Psychiatrist Explains: Where Social Anxiety Begins

hey friends i'd love to talk to you today about our sponsor audible so i'm a huge fan of audible i've been a customer of theirs for over a decade now um i really love listening to audiobooks i found that as i've gotten busier and busier it's hard to find the time to actually read and the other real challenge is that you know we're so concerned about screen time and eye strain that i've really come to love audiobooks i tend to combine them with other things that i don't want to do so suddenly things like chores are doing the dishes activities that i generally procrastinate on are things that i sort of combine with the dopamine enjoyment of listening to a gripping audiobook i'm listening to rage of dragons by evan winter right now it's an epic book really love it makes doing the dishes really enjoyable so i'd really recommend that you all check out audible's free trial uh it's 30 day it's a 30 day free trial right now and also check out the audible plus program which i'm a huge fan of so you get one free book a month and in addition to that you get access to their plus catalog and what i love about that is that the plus catalog has a lot of audiobooks that i may not necessarily want to buy but you can still get access to so i do a lot of my non-fiction listening and learning through the plus catalog so if you all are interested you all can check out audible.com healthygamer or text healthygamer to 500 500. hey guys dr k here so today i'd like to do something a little bit different here at healthy gamer we want to start sharing case studies with you which are examples of particular um people that i've worked with or people from our community and we're going to kind of explain a little bit about who they are and kind of what the problem they struggle with is and sort of a little bit behind the theory or neuroscience behind why that person is stuck in a particular way and then ultimately share a little bit about how that person was able to move forward so for today's case study i want to share a case about bullying and social anxiety um that has to do with someone from our community a guy named adam so adam is a 21 year old caucasian male who was actually one year ahead in school and was bullied a lot and eventually developed social anxiety and we're going to go through a little bit about how that process works what happens in the brain during social anxiety and then eventually share a little bit about how adam was sort of able to overcome his social anxiety so to begin with adam um was actually a little bit precocious so started school early and so was actually one year younger than a lot of his colleagues so early on um tended to get made fun of a lot and uh wasn't quite as good at sports probably because he was a year younger than everyone else and so adam describes a very vivid memory of him being seven years old and maybe in the second or third grade um and every day that when he went out to recess he would be like super careful because there were a couple of kids that would bully him and so he really remembers like enjoying recess but also dreading recess because he wasn't sure whether he was going to get bullied or not and generally speaking it wasn't a problem in the classroom because teachers were around but on recess you know no one really did anything when he got pushed around so he remembers a really distinct uh time where he went out to play and then he remembers kind of this this image of there's a particular person who bullied him and then he remembers kind of this semi-circle of other kids that would watch and so what usually happens when a kid gets bullied is you know there's one kid who's doing the bullying and one kid who's the the victim and then a lot of other kids are watching so i want you guys to pause for a second and just kind of envision this you know there's a seven-year-old kid with an eight-year-old who's like bigger than him more popular than him and is about to make fun of him and a lot of the other kids actually know what's gonna happen right because bullies are gonna like advertise that they're about to bully someone and other people are going to kind of join in for the entertainment or just to watch and so what happens in the brain of the seven-year-old at that point what happens in adam's brain and so i want to share a couple of different uh parts of the brain and explain those so we can understand a little bit about what happens in bullying and then eventually how that leads to social anxiety so the first part of the brain that i want to explain is something called the amygdala the amygdala is a really primitive structure in our brain and what primitive means is that it serves a really basic um function and is sort of even in like animals and stuff the amygdala is pretty much the same so the amygdala is our fear and survival center it's the part of our brain that activates when we're afraid and it's the part of our brain that sort of prepares us to survive conflict right next to the amygdala is uh the limbic system as a whole and the limbic system is sort of our emotional circuitry and so that's so the amygdala experiences fear and the limbic system as a whole sort of experiences all of our other emotions also relatively primitive or older structure in the brain and then the next structure that i want to talk about is the hippocampus and the hippocampus is our learning center for the brain the really interesting thing is if you look at