Parenting The Socially Phobic and Avoidant Adult
SEASON
1
EPISODE
5

18 Year Old Woman Conquers Social & Performance Anxiety

Patient “Z” describes overcoming debilitating perfectionism and performance anxiety during the year before college. While teenagers with social anxiety often require therapeutic parenting alongside individual treatment, Z successfully worked through her challenges and achieved significant therapeutic progress without her parents participating directly in treatment.
Episode Overview

What This Episode Is About

“Z,” an 18-year-old high-achieving student and athlete, describes overcoming social and performance anxiety that had affected her for years. Although academically successful, social, and involved in athletics, she experienced significant anxiety during sports and other situations in which she felt evaluated. Z discusses learning to identify catastrophizing, her internal critical script, and the connection between thoughts, emotions, adrenaline, and performance. Journaling and exploring difficult experiences from her past became important parts of her treatment. She also learned to reinterpret adrenaline as excitement and usable energy rather than automatically experiencing it as fear. Instead of waiting to feel completely comfortable, she began deliberately taking small steps into situations that made her anxious. Z explains how understanding her anxiety, developing self-awareness, and repeatedly challenging avoidance substantially improved both her confidence and overall happiness.
At a Glance

This podcast is best for:

Parents, concerned adults, and professionals supporting adult children who struggle with social anxiety and avoidance.

Episode Details:

20
 min, 
11
 sec
May 9, 2024
Full Transcript

This episode's transcript:

