Stop Agonizing About Presenting Yourself to Others
                                And ... Speak Without Fear NOW!

 Dr. Signe A. Dayhoff
Social Effectiveness Guru

                   
                            Q & A - ASK DR. SIGNE 

Because I receive so many questions about issues in social anxiety, shyness, stage fright, social effectiveness, and emotional savvy that I am unable to answer personally, this Question & Answer page will respond to your most commonly asked questions. Unlike the E+  FAQ (Frequently Asked Questions) which will soon supply more general information, this Q&A provides more targeted and personalized information. 

Furthermore, unlike the FAQ, this information will change with the questions that are asked. This format will provide larger numbers of people with the specific information they seek and do so more quickly than could be done on an individual basis. New groups of questions and answers will appear as often as they are received from you.

Please remember that no question is too trivial to ask. If you want to know something, you can be assured that numbers of others want to know that same thing as well. Knowledge is power. The more you know the better able you will be to work toward and accomplish your goals. So don't hesitate. Send your questions to me at mailto:AskDrSigne@Effectiveness-Plus.com . Please note: I will not publish your name or any other personal identifier unless you give me permission to do so.

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Dear Dr. Signe,

Do you feel very confident that your "How to Speak Without Fear Small Talk" program will provide me with significant results on overcoming this fear? I've tried so many things that haven't worked. If so, when will I start to notice changes or differences? Is this something that I can do while working a full-time job? How much time do I need to dedicate to this program each day? - Bob, Los Angeles

Dear Bob,

My program is one I created and followed to overcome my own fear of speaking with others. I have seen it work with hundreds of others. I know the program works but there is no guarantee that it will work for any one individual.  

Huh?  

What I'm saying is that where people have followed the program religiously, done the exercises, worked on changing their thoughts and behaviors, recorded everything in their
journal, and practiced, practiced, practiced in their imaginations and then in the real-world in a step-by-step fashion, they have created confidence and small talk skills. However, it takes motivation, patience, persistence, and an unambiguous commitment to
accomplishing your overcoming fear of speaking goal. Bluntly, there's no way I can guarantee that any particular individual will employ the necessary motivation, patience, persistence, and an unambiguous commitment to accomplish this goal.

All the essentials and guidance are there for you to use. But it's up to you to follow and use them as directed.

When would you expect to experience some changes? Since the program begins with foundation stones of reducing arousal and altering negative core beliefs and thoughts. It's important to note that only after you achieve the foundational basics do you go on to work on actual communication-related behaviors. While the program is made up of 10 modules, it is highly recommended that program participants not expect to be "all done" in 10 weeks. 

True progress and recovery take lots of personal preparation and practice. Of course, how long it takes any one individual depends upon that individual and what pace
is comfortable for them. It is essential that you work at it continuously so that there is always something on which you're working. Spreading the process out with lots of continuing practice and building on the practice success and confidence is better than
trying to get through the program as quickly as possible. 

Only doing each exercise or assignment once and moving on to the next does not help replace dysfunctional habits with functional ones. You have to incorporate the thinking and action into your personal approach to speaking and small talk. 

While I understand that we all want to become more socially effective as soon as possible, I think it's important to remember that it took many years to get you where you are when you start to work on your social fears. Consequently, you should plan on spending some time to work yourself out. Some people accomplish their goal in three months. Some longer. But, you must remember that not everyone starts at the same level of fear of speaking or feels socially inadequate in precisely the same areas or to the same degree.

To date, all my fear-of-speaking clients who have gone through this program have been employed full time. With a full work load you would want to pace yourself so that you can comfortably work on the program. However, many of the exercises will be things you can do in your spare time at work, like working on abdominal breathing, visualization, success recollection, and trying out different social behaviors (to name a few).

How much time you need to devote to the program each day will depend upon how you organize your time and the rate at which you work. Initially, you'll be doing a lot to prepare yourself for the steps of the program. Each evening you'll be making notations in your journal. You'll be doing one or two exercises a day, especially when you start out with reducing arousal and changing beliefs and thoughts. You need to include physical exercise. When you work on behaviors, you can incorporate numbers of them into your everyday activities. The program is set up so you can tailor it to your schedule and motivation level.