the the neuroanatomy of it the amygdal and the hippocampus are right next to each other and the reason for that is because one of the most powerful ways we learn is through negative experience so you can understand this really simply because if you think about let's say a restaurant that you like you've eaten there a dozen times and you really enjoyed it and if you eat there once and get food poisoning it's going to be really hard to go to that restaurant again even though like less than 10 percent of the time you actually get sick all it takes is one bad experience for your brain to learn that oh we want to avoid that right and that's absolutely a survival mechanism because we wanted to learn you know we wanted to learn very quickly if something was harmful to us we didn't want to be slow learners with negative things which is also kind of tricky because we learned so quickly from from punishment and negative experiences which is actually exactly what happened in adam's case so let's kind of go back to adam now that we understand these three parts of the brain and what happens when he sort of faces off against his bully is that his amygdala activates so he kind of goes into survival mode he may start to panic a little bit but as the amygdala activates it turns on this sort of symphony of physiologic and neurologic responses that are kind of what i call the danger circuit so his danger circuit activates so his blood pressure increases his heart rate increases his pupils dilate muscle uh blood rushes to his muscles and sort of prepares him for survival and blood moves away from other things too and this becomes really important so when our amygdala activates and our primitive structures activate what they actually do is shut off our more advanced parts of the brain so our cerebral cortex is a lot of what makes us human so the the outer parts of our brain is where we get a lot of our analytical thinking a lot of our kind of complex understanding of things a lot of our problem solving capabilities a lot a lot of our ability to see things in nuance or shades of gray so when the amygdala sort of activates we sort of turn to animalistic or primal responses as opposed to sophisticated ways of looking at things and that's absolutely a survival mechanism as well because we want sophisticated thought when we're kind of like calm and not in danger and we want black and white thinking and instant responses when we're in danger because it's kind of a life-and-death situation so our neurology is actually uh designed to shut off our ability to critically think and analyze situations in a rational way when our amygdala activates and so what going kind of back to the playground so our amygdala activates so his cerebral cortices shut off and then you know he starts to learn a really important lesson which is that when everyone is looking at me i'm in danger right so he wants to start to avoid being seen because being seen is being targeted and eventually what happens is as this happens again and again and so he gets pushed to the ground and stuff like that he starts to cry everyone laughs at him it's an incredibly traumatic experience and so his hippocampus is like hey anytime people are looking at us this is a real problem and so the bully continues to pick on him and then he also discovers something else that's really really important which is that if he's ever the center of attention and even for a good thing so like let's say he shows up so he told me a story about how um he showed up one day with a a psp right so he was like showing everyone his psp on the playground and so like in that moment everyone's like super impressed with like his his gaming console and so he's the center of attention and sure enough what happens is the bully walks over and once the bully sees that he's the center of attention he doesn't like that so he starts to put him down starts to bully him again things like that thankfully he didn't like lose his psp or anything um but eventually what what he learns is through each of these experiences that are a little bit traumatic his hippocampus is is learning right he's learning a very very important lesson which is that like it's important to be invisible it's safe to be invisible we don't want you know we don't want to be seen because whenever we're seen even though not whenever but ninety percent of the time we can be fine when we're seen but all it takes is ten percent of the time for us to learn to completely avoid that behavior and so over time his body wires his brain wires to avoid being seen and so as he continues to grow older and older and older you know that wiring is is kind of really deep rooted and sort of formed when he was really young so as he goes through his teenage years he starts to feel really awkward and then he winds up sort of eventually being 21 and he's incredibly socially anxious and he finds that any time he goes into a social situation where he's seen he feels targeted right and so what happens he goes like he'll go to a party where like no one even knows who he is and if anyone when he opens the door he told me this really distinct memory of like he's going to a party for the first time he opens the door and what is what do people do when you open a door everyone looks at the door and in that moment when people look at the door what happens in his brain his hippocampus is like hey we've been here before everyone's looking at us there are eight pairs of eyes on us right now and that