Shyness and Social Anxiety (Rebroadcast)

MS. DIANE REHM

10:06:53
Thanks for joining us. I'm Diane Rehm. For people who suffer from social anxiety, even simple activities, like buying groceries or asking for directions, can cause panic. For others, a shy temperament can be a source of strength that allows for a deeper understanding of friends and family members. Joining me here in the studio to talk about shyness and social anxiety, Todd Kashdan of George Mason University, Liza Gold of Georgetown University Medical Center and Susan Cain.

MS. DIANE REHM

10:07:41
She's the author of the forthcoming book titled "Quiet: The Power of Introverts in a World That Can't Stop Talking" -- great title, really great title.

MS. SUSAN CAIN

10:07:52
Thank you.

REHM

10:07:55
And throughout the hour, we'll take your calls, 800-433-8850. Send us your email to drshow@wamu.org. Feel free to join us on Facebook or Twitter. And good morning to all of you.

CAIN

10:08:18
Good morning, Diane.

DR. LIZA GOLD

10:08:19
Good morning, Diane.

MR. TODD KASHDAN

10:08:19
And good morning, Diane.

REHM

10:08:20
You know, let's start with this whole notion of the spectrum of shyness, which, it seems to me, Todd Kashdan, can go from, you know, that lovely bashful sort of quiet quality all the way to stressful, a social anxiety to phobia. Isn't there a continuum there?

KASHDAN

10:08:55
Oh, absolutely. And I would even say that -- so when we think of shyness, we're talking about a tendency to be reserved, to be inhibited, trying to be a little bit coy and not really expressing yourself openly with other people around you, not wanting to be in the social spotlight. And then, as you're saying, where it's a continuum, when you move a little bit further to the level of where it gets to become a problem, is that people we might describe as being socially anxious, where they're basically fearing the possibility that they might be scrutinized by other people.

REHM

10:09:34
And what about the notion of needing help, Dr. Gold? As a clinical professor of psychiatry at Georgetown University, you must see a lot of people who feel that they can't quite make it because they are too shy or socially phobic.

GOLD

10:10:03
Well, and it is a pretty common problem. Approximately 15 percent of the population would qualify for a diagnosis of social phobia and/or generalized anxiety disorder, and they do kind of get mixed up with each other quite a bit.

REHM

10:10:23
Fifteen percent. Really?

GOLD

10:10:25
Between 12 and 15 percent. It's pretty common. It's one of the most common disorders that you see, and it's also not necessarily recognized for its severity and impairment that it can cause. It can cause people to under-function in a variety of ways. And when it becomes problematic, people will often seek out help. Typically, people try to manage it on their own with a variety of compensating or coping mechanisms.

GOLD

10:11:02
But when those start to fail or are overwhelmed by a situation -- so, for example, I've treated a college student who, when she was going to high school and was familiar with the people around her and the teachers, whatever -- it was a familiar environment -- she had social anxiety, but she was able to function and do very well. When she got to college and had to walk into a new classroom, bigger setting, et cetera, she could not bring herself to walk into the room. Now, that's obviously going to be a problem.

REHM

10:11:32
Sure, yeah.

GOLD

10:11:33
And so, at that point, she presented for some help. So it can be quite disabling.

REHM

10:11:40
But Susan Cain, in your book "Quiet: The Power of Introverts in a World That Can't Stop Talking," I gather what you're saying is that shyness or introversion can be not only acceptable, but desirable.

CAIN

10:12:01
Yes, that's right. And there are so many different ways in which it can be acceptable and desirable. And just to tell you about a few of them -- so looking at shy children, to start with, children who display fearful temperaments also display stronger consciences. So studies show that these kids are much more likely to be described by their parents as having very high levels of empathy. They're much less likely to cheat or to lie, even when they think they can't be caught. And this is because part of the way that people form their consciences is by being very sensitive to disapproval.

CAIN

10:12:40
So if you're looking at a child who has that exquisite sensitivity, they are forming these strong consciences very early on and in very extreme ways. And this continues all the way through so that when you look at these children when they grow up, often, they are very high in traits like conscientiousness.

REHM

10:12:59
And what we would normally say about a child who displays that kind of temperament is, oh, isn't she or he sweet, bashful? I mean, just bashful, not thinking so much about introversion or extroversion, but rather about a sweet, bashful child.

CAIN

10:13:28
Yeah, and I think that what we often do -- well, two things. What we often do is we tend only to see the shyness or the bashfulness, and we're not thinking about the broader temperament that the shyness is a part of. So shyness itself is a painful thing. I don't think anybody likes to feel shy, and I don't think anyone wants to see their children feel shy. But when we look only through that lens, we're missing so much wider a part of the person and the temperament from which the shyness comes. And that's really the key.

