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Social Phobia and Self Concept and the Brain

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

Karen Blair, of the National Institutes of Mental Health reported on the findings of an important research project in which fMRI’s were used to study brain responses for those subjects who suffer from Generalized Social Phobia. Social Phobia is the fear and wish to avoid a specific type of social situation, perhaps private parties. A Generalized Social Phobia is the fear of and wish to avoid all social situations. The subject who suffers from GSP experiences constant fear of being judged badly and, as a result, experiences major inability to function at work or in all types social situations. In other words, the subject perceives a threat of such magnitude that they expect humiliation and embarrassment because of other people not liking them.

Brain Parts Involved:

Previously, it was thought that the part of the brain that controlled phobic reactions was the Amygdala. This part of the brain, right and left hemispheres, is responsible for storing memories of emotional reactions. For example, if a person experiences being stuck in an elevator and becomes frightened, the Amygdala will store not only the memory of the event but the frightened reaction as well. Then, a "potential" is established for the individual to become frightened again, in a similar situation such as going into an elevator of any type and anywhere.

The study discussed in this posting confirmed that the Amygdala does become "lit up" on the fMRI’s, meaning that the machine traces blood rushing to that brain part when the phobic inducing situation is present. However, what the study also revealed is that the all important Pre Frontal Cortex is also lit up. The pre frontal cortex is responsible for such things as making judgments as to what is good and bad, right and wrong and self concept and self esteem.

When phobic subjects read negative comments about themselves, as individuals, not only did blood rush to the Amygdala but to the pre frontal cortex as well. It is important to mention that non phobic subjects were also used in the study as a control or comparison group. This comparison group did not show any changes in their pre frontal cortex when they read negative or critical comments about themselves.

Implications:

These findings were received by the medical and psychiatric communities very enthusiastically. It means that new medications can be devised to help people overcome their social phobias.

The article does make mention, at the very end, of the fact that psychologists can use Cognitive Behavioral Therapy to enhance their treatment people with GSP.

In My Opinion:

It is not a new idea, it seems to me, that those with social phobias of all types, would experience low self esteem. I welcome my readers to send their comments about this issue because it has always seemed to me that the very nature of social anxiety and social avoidance is that there is a readiness to anticipate rejection. Countless numbers of people with this phobia have told me how they suffer, in all situations, with the dread that others will think badly of them.

While I am not anti medication I am pro psychotherapy. In my humble opinion, and please correct me or argue with me if I am wrong or if you believe I am wrong, but medication will not increase feelings of self esteem. For the phobic, positive social experiences along with Cognitive Behavioral Therapy set the stage for improvements in functioning and self esteem.

I look forward to your comments.

Allan N. Schwartz, PhD

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