Whenever one enters a new learning program, it will tend to seem overwhelming at first. This is perfectly normal and natural. Once you know what you have to do each day and get into the rhythm of doing it, it will seem less "burdensome." Once you become
acclimated, you will take it all in stride. How long this takes likewise depends upon the individual. It typically takes at least several weeks to start to feel more comfortable with the program's learning process.

I know you'd like more black-and-white answers but because everyone is a unique person, coming to this program with a different history, experiences, abilities, fear level, and strengths, there's no way I can give you a concrete, specific time line or amount of time each day required for you personally to achieve your recovery.

What I can tell you for certain is that those who are determined to finally overcome their fear of speaking/small talk and do all that's required, achieve greater speaking skills, confidence, and satisfaction. Only you can determine if you're willing to make the
commitment and effort and do the work. 

If you are, you can succeed in becoming more socially effective. I wish you much success!

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Dear Dr. Signe,

Is there anything else you can do to get through what might be an embarrassing situation? - PP, Texas

Dear PP,

Another thing I have found that works when I do something dumb is (1) admit to it but (2) do not make a big deal out of it. If others refer to it, I smile and acknowledge what they say so they do not think I am ignoring them. But then I say nothing further to extend the conversation about it. You see, if the topic doesn't get a rise out of me, or anyone else, then it will fade quickly. 

Another thing I do to prepare myself for potentially humiliating references to the incident is look for REALLY embarrassing things that well-known people have done publicly. I then compare my incident - the number of people who know about it, how important it is, what kinds of implications it has, and my degree of humiliation - to theirs. My favorite comparison was President Richard Nixon's having to resign from office. Compared with his situation, nothing I could do was more than a emotional blip. I figured if he could handle that and come back later as an elder statesman, I could handle ANYTHING that could come my way.

Along those same lines, I also would ask myself how some actor in some particular role would handle this situation. I'd think of someone using a style that would be comfortable for me and then pretend I was that actor playing the role of handling my situation successfully. Is "pretending to be someone else" using a crutch? No. What you are doing is looking for behaviors you admire and role-playing them. If they work for you, they become part of your behavioral repertoire and coping mechanisms for handling anxiety. If not, you try other behaviors and strategies.

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Dear Dr. Signe,

On page 36 of your book, "Diagonally-Parked in a Parallel Universe," you include a brief account of an embarrassing, humiliating experience. You finished by saying, " My expressions of anger were barely a squeak above my humiliation. I never went to the dances again." My question, quite simply, is what does one do if you HAVE to go back to wherever it is and you HAVE to face these people again. Then what? Avoidance has been my only recourse. Is there another course of action to recommend that wouldn't add to or result in additional humiliation?  - RP, Kansas

Dear RP,

Avoiding the dances made the whole situation worse because I ended up punishing myself for what he had done to me. In avoiding them and him I essentially gave over my control to him. I was allowing him to dictate where I would go and enjoy myself. This realization made a very big impression on me. While I was humiliated, I was even more angry. As a result, I vowed, embarrassed or not, I was not going to let it happen again.

So when it came time for me to receive an award at the college where I was receiving my counseling training, I had been up for several nights working on a project. I was exhausted and a little dopey. When the president of the college greeted me at the ceremony, I said something incredibly stupid and inappropriate. He just stared at me. This was someone I would have to see again and again. The next day when I recovered a little and realized the gravity of my faux pas, my first thought was to hide from him for the rest of the semester. But that wasn't reasonable or acceptable.

What I did instead was casually stop his office and offer a brief, rehearsed apology. Then every time I saw him after that, I simply smiled
and acted as if nothing had happened - as if we had both already gotten past my embarrassing behavior. And after awhile, we both actually had.

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Dear Dr. Signe,

I'm always afraid I'll do something stupid and then when I do something stupid I want to die on the spot.  I get embarrassed and angry and don't know what to do and that makes it worse. What can I do when I do something stupid? - GJ, Las Vegas

Dear GJ,

What I have found that works is when I do something dumb that I admit to it but do not make a big deal out of it. If others refer to it, I smile and acknowledge what they say and say nothing further to extend the conversation about it. If the topic doesn't get a rise out of anyone, then
it will fade quickly. 

