¹ https://www.inicea.fr/la-depression-chiffres-cles#chapitre

² Philippe Labro, “Tomber sept fois, se relever huit”, Folio, Paris, 2003, p. 37

³ https://www.inicea.fr/la-depression-chiffres-cles#chapitre

⁴ https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/antidepressants-on-trial-how-valid-is-the-evidence/E94E7663ACBC91A287A462E06B7B12EC

⁵ https://www.inicea.fr/la-depression-chiffres-cles#chapitre

⁶ Philippe Labro, “Tomber sept fois, se relever huit”, Folio, Paris, 2003, p. 178

⁷ ibid.

Cédric Bouët-Willaumez est psychothérapeute à Londres, exerçant en cabinet privé depuis plus de 20 ans. Vous pouvez le contacter pour prendre rendez-vous au +44 7876 035 119, ou en suivant ce lien.

1- What is social anxiety?

Most online and offline publications will define social anxiety as the excessive fear of social situations. People who have come to see me for help with this problem have also often described that they may feel discomfort in any social interaction, even if this is with “just the one person”. Because of this, I prefer to define social anxiety as the discomfort that relates to the experience of any relationship.

«In every contact, we communicate a bit of ourselves to the other, and the other is there to receive it, for better or for worse. In that respect, every social situation is significant, because it says something about us.»

2- Why does it happen?

We form our person and our character in the context relationships – to the family we were born in, to the community around us, to school, to our chosen communities of friends, spouses and children, to our communities at work. These relationships are not just a backdrop to our lives: by interacting within them, we evolve through them, and them through us.

It is perfectly healthy to feel a measure of trepidation in all forms of contact with other people, whether it is a brief exchange with a waiter, a discussion with a headmaster, or a presentation in front of the board of a company. After all, every personal contact, no matter how brief or apparently shallow, is an  experience that engages our person, consciously and unconsciously. In every contact, we communicate a bit of ourselves to the other, and the other is there to receive our communication, for better or for worse. In that regard, every social situation is significant because it says something about us.

«Psychotherapy, to be effective, must include two aspects at least: reflection on oneself and action on one’s environment.»

3- When does it become a problem?

However, for many, this creates a level of discomfort that can feel difficult to bear, which may lead some to assuming that all social contact will be painful, and therefore to avoiding certain social situations, and sometimes, most, if not all, social situations. This can be extremely distressing and debilitating.

4- Addressing the issue

It is my experience that psychotherapy, to be effective, must include two aspects at least: reflection on oneself and action on one’s environment. This is especially true when the concern that needs addressing is social anxiety. Action alone, which can be, for example, challenging one’s assumptions about other people’s thoughts about us and changing the way we interact with them, is not enough to create a deep-seated sense of safety in a social setting. Similarly, reflection alone will not help the person to “land” the insights acquired and create new and more helpful behaviours.

Therefore, I encourage my patients to:

• take a historical perspective on their experience of social interactions
• examine the feelings, thoughts and sensations that they associate with them
• get a deeper sense of who they are as a person, and what sort of social existence they are really meant to live
• observe in detail what they go through as they apply their insights and progressively approach life with others in different ways

The quote by St Francis of Assisi sums quite well my approach to helping people address their social anxiety, as it reflects its progressive nature and the surprises that can arise out of the process:

«Start by doing what’s necessary. Then do what’s possible; and suddenly you are doing the impossible»

Depression is the most prevalent of mental health problems. Studies have shown that it occurs in 1 in 10 adults or 10 per cent of the population in Britain at any one time. It is quite common to experience a depressive episode as a reaction to an event. It also happens that depression sets in “out of the blue”, and does not seem to go away by itself.

This experience can be deeply painful; poet John Keats wrote to a close friend: “I am in a temper that if I were under water, I would scarcely kick to come to the top”. It is part of life’s requirements that we should be able to tolerate periods of low mood, and it is to be expected that sometimes we find ourselves challenging the value of things and of life itself. If however we have an entrenched feeling of futility and find ourselves disempowered and persistently disengaged from life, this is probably something worth attending to.

In my experience it is possible to understand and successfully to address depression through the process of psychotherapy and counseling. Psychotherapist D.W. Winnicott (1958) wrote of John Keats that:

“[he] was someone who took the risk of feeling things deeply and of taking responsibility. […] If we look at depression this way, we can see that it is the really valuable people in the world who get depressed.”

These words remind us that the experience of depression should be respected in the process of psychotherapy. It is by working it through that its value ultimately appears, along with the fundamental qualities of the individual coming for help.  The goal of psychotherapy applied to depression is to allow insight to emerge and to use the therapeutic space as a “springboard” to reconnect with oneself, with others and with the world.