Social Anxiety in a Community Where Everyone Knows Everyone

He arrives at the simcha hall early to find a seat facing the wall. For the next two hours, he rehearses what he will say if someone comes over to his table. She often skips kiddush. She tells herself she's tired. She knows it's not that. This piece is for frum men and women who experience a particular kind of dread in the spaces we live out our lives: the shul lobby, the Shabbos table, the wedding, the shidduch date. And for the parents and spouses who recognize that something beyond shyness is occurring. Social anxiety is widespread. Social anxiety is treatable. And a tightly-knit community makes social anxiety its own creature.

First, let's define social anxiety. Social anxiety disorder is not introversion or being reserved. It is an intense, ongoing fear of being observed and judged by others, so severe that it interferes with daily activities. And social anxiety disorder is not uncommon. An estimated 12.1% of all U.S. adults will develop social anxiety disorder at some point during their lifetime, according to the National Institute of Mental Health. Therefore, social anxiety disorder exists in every shul and every classroom. Mostly silent.

Shyness Stops at the Door. Social Anxiety Doesn't.

Social anxiety disorder is different than shyness in terms of what the fear does to you. A shy person eventually gets comfortable. A shy person experiences discomfort walking into the kiddush. Within twenty minutes, the shy person is fine. Social anxiety disorder does not get comfortable. The fear begins prior to the event (sometimes days prior), surrounds the event with a running commentary about how you are perceived by others, and persists long after the event, reviewing every statement you made for the remainder of the evening.

The fear manifests physically as well. Your heart races. Your face heats up. You sweat profusely. You feel nauseous. Your mind becomes blank. Next comes the aspect of social anxiety disorder that quietly controls a person's life: avoidance. You cease participating in class discussions. You allow calls to go unanswered. You create excuses to avoid attending the vort. Each time you avoid a situation, you receive momentary relief. Because you receive momentary relief each time you avoid a situation, avoidance becomes self-reinforcing. Avoidance teaches your brain that the situation was indeed dangerous. And that avoiding the situation was correct.

Why "Everyone Knows Everyone" Intensifies Social Anxiety

Social anxiety is common enough that there are numerous articles available regarding social anxiety. What those articles fail to explain to a frum reader is that although frum life offers numerous opportunities for chesed and belonging, frum life can also exacerbate social anxiety far beyond what a clinical pamphlet describes. When considering frum life, it is apparent that frum life is communal-based by nature. You daven with the same men three times per day. Your children attend school with children of other families in your kehilla. There are numerous simachos throughout the year and attendance at simachos is noted. There is very little anonymity in frum life. And virtually no opportunity to be a stranger. While most people find this comforting and supportive, for a socially anxious person frum life is a constant spotlight.

In contrast to frum life, in a large anonymous city you can have an unpleasant interaction with another person and likely never encounter that person again. In a kehilla however, you will likely see that same person at the next bris. That same person's spouse may mention the incident to your spouse. In the mind of a socially anxious person, this interaction will be permanent.

Another factor contributing to social anxiety in frum life is reputation. In a society where reputation genuinely matters and where information spreads rapidly through informal channels, the fear of "what will they think of me" is not entirely irrational. Some aspects of this fear are directly related to the social structure of frum life. Consequently, social anxiety in frum life can be difficult to rationalize away. Treatment for social anxiety in frum life must therefore address the actual social consequences of social anxiety rather than dismiss fears as mere fantasies.

Shidduch Pressure Cookers

Dating is inherently an evaluative process. And social anxiety is fundamentally a fear of being evaluated. Combine these two elements and you have a period of life designed specifically to torture the very individuals who are predisposed to social anxiety. A shidduch date demands a great deal from a socially anxious individual. Hours spent engaged in sustained conversation with a complete stranger upon whose evaluation you are repeatedly reminded a great deal depends. Prior to the shidduch date you are aware that you were researched; that people were contacted; and that you are being discussed in living rooms you will never enter. Following the shidduch date you must debrief with either a shadchan or a parent and demonstrate your performance once again. Some socially anxious singles appear cold or uninterested during a shidduch date when in reality they are experiencing the opposite emotion; their fear has paralyzed them. Other socially anxious singles cannot even attend shidduch dates and therefore receive multiple names of potential matches without success. And no one identifies the cause because no one has asked about anxiety.

Social anxiety disorder impacts daily life. A socially anxious individual whose anxiety is controlling their dating life can remain stuck for years believing they are unlovable or too selective. When in reality their greatest impediment is a treatable condition. Recognition of social anxiety disorder can change everything about what occurs next.