Another thing I do is look for REALLY embarrassing things that well-known people have done publicly and compare my incident and humiliation to theirs. My favorite comparison was President Richard Nixon's having to resign from office. If he could handle that, I could handle anything that could come my way.

I also would ask myself how some actor in some particular role would handle this situation. I'd find someone using a style that would be comfortable for me and then pretended I was that actor playing the role of handling my situation.

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Dear Dr. Signe,

Is there clinical evidence that any particular SSRI's are more effective than others in specifically treating APD? - JJ, NYC

Dear JJ,

Information on "medications for AvPD" is all but non-existent in the medical literature. This may be because unless physicians or psychiatrists sees AvPD as an extreme end of the continuum of Social Anxiety/Social Phobia, they will tend to see AvPD as another Personality Disorder which are generally addressed by various forms of psychotherapy.

Since research on medication is being done with SA/SP, not AvPD, the medication that has the most data on use for SA/SP is the SSRI paroxetine (Paxil or Seroxat). However, this is not the only SSRI used for SA/SP. Other SSRIs that have been used with some success (about 50%) are sertraline (Zoloft), fluvoxamine (Luvox), and citalopram (Celexa, Cipramil). Fluoxetine (Prozac) has not generally been shown to help SA/SP. Mirtazapine (Remeron), which is sometimes thought of as an SSRI, is really a dual-action agent because it works on both serotonin and norepinephrine. While it has been shown to be better than SSRIs for depression, there has been only one study on it for SA/SP (and nothing for AvPD). In a pilot study of 12 people researchers found improvement in their SA/SP. But 12 people is merely suggestive rather than definitive. AvPD, however, has been shown to respond positively to both MAOI antidepressants and cognitive-behavioral therapy.

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Dear Dr. Signe,

Can you speak to the effects of caffeine, nicotine, and alcohol on anxiety? Are these things that we should completely cut from our diet?  Also, I've been a vegetarian for a number of years and over this time the anxiety has gotten progressively worse. Does this diet have any negative effects related to anxiety that I should be protecting myself against other than just a multi-vitamin?  - TD, California

Dear TD,

I'm glad you asked about diet because this is an area that is too often not considered. Both nutrition and stimulants can contribute significantly to our experience of anxiety. Caffeine and nicotine, for example, trigger the physiological arousal associated with anxiety through increasing the neurotransmitter norepinephrine. People who are anxious tend to smoke a lot and drink a lot of coffee. Besides creating irritability and insomnia, the caffeine can interfere with some antipsychotics, sedatives, and lithium. Both caffeine and nicotine deplete B-Vitamins (B1, B2, B6, B12). B-Vitamins, which are also depleted by stress and anxiety, are necessary for a healthy nervous system. 

Alcohol is a sugar so it stimulates our body's hormone insulin to increase to break down sugars and starches. Excessive sugar sends our insulin level soaring, often overshooting, leaving us feeling jumpy with a rapid heart rate, irritability, weakness, and sweating. This is very similar to our body's response to stress and anxiety. Yet, strangely, we often find eating sugar comforting. This is related to the selective effect insulin has on amino acids, such as tryptophan, the precursor of serotonin. The insulin causes all amino acids but tryptophan to be taken up by the muscles and other tissues while the tryptophan is transported to the brain where it is converted to serotonin. So we feel rewarded for eating sugar .. even though it simultaneously makes us feel anxious. Use of alcohol, a depressant, depletes both B-Vitamins and C, and in excess, can destroy brain cells. Low intake of calcium, Vitamin C, and amino acids (the precursors to all our neurotransmitters) leaves us vulnerable to stress. 

A well-balanced diet is essential whether you are a vegetarian or not. I have been a vegetarian (do eat some fish and seafood, but no milk, eggs, or meat) for over 20 years and it was during this time that I recovered from SA/SP. You may have to take extra B-Vitamins, Vitamins C & D, calcium, and be sure you are getting enough protein. Being a vegetarian (depending upon what type of vegetarian you are) and getting enough protein (source of amino acids) can be difficult. Soy products, which are coming out in more interesting and flavorful products, and various beans/legumes can help.