CAIN

10:13:53
And then I wanted to say something else. When you're talking about introversion and shyness, just for the benefit of listeners, I want to distinguish between the two of them 'cause they really are different. Shyness is much more the fear of negative judgment, the fear of social disapproval, whereas introversion -- an introvert might not have those fears at all. An introvert is merely somebody who prefers minimally stimulating social environments. So they would much prefer to have a glass of wine with a close friend instead of be at a raucous party, let's say.

REHM

10:14:25
Dr. Gold, would you agree with that kind of differentiation?

GOLD

10:14:32
Yes, as broadly speaking. Again, someone who is introverted, that is a personality type of characteristic. And there are people who just prefer to sit at home and read rather than go out to a party, that kind of thing, and there's nothing pathological about any of it. We all have personalities. We all have personality characteristics and traits. Shyness becomes an issue because it is on -- or could become an issue because it's on a spectrum where, at one end, you have shyness and at the other end, you have an extremely painful -- you know, the minimal shyness can be painful.

GOLD

10:15:13
But you have an extremely painful and impairing condition that may actually interfere with someone's functioning and productivity and life. And, in fact, the incidence of suicide in people with various kinds of anxiety disorders is approximately as high as the incidence of suicide in people with mood disorders. The anxiety is so painful and people struggle so much with it that it can lead to the kind of despair and desperation that you sometimes see in depression.

REHM

10:15:47
Now, Todd, can you once more differentiate between anxiety and phobia, full-blown phobia?

KASHDAN

10:15:59
Sure. But let me just address something that Susan mentioned. And what we find in our research is that while people with high social anxiety might possess these interpersonal virtues, such as empathy or generosity or gratitude, what we find is they end up being dormant and unused. And the reason is, is that they're so self-focused, they're so worried about making a blunder, they're so focused on whether someone can see their anxiety that they have a difficulty actually being there when good things happen to other people.

KASHDAN

10:16:33
So we bring romantic couples into the laboratory, and we do this weird stuff where we ask them to share events they've never shared with each other before. So share something, a triumph or a joy, you've never shared with a romantic partner before. And we're observing them through a one-way mirror because we're psychologists, so we have to deceive people -- that's our job. And what we find is, is that people with elevated social anxiety, is they tend to have difficulty sharing in their partner's triumph.

KASHDAN

10:17:01
Instead of saying, that's amazing that you got a new promotion, they tend to say, wow, that sounds like you're going to have to be working a lot more hours. So they're discounting it, or they're moving the conversation to something totally different. That sounds really nice, but what are we having for dinner tonight? Now, here's the thing. When your partner is sharing a really beautiful thing that happened to them and you're not elaborating on it or expanding on that, what happens is they feel -- they don't feel valued. They don't feel cared for.

KASHDAN

10:17:31
And the partners recognize this. And one of the greatest predictors that we're finding six months later in romantic relationships is a decline in satisfaction, a decline in the commitment of the romantic partner, is that people with elevated social anxiety are showing a failure to attend to the enthusiasm of their partner. So they might have these strengths, but they're not being used. They're unrealized.

REHM

10:17:57
Susan, would you agree with that?

CAIN

10:17:59
Well, yes. But, I think, really, the key here to be thinking about is the concept of a spectrum that we were talking about earlier. So, sure, when somebody is on any kind of an extreme end of the social anxiety spectrum, it's going to cause all kinds of problems, like the kinds that Todd was talking about and others as well. The real key, I think, is, how can you move people towards the end of the spectrum where the shyness is merely a part of who they are, but it's not interfering in these significant ways and, instead, it's actually leading to positive outcomes?

REHM

10:18:33
Susan Cain, she's author of a forthcoming book, and it's titled "Quiet: The Power of Introverts in a World That Can't Stop Talking." Short break and we'll be right back.

REHM

10:20:01
As we talk about shyness and, indeed, social anxiety, joining us now from an NPR studio in New York, David Sloan Wilson. He's Professor of Biology and Anthropology at State University of New York in Binghamton. Good morning to you, Prof. Wilson. Thanks for joining us.

PROF. DAVID SLOAN WILSON

10:20:27
Good morning to you.

REHM

10:20:28
Tell me. Isn't some amount of anxiety necessary for survival? What's the role of evolution here?

WILSON

10:20:41
Well, there's two roles. All of us need to feel pain and anxiety and depression. All of these things don't feel good, but they do help us survive. So that's part of the equipment of every individual. But there's also individual differences to consider. And it's fascinating that, not just in humans, but in many other species, there's individual differences that we associate with shyness and boldness. So we have to think beyond our own species to other creatures, such as primates and birds and even fish, as strange as that might seem, also have these personalities that we associate with shyness and boldness.

