have to believe that they do, and their actions of avoidance help to reinforce these biases, which in effect helps them to manifest.
  • Early maladaptive schemas affect the way the individual thinks and processes situations, and have been shown to be more commonly present in those with social phobia particularly, in the sense of disconnection or rejection, but also including self-focused attention, anticipatory processing and post-event processing.
  • Post-event rumination is suggested to be one of the main cognitive biases in those suffering from social phobia. It is suggested that socially anxious individuals negatively perceive themselves and the way they have previously behaved in a social situation, which takes over their attentional resources causing them to negatively over-evaluate . This in turn will influence avoidance of similar situations in the future.
  • In addition, the idea of pre-event rumination has been offered, which involves the individual negatively anticipating an event with obsessive faulty thinking, which may influence them to avoid it before anything negative has actually happened.
  • Those with social anxiety disorder also appear to have attentional biases to threatening stimuli, which may account for why they find social situations particularly intimidating. If all the focus is on the negative aspects of a situation, the individual will feel a heightened sense of fear. This has been shown in studies where attention is monitored, and individuals with social anxiety disorder pay more attention to relevant negative stimuli, for example threatening faces compared to neutral ones influencing a state of panic.

There is also an overall feeling of low self-efficacy that is suggested to result from childhood relationships, for example peer rejection or overprotective parenting styles. This could potentially arise through acts of conditioning, for example observing others being embarrassed or humiliated in social situations. It has been suggested that because shyness has a negative stigma, this promotes social avoidance.

Genetics and biological processes are also proposed theories of the manifestation of social anxiety. Evidence has been suggested to support a biological explanation of social anxiety in terms of neuropeptides. Oxytocin is believed to be a peptide linked to social behaviour as it facilitates approach behaviours, and impacts on social bonding and trust, by linking the amygdala to socio-emotional areas of the cortex. It has been observed that those with social anxiety possess lower levels of oxytocin than controls, due to a variation in the CD38 gene that regulates its secretion. A-allele carriers on the SNP rs3796863 appear to have higher levels of trait anxiety with particular vulnerabilities to developing social anxiety than the C-C allele.

The function of this neuropeptide is to reduce excessive amygdala activation to threatening stimuli, therefore with a reduced amount, this repression is dampened, increasing the fear that those with social anxiety feel. In addition, there is also reduced functional communication between these areas of the brain during stress inducing situations, reducing the positive emotional effects that the peptide has on social behaviour.

An additional biological perspective is associated with genetics and heritability. Data has shown that direct relatives of those with social phobia manifest higher rates of the same disorder than control patients do. For example, it has been found that the phobia is more likely to manifest in children when one or both of their parents suffer from the disorder also.

Risk factors for social anxiety have been found to be highly hereditable (66%), which appear to have higher impact in young people, suggesting that genetic risk factors have higher influence in those who develop social anxiety in their youth.

It is suggested that the overall process is that genetic vulnerabilities make those more susceptible to environmental influences concerning the onset of social anxiety disorder, which integrates both explanations of the manifestation of the disorder. There have been significant gene environment interactions found in terms of stress or attachment types for example, suggesting that this interplay between nature and nurture is a solid explanation for the onset of social anxiety disorder.

One of the most common form of treatment of social phobia is cognitive behavioural therapy (CBT). Patients can attend between 8 to 12 sessions with a therapist in a one on one setting. The therapy involves forms of exposing patients to their feared situations with support, and should aim to help the individual understand the irrationality of their fears. This individual therapy may also involve teaching different types of social skills, either verbal or non verbal. These may involve anything from keeping eye contact and retaining posture, to specific word use, voice, volume and tone, or easy conversation topics. Methods of relaxation are also taught, to help diminish feelings of apprehension or the general physical arousal induces from social situations. What is described as ‘cognitive restructuring’ is another tactic used which aims to correct faulty cognitions within the patient. This works by getting the individual to analyse their own statements or social expectations to understand why they may be irrational, which may in turn aid in reshaping the maladaptive schemas.

Once someone appears to be making some form of improvement, cognitive behavioural group treatment may be suggested, to help ease them into a welcoming social situation with others who have the same feelings as themselves. This gentle ease may drastically help the treatment process. Sessions may include discussing various social skills techniques with others, and learning interaction techniques with each other. Group members may also find themselves being exposed to anxiety provoking situations in a structured and graded way, starting with minimal exposure which gradually increases once the phobic becomes at ease. The efficacy of group therapy for anxiety has been shown by Mychailyszyn, Brodman Read and Kendall (2012) who found that 64% of children who participated in the FRIENDS (a specialized form of CBGT for adolescents) programme no longer met clinical criteria for social phobia after treatment.

An emerging form of group therapy that may also be an option is mindfulness and acceptance based group therapy. In these therapy session mindfulness strategies are used to increase the feelings of acceptance of unwanted physical symptoms, for example trembling, or anxious thoughts, such as feelings of embarrassment. This in turn reduces the feeling of panic that a phobic will experience when they sense their face blushing or their hands shaking. There has been an effect size of 43% observed for the success of this treatment in those with social anxiety.

Trials have shown group therapies to have a positive effect on the reduction of symptoms in social anxiety, for example decreases in subtle avoidance behaviours, cognitive distortions and attention focusing and rumination. However, there do appear to be more issues with group therapy as opposed to individual therapy, for example, a group first needs to be formed before therapy can begin therefore potentially taking longer to initiate. It has been suggested that overall individual therapy is more successful for those with social anxiety disorder, as a majority of patients find the group setting too intimidating to handle whilst still going through treatment, which could potentially worsen their feelings of fear. More feelings of self-consciousness may be induced with feelings of scrutiny. In addition, individual therapy allows the therapist to form a more careful and personal assessment of the patient, in turn catering for a more effective treatment system.

Both therapies have their advantages and disadvantages, however the right programme should be based on the patient’s individual progress and preference.

To see references, turn to the next page.

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