One of my first recollections as a child is hiding behind my mother, too scared to say hello to someone I had just met. My mother would excuse me, saying, she is just shy. Now the DSMIV (Diagnostic and Statistical Manual of Mental Disorders) lists shyness as part of a social disorder. But is it really a disorder? How does something go from being just a part of someone's personality to being listed as an actual disorder? In this paper, I will touch on what shyness is defined as, what are believed to be the main causes of shyness, how shyness affects our relationships and finally, things you can do to overcome shyness.
It is not unusual to feel uncomfortable in social or performance situations, most of us have at some time in our lives. However, many people experience much more than just that fluttery, nervous feeling in your stomach that might make you feel a little nauseous. Some individuals may go through a majority of their lives feeling extreme discomfort or feeling paralyzed when engaging in social encounters. We used to say those people were just shy, but some of these people most likely suffer from a social anxiety disorder that causes them to fear being scrutinized or embarrassed. For them the answer is to either avoid the social encounters, or face them and suffer intense distress. (Shields, 2005). In past years, before shyness became a diagnosed disorder, shyness was dismissed as just a natural personality variation. More recently, studies have shown it to have a recurring and unremitting path characterized by severe anxiety and impairment (Shields, 2005). Starting in the 1970s the Diagnostic and Statistical Manual of Mental Disorders (DSM) went from being a thin, spiral-bound publication to a weighty manual. Psychiatric diagnoses began to skyrocket; as a consequence shyness and a large amount of other conditions were classified as anxiety and personality disorders (Goldberg, 2007). Before the 1980's social anxiety disorder was believed to be a mild and relatively rare condition as most people did not seek treatment for their fears. It was added to the Diagnostic and Statistical Manual of Mental Disorders in the 1980s, in the 1990s studies began to show that it was associated with significant impairment and much more prevalent than previously thought (Goldberg, 2007). In the book, Shyness: How Normal Behavior Became a Sickness, author Christopher Lane focuses on how “psychiatrists, journalists, and drug companies combined to make shyness-once seen as a normal variation of character or personality-became incorporated into the DSM as social phobia or avoidant personality disorder”(Wessex, 2008).
I t is said that it follows a predictable path, first a few cases come to the attention of the mental health services, then large scale studies, suddenly the new condition is seen as a new hidden public health problem. Once that happens it can be labeled a social anxiety disorder and efforts to educate the public proceed. The drug companies will then come up with drug compounds that can help combat the problem. Isaac Marks, who pioneered research of anxiety disorders has been quoted as saying that the promotion of social anxiety disorder is used as an advertising ploy to exaggerate the plight of the socially anxious (Wessex, 2008). Psychiatric professionals can play a part by exaggerating some of the more vaguely defined ailments without a great deal of scientific research or credibility(Wessex, 2008). Partly because of the reimbursement system that governs psychiatry. “Treat someone for shyness, and the insurance companies will laugh at you. Treat someone with social phobia, with its DSM seal of approval as disorder 300-23, and the bill will be paid”(Wessex, 2008). Are we left with the assumption that adding the diagnosis of shyness to the DSMIII was because of drug companies or billable charges for psychiatrists?
Psychiatric professionals can play a part by exaggerating some of the more vaguely defined ailments without a great deal of scientific research or credibility(Wessex, 2008). Partly because of the reimbursement system that governs psychiatry. “Treat someone for shyness, and the insurance companies will laugh at you. Treat someone with social phobia, with its DSM seal of approval as disorder 300-23, and the bill will be paid”(Wessex, 2008). Are we left with the assumption that adding the diagnosis of shyness to the DSMIII was because of drug companies or billable charges for psychiatrists? Psychiatrist Arthur Kleinman believes that including items like mild forms of anxiety or depression under the constantly widening umbrella of mental disorders will only serve to divert attention and resources away from diseases like schizophrenia and major depression, leaving them to remain under treated and stigmatized across the majority of the world (Sessex, 2008). If this is true, is society being helped or harmed by the constant addition of new disorders to the DSM, can someone just be a little “shy” without it being diagnosed as a disorder?