REHM

10:21:19
So what determines whether shy animals or bold animals survive in nature?

WILSON

10:21:31
Well, just as there's many species out there and they all survive and reproduce in different ways, have different niches, it turns out that's also true for individuals within a species. And you can well imagine the advantages of boldness and the cost of boldness. Because if you take risks, you know, if you grab life by the horns, sometimes you get gored. So -- and, on the other hand, if you're shy and you hang back, then you're not going to be the one that's grabbed by the predator. So it's pretty easy to think about the cost and benefits associated with both of these personality types.

WILSON

10:22:07
But something else has emerged, which is more subtle, and that is the degree to which individuals pay attention to their environment. This is something that never occurred to us until we started to -- it started to emerge from studies. But some individuals are kind of on automatic pilot. We know people like this. And other individuals are really, you know, acutely sensitive to their environment.

WILSON

10:22:30
And what that means is that sometimes they get overwhelmed by that ability, but sometimes that leads to great accomplishments, basically, which the inattentive ones tend not to achieve. So there's good news and bad news associated with both.

REHM

10:22:47
Susan Cain, do you want to comment?

CAIN

10:22:49
Oh, yeah. You know, I just think it's interesting what Prof. Wilson is talking about with animal behavior, and you see this in -- translated into human behavior almost automatically. You go in, for example, into your typical mommy and me music class, and you will see a group of children around the room, each one on their mothers' laps. And you'll see the bold children automatically getting up from their mothers' laps and marching around the room and banging their drums and exploring and shaking around their maracas.

CAIN

10:23:19
And then you see the more sensitive or quiet children, and they are sticking closely to their parents. And it might look as if they're not getting as much, at first, out of that music class. But, really, what they're doing, to Prof. Wilson's point, is they are closely observing, very alertly, everything that's going on. And then you'll often see them days later or weeks later performing some of the...

REHM

10:23:45
Interesting. Prof. Wilson, give us an example from your own research. Tell us about the rovers and the sitters in the pond of sunfish.

WILSON

10:23:58
Well, we were among the first people to study this. And we went to a pond where there were little sunfish, and we threw in minnow traps. Most of your listeners know what that is, shiny funnel-shaped traps. And, you know, you'd think that would be scary, and, indeed, some fish ran the other way. But some were just so curious that they were sucked into the traps just by their own curiosity. So we retrieved those fish, and then we caught the ones that didn't go into the traps with a net. And then we examined their individual differences in the laboratory.

WILSON

10:24:31
And what we discovered were just enormous, enormous differences between these fish that we caught in different ways. So that was our own way of starting to study shyness and boldness. Other researchers in birds will catch birds, like our chickadees, and bring them into an aviary where there's trees and things like that. And they'll simply put them in, and they'll measure how long does it take for them to start hopping around. And some begin very quickly, and others hang back. And they're precisely like the children that Susan just discussed.

WILSON

10:25:09
So they're just -- so that the -- this is a difference which is extremely general, not only between species, but also kind of across sensory modes, so that the same individual that hangs back also tends to have sensitive skin, is especially sensitive to coffee, is likely to be overwhelmed by a symphony. So we're talking about people that are wired in very different ways.

REHM

10:25:36
Interesting. Susan Cain, you are a self-described sitter. Were you always that way? Describe your own growing up.

CAIN

10:25:48
Oh, yeah, sure. So I can remember being shy as a child. And my parents say that when people used to come to the house, people who I didn't know, I would run upstairs 'cause I didn't want to see them. So I really was a classic sitter in these ways. And I'm also, I would say, a classic introvert in the sense of really enjoying my time alone reading and that kind of thing. I've always had a lot of friends, but I've also, at the same time, had always the initial period of needing to get comfortable before plunging ahead, in classic sitter style.

CAIN

10:26:22
But, you know, I really started to think about the advantages of this kind of a disposition when, through a strange set of circumstances, I found myself practicing corporate law on Wall Street for seven years when I was in my 20s and 30s.

REHM

10:26:35
Whoa.

CAIN

10:26:36
Yeah. And, at first, when I did this, I had the idea that, as a sitter, I would be disadvantaged, you know, that a powerful corporate lawyer had to be very bold and alpha and comfortable in the spotlight. And I quickly found that that was completely not true and that, yes, that's one way of being powerful. But there was a completely different constellation of traits that you could bring with you that would also make you very powerful, you know, traits like listening carefully to people and asking questions and building alliances one-on-one behind the scenes with people.

CAIN

10:27:05
You're not so comfortable in groups? Fine, you do it one-on-one, and that can be much better.

REHM

10:27:10
Liza Gold, what do you think of the personality trait she just outlined?

