# What is the best sort of therapy for us lot with SA?



## MoonlitMadness (Mar 11, 2013)

I have tried CBT several times on the NHS but always ended up discharging myself. I did three sessions of private therapy but the therapist just stared at me. She hasn't helped me at all so far. I am on the waiting list to try therapy again, but normally they only offer 6-12 weeks of therapy, I believe. My social anxiety is severe, I had an abusive childhood. I just don't think a few weeks of therapy will be enough. What can I do? I can't afford private therapy any more. I really need to work on my problems because they are crippling.


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## Maslow (Dec 24, 2003)

Since SAD is rooted in low self-esteem, you need to find a way to boost your self-esteem There are a few good books out there, such as The Six Pillars of Self-Esteem. The author has quite a bit of information on his website, also.


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## Testosterone (Sep 6, 2015)

Maslow said:


> Since SAD is rooted in low self-esteem, you need to find a way to boost your self-esteem There are a few good books out there, such as The Six Pillars of Self-Esteem. The author has quite a bit of information on his website, also.


That is true 100%? Social anxiety is caused by low self esteem? A person with high self esteem can not have SA?


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## harrison (Apr 14, 2012)

Well I think it depends - I think there's a lot to be said for medication, but results seem to vary a lot from person to person. CBT is apparently good for social anxiety - but finding a therapist that's even worth talking to is often pretty hard, and then there's the expense plus whether you're compatible etc.


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## Maslow (Dec 24, 2003)

Testosterone said:


> That is true 100%? Social anxiety is caused by low self esteem? A person with high self esteem can not have SA?


Yes. A person with healthy self-esteem isn't overly concerned with being judged negatively.


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## Testosterone (Sep 6, 2015)

Maslow said:


> Yes. A person with healthy self-esteem isn't overly concerned with being judged negatively.


Who told you that social anxiety is caused by low self esteem? A psychiatrist? Therapist?


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## Testosterone (Sep 6, 2015)

There are people who have low self esteem and don't have SA. Why?


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## Elend (May 7, 2017)

Makes sense that people with low self esteem are more likely to have SA. Think about it, many people with SA think people won't like me, or I sound stupid, I'm not smart enough, cool enough... Whatever is going on through your head, it's a symptom of low self esteem holding you back from being able to socialize. 

I remember sitting at a table with a friend and two other guys, one of which also had Social anxiety. He seemed to be doing okay on the outside, but me, I could barely say a word. The subject was on anime, and I really know nothing about anime, so I felt I could not participate in the conversation. I was also too nervous to change the subject because what if they didn't want to talk about it? 

As far as some people with low self esteem not having SA? I really can't explain that one. Maybe low self esteem just manifests in different ways. I would be more interested in how to raise my self esteem.


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## truant (Jul 4, 2014)

Testosterone said:


> That is true 100%? Social anxiety is caused by low self esteem? A person with high self esteem can not have SA?


I have very good self-esteem and SA.


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## GreenOwl (Oct 1, 2017)

truant said:


> I have very good self-esteem and SA.


I think it depends on the kind of Social Anxiety you have. If a person only has an intense Performance fear of SAD, then whether his self-esteem is high or not is something that doesn't matter. You can be proud and feel great about yourself, but when having to expose yourself, then.....
That's only my opinion and I don't know if it even makes any sense.
:smile2:


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## truant (Jul 4, 2014)

GreenOwl said:


> I think it depends on the kind of Social Anxiety you have. If a person only has an intense Performance fear of SAD, then whether his self-esteem is high or not is something that doesn't matter. You can be proud and feel great about yourself, but when having to expose yourself, then.....
> That's only my opinion and I don't know if it even makes any sense.
> :smile2:


Yes, it depends a lot on what your fears are. I am not an insecure person, but I am afraid of being discriminated against or assaulted. I've been in those kinds of situations and I have no desire to repeat them. The easiest way to avoid them is to avoid people.

There does seem to be a strong correlation between poor self-esteem and SA, but I think that's natural: a person with healthy self-esteem still has reasons to fear certain kinds of social interactions (like me), but a person with poor self-esteem has many more reasons to fear them. So the worse your self-esteem, the more prone you are to SA.

But there's more than poor self-esteem at work. There are people who act shamelessly _because_ they have terrible self-esteem; the exhibitionism is a form of self-destructive behavior, a sort of "Look how terrible I am? Ain't I repulsive?" They go out of their way to show off their flaws.