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Dear Dr. Signe,

I have a speech problem. My parents took me to a speech therapist who said that she had never heard of a speech problem having to do with distorted sounding vowels. Before I was a teenager I could talk normally though. What could have caused me to have this speech problem. I have it even when I'm alone? How can I overcome it? - MN - Minnesota

Dear MN,

It sounds as if something might have happened after you were 13 years old that may have made you uncomfortable expressing yourself. Sometimes when we want to express ourselves but are concerned about what others will say or do as a result of what we say, we may modify how we speak. Some people speak softly, some swallow their words or find other ways to slightly disguise what they are saying. For these people, if someone disagrees with them or doesn't like what they say, they can protect themselves from feeling criticized by indicating the person misheard or misunderstood them. For them it is a survival avoidance technique.

If you have a similar problem, you might address it by working with a tape recorder. You could start out by listening to yourself and making note of what vowel sounds you were making that you perceived to be slightly off. How did they sound to you and how should they sound? Use examples, such as: "A short 'a' sounds like 'X' in the word 'Y' but should sound like 'B' in the word 'C'. A long 'a' sounds like 'M' in the word 'N' but should sound like 'G' in the word 'H'." And so on for each vowel. 

Then you could practice creating the vowel sounds you want. You would practice this daily, first by yourself then with people you trust. Then later in the process you would practice speaking loudly into the tape recorder at a distance of 15 feet, making sure you were still projecting the correct vowel sounds. You would follow by speaking to strangers. However, since confidence is always a helpful supporter, you would benefit from working on your self-confidence and social effectiveness skills at the same time. 

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Dear Dr. Signe,

I am on a SSRI for my anxiety but I am having problems with feeling even more anxious. I want to stop taking them. Is it okay if I just stop? - CC, Chicago, IL

Dear CC,

Very glad you asked. The answer is a resounding, "No!" With antidepressants, and especially with SSRIs, it is imperative that you s-l-o-w-l-y taper off the medication. While most antidepressants produce some side effects while you take them, they can produce even more troublesome side effects if you stop them cold turkey.

Symptoms often include dizziness of several days' duration, headache, fatigue, and nausea. But these can seem minor compared to the intense anxiety or depression that are possible.  It is not uncommon for people to have crying spells, nightmares, ringing in their ears, blurred vision, flashing lights before their eyes, or feel a burning and tingling in different parts of their bodies. Some also feel as if they have been struck by a bolt of lightning. Their muscles seem to jerk abruptly, sending a shock wave through their arms and legs. 

Keep a log of your unpleasant symptoms. Be sure to chart when they started as well as their duration. It is important to remember that in the initial 4-6 weeks that you are on the medication, it may take your body a while to adjust. During this time, you may experience some unpleasant symptoms which, hopefully, will go away shortly. However, most antidepressants have some common side effects which will continue to occur throughout the time you are on the medication and as you taper off it. Depending upon how severe the symptoms are, your physician may lower your dose, add a medication to counter the negative symptoms, have you taper off, or put you on some related medication. 

Whenever you are having symptoms on a medication that do not match what you have been told to expect or they are severe, tell your primary care person immediately. 

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Dear Dr. Signe,

I started to get sweaty palms at 16 and had a hand tremor. I never really considered myself overly shy but the last couple of years in high school were difficult. After I left school, I sank into a depression. I didn't feel competent to hold a job even though I was quite bright. I left home and started recreational drugs, which lasted on and off for about 8 years. I have perfectionistic qualities and have never quite succeeded. I've felt like a failure. 

Four years ago things started to go really bad I ended up with repetition strain injury in my arms so bad I'll never be able tot type full-time. I got TMJ, social anxiety, profuse sweating under my arms, paranoia, dizziness, blurred vision, and finally became housebound. I went to a psychologist for 8 months with no improvement and now am with a counselor who is great. But I'm sick of doing CBT. In fact I get quite obsessive about writing down my thoughts and challenging them. I had my sweat glands under my arms removed but it didn't do anything for my social anxiety. I do a great deal of meditation, relaxation, yoga, etc. but feel I'm missing the point. I don't know how to do self-acceptance. I feel I'm at the end of the line. - DM, Australia

Dear DM,

You certainly ran the gamut of difficulties before you were diagnosed with social anxiety disorder. That sounds incredibly frustrating and disappointing. However, because your symptoms have been so varied over the years, I can see how health care professionals might find it difficult to put you into any one category in order to treat you properly. I know I wouldn't want anyone to jump to conclusions that stress or anxiety was the cause without doing extensive testing first. There are too many health problems that can mimic each of those individual and clusters of symptoms.