GOLD

10:27:16
Well, what Susan's talking about is, you know, finding fits. You know, we all have personalities. We all have strengths. We all have things that, if we're challenged to do, we may not do as well as other people. And if you know yourself and you understand what fits well for you, people, who can adapt, who find an environment which is adaptive to their strengths, will do well, even if it's something that you think of as not necessarily straightforward a strength, like shyness.

GOLD

10:27:52
So it sounds like what Susan did was know herself, know what worked for her and then adapt in the environment that she found herself.

REHM

10:28:04
But how often do you think today's young people, middle-aged people, older people need medication to be helped with that?

GOLD

10:28:17
Well, that's a very difficult and different kind of question...

REHM

10:28:21
Yeah.

GOLD

10:28:21
...because, first of all, medication's not the only treatment for anxiety disorders. And it's not even necessarily the first line treatment. It really depends on the severity of someone's symptoms and presentation and the degree of impairment that it's causing. There are other treatments, cognitive behavioral therapy, exposure therapy, meditation, relaxation, even acupuncture, which I've seen work very well for people. Some people need to do those things in combination with medication to get the best effect.

GOLD

10:28:55
You know, the more impaired someone is and the more physically uncomfortable they are in their own skin, the more one thinks about whether medication is another tool to put in their toolkit to manage anxiety.

REHM

10:29:09
Todd.

WILSON

10:29:10
I would like to reinforce that.

REHM

10:29:11
Sure.

WILSON

10:29:12
I think that medication is a second or third line of defense and that the proportion of people that require meditation is more in the range of 3 to 5 percent, not 12 or 15 percent. There's many environmental solutions. So I simply want to reinforce that point.

REHM

10:29:30
Sure. Todd.

KASHDAN

10:29:31
And, building on what David said, I mean, one thing that we -- this big question I've been interested in is, even if you have a disorder, schizophrenia or eating disorder or social anxieties or -- the fact is, you're going to have some days that are good. So we've been asking, well, what makes for a good day for someone with extreme shyness or social anxiety problems? And what we found is there are natural therapeutic processes in everyday life that ameliorate difficulties, that enhance our positive experiences.

KASHDAN

10:30:02
And, for example, if you were to have -- there are very few situations where we objectively know that somebody cares for us and is actually interested in us, except for maybe a warm embrace by our parents and then maybe a really caring sexual experience.

KASHDAN

10:30:18
And so what we were interested in is, well, if someone with social anxiety had really intimate sexual experiences, felt close and connected to their partner, would this sense of belonging carry over into the next day where they wouldn't feel that they had to make a good impression on other people, they wouldn't feel that they had to make -- compare themselves to other people and see themselves as not as attractive or interesting?

KASHDAN

10:30:40
And what we found was with more pleasurable intimate sex with a romantic partner led to less shyness, less social anxiety symptoms the next day, and they were functioning better. And we also found -- and this, I think, is really relevant to thinking about therapy beyond medication -- that on days when people find that they're committed to a profound purpose in life -- it doesn't have to be religious. It could be caring for your kids, could be making the world a better place, could be putting your personal signature in your work.

KASHDAN

10:31:13
On days when people commit to a purpose in life, their self-esteem, their sense of self-worth looks no different than the most healthy alpha male on the top of the social hierarchy.

REHM

10:31:25
Interesting, interesting.

GOLD

10:31:27
Can I add, though...

REHM

10:31:28
Sure.

GOLD

10:31:28
...that a lot of these techniques, which are incredibly useful and research supports how helpful they are, there are still a category of people who are unable to tolerate or engage in the anxiety that even these techniques produce without some decrease in the amount of anxiety they feel on a minute-to-minute basis. And there's a lot of generalization of anxiety. It can start as social anxiety, and then one becomes anxious generally...

REHM

10:32:01
Yeah.

GOLD

10:32:01
...about any situation, or certain kinds of situations. And things get very tangled up and very difficult for these individuals. And so sometimes you do have to start with the medication in order to move them into some of these other things, although I would like to find out how to prescribe the sex...

GOLD

10:32:22
...as a cure for...

REHM

10:32:23
All right.

GOLD

10:32:23
That would be very useful.

REHM

10:32:24
Let me read this email from Maggie who says, "My husband is an introvert. I am not. We balance each other out. I believe this may have been one factor that actually brought us together. On the other hand, at the end of a day at home with our baby, I'm dying to chat with an adult while he's exhausted from a day communicating with colleagues and wants quiet time. This," Maggie says, "is a challenge." And you're listening to "The Diane Rehm Show." Susan, do you want to comment?

CAIN

10:33:05
Yes. Maggie, in doing the research for my book, I must have spoken to hundreds of couples just like you and to hundreds of extroverts who have the same frustration. It's very common for introverts and extroverts to come together in marriage because the two people understand that they can complement each other in a very beautiful and fulfilling way. And then it's also very common for that to lead to these kinds of...

