People with social anxiety disorder (SAD) display a range of secondary symptoms. Some people cannot participate in any type of group discussion for fear that they will become shaky and their voice tremulous, even mute. Others have such anticipatory anxiety about being in groups that they cant even hold a job. It is common for these individuals to avoid crowds and large gatherings, although an even more threatening scenario is presented where there will be real human interaction required of the sufferer. Another aspect of social anxiety is the physiological distress that those afflicted often feel. For some, social anxiety and panic disorder go hand in hand and certain social situations, or just the anticipation of them, will trigger a full-blown panic attack with all its discomfort; sometimes accompanied by the fear that one is suffering a heart attack or that their racing thoughts will cause them to go permanently insane. These are not easy episodes to endure and the fear that such an attack may be precipitated in public makes it all the worse.

Most people with SAD realize that that their thoughts and fears are unfounded and irrational, though this is of little comfort to them. Although people with SAD know that others are really not critically judging or evaluating them, are not trying to embarrass or humiliate them, the social encounters they have to endure are often torturous and traumatic causing extreme mental and physical discomfort. Even though the afflicted individual may realize that their thoughts and feelings are exaggerated and irrational, their discomfort is still triggered regularly by certain social situations, normal encounters that others seem to navigate with impunity. It is these automatic "feelings" and thoughts that occur around social triggers that need to be addressed. Fortunately, with a new understanding of SAD, more effective treatments are available. An encouraging development is that SAD is now understood as a phobia rather than a generalized anxiety disorder. Phobias tend to respond quite well to specific set of treatments for a number of individuals. In the past, when treating SAD as an anxiety condition of unknown origin, the only available treatments were medication and traditional psychotherapy. Both of these have the potential to worsen the symptoms of the SAD sufferer over time.

How can social anxiety be treated? Social anxiety responds to relatively short-term therapy, depending on the severity of the condition. Completion of a behavioral therapy group can also be quite helpful. What socially anxious people do not need is years and years of therapy or counseling. You can't be "counseled" out of social phobia. In fact, socially anxious people who are taught to "analyze" and "ruminate" over their problems usually make their social anxiety and fears much worse. The following is a partial list of treatments that have shown great promise with social phobia and social anxiety:

1) Cognitive-behavioral treatment methods, techniques, and strategies may help lessen anxiety for some and actually make it bearable enough to resume a normal life for the most part. This treatment is generally short-term and is designed to restructure thoughts and behaviors that reinforce the vicious cycle of the social phobia. One type of therapy traditionally used with phobias is desensitization. This holds promise for SAD sufferers as it gradually reintroduces the anxiety-provoking stimuli in increments that the client can handle. While it is effective with some, a number of participants quit as the stimuli become more painful to them. Adding a coach may be helpful here. The coach is in close contact with the SAD sufferer and helps them literally walk through the treatment regimen. They are also available for general support on a regular basis.

2) One approach I personally find quite helpful is affirmation and visualization, either as a stand-alone treatment or particularly in conjunction with other therapies. Most people are familiar with affirmation and the application as a support for new ideas, attitudes and behaviors. Used in tandem with visualization it can support changes in the response to social stimuli as well. Visualization is used to call up potentially threatening situations and then mentally work through them in a manner that is safe for the sufferer. By utilizing visualization as a practice scenario one can control the amount of anxiety experienced and increase or decrease it the session dictates. Ideally, one learns to increase the potential stressors while lessening the anxiety response to them.

3) Probably the method Ive found most successful in recent years is the use of brainwave biofeedback. Brainwave biofeedback, like its predecessor autonomic biofeedback, teaches self-regulation of biological processes, in this case brain wave activity. By invoking certain slow waves (alpha), an individual can learn to put their central nervous system in a more relaxed and receptive state. Working with visualization, this skill can be internalized and applied in real-world settings. These technologies have been used to successfully treat a variety of panic and anxiety disorders.

While there are likely to be more breakthroughs in coming years, the behavioral and psycho physiological treatment currently available promise hope of a much brighter future for the SAD sufferer.