I'm sorry to hear that Cognitive-Behavioral Therapy has not been to your liking. It has been my experience that if it is properly tailored to the individual anxiety sufferer, it can be very helpful. Research has shown that it is effective in nearly 90% of social anxiety cases. However, I can see how a co-occurring obsessiveness might interfere with your carrying out your CBT exercises. 

Furthermore, it is unfortunate that ETS (Endoscopic Transthoracic Sympathectomy - a surgical procedures that blocks the upper thoracic sympathetic nervous system ganglia which control sweating and blushing) was not helpful to you. Even though some surgeons who perform it claim ETS "cures" social anxiety disorder, there appears to be no valid research results by clinical researchers in the field of social anxiety disorder to support its usefulness for SA. However, if one is anxious only because one sweats profusely in social situations, that anxiety about sweating can be eliminated by removing the cause of the sweating. This reflects a Specific Phobia, not Social Anxiety Disorder.

Assuming there is no underlying pathology to your present condition, there appears to be a good likelihood you can take control and overcome your anxiety. Part of the process of overcoming your anxiety is working on increasing your self-confidence, interpersonal skill, and self-acceptance. One way to start to do this is to look at your core strengths. Since it is often hard for those of us with social anxiety to be aware that we have strengths, much less recognize what specifically they are, we need to find a another avenue for drawing them out. 

To determine yours go to http://www.authentichappiness.org/ and register to take the VIA Signature Strengths Survey. It is a long but powerful test. Once you get your results, take a sheet of paper and write down positive instances in which you have used each of your five core strengths. Keep adding to the list. At the same time ask how and where else you might use them to find solutions and help get you what you want. These will help create a repository of Success Events to which you can refer whenever you start doubting your competence, confidence, and effectiveness.

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Dear Dr. Signe,

About four years ago I found I met the criteria for social anxiety disorder, generalized anxiety disorder, and avoidant personality disorder. I've had problems since I was a kid. I had over-protective parents. I took 12 months of Cognitive-Behavioral Therapy and improved. Two years ago I heard about Asperger's Syndrome (AS) and became convinced that even though I didn't meet all the criteria that I had that too. I wasn't good at sports and Aspies are physically clumsy. I really liked cats when I was young and thought this could the autistic-like "special interest." I have no idea if my social skills are any good and tend not to pick up on other people's nonverbal behavior. Both my social anxiety therapist and a psychiatrist didn't think I had it - but they were not experts. I have a huge fear that someone, such as a future friend, may read something about Asperger's and "diagnose" me. I'm afraid if I get over my SA and APD, I may find I still can't make friends. - WN, Portland, OR

Dear WN, 

Asperger's is often thought of a "dash of autism." Because of what you have told me and your professionals' assessment of you, I would be disinclined to think that you have it. Most of what you describe can easily fit into the reality of social anxiety. Clumsiness in a shy child, especially one with overly-protective parents, is not uncommon. Such parents tend to make us feel unsure of ourselves. When we're unsure and we lack self-confidence, we hesitate to make decisions and act. We are so busy thinking about  what we are doing, what people will think, and if we're doing it correctly that we tend to become uncoordinated.

Whenever we feel inadequate, embarrassed or rejected, we respond to situations accordingly. Others mirror the signals we send out. As a result, we ask ourselves, "What's the matter with me?" This is quite normal for people with and without social anxiety.

AS's autistic-like special interest has a certain obsessiveness about it. Shy and socially-anxious children often relate very well to animals. This is because the animals will play with them, stay with them, listen to them, not judge them, and be loyal. This is a substitute for people who are harder to understand, trust, and rely upon for attention and unconditional love. In general, this would not be considered obsessive.

AS's self-stimulatory behavior likewise has more compulsive and stereotypic quality. It is not the same as an shy or anxious person's touching themselves, playing with their hair, licking their lips, etc. These are common self-comforting  and distracting behaviors. And with respect to not reading other's nonverbal behavior, socially anxious people tend to be too self-focused to accurately  read the messages others are sending, whether verbal or nonverbal.