REHM

10:33:31
Frustrations.

CAIN

10:33:32
...frustrations.

REHM

10:33:32
Yeah.

CAIN

10:33:33
Excuse me. I think the first thing to do is -- and it sounds like you've done this already -- to really -- pardon me -- to really understand where your partner's coming from and for he to understand you, and then maybe to take it a step beyond that and to really come up with concrete practices that you're going to follow together -- like, we're going to understand, both of us, that -- this is just by way of example -- when your husband comes in from his day of work, he takes half an hour by himself.

CAIN

10:34:04
And no one's asking any questions, and he's taking the time that he needs to recharge from all the energy he's had to spend in his workday. And only after that half hour do you -- does he come together.

REHM

10:34:15
Sounds like couples therapy is an appropriate approach at that point. But, you know, it does seem to me that we have sort of a beautiful example of this in our own history, David Sloan Wilson, and that is in Eleanor Roosevelt, certainly a shy young woman.

WILSON

10:34:46
That's right. And so she rose to the occasion. One point that I've been wanting to make during this interesting conversation is that people do have a remarkable ability to rise to the occasion. Even if it's not what they would prefer, they do manage, and they manage in their own way, as Susan did as a corporate lawyer. And, also, research shows that if you take these highly sensitive people, these ones that are so attentive to their environment, whether they become shy or bold actually depends on their experience.

WILSON

10:35:21
About 80 percent become shy, as we've been describing, but 20 percent figure things out so well that they become bold. And you actually might not recognize them for being the sensitive people that they are. I think we've all met people who seem to be outgoing and, in fact, are outgoing, but when they talk to you about it, they say, well, you know, I'm really a shy person on the inside.

REHM

10:35:42
I'm really shy, yeah, yeah.

WILSON

10:35:44
And I think Eleanor Roosevelt is an example of a person who was clearly a very sensitive introverted person, and yet she was kind of called to greatness.

REHM

10:35:54
Sure.

WILSON

10:35:54
And she rose to the occasion.

REHM

10:35:55
Yeah. Todd.

KASHDAN

10:35:57
And just to agree with David's point is we need to look beyond the veneer of how people overly define themselves as one or the other. I'm pessimistic or optimistic. I'm introverted or extroverted. All of us are some degree of both and that, if you look at people's behavior, you find that everyone tends to exhibit some of these behaviors some of the time. And hitting what David said, what we find is, when you look at people, whether they appear extroverted and social and aggressive, sometimes the motivation for that is, I'm going to reject you before you have a chance to reject me.

KASHDAN

10:36:35
And so you find that a lot of people that are shy, they tend to be hypersexual, aggressive, substance abusers and what this is, is it relieves their anxiety in a very different way than a shy person who might walk away from a social situation because it's too stimulating. These are people that -- I'm going to take what I desire. And in this way, I'm going -- if I want to find -- to satisfy this need to connect with other people, I'm going to go seek out very quickly and find a sexual partner. And if someone's going to potentially harm me, I'm going to harm them before they get a chance to harm me.

REHM

10:37:12
Todd Kashdan, he's Associate Professor of Psychology at George Mason University. Dr. Liza Gold, she's Clinical Professor of Psychiatry at Georgetown University. Susan Cain, she's the author of a forthcoming book titled "Quiet." And, joining us from an NPR studio in New York, David Sloan Wilson of State University of New York.

REHM

10:40:02
And we're back. It's time to open the phones. We've got lots of shy people on the phones. Let's go first to Fort Lauderdale, Fla. Good morning, Tony. You're on the air.

TONY

10:40:17
Good morning, everybody. This is a very exciting conversation, and I'm really glad that everybody -- that we're talking about this.

REHM

10:40:25
Good.

TONY

10:40:26
I identify as an introvert, and I'm known by others as such. And I'm very comfortable with this. I don't -- I don't suffer from social anxiety. I'm really not going to talk about that. But I just feel there are a great deal of benefits to this type of being the way I am, and I'm -- it's always been my belief that there's two types of people. You're either outgoing and extrovert, or you're an introvert. And it's been my experience that people who are extroverts tend to think that there's something wrong with people who are more shy.

TONY

10:41:02
And I've actually had one person tell me it's a disorder, a personality disorder, and I just don't understand that. But one that -- you've covered a lot of the advantages and the benefits, such as empathy, which I'm known for and the like. One of the great things about it is being that I don't talk all that often, when I do speak, people really pay attention. You know, they'll sit up and, oh, my gosh, he said something, you know, and they'll listen. And it has more of an impact, and it's just -- opposed to someone who's always yacking away.