Psychologists Rubin and Coplan talk about the fact there has been a large amount of research done on childhood shyness and social withdrawal in recent years (Rubin & Coplan, 2010). With all the attention concentrated on this topic recently what have we learned? Children's initial reactions to unfamiliar events served as a source of intraspecific variation in humans in one article written in 1988. Two longitudinal studies consisting of 2 year old children that displayed extreme behavioral restraint or spontaneity when engaging in unfamiliar contexts were used. By 7 years of age these same children were exhibiting similar behavior to what they had done at 2 years of age, the restrained children were quiet and tended to avoid social interaction while the unrestrained children were talking and interacting. The study of the children showed an association between inhibition and heart rate acceleration and higher levels of salivary cortisol. This suggests that inherited variations in the threshold of arousal from specific limbic sites might have a factor on the degree of shyness in childhood and possibly on extreme degrees of social avoidance in adults (Kagan, Reznick & Snidman, 1988). However, this data was selected from children that were chosen because of their extreme behavior and the results hold true only for those children. l
Would it surprise you to hear that personality disorders have been associated with both internalizing and externalizing characteristics? Antisocial personality disorder has been characterized by externalizing behavior like aggression, avoidant personality disorder is characterized by tendencies like social withdrawal and borderline personality disorder has been found to contain both internalizing and externalizing problem behavior (Hutteman, Denissen, Jaap, Asendorph & van Aken, 2009). This might indicate that personality disorders are just extreme variations of normal development rather than specific personality structures (Hutteman, et al. 2009).
During this study the findings indicate that shyness actually protects individuals from developing aggression in early years but may be a causal factor for developing aggression between a child's adolescence and emerging adulthood. Findings also bear out the fact that a continuity exists between normal variations in shyness, aggressive behavior, and abnormal variations, and may result in a co-occurrence of shyness and aggression during early adulthood. There is also a focus on the importance of person/environment interaction, as the effects from shyness to aggressiveness were only found with those adolescents receiving low parental support or spending small amounts of time working in a part time position. Using this line of reasoning people in specific environmental circumstances might develop personality disorders while those with the same basic personality structure, but in a more supportive environment, might be more able to adapt (Hutteman, et al. 2009).
Since shyness may act against developing aggressiveness in childhood, but also acts as a risk factor later in life, the conclusion is that prevention and intervention can be applied during that developmental period and help that person to adapt their behavior. There have been several studies that have shown that shyness can be a barrier to well being and social adjustment during childhood and adolescence, but what about when emerging into adulthood, what can be said about the impact of shyness during that period of life? One study compared shy emerging adults with non-shy peers, looking at three key factors; internalizing behaviors, externalizing behaviors, and close relationships. There were 813 participants in the study and it consisted of 500 women and 313 men, all undergraduates, from various locations around the United States. The results showed that both men and women who were considered shy emerging adults had more internalizing problems like anxiety, depression, and low self esteem. They also engaged in fewer social behaviors such as going out to bars or parties and experienced poorer quality relations with their parents, friends, and romantic interests than those participants considered non-shy in nature.
A similar study conducted with undergraduate students at a university in Turkey found similar findings. Their study was between shyness and dysfunctional relationship beliefs and to extend those findings to self esteem and fear of negative evaluation from others. These participants completed J.M. Cheek & A. H. Buss Shyness Scale, Interpersonal Cognitive Distortions Scale, Brief Fear of Negative Evaluation Scale and the M. Rosenberg Self-Esteem Scale. The findings of those tested indicated that fear of negative evaluation, self esteem and interpersonal rejection were significantly predictive of shyness and of those three predictors, self esteem was considered the best. Other factors can also affect shyness or social anxiety, one Canadian study found that social anxiety disorder was more prevalent with individuals living in households with low income levels. Those people that reported anxiety symptoms within the last 12 months were less likely to have jobs and those that did had low personal incomes. This results in part from low educational levels or difficulties dealing with people socially in a work environment, only 37% had sought professional help for their anxiety symptoms.