means we're in danger and so it activates his amygdala it activates his limbic system it activates his sympathetic nervous system he starts to get flushed with adrenaline and he starts to feel like he's in danger now if we stop and we think about this for a second we'd think like oh this is social anxiety this is a mental illness right but if we really pay attention what we discover is that this isn't his brain malfunctioning this is his brain functioning the way that it was supposed to this is his brain learning that vaccine is to be targeted and so what what happens is each time he kind of goes into these social situations there are signals in his brain telling him hey man we're in danger because people are looking at us and so he tries his best to kind of overcome that right so what he does is he he tries to convince himself that his you know it's not really a problem and he has these like little arguments or wars with himself he goes into battle with his own mind before he gets to the party while he's at the party every instinct in his body is telling him to run run run but he says no i'm not going to have any friends if i run away and then he's just kind of tortured and if we really look at it why does that argument not work very well it's because remember the amygdala is shutting off his cerebral vortex so even though he's trying to argue with himself there are actually inhibitory signals from his amygdala to his cerebral cortex that are preventing it from acting fully so even though he's arguing against himself the parts of his brain that come up with good arguments the parts of his brain that can convince him of things and can actually change are actually being shut off by the amygdala which is why he feels so tortured at home right because when he's at home he can really see things logically because his cortices are actually functioning and so he he convinces himself he's like okay i'm going to go to the party today i'm going to be fine it's all in my head there's no big deal and and that feels real to him in that moment because his cortices are active and his amygdala is shut off but the second he walks in that door the second he opens the door and those eight pairs of eyes swivel and target him that part of the brain shuts off his cortex shuts off and the amygdala turns on and then all of his logic and all of his thinking go completely out the window and so he struggles with this immensely beats himself up all the time and is always kind of telling himself i don't know why i'm this way i figured it out i can be calm i know that it's not a problem and then the second that people start to look at him whether it's raising his hand in class or going to a party everything gets triggered and so he starts to become really frustrated with himself he also you know turns to the computer because he can form social connections there and why is it that he's okay talking online or interacting with people on games or social media it's because literally the hippocampus has learned that eyes looking at me is the problem that's what indicates danger and so the cool thing about the internet and also the addicting thing about the internet the thing that sort of keeps him trapped but also offers him salvation is that on the internet that danger signal doesn't activate because the danger signal is activated by pairs of eyes looking at me it's not actually activated by a computer screen and so while he interacts with people online he's completely fine because his cortex is working fine his amygdala is shut off that trigger doesn't flip the switch and so what do we do for adam right so he's kind of 21 years old spends a lot of time on his computer all of his social connections are through online communities and so what did we do for him so that the key thing it comes down to the neuroscience right so the first thing that we had to explain to adam is that first of all dude you're not busted there's nothing wrong with you this is just your brain kind of miscalibrated right it's like your brain has learned a particular thing and so all we need to do is like unlearn it and and learn something else and the more that i was explaining able to explain that to adam something really cool happened is that he used to beat himself up and then all of that negative emotion all of that frustration and all of that shame makes it really hard to rewire your brain and learn something new right it's really hard to move forward in life when all you feel is like shame and frustration with yourself so the first thing is to explain to him hey man like you're not busted you can actually change this it's just this is what happened to you and this is how your brain wired because you used to be in danger so that actually helped a lot the second thing that we did is we taught him how to meditate and more important than than sort of teaching him how to meditate in and of itself is that we um helped him notice his reaction and so what he was able to do is like observe that like mentally prepare and observe it's not that he was going to try to force himself to do anything because forcing himself to do something just led to failure and frustration and each time he forces himself he fails feels more ashamed and then he has to force himself harder and force himself harder and with each failure comes more shame and a higher problem to overcome and it was a vicious cycle so we had to break that cycle and the way that we break that cycle is by not trying to succeed but