Social Explanations of Anxiety DisordersMatthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D.Although the biological and psychological vulnerabilities may explain why some people are more likely than others to develop an anxiety disorder, you may be wondering, how is it possible that different people come to fear different things? More specifically, what accounts for the different manifestations of anxiety? For example, how is it that some people come to experience social situations as extremely frightening, while others may be unaffected by social situations, but are deathly afraid of bridges? The reason for these different experiences appears to be that our early social experiences focus our anxiety on certain types of objects, and/or certain situations. These social influences represent a third type of vulnerability, and may account for the many different types of anxiety disorders.
A key concept in understanding the role of social experiences in the development of anxiety disorders is the social learning theory (SLT). According to Albert Bandura (1977), the principal founder of SLT, individuals learn new ways of thinking and/or behaving by observing how other people think and behave, in similar situations. More specifically, unlike the more traditional view of "behaviorism" which suggests people learn a behavior according to whether the behavior is "reinforced" or "punished," SLT proposes people can actually learn how to behave vicariously, without ever having direct experience with a particular situation themselves. Instead, individuals are able to learn how to respond to a particular situation simply by observing how others respond. This concept, that learning can take place without any direct experience, has important implications for the formation of anxiety disorders, and may offer one explanation for the many different ways that people experience anxiety.
According to SLT, people with anxiety disorders may have learned to be anxious through prior contact with other people who communicated, via their actions or the information they provided, that certain situations or objects are dangerous and subsequently must be avoid at all costs. For instance, some people with Social Phobia were taught (directly or indirectly) that it was extremely important to receive the approval of other people, and that "looking bad" in front of others was unacceptable. For example, a child may watch her parents getting ready for a visit from Grandma. During these preparations she observes her parents becoming highly anxious. She overhears her parents arguing about the impending visit. Then, her usually friendly parents become very formal and stilted in front of Grandma. In addition, her parents have carefully instructed her about what she can, and cannot say to grandma, with the threat of punishment for any misbehavior. As result of these experiences, this child may learn social interactions are not considered opportunities for rewarding and enjoyable experiences; but rather, social experiences represent potentially threatening and risky situations. As a natural outcome of these learning experiences, a Social Phobia may develop. Similarly, some people with Panic Disorder may have learned at a young age that any unexplained bodily sensation signals a dangerous or dire illness simply by observing the way their family members behaved; or, people with Obsessive-Compulsive Disorder may have been provided information that germs are everywhere and will positively make them very sick (omitting the important fact that the body is fairly well protected against germs). As you can see, the way early role models handled their own anxiety may directly, or indirectly, teach a child to respond in a similar manner, and may determine whether that child will subsequently experience their own anxiety as a result.
Therefore, through exposure to these early learning experiences, individuals may come to "mimic" the anxious behaviors of others. Since SLT suggests that this learning can take place simply through observation (i.e., as opposed to direct experience), individuals may learn to avoid certain objects or situations without ever having any independent knowledge or experience. As such, they have no opportunity to form their own beliefs or opinions about the accuracy of the information they were provided: It is irrefutable. Therefore, the avoidance of objects or situations that are feared by a caregiver, or other influential role-model, is nearly guaranteed. Although a large portion of social learning stems from direct interaction with caregivers, social learning may also occur through the observation of other influential role-models (e.g., actors and actresses, musical artists, prominent business people, politicians, etc.). This influence may be exerted through a variety of mediums, such as television, movies, and videogames.
While the social environment provides a guide for understanding the world and how to cope with anxiety, the social environment is also a key factor in the development of certain beliefs about oneself and one's abilities. Thus, the social environment influences our cognitive appraisals, and further illustrates the importance of social influences in the development of an anxiety disorder. Furthermore, the social environment can greatly influence whether or not individuals believe they are capable of learning new ways of thinking and behaving in the here-and-now, regardless of their past experiences. Indeed, in CBT treatment for anxiety disorders, the therapist becomes an important, new role-model in the therapy participant's social environment by expressing confidence in the participant's abilities; modeling helpful or adaptive behaviors; and supporting the participant's efforts to apply these new behaviors in their daily life. Thus, while social learning may contribute to the development of an anxiety disorder, it may also facilitate the recovery from an anxiety disorder.
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