Being “outed” as a psychologist has consequences.

You will hear stories from

acquaintances and strangers, lots of them. I walk my 7-year old daughter to
elementary school each morning, hug her goodbye, and watch her happily
skip through the hallways. As soon as I turn around, another parent will try to
grab free advice in 2 minutes or less. “Hey, you have a second?”

 “I feel compelled to lick my fingers and rub them all over my elbows.
Which is weird because I don’t even like the texture of the skin around
my elbows. What’s up with that?”
 “My husband is a narcissist and psychopath. What do I do?”
 “My romantic relationship is amazing, so why am I into tentacle porn?”
A job hazard of being a psychologist is that you learn things about the
underbelly of humanity that nobody else knows. One topic appears to be
increasing in frequency: The number of people who mention that they suffer
from social anxiety, or that their kids do, or both. What’s interesting is that there
is a sociological trend in which people are becoming less comfortable in social
situations and more likely to avoid face-to-face conversations.

A close examination of 8,098 15-54 year olds from the United States
demonstrates that diagnoses of social anxiety disorder are increasingly
common. For instance, people born in 1966-1975 are showing a steep rise in
the prevalence of social anxiety disorder, and the onset is much earlier than
previous generations.
Generational differences in social anxiety
Source: Elsevier

Scientists don’t know exactly why social anxiety is becoming commonplace

but there are a few culprits. There has been greater geographical
mobility such that people are apt to move away from close family and friends
for work. By switching communities, attempts to rebuild a secure base of
safety, security, and belonging becomes an omnipresent milestone. It’s harder
to make close friends in adulthood, especially for men. Then there is
everyone’s favorite boogeyman: the advent of smartphones and social media.
A scientific controversy exists with some researchers pointing out that
anxiety, depression, eating disorders, compromised well-being, and a preference
for pork rinds are the direct result of carrying smartphones whereas other
scientists cast doubt on any connection between smartphones and the
psychological functioning of teenagers. Read the studies hyperlinked
above and you can decide. Another mechanism that might account for the rise
in social anxiety is a decline in community institutions such as regular
attendance at religious services. Without regular, meaningful social
interactions where social support is prevalent, the social world is a much less
stable, uncertain place.

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Rather than spend time on why social anxiety is pervasive, I wanted to share
neglected research on how to treat this problem, particularly in youth. It is
important to help kids early because an earlier onset of social anxiety disorder
interferes with a critical period when social skills develop. When a kid suffers
from social anxiety difficulties they are less likely to experiment with initiating
and maintaining conversations (impeding positive relations with others); less
likely to ask questions when intrigued or confused in class (impeding
learning); and less likely to invest in activities that they enjoy as opposed to
what they think will gain social approval (impeding the development of a
strong identity and passionate interests). The fear that perceived flaws in one’s
character will be visible to other people and the cause of scrutiny and
rejection prevents people from being the author of their own lives.

Several treatments exist for social anxiety disorder. One that has fascinated
me is Social Effectiveness Therapy (SET) by Deborah Beidel and Samuel
Turner. The goal of SET is to reduce social fears, improve social skills, and
increase the willingness to approach instead of avoid social situations. There
are three parts — social skills training, exposure to feared situations, and the
production of positive social events with supernormal youth. In social skills
training, youth learn some of the basics of interacting with other people
including greetings (hitting those fist-bumps knuckle to knuckle), starting and
sustaining mutually satisfying conversations (let your friends get the weather
report from Alexa), listening and remembering social details (know what gets
people hot and bothered), strategies for joining groups (if there is
anything Survivor taught us, it's don’t be the loudest or the quietest tribe
member), and being assertive to effectively express what you like and do not
like (say no to noogies). Exposure training begins with a list of things a person
is fearing and avoiding. By rank ordering how often distress and the desire to
escape occurs in particular social situations, an exposure hierarchy emerges.
With guidance, the situations at the bottom of the hierarchy that are the least
distressing and least likely to be avoided are experienced. By remaining in
distressing situations for a lengthy period, you learn that despite the presence
of anxiety, you can persist. You learn that thoughts, feelings, and memories
cannot stop you from doing what you care about.

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The course of social anxiety in a given situation
Source: Todd Kashdan

Another lesson is that anticipatory anxiety tends to be the worst moment and,
upon entering a situation, anxiety tends to lessen. The more exposures, the
more anxiety tends to lessen. It is often the expectation that anxiety will only
get worse if a situation is entered that prevents someone from diving into the
social world.

What I’ve described are standard operating procedures for treating social
anxiety. The magic ingredient of SET is the involvement of supernormal kids
as helpers. Socially anxious, socially isolated children and teenagers rarely
get a chance for high-quality, positive social events. And if they do, these
social events are often with socially awkward peers, or the good intentions of
parents and teachers to “force” social interactions with someone who doesn’t
want to be there. In SET, supernormal youth serve as volunteers who help
provide opportunities for socially anxious, socially isolated youth to experience
lengthy, satisfying, playful activities. Supernormal youth are recruited from
various school districts so that what happens in SET stays in SET. With the
help of popular, socially intelligent peers, group activities are set up for social
success: Trips to a skateboard park, where everyone is learning a new skill
together. Pizza parties. Floating down a river on inner tubes. Nature hikes. A
different activity occurs every week, and always includes lunch. This way
youth acquire regular opportunities to experiment with newly developed social
skills in a natural environment where success is basically guaranteed.
Activities have minimal structure to mimic the extemporaneous nature of
everyday life. And after these activities, with guidance, the experiences can be
dissected to provide behavioral evidence of social skill gains and
acknowledgment that anticipatory anxiety tends to be the peak of distress,
and declines over time. These activities offer behavioral evidence that even
when distressed, youth can execute skills and extract moments of joy,
belonging, and meaning. And perhaps most important, youth learn to judge
themselves on how they perform and not what they cannot control — whether
a friendship is formed, whether they win an athletic competition.

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The scientific evidence for SET is impressive. SET elicits positive changes in
youth in terms of less social anxiety, less social impairment, and an increase
in extraversion compared to a comparison group that merely received contact
with a therapist. The benefits are observable 3 years later. Five years later,
adolescents suffering from social anxiety disorder who received SET
were indistinguishable from healthy, non-anxious adolescents on their anxiety
during social interactions, anxiety when reading aloud to a group, impairment
in daily life, and extraversion; trained observers failed to notice any
differences between these groups.

Yes, social anxiety does appear to be increasing. But, yes, social anxiety can
be effectively treated.

An important lesson is that perhaps the greatest, untapped resource to help

our youth become less socially anxious are peers. Adults often underestimate
the intelligence, wisdom, and value of youth. In the United States, youth cannot
be formally employed, even if they want a job that offers engagement and
meaning. Science has found that recruiting and training well-intentioned,
socially intelligent, generative kids and teenagers might be the missing
ingredient to treating social anxiety. If we are going to change social
conventions about mental health and well-being, let’s extract the help of the
best of society, at every age.