just by trying to notice so i started to tell adam is the next time you go to a party if you feel like turning around and walking away just turn around and walk away if you feel embarrassed about it no big deal we're gonna meet every week you know for therapy anyway so you can just tell me about your feelings and we'll work on those all i want you to do is notice what happens to you okay so when you walk inside the door prepare yourself for it recognize that there's a part of your brain that's going to turn on and is going to drive you absolutely crazy and recognize that these are primitive really important survival mechanisms that are designed to control your behavior these are the mechanisms that protected your ancestors from tigers and snakes and other predators so of course they're going to be powerful and you may not be able to control it just see what happens and so something really cool happens when he starts noticing it so he does lose some of those battles which is completely fine right because we want to teach him to not be ashamed of failure and to let him practice more because it takes practice but what he starts to realize is he starts to see that oh okay this is just a physiologic reaction and sometimes it's going to take control of me and the more he starts to notice it the more it actually starts to subside which is really really bizarre so instead of getting caught up in it he sort of sees it run its course so it starts to activate he's he knows that he's gonna feel like sweaty he knows that he's gonna feel you know very constricted he's gonna feel tightness in his chest and he's like okay here comes the tightness and he watches it and it rises and the more he watches it the more he actually doesn't react to it the more he doesn't engage in a war against it and try to control it the more it starts to just kind of wither and melt away and then he comes upon a really important discovery which is that when he fights his anxiety it actually fuels it and by noticing it and letting it be it starts to naturally just kind of subside because it doesn't have that sort of conflict to fuel it the other thing that happens in the brain so we're sort of telling him to do this but we're also being a little bit sneaky because noticing comes from your frontal lobes in your cerebral cortex so when i ask him to notice what we're actually doing is activating the parts of his brain that are actually going to help him overcome the anxiety we're we're turning on the very things that the amygdala turns off and there are numerous studies that show that especially the frontal lobes which are the parts of our brain that let us plan and execute an action right when i set an intention i set a goal and i follow through with our goal that comes from the frontal lobes so when he sets an intention to go to the party follow through comes from the frontal lobes and the frontal lobes get shut off by the amygdala along with the cortices so when we're asking him to notice what we're literally doing is flipping the on switch on his frontal lobes which allow him to set a goal and follow through to it and over time the a third thing happens which is that his hippocampus starts to learn that oh every time i open a door nothing bad happens and so i actually don't need to be in danger and so by activating his frontal lobes by reducing his self-judgment by giving him the capacity to fail and tuck his tail between his legs and run away and not letting him feel ashamed about that what we actually do is we desensitize him to the social situation right we help his brain actually rewire and about after about six to eight months of really kind of focusing on this you know he walked into my office one day and said you know what i actually have no problem going to parties now i still feel that anxiety but the anxiety doesn't control me so now what i do is i i kind of go in and i'll like just kind of be by myself for like 10 or 15 minutes and i'll let the anxiety kind of subside and then i'm fine for the rest of the night and so what we can really take away from this is that you know if you have social anxiety a lot of times it comes from roots earlier in your life and if you really understand the neuroscience if you really understand the biology and you really understand the process you can go about systematically dismantling it and i really hope that this case study illustrates that and if you guys struggle with anxiety i hope this is helpful and i encourage you guys to follow adam's same same process which is you know let yourself fail first and foremost and if you feel ashamed notice that shame the second thing is to notice the social anxiety process and don't fight with it and don't give in to it as best as you can just notice it and as you do that something magical will happen which is that the anxiety will start to subside it's not going to be around forever that's just not how our brain works right you're only anxious at the party and the anxiety is going to go away so i really hope that you guys enjoy this kind of content if you do you know please give us feedback and we'll present more case studies so take care and thank you very much adios from dr k

Channel: HealthyGamerGG

Views: 215,580

Rating: 4.9914436 out of 5

Keywords: mental health, drk, dr kanojia, healthygamergg, healthy gamer gg, twitch, psychiatrist

Id: CerQFsM7fWs

Length: 21min 14sec (1274 seconds)

Published: Fri Apr 30 2021

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