It is important to note that you report having improved significantly after 12 months of group CBT. I would not expect CBT to have a significant effect on the thoughts, feelings, and behaviors of someone with a neurological, autistic-like disorder, such as Asperger's. I have not seen anything in research studies to suggest that SA treatment approaches would work equally well with AS. It may be productive for you to ask yourself why, when professionals tell you you don't have AS, you keep thinking you do. 

With respect to APD, it may be more productive to think of APD as an extension of SA. That is, it may be a more extreme degree of avoidance along the social anxiety continuum. Based upon what you have told me, your symptoms appear to fit the social anxiety disorder diagnosis. The same may be said for APD. But not so for AS. 

Your best bet is to go with what you already know specifically and concretely describes you. Go with what is changeable. Go with what has already produced success for you. When you worked to change the changeable, you did it.  If you did it once, you can do it again. If after you have continued your work on recovery from social anxiety/APD, if you still have significant, chronic, persistent difficulties, pursue those separately at that time. But once you have become more socially effective and confident, you may no longer "see" AS symptoms - or, perhaps, need to see them. 

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Dear Dr. Signe,

Did you ever feel that you weren't fully present with others because of your social anxiety?  It takes a lot of effort for me to stay present or "on." I have been working on this through meditation, etc. I also tend to get over-stimulated easily and am overly sensitive in general - DSI (sensory integration dysfunction). It also causes ADD symptoms in me. I'm trying to tease out what to attribute to DSI and what to attribute to SP or if they are related. Thank you. - SM, St. Paul, MN

Dear SM,

People with social anxiety disorder also experience stimulus overload. This is similar to their fear magnifying everything and their experiencing it through a negative filter. The result is a barrage of negativity, laying layer upon layer. When any organism is too stimulated, it may respond by becoming aggressive or withdrawing from the situation. (See reference to Elaine Aron and HSP in response to RH below.)

What she suggests is that there may be a correlation between being HSP and having extreme shyness, introversion, and/or social anxiety disorder. I am HSP and find that I can be overly stimulated very easily if I don't counteract it. After recovering from SA/SP, I am able to regulate social stimuli but have little control over my body's response to environmental stimuli. I also startle easily.

Is your tendency toward negative reaction to over-stimulation or your hypersensitivity part of a diagnostic condition? Or is it simply a personality variation? It is very difficult to say. Since we are all individuals who operate along a continuum of behavior - from one extreme to another - it is possible that your behavior is within normal limits. But the real question is to what degree is "not being present" dysfunctional for you. Specifically, is it intense, persistent, chronic, and interfering with your normal activities? Currently there is nothing in the SA/SP research literature to indicate "not being present" is a symptom of SA/SP.  

It is important to note that how we respond to social interactions is often predicated upon how interested we are in the topic or the person; how anxious or depressed we feel at the moment; how self-confident we are; and how effective our interpersonal skills are. Furthermore, "not being present" may be a form of avoidance or coping with stress.

If your "not being fully present" tends to occur in all situations - that is, unrelated to the social content and degree of fear, then it may be helpful for you to ask yourself how well you are functioning in general. Are you taking medications, alternative health supplements, steroids, hormones, recreational drugs, caffeine, nicotine or alcohol? What is your diet like? How do you control stress? How much exercise do you get? What are your sleep habits? Because biochemical imbalances and physiological disorders can mimic psychological disorders, your next step should be a medical investigation.