With shyness effecting childhood, adolescence, emerging adulthood, and beyond in so many different ways, what kind of interventions can be used to help mitigate the problems that someone who is shy might suffer from. By intervening as early as possible you can make sure that children have the opportunity for plenty of social interaction when they are growing up. Sports can be a good outlet for children, studies have found that children that participate in sports will have positive psychosocial outcomes (Findlay, 2007). One such study of 355 children in grades 4 and 5, showed participation in sports indicated greater levels of social skills, self-esteem, and positive adjustment for all children involved in the study. Findings also indicated that team sport participation was of particular benefit for children that had difficulty relating to their peers, children that participated in sports over time had a significant decrease in anxiety as well. (Findlay, 2007). Morita Therapy is one type of therapy that has been found to help individuals dealing with shyness. Clients are encouraged to use self-actualization to understand the meaning of social anxiety and to help them understand it is not necessarily abnormal, the focus is on dealing with the symptoms of their anxiety and not being preoccupied with them. Part of the procedure is being challenged to reevaluate their maladaptive behavior and unproductive passivity,use of didactic, confrontational, and supportive messages are also part of this method of counseling (Ishiyama, 1987). Different kinds of therapy can also be used to treat shyness anxiety including cognitive therapy, a more familiar type of therapy for many individuals. Finally, if you were unable to effectively deal with your shyness while you were a child and therapy was not the answer for you, there is a drug commonly nicknamed the “anti shyness” pill. Currently in use in Spain the drug, Scroxat, is actually an antidepressant which became better known as a drug to help with shyness. The Spanish National Institute of Toxicology has released a warning, being nervous about possible misuse or overuse, especially among younger people that might think it is a cure for all types of social awkwardness. An education campaign was started among public health facilities to help educate individuals about the dangers of misusing are abusing this drug. While it can be used for panic attacks it is important to remember that like many other prescription drugs it has possible dangerous consequences when taking it with alcohol or other drugs.
Beginning this paper I had a personal interest in when shyness began to be listed as a social disorder. When I was a child it was considered appropriate for a child to hide behind his or her mother when confronted with a stranger and it was not looked at as a social disorder, just a young child being shy around new people. At some point shyness went from a natural personality variation to part of a social disorder listed in the DSMIV. In 1980 shyness was added to the DSMIII as a “social phobia” and in 1994 it became listed as a “social anxiety disorder” in the DSMIV (Goldberg, 2007). Has our society really changed so much that now shyness is considered a disorder? Studies about shyness have found biological, interpersonal and cultural moderators that affect shyness and social withdrawal, with includes a focus on the effect of internet communication (Rubin & Coplan, 2010).
One study followed children from 1.5 to 2.5 years of age, their shyness and extreme sociability traits in unfamiliar contexts stayed the same when measured again at age 7. Those that showed the shyness traits continued to show them several years later as did those with extreme sociability; this would seem to indicate that most personality traits stay the same as children age (Kagan, Reznick & Snidman, 1988). Shyness can be a barrier to social adjustment and well-being during childhood and adolescence, with shy emerging adults having more problems with internalizing behaviors and engaging less in externalizing behaviors (Nelson, Padilla-Walker, Badger, Barry, Carroll & Madsen, 2008). Selda Koydemir and Ayhan Demir looked at Turkish Undergraduate students to see if there is a relationship between shyness and dysfunctional relationship beliefs were able to show a clear connection between fear of negative evaluation and self-esteem in relation to shyness (Koydemir & Demir, 2008). Shyness seems to effect the very young and can be ongoing at the college level and into adulthood. However, not everyone has to suffer from shyness, when you are a child you can participate in sports, results revealed that children that participated in sports on a regular basis had less externalizing problem behaviors (Findlay, 2007). You can use medication like Scroxat, known as the “anti shyness drug” that is currently being used to treat social phobia in Spain or if you do not want to use medication you can look into Morita Therapy where clients are encouraged through self-actualizing to help themselves with their social anxiety (Ishiyama, 1987). It appears as if the reason shyness was added to the DSMIII might have been more reliant upon the fact that studies have shown that more challenges affect those suffering from shyness and social disorders than we first assumed. As more studies are done on the effects of a shy personality within a lifetime, it could be that we will find a definitive cure for the type of shy behavior that is effecting people negatively, or perhaps we will look at it in still a different light, and come to believe that shyness does not have the far reaching consequences on lifestyle and sociability that we currently believe it has.