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## truant (Jul 4, 2014)

MoonlitMadness said:


> I have tried CBT several times on the NHS but always ended up discharging myself. I did three sessions of private therapy but the therapist just stared at me. She hasn't helped me at all so far. I am on the waiting list to try therapy again, but normally they only offer 6-12 weeks of therapy, I believe. My social anxiety is severe, I had an abusive childhood. I just don't think a few weeks of therapy will be enough. What can I do? I can't afford private therapy any more. I really need to work on my problems because they are crippling.


I think for something like childhood abuse you need more than standard CBT. I think longstanding psychological problems (childhood depression, childhood anxiety, etc.) need to be treated like personality disorders. Your self-concept has been shaped by your experiences.

Schema therapy would probably be more effective than standard CBT, but I have no idea how easy it would be to find a therapist who uses it. I think you probably need longterm therapy with a professional, not self-help homework assignments.

When a person gets an infection, a doctor writes a prescription, and the patient goes home and takes their medicine. Brief therapy (like standard CBT) is like that: the therapist explains how the therapy works, and the patient does their homework assignments and eventually gets over their illness.

When a person has a serious condition, however, you don't send them home with a prescription. You have to monitor their condition and intervene on a regular basis; sometimes for the rest of a patient's life. There is as much variation in the complexity and severity of mental disorders as there is in physical disorders, but it still seems to be fairly difficult for therapists to correctly gauge the seriousness of a condition.


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## scarpia (Nov 23, 2009)

MoonlitMadness said:


> I have tried CBT several times on the NHS but always ended up discharging myself. I did three sessions of private therapy but the therapist just stared at me. She hasn't helped me at all so far. I am on the waiting list to try therapy again, but normally they only offer 6-12 weeks of therapy, I believe. My social anxiety is severe, I had an abusive childhood. I just don't think a few weeks of therapy will be enough. What can I do? I can't afford private therapy any more. I really need to work on my problems because they are crippling.


My theory is that it takes you as long as you suffered the abuse to get over the abuse. So if you had an abusive childhood that lasted until age 18 it will take 18 more years to gradually get over it. That's about how long it took me.


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## Chris1121 (Oct 20, 2017)

Nothing I've read (and logic would dicate) that a person with healthy self-esteem would have SA. If you look inside yourself and connect the dots you will realize this. Think about it; when you're concerned that other people think negatively of you it's because you're afraid that they perceive something flawed about you. If you're confident and secure in who you are then you wouldn't really care what they thought of you. But you do care excessively because of the fear that the flaws they see in you are real, and thinking about this makes you feel bad about yourself. This makes you anxious and dread interacting with people because of the anticipation that your imagined inferiorities will become visible to all, and once again highlighted in your mind. I think a lot of us are just highly sensitive as well, making us more easily affected by these experiences. Now, disliking large crowds or environments because of the high level of external stimuli that's usually involved, is different. Can it make us irritable, tired and stressed? Yes. But it shouldn't cause one to feel bad about themself. I don't think any of us introverts, confident or not, really enjoy too much people time.


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## globalfromal (Oct 23, 2017)

MoonlitMadness said:


> I have tried CBT several times on the NHS but always ended up discharging myself. I did three sessions of private therapy but the therapist just stared at me. She hasn't helped me at all so far. I am on the waiting list to try therapy again, but normally they only offer 6-12 weeks of therapy, I believe. My social anxiety is severe, I had an abusive childhood. I just don't think a few weeks of therapy will be enough. What can I do? I can't afford private therapy any more. I really need to work on my problems because they are crippling.


Some of the comments kind of got off track. First, anxiety affects people differently and can be caused by different situations or patient history. While self-esteem issues may affect some, it is not true for all.

I have PTSD, Panic Disorder, and SAD. I also have very healthy self-esteem. Granted, I?m the midst of a panic attack that may change drastically. I have found CBT to be the most effective treatment for me. Mostly because it keeps me off the benzos.

The next thing that has been a complete game changer is meditation. Just 10 minutes a day. I use Headspace and highly recommend it. I know there is some kind of a stigma there or one may hesitate to try it (I was such a person), but it is fantastic. This is meditation when you are not having an attack. Of course, there are SOS sessions you can do as needed too.

Give it a try!


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