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Dear Dr. Signe,

I am 23 years old . My social skills are not the problem, but the persistent fear of unexpected anxiety is killing me. I can handle short spurts of 4 hours of being around others. But if I know if I have to be around others for 8 or more hours, I start to lose my nerve and have a panic attack. The symptoms mostly include a nervous stomach. I'm not sure if this can be classified as Irritable Bowel Syndrome (IBS) but it is constantly wearing me down whenever social situations arise. Are these symptoms fairly common to people who have social phobia? What kind of treatment is there for psychosomatic symptoms? - RH, Indianapolis, IN

Dear RH,

The fact that you seem to have a low tolerance for very long periods of social interactions but can handle 4 hours reminds me of Elaine Arons' book, The Highly Sensitive Person. HSPers tend to be more introverted than extraverted. This means they tend to respond to larger numbers of people or people over an extended period of time with fatigue, agitation, and a desire to escape. Because social interaction can act as stimulus overload for them, they become uncomfortable fairly quickly because people drain and deplete their batteries.  You can check out this HSP label for yourself by determining whether you tend to be more sensitive to most sensory stimuli as well. That is, lights seem brighter, sounds louder, fabrics  rougher, tastes more sweet, sour, bitter, or salty, for example, that they seem for others. Knowing where your comfort boundaries will go a long way to helping you control your environment and how you respond to it.

However, it is important to note that wanting to deal with fewer people at a time or for shorter periods of time does not make one socially phobic. Instead, especially since this problem seems to be time-related, you might just be a little introspective. Introspection is a normal variation along a personality trait continuum of "Introversion - Extraversion."  Not everyone is going to be a party animal - thank goodness. Introspective people tend to be more thoughtful and creative. Were it not for them, communication could not take place. There needs to be someone who is more quiet and listens for those who like to talk. Also, remember: Social anxiety disorder is an intense, chronic, and persistent irrational fear of being evaluated, found inadequate, humiliated, and rejected in social situations. It is not so much a time-people-boundary issue.

As for the IBS, both "nervous stomach" and IBS are common with any kind of anxiety. But the descriptions suggest different things. 
'Nervous stomach" may suggest butterflies or flip-flops (maybe temporary diarrhea) whereas IBS frequently suggests a stomach/intestinal cramping with loose bowels and gas. IBS can make social life physically very difficult. But "nervous stomach," which may also include racing heart, shallow breathing, dry mouth, blushing, and sweating may allow social interaction because physiological difficulties are less socially demonstrable and tend to be less severe.

Because our body responds to our thinking, feeling, and acting, the best ways to control these anxious physiological symptoms is to modify our thinking, feeling, and behaving as they relate to negative expectations and negative, unreasonable perceptions. There are lots of exercises available, such as systematic abdominal breathing, which are powerful in controlling panic attacks. Other such techniques include addressing and disputing negative or irrational thoughts, distracting ourselves, reinforcing our mastery and self-confidence, knowing our core strengths, and harnessing our past and present successes to make a less anxious future possible.

However, before you start any social anxiety disorder program, it is important for you to determine what underlies the physiological symptoms you experience. You can eliminate or pinpoint a medical condition as the basis or contributor to your symptoms by having a complete physical with blood chemistries. If there is no physiological cause, then you need to determine how closely what you experience matches the definition of "social anxiety disorder." Could it be an introspective nature or something more? Be sure to take the Social Anxiety Questionnaire on my site to see how closely your fit the definition.

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Dear Dr. Signe,

I have had problems with social anxiety for about 20 years. About three years ago, I read your book. I wanted to than you because the page you wrote about eliminating sugar from your diet really helped me. I was diagnosed with hypoglycemia a few months ago and changing my diet has made me less anxious. I would like to volunteer to help  people with social anxiety. Do you have any ideas how or where I could do this? - J., Midwest

Dear J.,

Big Congratulations! That's terrific news. I am very happy for you. It is wonderful that you want to help others with social anxiety. The helping possibilities that leap to mind are both offline and online. In your community you might want to check to see if there are any support groups for social anxiety/social phobia or shyness research programs. They might know of support groups around or have suggestions as to how you could use your experience with the disorder and your recovery to help others. If you have not already done so, you may wish to check my Links Page to see if there is anything. listed under "Social Anxiety Group Links" for your  location. 

Online there are numbers of lists, forums, and chats devoted to social anxiety/social  phobia where you could benefit others by your experiences. Be very proud of yourself and pat yourself on the back not only for recovering from social anxiety but also wanting to reach out to others to help them do the same.