TONY

10:41:36
So the other advantage is I have a really fair amount of very good friends, people who are very close to me. And they all tend to be extroverts, which is good for me because they draw me out of my shell and force me to engage. That's what I get out of it. What they get out of friendship and relationship with me is someone who they can confide in that they don't talk to other people about certain things. And I'm very flattered by that, and I'm very honored -- you know, I feel very fortunate that they can -- they feel that way about me because I do listen.

REHM

10:42:16
That sounds very much as we were talking earlier about the empathetic listener, the person who is shy who's not demanding the attention all the time, but is willing to sit back and listen.

WILSON

10:42:34
Diane, Diane?

REHM

10:42:35
Yes, David.

WILSON

10:42:37
I would like to add something to that, that interesting comment, which is that it makes an enormous difference how something is framed by the culture. And if something is characterized as a disorder as opposed to a strength, of course, that makes all the difference.

WILSON

10:42:50
I think that we could make a huge contribution right away by saying that -- with some exceptions in which -- rare exceptions in which social anxiety is a disorder -- in most cases, you know, what you are is somebody with enormous strengths that you need to develop and you need to develop that in certain ways, you need to avoid some situations, not others, but what you have is a strength and not a disorder.

REHM

10:43:13
Liza.

WILSON

10:43:13
That all by itself is going to be huge.

REHM

10:43:16
Absolutely.

GOLD

10:43:17
And I was thinking along the same lines. As a society, we have developed a tendency for all kinds of reasons which would form the basis, I think, of another hour of discussion, to pathologize what are really basic, normal human traits and characteristics, even anxiety. When people say anxiety, we think, oh, anxiety is bad. Anxiety is not a bad thing. If a lion is about to eat you, you should be anxious, and you should run as far as you can go. Your anxiety should not just suddenly disappear...

REHM

10:43:50
Right.

GOLD

10:43:50
It should be -- not be (word?). So you want to run and run and run until you're sure that that lion is not going to eat you, okay? That is what anxiety is for, speaking of evolution, I mean.

REHM

10:44:01
Fight or flight.

GOLD

10:44:02
Well, right. It's there to help us protect ourselves. So to say that, you know, that's -- that a situation makes someone anxious is not necessarily a negative comment, although it is typically construed, you know, as a negative comment just because of the word. And I would comment on the caller that -- very small part of his -- what he said was that, you know, someone even said he had a personality disorder.

GOLD

10:44:27
I think that's a very slippery slope, this pathologizing of, you know, who we are in our personality traits and our characteristics. I think it's hard to define where the line is sometimes. But generalized anxiety disorder, generalized social anxiety, people who really suffer from that are really suffering from that.

REHM

10:44:52
All right. Let's take a caller in Hyattsville, Md. Good morning, Carol.

CAROL

10:44:58
Yes. Thank you for taking my call.

REHM

10:45:00
Surely.

CAROL

10:45:01
I wondered if your guests would discuss Emily Dickinson and her withdrawal.

REHM

10:45:10
David.

WILSON

10:45:11
I have to confess that I don't know that much about Emily Dickinson, per se, so I need to pass that to somebody else.

REHM

10:45:16
All right. And Susan.

CAIN

10:45:17
Well, yeah, I mean, Emily Dickinson is a classic example of a poet who was known for her reclusive ways and used that to fuel her poetry. And, you know, it's funny. We've got a strange cultural current going on right now. It used to be that we had an idea of creativity as something that kind of happened alone on a hillside, romantically, you know, when you were out wandering among the clouds, the way William Wordsworth spoke of.

CAIN

10:45:44
And, now, we're in this strange cultural moment where we think of creativity as being something that is group oriented and that emerges from a group-based collaborative process, when, in fact, 40 years of research on brainstorming tells us that groups brainstorm horribly, and individuals almost always will come up with better, more innovative, more creative solutions to problems than groups will.

REHM

10:46:08
That's interesting...

GOLD

10:46:09
I...

WILSON

10:46:10
I have to respectfully disagree, and I look forward to talking, having a wonderful conversation with Susan about that particular topic. But we move on.

REHM

10:46:20
All right. But...

GOLD

10:46:20
And I -- and I would add one quick thing to...

REHM

10:46:22
Sure.

GOLD

10:46:22
...that, which is, you know, the larger the group, of course, the more difficult it is to get anything done. But that overlooks -- and I think Todd brought it up. That overlooks the role of relationship in creativity and the role of connectivity. If you have a good connection with someone, can bounce things back and forth, I have found that some of the most creative people, they do create alone, but they have a small group of people that they go back and forth with and talking things. And it stimulates them, et cetera, so I wouldn't necessarily just say, you know, the group thing is -- I would refine it.