Caranicas Slideshare Presentation On Shyness
Literature Review <ul>Shyness: A Natural Personality Variation or Social Disorder? </ul>
Abstract One of my first recollections as a child is hiding behind my mother, too scared to say hello to someone I had just met. Now the DSMIV lists shyness as part of a social disorder. But is it really a disorder? This paper will discuss: <ul><li>What shyness is
What can be done to overcome shyness. </li></ul>
Shyness Added to the DSMIII <ul><li>Many people feel uncomfortable in social or performance situations
In the 1970s psychiatric diagnoses begin to skyrocket and shyness is classified as anxiety disorder (Goldberg, 2007).
It was added to the DSMIII in the 1980s (Wessex, 2008). </li></ul>
Shyness Added to the DSMIII, cont. <ul><li>The 1990s saw studies into shyness showing significant impairment and higher prevalence than previously thought (Wessex, 2008).
Isaac Marks, pioneer of research into anxiety disorder has been quoted as saying that promotion of social anxiety disorder is used as an advertising ploy to exaggerate the plight of the socially anxious. </li></ul>
Shyness Added to the DSMIII, cont. <ul><li>Psychiatric professionals may play a part with exaggerating vaguely defined ailments
“Treat someone for shyness, and the insurance companies will laugh at you. Treat someone with social phobia, with its DSM seal of approval as disorder 300-23, and the bill will be paid” (Wessex, 2008). </li></ul>
How Shyness Affects Relationships and Social Interactions <ul><li>Large amount of research done in recent years (Rubin & Coplan, 2010).
Inherited variation in threshold of arousal from specific limbic sites might have factor on degree of shyness in childhood and social avoidance in adults (Kagan, Reznick & Snidman, 1988). </li></ul>
How Shyness Affects Relationship and Social Interactions, cont. <ul><li>Antisocial Personality Disorder has been characterized by externalizing behavior like aggression (Hutteman, Dennissen, Jaap, Asendorph & van Aken, 2009).
Avoidant Personality Disorder is characterized by tendencies like social withdrawal (Hutteman, et. al. 2009). </li></ul>
How Shyness Affects Relationship and Social Interactions, cont. <ul><li>Borderline Personality disorder has been found to contain both internalizing and externalizing problem behavior.
Shyness protects individuals from developing aggression in early years
Could be causal factor for developing aggression between adolescence and emerging adulthood. </li></ul>
How Shyness Affects Relationship and Social Interactions, cont. <ul><li>Prevention and Intervention can be applied during developmental period to change behavior (Hutteman, et. al. 2009).
Shy emerging adults had more internalizing problems like anxiety, depression and low self esteem (Nelson, Padilla-Walker, Badger, Barry, Carroll & Madden, 2008).
Engaged in fewer social behaviors (Nelson, et. al. 2008). </li></ul>
How Shyness Affects Relationship and Social Interactions, cont. <ul><li>University of Turkey study found those tested had fear of negative evaluation, self esteem and interpersonal rejection were significantly predictive of shyness (Demister & Emir, 2008).
