Painful shyness in children and adults

Avoidance and inhibition include:

• Canceling social events at the last moment

• Avoiding situations that provide positive social interaction

• Few or no friends

• Avoidance of activities that are otherwise pleasurable

• Passivity, pessimism, and low self-esteem

• Friends, family members, teachers, or mentors are concerned

• Excessive computer use that is not social in nature, and is without face to face contact with others

Temperament or Biological Influences

• Withdrawn, avoidant, excessively emotionally reactive

• Highly sensitive, when lacking adequate social support

• Poor emotional "fit" with family members or some environments

Stressful Life Events

• Shaming experiences

• Major moves from one school or city to another

• Abrupt changes or disruptions in family life

Negative Family Interactions

• Frequent parental criticism and shaming to enforce behavioral compliance, high parental control with little expressed warmth

• Chaotic family interactions or neglect

Stressful Work or School Environments

• Highly competitive, critical, or hostile environments

• Public embarrassment for poor performance

• Dominance behaviors rewarded, and bullying or teasing ignored or encouraged

Maintain Appropriate Expectations

• Maintain appropriate expectations while communicating empathy for the shy person's painful emotions.

• Encourage them to tell you about their daily experiences and how they feel about them.

• Acknowledge the conflict between needs to belong and fears of rejection.

• Role play challenging situations with the shy person.

• Help the shy individual set specific, manageable behavioral goals, and agreed upon reasonable means to attain them.

• Help challenge the frequent negative thoughts about the self and others, and help them develop constructive alternatives.

• Avoid negative labels and intense pressures for social performance.

• Remember that shyness and social anxiety are common and universal experiences at all ages for most people.

• Group therapy provides a place to explore, experiment, test pessimistic hypotheses about the self and social interaction, and develop adaptive interaction styles.

• Successful therapy lowers barriers to action and increases appropriate risk taking and self-acceptance. Deliberate social "niche picking", or choosing situations that suit one's temperament, also increases.

• Individual therapy provides a place to explore one's needs, attitudes, beliefs, and behaviors without pressure from others.

• Group and Individual therapy help clients develop more empathy for others and themselves by reducing negative selfthoughts, self-blame and shame while building positive perspectives and effective behavioral patterns.

• Medication may help clients enter feared situations.