Welcome to speak the truth. Podcast and voted to giving. Physical truth for educating. Equipping and encouraging the individual church and counseling. 

Hello? Hello? Hello. We are sorry, Shauna. Cause you're not here. We are back in studio and I am joined with Jeremy. Jeremy, how you doing brother? I'm doing great. Good to be here, man. We are glad you are with us. And it's just Jeremy and I today. But we're excited about this next mini series. We're actually going to be talking about social anxiety disorder. Otherwise known as sad. And so we're just like we were doing in our last series. The last series was focused on anxiety as well. So we just want to continue to follow that vein and get into more nuanced struggles of it. And how these different anxieties manifest themselves in different environments. So on and so forth. And then, so we're going to talk a little bit about that today. We're going to introduce that topic. And so Jeremy, you want to launch us into this conversation, brother? Yeah, sure. 

So as we did in the last series, I think a good place to start is just to get an understanding of the cultural perspective of what is called social anxiety disorder. And again, we get that. That perspective or that cultural lens from. Psychiatry's handbook called the diagnostic and statistical manual. And which one are we on now? Five version five. Six coming shortly here probably. What do they last about 20 years of version? At best. Five has already had several revisions. Cause it, it came out in, was extremely controversial and actually the editor of the DSM four. Wrote an entire book. Critiquing the weaknesses, So he, he wrote a book just showing how they made a lot of changes. It's not when I was in grad school I studied the DSM-IV. Yeah. Now the diagnostic process is completely different based on DSM-V and DSM-V made a lot of different changes in various diagnoses as well. Or what would you say just for those who may not be sure of what that means? What were they primarily? Were they around gender and. Well, I think. There was a L there was a change on gender identity disorder. I, I'm not an expert on DSM-IV, but I don't think that is there anymore. I know they made some big changes on the autism spectrum. But just the entire process of diagnosis is very different. And I think some of the major critiques of, of that. That version was just a lack of empirical support for some of the changes that were made. Again, DSM. It's giving us some categories to think about. But as biblical counselors, I think we have to put these diagnoses through a biblical lens. And just see, how are we going to. Conceptualize the struggles. people are coming in to our office with preconceived ideas. Oftentimes people assume that if they have a diagnosis, like if they've been to a psychiatrist and they've been diagnosed with one of these labels that are in the. The manual that they somehow have a disease and a popular phrase in our culture is mental illness. And that's because the psychiatric community is coming from what we would call the medical model. And so they are going to be conceptualizing these disorders. To a large degree, not exclusively, but to a large degree from. biological frame of reference. That's good. That's good. Cause I know obviously that's a lot of people are intimidated by the DSM. Yes. So that's just a quick little response and demystifying it a little bit, kind of bringing it down to a lower level where it belongs. Yeah. And so I'll always remember, you know, licensed folks. Probably get this, but if you're listening in, you're working in a church and you're more in more of a late lay counselor, pastoral counselor. The DSM is simply those diagnoses are simply descriptors. It's all it is. There are inferences in the manual as to what might be causing this. But the diagnosis itself is simply the person meets a certain criteria of descriptors. And if you meet, if it says you must meet four or five of these, if you meet four or five, you might get that diagnosis. It's not accurate to go ahead and assume because there's been a diagnosis. There is a disease that can get very confusing for people. Yeah, for sure. Well, thank you for introducing how it operates. And so specifically though, with social anxiety disorder, at least in your specific practice, how have you. Experienced people coming in well, you know, the recent pandemic that we've all lived through. Conditioned people to find solace in isolation. I want to come back to that term conditioned at a little bit later, but that's that's that's key. Yeah. Yeah. You know, we were told to stay home. We were told to isolate. We were told to not be around others. And this created a context for people to. Begin to fear being in open space or out in public. Yeah. And if you're living. A couple of years sort of just in your home and not going out and doing much else that becomes your norm. Yeah. I remember, in the lockdown. I experienced some anxiety at the beginning of all that, but I serve on a public school board. And our superintendent was amazing. At just rallying the troops and making sure that these students it's a huge school that these students were going to the seniors were going to get to have their graduation. And he was able to secure the new facility where the Texas Rangers play. And I just remember that was the first time when, cause as a school board member I'm sitting out. You know, watching the graduates. And I just remember driving to that event. That was the first time I had really been out and around people. This would have been may. So lockdown was March. And I just remember my own anxiety, just not wanting to be around other human beings. And I remember the discomfort that I felt just entering into that building. There were a lot of parents there, which was very surprising to me. But just my own . Yeah. And so there are people that stayed in that mindset for a couple of years. I mean, there are still people that are afraid to go out. And so this idea of social anxiety. I think it's been exacerbated by that. Those conditions that were coming out of as a people who went through a very, very terrifying pandemic. Yeah, that's helpful too, because I think what you use as an example. Is more situational, right? Because there were different things that play And we'll get into this more, but fear. Yes. Right. So there's this virus out there and we don't know it's quote unquote killing people, there was all these things going on. Nobody really understood what was going on. So it obviously produced a high level of fear. So obviously social anxiety is going to be. Rampant and it's going to be, it's going to be bad. So there is a situational thing, but to that point, There's actually people that truly struggle. Not just situationally, but like in a constant state. Yeah. And so that's kind of, you know, to go back to the DSM sort of those symptomologies in those four or five things that they're looking to to like, okay, so yeah. These descriptors you'd fall into this category. Yeah. So if these, if, if a person is diagnosed let me just read the current DSM five. Descriptors. Of a social anxiety disorder. It's a persistent fear of one or more social or performance situations. In which the person is exposed to unfamiliar people or to possible scrutiny by others, the individual fears that he or she will act in a way or show anxiety symptoms that will be embarrassing and humiliating. That's the first one, the second one. Exposure to the feared situation, almost invariably provokes anxiety, which may take the form of simultaneous situationally bound or preconditioned, panic attacks. So panic attack is often a part of this. So a person gets into a public place. They begin to feel their heart rate rising. They're starting to sweat. Their stomach is starting to churn. And then they get to a place where it feels uncontrollable. That's very humiliating and embarrassing, so they don't want that to happen again. So what do they do? They don't go out. Because that's where they find their, their ability to control those panic attacks is an isolation. The third descriptor is the person recognizes that this fear is unreasonable or excessive. And what comes with that in my dealings with folks who struggle with anxiety, especially Christian people yeah. Is since they know this is. Irrational or unreasonable. There's a lot of shame associated with this. Because they really do believe in their heart of hearts. They cannot control this. And they translate that into the idea. I don't have enough faith. Therefore I'm a terrible Christian and a terrible person. I'm humiliated. So for the believer. That that recognition kind of has an added layer because Christians aren't supposed to be struggling like that. Are some people would think that the fourth is the feared situations are avoided or else are endured with intense anxiety and distress. So there's the two approaches I'm just going to stay away from what I'm afraid of, which is social. Yeah. Social events. Or if I go, I'm just going to grit my teeth and get through it. And as soon as it's over rush out and get out of there. Still a very miserable experience. Next the avoidance. Anxious anticipation or distress. In the feared social or performance situations interfere significantly with the person's normal routine. Occupational academic functioning or social activities or relationships, or there is marked distressed about having the phobia. Mmm. Mmm. As far as the DSM is concerned, that is a major criteria. If it's interfering with normal life. Yeah, so we want to be careful. All of us might feel anxious when we go. When we have to speak publicly. Yeah. 