REHM

10:47:01
All right.

CAIN

10:47:01
Yeah, and can...

REHM

10:47:02
Sure.

CAIN

10:47:03
If I can add to that, I think that what ends up happening is the best creative processes often come with an individual working on their own and then coming back and talking about it with a group. But the germ of the idea happens on one's own. And if you look at many artists describing their creative processes, they'll often describe themselves being inspired by kindred spirits. But when you look at where they actually did the work, they're often working on their own.

REHM

10:47:27
Alone time.

CAIN

10:47:28
Yeah.

KASHDAN

10:47:29
Allow me to make a...

WILSON

10:47:29
There's an alone...

KASHDAN

10:47:29
Let me try and get a quick point in...

REHM

10:47:30
Hold on, David. Go ahead, Todd.

KASHDAN

10:47:33
...which is, you know, the nature of this conversation is we're focusing on one personality trait, shyness and social anxiety. And these things don't occur in vacuums. In the real world, there's a lot of variety, and so it can have -- you're going to find creative people that are shy. You're going to find sociopaths who are shy. You're going to find people who are incredible parents. You're going to find people who should not have had any exposure to kids whatsoever in their lives.

KASHDAN

10:47:57
We have to remember that everyone's personality is like a 16-sided dye, and we don't want anyone to over-identify with shyness or extroversion.

REHM

10:48:06
All right. Here's a question for you, David Sloan Wilson. Rick sends an email saying, "Where do we think shyness comes from? Is it a product of the environment, something inherited or both?"

WILSON

10:48:25
Well, of course, it's always both. And in order to make that interesting, we need to specify more about the interaction. There is a big genetic component to especially this processing sensitivity, and we've even identified some of the genes, some of the well-known genes that affect, for example, dopamine systems and serotonin systems. So enough science has been done to know that if you have certain (word?), then you are more likely to be this sensitive type which has both good news and bad news associated with it.

WILSON

10:48:58
But you don't want to underestimate the environmental component either, and I'm most impressed by the capacity of everyone to rise to the occasion, as we've described earlier, and to do things that they were most unsuited for, and to be good at it. And then the genetic differences kind of follow that, but you have to be most amazed by our flexibility.

REHM

10:49:22
All right. To Aurora, Ill. Good morning, Mark.

MARK

10:49:27
Good morning. I'm afraid to have to report -- I'm sad to have to report that dictionaries are not fair, either. They tend to leave you feeling that introverts are the ones with the problem. And I acknowledge that introverts do have a gentle touch, which often makes them excel at hospitality. And when an extrovert ingratiates people in order to get them to do what they want, they're never called pathological. They tend to be called smooth or shrewd, which is not fair.

MARK

10:50:00
And I like the Myers Briggs formulation because it focuses on psychic energy flow and manner of processing but remains neutral while doing so. And I'd like to ask your guests what they make of King George in "The King's Speech." Would he be someone who was pathologically shy or introverted by temperament? Or was it more true to say that his speech impediment had a major impact on the way he turned out, independent of all that other stuff?

REHM

10:50:36
Exactly. In other words, did the speech impediment, in some way, help him to grow?

GOLD

10:50:47
Well, I think as it's portrayed in the movie, it did. As he was able to overcome it, it gave him a new sense of himself. But it clearly -- I think, again, at least as portrayed in the movie -- I'm not personally familiar with the circumstances of the situation. But in the movie, certainly at the beginning, it was a source of extraordinary family difficulty, social difficulty, educational difficulty.

GOLD

10:51:16
It seems to me that, had he not had the speech impediment, it's impossible to know who he would have been because the speech impediment was such an overwhelming part of his life. And so poorly understood by the others around him, he got no support, et cetera. But in the end, it certainly -- it became a strength through a connection that he was able to make with another human being, and I thought it was a beautiful story...

KASHDAN

10:51:47
And just to add to that point is we have stigmas here about shyness, about social anxiety, about seeking help, which, you know, if we described it and said, a coach was going to help you improve your social fitness, we would have a very different attitude than the idea of a therapist is required...

REHM

10:52:06
True.

KASHDAN

10:52:06
...to improve your mental health because you have a disorder.

CAIN

10:52:09
Yeah.

KASHDAN

10:52:09
And so the system is designed, in a way, to pathologize. But the fact is, is when somebody goes to see a personal trainer to reduce the amount fat on their body or increase the leanness of their muscle fibers, we don't say that there's a problem. They're just working on themselves.

REHM

10:52:24
Yeah.

KASHDAN

10:52:24
So the idea of enhancing wellbeing should be a fundamental aim of people, and pretty much almost everyone in humanity should be having psychological fitness checkups and not just people -- we're talking about these, you know, King James (sic) and these extreme examples.