[00:00:00]
The other end of the line is we’re going to call her Z, which is short for her name. And Z is 18 years old now, right? Yeah. Okay, and I’ve been working with Z for about a year and a half. We’re coming to the end of our therapy and just for the audience’s information, Z is an attractive, intelligent teenager who basically gets straight A’s, who’s going to a really fine university next year. She’s been on the wrestling team. She’s very social and now we’re gonna tell her story, which again, I’m very excited because although I’ve worked with countless teenagers, it’s very rare that you can work with a teenager without the input of the parents because most teenagers don’t have the initiative to do this kind of mental health work, which is really difficult.
[00:00:59]
Okay, so Z, thank you for doing this. When we started therapy, what was going on for you? What was the problem? I was having a lot of anxiety with like, when I was doing sports, I was getting a lot of like performance anxiety and that was bugging me more than anything. But I also had like, I was always been shy in school and had like social anxiety and like that had always been a problem for a long time. And I was getting to a point where I really wanted to change like, and like get better. And so like I told my mom and she helped me like find you and I really like, now I knew I had to work hard to like change it, but I really wanted to.
[00:01:58]
So give an example or two of what the problem looked like. You know, it’s just a trick. I would, I would get in my head a lot and I would be very negative about things and I would assume the worst and then it would like cause me to freeze up and like get really nervous and like really sweaty. And that also bothered me a lot. Like how much I sweat and it made me like want to not like talk to people cause I knew I’d get like really sweaty and nervous. Okay. And as you referenced sports, what give an example of the problem there? Like I think I had more anxiety for soccer.
[00:02:50]
And with that, like I think it was more because it was a team sport. So I felt like I was letting down like my teammates if I wasn’t performing well. And also I felt like I had like pressure from my dad to like do well. And I would like, I would do okay during practices and stuff, but like then the game like I would get really nervous and like I felt like I wouldn’t play as well and I get into my head. And then I would come out like really upset and like beating myself up after the game. So you know when I work together, we reduce the universe to a scale of one to 10. Okay, we like to do statistics. Okay. So, and again, for the listening audience, the words anxiety, ruminate, obsess, worry, et cetera, they’re all interchangeable with the concept of pain.
[00:03:49]
Okay. So when you started therapy on this one to 10 scale for the sake of relativity, you were at a one. Where do you believe you’re at now? And like 10 is like healed, like 10 is like perfectly healed. Okay. I would say like a seven. Okay. How did you get there in your own words? What did you do to achieve that at 70%? I would, I think understanding like what the issue was, helped me like understanding what was going through my head.
[00:04:41]
Like what my thought process was, helped me to stop like like certain voices and like understand what I needed to do. And then like putting that into practice by like knowing, you know, I’d be in a situation that gave me anxiety, but then like just doing it and then like being able to kind of like be like my nurturing self and like, you know, either outcome, just be able to still be part of myself and like still like keep encouraging myself to keep going. And I think also journaling helped me a lot, kind of understand like why I felt anxious about like certain situations. And then it also helped me like let go of like things that I was like holding onto from the past.
[00:05:33]
Okay. Let’s talk about journaling. Let’s run it. I did a recent podcast, which can be accessed at the website. It’s called Public Speaking Anxiety and Fear of Being Noticeably Nervous Mind Surgery for High Performers. And in this podcast, the first 10 people that I’m referencing are super high achievers making a lot of money, very successful in their careers. But again, nobody calls me without a significant problem. The point I want to make here and you know, when you listen to this interview down the road, you’re gonna feel, I hope you feel proud about what I’m gonna say is that your journaling is better than all of those CEO high performers. You really did an amazing job with it.
[00:06:25]
What was it like for you to journal? It was really hard at first because there’s not like I was like scared to share things. Like I didn’t want to really write it like, say it out loud. And I think there were certain feelings that I didn’t want to admit that I had about issues. And it was really hard to kind of relive experiences because while I’m writing it, I’m going through what I felt all over again. But I think that helped me because before, before I think I kind of kept things in and it still was a problem. And I would like, it was like eating me. But when just kind of letting it go and just writing it out, helped me understand why I felt a certain way and helped me let go of the issues.
[00:07:23]
Absolutely fantastic with that. Okay, now you mentioned a keyword a few minutes ago. You used the word nurture, which is one of the mind states that we’ve been working on, the mind state technology. And another mind state was that your internal critical script, which we gave the name booger to, right? You know, booger, right? Okay, a little sense of humor. Can you give an example of how booger was impacting you a year and a half ago and how you have that entity tamed presently? Yeah. I think, okay, I remember like one issue I had that was bothering me was that, like I was scared to like run outside, like go on a run.
[00:08:19]
And I had all these thoughts like booger was telling me that like, like people, like when people would see me, like, they would judge me, like think I was a bad runner, like, like, like, like, like I didn’t want to, like I felt like I’d like, I look ugly while I’m running and I was afraid that people would judge me off of that. And then like now, like I know, like, I was catastrophizing and like I was putting my own thoughts into like other people’s heads, like even though like, you know, people didn’t necessarily think that. I just assumed it. And I was like also learning now, like, it doesn’t matter like what’s the worst that happened if somebody thought that I suck at running and that, like, I was out of shape.
[00:09:14]
Yeah, but booger, booger was tough. Booger was very tough. Okay, so one of the ways also that you learn to get this stuff under control is that we did use some pharmaceutical assistance. Okay, so talk about you went on medicine and then you went off medicine. Okay, you did this from my perspective, you did it perfectly. You went on the medicine. The purpose was to create neuroplasticity, which is to help balance out these mind states. I gave you a sense of evenness and then you slowly and methodically went off the medicine. All too often people will be on medicine. They have no clue of what they’re doing. They have no strategy.
[00:10:04]
It appears you did it just the right way going on, using it for what it’s worth then going off. Can you talk about your experience with medicine, please? Yeah, I remember being really hesitant at first and I had to get my parents’ approval for it, but I trusted what you said about the medicine and then once I was on the medicine, I noticed that I felt like more more energized, more excited to do things instead of fearful. I could definitely tell that my critical script wasn’t as loud even if it was still there. I still had those thoughts like that bigger was telling me it was easier to control them.
[00:11:02]
And it was easier to have those nurturing thoughts too to tell myself positive things about things and push myself. I think what help was when you would tell me, now you’re on offense, like, You have to go do things, push yourself for the medicine to really work. And so then that’s what I would do. And then when I slowly got off, I didn’t really notice too much of a difference because those actions turned into habits now. Okay, so the use of the medicine help you get more in touch with your nurturing self.
[00:12:00]
Keep concept. Can you just go free flow? What was that nurturing for you? What do you mean? My nurturing self was the thoughts that were like instead of being like, oh my gosh, I’m so scared, I’m so nervous. It was the thoughts that were like, okay, I’m excited. This is something new. They were like positive. They were like, you know, pushing me out of my comfort zone. But also like even if something went wrong, it was like those thoughts are like, that’s okay. We’re getting there. Like it was like, it’s okay. Something went wrong. Instead of before, I would be like, oh man, I messed up. I don’t want to ever do that again. It was it helped. It was like, okay, that wasn’t the end of the world.
[00:12:55]
Yeah. You said something really important in the last journal that you sent me. You made a reference to depression. Okay, it was very important. Can you go with that? You’re inside about it. Um, when I first came to you, I didn’t um, like I didn’t think I had depression or like I ever had depression before. Like, I didn’t think that. I just felt like, you know, that’s like my negative thoughts and like, that was just my head. Like that was just how I was. And to me, that felt like that was normal because that that was my normal. And it wasn’t until like when I started when the nurturing self started having these positive thoughts started like stopping and like quieting down like the negative thoughts that I had that I felt like, oh, like there is like, I’m not like this. Like, I’m not a negative person. Like I’m actually like a friendly, bubbly person. And I just, I remember being like really surprised when you mentioned like the depression.
[00:14:19]
And yeah, like, and I know like, it was surprising because like, in my idea of like depression was different than like how I was, I felt like externally, nobody could have, nobody would have ever guessed that I was depressed. Um, like I remember my parents thinking like, what? No, like you’re not depressed. And yeah. Okay. So to wrap it up, because this is a little complicated, you, you now you know that you, what you were what that I was depressed and like sad. And I was unhappy with myself and like, I realized that now, you know, because I, because now like I am happy, I am like, I do have positive thoughts and you know, I’m realizing that there was a difference when I, at the time, like I felt like that’s, you know, who I was. And I was just, that’s how like it was. Yeah. Okay. Spot quiz. You ready?
[00:15:33]
Get a little adrenaline. Okay. Do you remember what the word, um, the Latin word, emotere, E-m-o-t-e-r-e? Emotion? Very good. Um, energy in motion. Okay. So now that you’re, you’ve accomplished a lot of goals and, you know, we’re in the final phase of this treatment. How is your emotere? How is your emotional energy different now than it was when we started? Um, I think like when you explained the like emotion and energy, um, like understanding that those two are connected with each other, uh, help me because, you know, when I did feel like, you know, anxiety and like, you know, I, I realized that’s adrenaline and now I use it in more of a excited way instead of like a scared, you know, because I, I mean, yeah, I can’t help the adrenaline, but it’s like, now I’m not afraid of it and I can keep it under control.
[00:16:40]
If that makes sense. It makes a lot of sense. Um, okay. Another one to 10. Okay. So if you started at a one, what number happiness are you carrying around in general these days? I think we’re going to eight. Lastly, what advice do you have for other kids your age who, you know, have this kind of problem because it’s not the type of thing that, you know, people tend to talk about. I think they’re all alone and you’re quite a role model. So your advice is what? Um, my advice would be to like first understand what’s going on in your head. Um, like, what catastrophizing is, what the critical script is, like what the nurturing child is.
[00:17:36]
And then I, I, well, because for me, like the journaling helped me, I think the most and just really like, even if it’s hard to like open up things from your past, it’s really important and also being it just like pushing yourself like it doesn’t have to be, you know, like immediately go give a speech in front of like a bunch of people. But like little things that scare you just like start out small and like keep building from there. Excellent. Um, is there anything else that you think would be important to share? Um, I don’t know. Okay. Well, listen, Z, thank you very much for sharing your story.
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Meet the Speaker

