Integrative Approach to Psychotherapy Social Anxiety Disorder

Case Example

The film Elling presents a story of Elling, the seventh in a family of nine musically-talented children, who is only six when his and his brothers' musical talents are discovered by a visiting tycoon who then offers to sponsor the family troupe on a merry-go-round of public performances. During one of his first performances, Elling runs off-stage, afraid of the flashing lights and the audience applause. In another instance, he is asked to perform an Ella Fitzgerald song, but is unable to, and cries the entire night after his younger brother beats him to the prize. The fear of performing grows strong, and Elling continues to be paralyzed by the same while onstage; at times recalling nothing about his performance, other than the curtains being drawn. This fear perforates into other areas of his life and he soon finds himself shunning social places for fear of what people may be thinking of him. With time, the family's 'good boy' finds himself too frustrated, and is tempted to try alcohol. The sponsor, however, who still believes in Elling's talent and openly favors him over the rest, obtains professional help for him; and only then does Elling get diagnosed with social anxiety disorder (SAD).

The Multidimensional Model to Abnormal Behavior

Whereas one-dimensional models attribute psychopathology to a single, specific cause; multidimensional models posit that various reciprocal influences interact to yield the etiological processes that give rise to abnormal behavior (Wakschlag et al., 2013). These influences can be categorized into four -- biological; behavioral and cognitive; emotional; and social, cultural, and interpersonal influences. The subsequent subsections...

Studies have shown that a child would have higher chances of having SAD if a first-degree relative has the disorder (Wakschlag et al., 2013). This has been attributed to genetics, and the fact that children acquire avoidance and social fears through parental psychosocial education and the process of observational learning (Schneier, 2006). To this end, a child with shy and socially-isolated parents is highly likely to develop social phobia. This heritability may, or may not apply to Elling's situation, given that he was the only one with the disorder; however, we also cannot rule out the possibility of there being other forms of anxiety disorders in the rest of the family. Furthermore, individuals who had insecure (anxious-ambivalent) relationships with their mothers are twice as likely to develop social phobia later on in life (Schneier, 2006).
Social, Cultural, and Interpersonal Influences: negative social experiences have been found to trigger social phobia, especially in individuals with high levels of interpersonal sensitivity (Schneier, 2006). The humiliating social events during public performances were a trigger to social phobia in Elling's case. Being ignored, rejected, or bullied could lead an individual to develop feelings of inferiority and inability to fit in, both of which are triggers to social phobia (Wakschlag et al., 2013). Cultural factors also have a hand in the worsening of social phobia. The style of parenting, for instance, depends on the culture of the people among whom an individual lives. In America, for example, a…