That's a normal thing. But. For this particular diagnosis, if that's what we would, if that's how we're approaching this. This would have a significant impact on that person's ability to just function in life. Yeah. The fear, anxiety or avoidance is persistent, typically lasting six months or more. And then finally the fear or avoidance is not due to direct physiological effects of a substance such as drugs. Or alcohol or yeah, like that. So that's your basic description. If you meet. 

It doesn't say here how many you would have to meet, but. You probably would not be all of those criteria, but probably three to four of them. If you meet that, you might be. Diagnosed by a psychiatrist with social anxiety disorder. Jeremy, thank you for just that quick introduction and we, what we want to do is we want to go into just more biblically speaking, just how do we engage with. God's word. God himself. Seeing and understanding ourselves correctly. In light of our struggles. Why are we experiencing this level of anxiety? Why do I fear X, Y, Z? Yes, we can, we can understand it from a fear of man perspective, because scripture is very clear on that, but it's certainly more than that. And so we want to get into that part of the discussion and talking about, and we can, we're all, we'll also talk about a case study or two of people that come in With social anxiety disorder, any final concluding thoughts, Jeremy? Well, you know, the wonderful thing about biblical counseling is we don't have to necessarily reject these descriptions. They are describing things that people experience. But the exciting thing about biblical counseling is we can kind of reinterpret these experiences through a biblical lens. Yeah. And it might look just a bit differently than what. The diagnostic and statistical manual, that the picture that it paints because we're not just looking at, at people biologically we're understanding that there is a. Profound spiritual component to this. And so, in our next episode, we'll begin to look at. Just re-interpreting some of the data here that's helpful, but how can we reinterpret it in such a way that it's really beginning to center us on God's reality? That's great. Well, thank you guys for listening. And remember, go ahead and subscribe on YouTube if you're an audio listener to the podcast. Awesome. Thank you. But we definitely want to try to engage a little bit more on YouTube and have this video version in order to help us do that. The more engagement you guys have with us, the more we kind of know, and we want to engage with you guys back with that. So don't forget to subscribe, leave your comments into these episodes, and we look forward to engaging with you next time. ​