Jonathan Berent, LCSW

Psychotherapist & Author — Social Anxiety and Performance Anxiety

Jonathan Berent, L.C.S.W., A.C.S.W., is a psychotherapist who has been practicing since 1978. He has created the Berent Treatment Method for Social Anxiety, which is the result of his clinical work with thousands of individuals of all ages with social anxiety since 1978. He has extensive clinical experience with avoidance and dependance personality disorder, and is the author of Work Makes Me Nervous: Overcome Anxiety and Build the Confidence to Succeed (Wiley, 2010), Beyond Shyness: How to Conquer Social Anxieties (Simon & Schuster, 1992), and Social Anxiety: The Untold Story, which is a training course for mental health professionals in using the Berent Method to treat social anxiety. (Andrew Kukes Foundation, 2011).
SocialAnxiety.com, has served millions of unique visitors as a multimedia clearinghouse for patients, parents, and fellow mental health professionals in search of articles, educational materials, and books on social anxiety and related subjects. His library of clinical interviews appears to be the most documented clinical success with social anxiety.

Guest Speaker

Frequently Asked Questions

Common Questions About Social Anxiety Treatment

Social anxiety disorder is more than shyness or nervousness. It is a condition in which the fear of being judged, embarrassed, or negatively evaluated becomes so intense that it interferes with everyday life. Adults with social anxiety often avoid conversations, relationships, employment opportunities, public situations, and other activities that involve interpersonal interaction. When left untreated, this pattern of avoidance can significantly affect independence, confidence, and overall quality of life.

Yes. Long-term social anxiety and avoidance can contribute to isolation, lost opportunities, low self-esteem, frustration, and hopelessness. Depression is commonly co-morbid and can then further reduce motivation and activity, creating another cycle in which anxiety, avoidance, isolation, and depressed mood reinforce one another.

Yes. The clinical interviews at www.social-anxiety.com are evidence of this. Long-standing social anxiety and avoidance can become deeply ingrained, but meaningful change is still possible. It takes hard work. When adult children are phobic and avoidant they lack initiative for their mental health. Parents need to learn a therapeutic strategy to compensate for this. Treatment needs to address the individual’s specific patterns of anxiety, avoidance, emotional regulation, dependence, relationships, and functioning rather than assuming that the problem is permanent because it began in childhood.

Yes. Perfectionism is OCPD; obsessive compulsive personality disorder. An adult child may avoid applying for jobs, pursuing education, dating, or trying unfamiliar activities because of an intense fear of failure, criticism, embarrassment, or not performing perfectly. Avoiding the situation can feel safer than risking an imperfect outcome, but this can significantly interfere with adult development.

Chronic social anxiety can interfere with social skills, such as initiating conversations required in maintaining friendships. Participating in activities and tolerating the vulnerability involved in relationship development are required for sustaining friendships. Years of avoidance can also result in limited social experience, making future interactions feel even more intimidating and reinforcing isolation.

Take the Next Step

You Do Not Have to Manage This Alone

Public speaking anxiety, performance anxiety, and social anxiety respond to treatment. If this episode described your experience, a conversation is the great next step.