Consider medication like the “Anti-Shyness” pill, Scroxat </li></ul>
Conclusion <ul><li>Once was considered appropriate to be shy as a child
Shyness went from natural personality variation to social disorder
1980 saw shyness added to DSMIII as “social phobia”
1994 shyness became listed as “social anxiety disorder” </li></ul>
Conclusion, cont. <ul><li>Personality traits stay the same as children age (Kagan, et. al. 1988).
Shyness can be barrier to social adjustment and well-being during childhood (Nelson, et. al. 2008).
Clear connection between fear of negative evaluation and self esteem in relation to shyness (Koydemir & Demir, 2008).
Can mitigate shyness by participating in sports, taking medication or engaging in therapy </li></ul>
References Bosch, X. (1998). Spain's warning on "anti-shyness pill". The Lancet, 352 (9136), 1292-1292. Retrieved from http://search.proquest.com/docview/198984592?accountid=34899 The development of shyness and social withdrawal. (2010), Scitech Book News, 34 (4), n/a. Retrieved from http://search.proquest.com/docview/815396804?accountid=34899 Findlay, L. C., & Coplan, R. J. (2008). Come out and play: Shyness in childhood and the benefits of organized sports participation. Canadian Journal of Behavioural Science/Revue Canadienne Des Sciences Du Comportement, 40 (3), 153-161. doi:10.1037/0008- 400X.40.3.153 Goldberg, C. (2007, Nov 17). SHYNESS: How normal behavior became a sickness. Science News, 172 (20), 319-319. Retrieved from http://search.proquest.com/docview/197448450 ? accountid=34899
References, cont. Hutteman, R., Denissen, J. J. A., Asendorpf, J. B., & Van Aken,Marcel A. G. (2009). Changing dynamics in problematic personality: A multiwave longitudinal study of the relationship between shyness and aggressiveness from childhood to early adulthood. Development and Psychopathology, 21 (4), 1083-1094. doi:10.1017/S0954579409990058 Ishiyama, F. (1987). Use of Morita Therapy in Shyness Counseling in the West: promoting Clients' Self-Acceptance and Action Taking. Journal of Counseling & Development , 65(10), 547. Retrieved from EBSCO host . Kagan, J.,J., Reznick, J.,S.J.S., & Snidman, N.N. (1988). Biological bases of childhood shyness. Science (New York, N.Y.), 240 (4849), 167-171. Retrieved from http://search.proquest.com/docview/78165591?accountid=34899
References, cont. Kamath, M., & Kanekar, S. (1993). Loneliness, Shyness, Self-Esteem, and Extroversion. Journal of Social Psychology , 133(6), 855-857. Retrieved from EBSCO host . Demister, S., & Emir, A. (2008). Shyness and Cognition: An Examination of Turkish University Students. Journal of Psychology , 142(6), 633-644. Retrieved from EBSCO host . Nelson, L. J., Padilla-Walker, L. M., Badger, S., Barry, C. M., Carroll, J. S., & Madden, S. D. (2008). Associations between shyness and internalizing behaviors, externalizing behaviors, and relationships during emerging adulthood. Journal of Youth and Adolescence, 37 (5), 605-615. doi:10.1007/s10964-007-9203-5 Romney, D. M., & Brynner, J. M. (1997). A re-examination of the relationship between shyness, attribution style, and depression. The Journal of Genetic Psychology: Research and Theory on Human Development, 158 (3), 261-270. doi:10.1080/00221329709596666
References, cont. Shields, M. (2005). Social anxiety disorder: Much more than shyness. Canadian Social Trends, (77), 22-28. Retrieved from http://search.proquest.com/docview/224122302 ?accountid=34899 Wessex, S. (2008). Book: How shyness became social phobia. The Lancet, 371 (9618), 1063- 1064. Retrieved from http://search.proquest.com/docview/199008615?accountid=34899