REHM

10:52:40
King George, actually.

WILSON

10:52:40
I love that. I second that motion.

REHM

10:52:44
All right. Let's go to...

GOLD

10:52:44
And I -- I would agree with that as well.

REHM

10:52:46
...Rachel in Syracuse, N.Y. Good morning, you're on the air.

RACHEL

10:52:52
Good morning. I have a child who was recently diagnosed with selective mutism, and I was wondering if your guests could touch upon that and maybe give me some ideas on how to help him as he enters formal schooling. He's an incoming kindergartener.

REHM

10:53:08
Be a little more clear, if you would, about what you're calling selective mutism.

RACHEL

10:53:14
Selective mutism, right. It's a disorder that usually occurs when they're young, and it's when a child chooses not to speak in social settings. But in other situations, they are just your normal, typical child.

REHM

10:53:28
Interesting. At -- and just to remind our listeners, you're listening to "The Diane Rehm Show." Sounds like shyness to me. What's it sound like to you, David?

WILSON

10:53:43
Let me pass that on to some of the people that are more familiar with a clinical setting.

REHM

10:53:45
Okay. How about you, Liza?

GOLD

10:53:48
Well, with the caveat that I don't work with children and selective mutism is not a problem that I typically work with, it's not simply shyness if it's become an impairment. So a child who cannot speak at school is going to have a problem, and that problem is going to have an educational impact.

REHM

10:54:08
Of course. Does your child speak at school, Rachel?

RACHEL

10:54:12
Rarely. Usually, it takes a lot of prodding to get him to speak. A lot of head nodding is what he usually uses.

REHM

10:54:19
Interesting.

GOLD

10:54:20
So that's going to be a problem. And, again, I can't really speak to the treatment of selective mutism because I don't treat children. But in answer to your question, it's not -- at that point, that's a good example of where you have likely crossed the line from shy to an impairment, and I don't know if that impairment's based on social anxiety or if there are some other some other issues this child may be having. But that's would you would need to sort out in order to help.

REHM

10:54:47
Are you getting help for your child?

RACHEL

10:54:50
We are. Our school system has been very generous in getting us the help we're going to need.

REHM

10:54:55
Good. I'm glad to hear that. Good luck to you, Rachel. And, finally, to Jacob in Raleigh, N.C. Good morning.

JACOB

10:55:05
Hi. Thank you for having me.

REHM

10:55:06
Sure.

JACOB

10:55:08
Well, I just wanted to touch on a topic that has kind of, well, I would say plagued me for most of my life since I was a child. I've always been -- I feel outgoing. I love being the center of attention. I love talking about myself and -- but I was a shy child. And, even as an adult, I feel it in certain situations, you know, often when I'm on the spot. You know, my face will turn red, and I can -- I can feel it. I can feel it, you know, being flushed and often that, you know, comes with it the anxiety of, you know, the other person noticing and kind of what they're thinking. And it can kind of...

REHM

10:55:40
Sure.

JACOB

10:55:40
...you know, I feel, jeopardize my, you know, (unintelligible) I guess.

REHM

10:55:43
So tell me what you question is, Jacob. We're almost out of time.

JACOB

10:55:48
Sorry. Is that something -- is there anything that can be done about that or is that just something I have to deal with?

KASHDAN

10:55:53
I mean, one thing is that this is a very common occurrence, whether it's blushing or sweating, the idea that people can see everything that's going on inside me. So I can look calm and serene walking down the street with my chest out. But, inside, I feel like I'm going to explode, and everyone notices. And one of the things is, is to actually do these little behavioral experiments in your everyday life, which is to kind of to ask people, what did you just notice of what you liked and didn't like, in terms of -- your close friends.

KASHDAN

10:56:22
And what you'll probably find is -- this is my hypothesis -- is that most people don't see nearly the amount of blushing or redness or anxiety as you think they see.

REHM

10:56:32
Liza, quick comment.

GOLD

10:56:33
Yes. I think that that in itself is a kind of exposure therapy or behavioral therapy...

REHM

10:56:38
Sure.

GOLD

10:56:39
...where you overcome the anxiety by exposing yourself to it over and over again in an attempt to extinguish.

REHM

10:56:48
And, sadly, we're out of time. It's clearly a subject that touches the hearts and faces and minds of many people. Todd Kashdan of George Mason University, Dr. Liza Gold of Georgetown University Medical Center, Susan Cain. Her forthcoming book is titled "Quiet: The Power of Introverts in a World That Can't Stop Talking," and David Sloan Wilson, Professor of Biology and Anthropology at State University of New York in Binghamton. He's author of "Evolution for Everyone." Thanks to all of you. Thanks for listening. I'm Diane Rehm.
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