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Dear Dr. Signe,

What describes Social Anxiety better: A lack of social skills or lack of social confidence? - CWK, Massachusetts

Dear CWK,

While those with social anxiety disorder often feel they are lacking in social skills, more often than not they already have the social skills, although they may be a little rusty from disuse. To be sure, there will be some who do lack these skills, but they are in the minority. What most individuals with social anxiety lack is self-confidence in social situations. Where children with social anxiety are concerned, the treatment of choice has been social skills training. While this may help those deficient few, unfortunately it is not as likely to help those with low self-confidence. In fact, it may even have the opposite effect by reinforcing their low self-esteem. However, a program that is designed to develop self-efficacy is another story.  Through self-efficacy training, which I employ, those with social anxiety, shyness, and stage fright learn how to master tasks bit by bit so they can gain strengths, abilities, and confidence, and, thus, feel good about their accomplishments. 

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Dear Dr. Signe,

I am 31 and I have been unemployed for about six years due to social anxiety. I used to work as a file clerk but kept moving from one job to another because I did not feel at ease with other people. I was afraid of being watched by my colleagues and kept looking for a job where I could be working in an office alone. I didn't enjoy office work anyway and always wanted to do more with my life but I know I'm too shy. Maybe I could find something to do from home that would give me confidence to look for other work in the community. Have you any ideas? - JL, Wisconsin

Dear JL,

Working from home may eliminate some of the distressing social interaction you wish to avoid but will not eliminate all of it because all business involves it to some degree. And, actually, it's better if it doesn't eliminate it. If you're too "comfortable" being a hermit in a cave, as I once tried to be, you'll be less inclined to experience the pain of change to become more social. And, believe me, the pain of change is worth what you find when you come out on the other side! 

You can work from home if you're an artist, graphic designer, sculptor, potter, carpenter, writer of any kind (newspaper columnist, feature writer, copywriter, short story writer, technical writer), editor, typist, manuscript proofreader, bookkeeper, accountant, stuffer of envelopes, draftsperson, web designer, web advertising salesperson, information researcher, babysitter, house sitter, pet sitter, plant sitter, gardener, house painter, mechanic, library assistant, for example. Do some brainstorming to see what other occupations come to mind. 

People with SP are generally more comfortable working with animals and children because they are less threatening. For other possibilities you can look at any business, nonprofit, or association that wouldn't require its helpers to be on-site to do their work. If you have a web site (or could create one) with products or services with lots of perceived value to sell, you can do that. Initial costs are minimal. 

Selling information in many forms, especially online, is very hot right now; it can be your information or other people's. For example, many people with articles, reports, and e-books will license you to sell their information products. Some also offer commissions for referrals resulting in sales. Of course, whatever's available will be shaped by your talents, abilities, expertise, and experience. While interesting and acceptable online jobs do exist, it important to remember that most  jobs that are well-paying are offline. However, they require more frequent and more intense interpersonal interaction. 

You need to get a pencil and piece of paper, make five columns, and label the columns: My Work Abilities; My Work Experience; My Knowledge Base; My Interests; and Where I've Felt Good About Myself. Then go back and rank-order, from highest to lowest, the seven (7) most important items in each category. You need to spend time thinking and writing as you fill in those columns so that your responses represent an honest and OBJECTIVE assessment (that's the tough part) of who and what you are and what you've done and could do. You need to spend at least several hours on this. 

This should begin to give you some sense of what sorts of things to look for. But, you may ask, why not just get work, any kind of work? Because that can be lethal. If you don't much like it AND feel forced to do it because of your circumstances, you'll not do your best. You'll become dissatisfied and feel resentful. And, worst yet, you'll start blaming yourself for this. Remember that we who have social anxiety or shyness don't need to blame ourselves more than we already do!

In order to find what types of work might exist for a person with your educational background and interests, I would suggest you check out your library. The U.S. Department of Labor publishes a directory of different types of work and what's required for them. I would check out different categories that are either associated with your educational level, interests, and/or have elements of what you have learned and already know. I'd check to see if the work can be done from home. Then I would ask myself, can this be done via computer/Internet as well. If so, how? What companies might be handling it if I don't want to do it all on my own?  Be sure to take the preliminary list of low-interpersonal-interaction jobs (listed above) to see what you can do with that as well.

This will take some library research time but should give you a much wider appreciation of what the possibilities are for you. I wish you much success in your research.  

Effectiveness-Plus LLC

P.O. Box 340

Placitas, NM 87043

USA

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