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Dear therapist, 

Ever since I was younger, I’ve had stage fright and social anxiety. I’ve managed to get through my school years by pushing myself to do what was necessary at the time. I’m not sure why but I’m finding myself struggling with it more and more to the point where I need to walk out of shul during laining because of my fear of getting called up to the Torah. Is this something I need therapy for or are there tips you can share that I can help myself with?

When anxiety is healthy it’s there to alert us to a danger in our environment and urges us to take action whether to protect ourselves or run away . God put it there so that we can survive . But sometimes our anxiety is a false alarm that goes on and we react to a situation with greater intensity then it calls for or feeling danger when there is no acute risk. When this type of response is happening often and interfering with our daily functioning it may indicate an anxiety disorder.  Anxiety disorders come in many shapes and sizes but the quality we see in all of them is that a person is either seeing threat where there is none or overvaluing the degree threat that’s actually present. Some people are nervous of specific things which we call phobias for example spiders Heights or small spaces (claustrophobia). Others have general anxiety and just tend to worry a lot about almost anything in their lives. In general, the therapeutic approach in treating anxiety is to help the person learn experientially that the situation is safer than it feels at the moment. This is done through purposefully exposing ourselves to the situations we fear.  For example, when dealing with social anxiety the person will usually fear being in public places, starting and/or continuing conversations with others, and a heightened terror of any form of public speaking. The typical underlying fear here is of being shamed publicly and the pain that comes with it. The truth is we all make mistakes and get embarrassed at times but we know that it passes and therefore doesn’t paralyze us from continuing to live life and be around others. The treatment therefore is to slowly but deliberately enter into situations that trigger the anxiety and not allow ourselves an escape from the feelings. The goal is not to avoid getting embarrassed but rather accept that it may happen and despite that we will live through it and be ok. No matter how much talk therapy a person does healing typically takes place only when we take the actions and experience and learn about this “false alarm”. In fact, the goal is not to avoid embarrassing ourselves but even if we make a mistake to see that the world doesn’t come to an end and that will be OK . Normally with a client we will together create a hierarchy of situations they fear and tent to avoid fears and have them slowly expose themselves to those situations from least top most fearful. For example, they would rate situations they avoid on a scale of 1 to 10 and start with the ones that only trigger a 1-3 rating.  In applying this to the specific example you gave, it seems that the fear of being called up to the Torah is that you’ll either make a mistake which will be embarrassing or just turning red and being noticed as being embarrassed or anxious even prior to that. The goal is to accept and understand that even if that happens, you’ll be able to survive and be OK . 

This same concept can be applied to the other similar challenges you face. 

When it comes to a person deciding whether or not to enlist the therapist, one way to approach it is to see how much the struggle is affecting their day-to-day life and functioning. If it’s causing significant impairment in their functioning, that would typically indicates the need for a therapist. In more mild cases there are workbooks that outline the approach I spoke about and some people are able to manage working through the fears in that manner. One such that I would recommend is The Anxiety and Phobia Workbook by Edmund J. Bourne PhD. I wish you luck on your journey and know that you are not alone in your struggle.

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