When Payal Sharma noticed that her six-year-old niece became nervous and embarrassed at events where everybody else was relaxed and enjoying themselves, she became concerned and consulted the school counsellor. The child was diagnosed with learning disabilities and found coping with daily life difficult. This led to frustration within the child and she became awkward around people. A vicious circle had formed, where the child had become excessively worried and hence experienced peer rejection, and her social exclusion was in turn causing her more anxiety. But because of an early diagnosis, the child was taken to a psychotherapist. The therapist worked with the parents, educators and the entire family to help manage the child’s symptoms. Today, after 15 long years of learned behaviours, the child is managing her education and social relationships well.

The difference between a shy and a socially anxious child

What do the children mentioned above have in common? They are fearful of interacting with others in a healthy, positive and productive manner. This is psychologically termed as Social Anxiety [SA]. Every child is introverted or self-conscious to some extent; but SA is a condition of excessive insecurity that goes beyond common shyness. In situations involving groups of people, like going to a party, calling up friends or talking in class, a shy kid may be reluctant to do it, but a socially anxious child dreads even thinking about doing such activities. A shy kid might remain quiet in a group and waits to be introduced, but a socially anxious kid is terrified of making a fool of himself.

Roots of SA lie in early social experiences

The home and the family provide the child’s first social environment and determine what his first attitudes toward people and social activities will be.

Factors that establish the specific social attitudes in the child and affect his behaviour are:

• Child training methods
• Parent-child relationship
• Gender differences
• The position of the child in the family structure.

The parents ought to constantly guide the child on how to get along with people by adjusting his interests and desires to be in tandem with those of the members of the group of which he is a part. A child must have regular social interactions to reinforce positive behavioural patterns by the child, so that they can develop favourable attitudes towards social experiences when they are young. This in turn strongly motivates the child to seek social contacts and remain comfortable in social interactions.

Can you inherit SA?

When the school counsellor diagnosed 12-year-old Kartik with SA, his parents were summoned. The father refused to come, something he always did; his wife told the counsellor that he avoided public appearances and social interaction. After an interview with the mother, the counsellor concluded that the child inherited this disorder from his father. Social anxiety had been running in the family for many generations. This tendency, called Behavioural Inhibition, can often be inherited by the child which, if left untreated, can lead to SA.

The signals of social anxiety

• Toddlers with this disorder display crying, whining or clinging to their parents
• In the early childhood years, kids often complain of headache, stomach-ache, nausea and dizziness. They often invent these aches to keep away from frightening situations; however these symptoms can sometimes be the physical manifestations of the child’s stress
• Early signs indicating SA can be noticed when the child gradually becomes withdrawn and avoids going to school, picnics or field trips
• There is a noticeable decline of memory and concentration
• They will remain silent for a long time during conversations and if they try to speak, it will usually be with a poor voice tone and they’ll have a poor facial gaze, most of the time avoiding an eye contact
• They become extremely self-conscious and shake, sweat and shiver when faced with simple situations like shopping in stores, ordering in restaurants, reading aloud in front of the class or speaking in public
• Less extreme behaviours could be procrastination, fidgeting and stammering.

Problems in teenagers

When SA in children is left undiagnosed, it leads to problems in the child’s teenage years. Reports show that teenagers with SA have low levels of social acceptance by their peer group; this damages their self-esteem and consequently leads to unhappy interactions with peers. They lack effective communication skills and assertiveness, and fail to maintain meaningful social discourse. These kids dread using public lavatories and going to restaurants. In extreme cases, they start abusing alcohol or drugs to avoid shyness or inhibition. Teenagers with SA have difficulty dating and building romantic relationships. In the corporate world, they can have trouble with job interviews and interactions with bosses and co-workers.

Treatment

Diagnosing SA requires the symptoms to manifest in settings with the child’s peer group and with adults that last for a duration of six months or more. The child will sometimes downplay the symptoms when taken to a doctor. To accurately analyse the child, her parents, teachers and other caregivers should also be interviewed. If untreated, this disorder leads to social isolation, chronic anxiety and depression.

Cognitive/ behavioural therapy helps the child to:

• Learn what triggers the anxiety
• Replace the irrational negative thoughts with positive ones
• Handle stressors
• Negotiate social situations.

It can also be treated with medicines, but this is only recommended in the worst cases because drugs have their own side-effects and need proper monitoring, otherwise it aggravates the symptoms.

Children with SA tend to go unnoticed by teachers and parents, and try to remain invisible. However, the moment you notice a child with any of the symptoms mentioned above, consult a doctor or a psychologist because the earlier the treatment starts the better are the prospects of cure. As parents, help your child to manage her anxiety by focussing on her strengths, help her to face her fears and take risks, and reward her for her brave behaviour. This facilitates confidence in them and leads to a cure.

This was first published in the October 2014 issue of Complete Wellbeing.