When Anxiety Is More Than Nervousness

Everyone experiences nervousness prior to major social events. It is normal and beneficial to feel nervous prior to speaking at a sheva brachos. How then do you differentiate between typical nervousness and social anxiety disorder requiring intervention? There exist several indicators helping to make this distinction:

• Persistence vs. Occasional Occurrence: Dread appears in numerous contexts for months (not merely before a single major event).
• Life Shrinkage vs. Maintenance: You are declining invitations; avoiding synagogue attendance; avoiding simchas; or modifying your career path/dating habits to accommodate your fear.
• Anticipation vs. Event Itself: You lose sleep/days prior to events worrying about them and spend hours following events obsessing over them.
• Reaction vs. Proportional Response: Your body/mind react to kiddush as if it were a life-threatening situation.

Females exhibit social anxiety disorder at slightly higher rates than males; however, many males suffer silently from social anxiety disorder as well. In a community where young men are expected to participate actively in tishes, and young women are expected to engage socially at vorts, pressure to conceal social anxiety disorder exists in both sexes. Concealed is the key word. Social anxiety disorder is particularly adept at concealing itself as aloofness, arrogance, disinterest, etc., as well as appearing as "not a people person." Behind the mask lies an individual desperately seeking connection yet dreadfully fearful of it.

What Helps Most Effectively

Fortunately, social anxiety disorder is one of the most effectively treatable mental health disorders existing today. The primary method utilized in treating social anxiety disorder is Cognitive Behavioral Therapy (CBT). A component of CBT used in treating social anxiety disorder is Gradual Exposure Therapy (GET). GET is not throwing you into the deep end; rather, it is a systematically developed program involving incrementally increasing levels of difficulty/discomfort in various social situations until your nervous system learns that kiddush is not a threat and that dreaded outcomes do not occur as anticipated. GET is developed by a trained professional working collaboratively with you to identify areas where you wish to improve your ability to cope with anxiety; develop strategies for coping with anxiety in those areas; and gradually expose you to those areas until you gain confidence in your ability to cope with anxiety in those areas. Depending upon your individual needs/preferences, medication may assist you in managing anxiety enough to allow you to participate in therapy sessions. Medication selection should be determined collaboratively between you and a board-certified psychiatrist. Neither CBT nor medication requires you to become a fundamentally different person nor cease being private by nature. Rather, CBT/medication enables you to regain control over choices regarding how you interact socially that avoidance had quietly stolen from you.

It would be advantageous for you to locate a therapist who possesses knowledge regarding frum life since treatment for social anxiety disorder must incorporate the actual social context in which you exist; not some generalized social context. A clinician familiar with what a vort is; why the shul lobby holds significance for you; and how shidduchim function can develop GET programs specifically tailored to meet your individual needs/preferences rather than expecting you to describe your social world to him/her first. Tailoring GET programs to fit your social world is not optional; it is fundamental to ensuring that GET programs are effective for you.

How Frum Families Can Start

If you identified yourself or someone in your family/home in any of this material, do not push yourself/family member(s) to "just go, you'll be fine." Instead, seek assistance from a professional trained in dealing with anxiety. OKclarity's Guide to Anxiety & Therapists Who Treat Anxiety In Jewish Communities provides a starting point for identifying therapists specializing in treating anxiety in Jewish communities and its Directory of Frum/Jewish Therapists allows you to locate a therapist who understands both anxiety and the social world in which you live. You are not antisocial nor broken; you are struggling with a common problem that responds favorably to treatment far more often than anyone realizes.

Glossary

For readers unfamiliar with Hebrew/Yiddish terminology used above:

• Bochur - Young man; typically Yeshiva student
• Bris - Circumcision ceremony occurring on eighth day
• Chesed - Acts of kindness; loving-kindness
• Daven - To pray
• Kehilla - Jewish community/congregation
• Kiddush - Refreshments/gathering following Shabbos morning davening
• Redt - Yiddish for "suggested"; used for recommending shidduch match
• Semachos (singular simcha) - Joyful occasions e.g., weddings/bar mitzvahs
• Shadchan - Matchmaker
• Shabbos - Sabbath
• Sheva Brachos - Week-long festive meals following wedding
• Shidduchim (singular shidduch) - Matches for marriage; frum dating/shidduch system
• Shiur - Torah class/lecture
• Shul - Synagogue
• Tish - Gathering around Rebbe's table; often includes singing
• Vort - Engagement gathering/short Torah thought

References

• National Institute of Mental Health. Lifetime prevalence/past-year prevalence of Social Anxiety Disorder among U.S. adults. https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder
• National Institute of Mental Health. Background information regarding prevalence/impairment associated with Any Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

• Anxiety
• Relationships
• Transitions & Change