Wednesday, April 26, 2023

Social Anxiety, Liberation Psychology, and Perception Matching Reality


This article brought to you by the Peer Voices Network. 

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Today a question came up about social anxiety. In response, I drafted the following reply. It touches on a larger theme actual reality struggle versus struggles where "it's just in your head". Including the mental health industry's colossal failure to properly validate both situations existing as separate, valid, and equally real issues in need of very different kinds of support. 

I have almost never seen this topic truly acknowledged and discussed in psychotherapy or even most broader mental health communities. Which is a literal injustice. Let's get into it...

Perceptions and Realities

With social anxiety, and this can be applied to many other conditions as well, at least two separate kinds of situations exist...

1) Struggles with your current perception not matching reality.

Example: You think people don't or won't like you, but they actually do

2) Struggles where your current perception is in fact matching actual reality

Example: You think people won't like you, and they actually don't like you

The vast majority of modern trauma therapy, and we can trace this back historically to the original PTSD descriptions and treatments, is squarely aimed at item #1. You were in a car crash. You were in a war zone. you were bullied as a child. You're not anymore, but your brain - like a muscle - was practiced and exercised to be "battle ready" for one environment and now needs to unlearn it. You weren't safe, but now you are.

This is one of the most astoundingly damaging starting assumptions almost every therapist makes about you as a trauma survivor or experiencer of emotional distress. That anything you are experiencing can be explained away as, solely and only, "brain muscle misalignment". That your problem is, in essence, that some combination of either or both of your conscious and unconscious thoughts and feelings are reacting to perceptions that don't match actual reality.  

This is, to be clear, a set of very real experiences that some people do experience. But it's only one subset of emotional distress. Yet it's by far the top starting assumption almost any therapy office is based off of. That's there's nothing to fear in current reality. Which ... is deeply problematic.


Because of item #2. There are thousands of ways in which current modern life, for so many people, is currently emotionally or even physically unsafe. And they're experiencing emotional reactions as a result. This is not "brain muscle misalignment", this is the body functioning correctly. Still suffering, but it's the body doing its job correctly. Telling us we are, in fact, actually unsafe. That there is something to be concerned or worried about.

To get less abstract and back to real examples - worries like people not accepting you for who you are and rejecting you. Isolating you. Even enacting violence toward you if you behave a certain way. The worry about that is one form of social anxiety. The type where perception is matching reality. Yes, the other type also exists. But the point is both exist, and almost nowhere in the mental health literature is that admitted or discussed.

Reactions To Asserting That Reality Is Real

If you're truly facing situation #1 - a perception issue - therapy might help. There's still dozens of issues and pitfalls to discuss, and I'll leave that for another article. At least they're operating under the correcting underlying understanding of the situation. That it's a "mind not matching reality" problem. I genuinely wonder what percentage of emotional distress falls into this category and I reckon it's much lower than we think. Still very real. Still a problem. But, as we'll get into below. I think society deeply hyper-inflates that percentage.

So what about situation #2. The one where social situations are real threats with light, moderate, or even severe non-safety threats and negative consequences? Therapists, the broader set of healing communities, and modern Western society as a whole, tend to respond with astounding amounts of prejudice and oppression in response to making a claim that the reality is actually real and not just faulty perception.

Example replies include...

A) Active denial and/or gaslighting

Example: "I'm sure you're wrong about that"

Example: Are you sure people don't like you?"

B) Fixing the individual

Placing total and full responsibility on you, the individual, to change. 

Example: "What about you might need an attitude adjustment?"

Example: "What are you not doing right"

C) Telling you to just avoid it and go away

Freeing others from accountability to adjust to your needs

Example: "Just find other friends" 

D) Denying responsibility for fixing "reality is hurting you" problems

Example: "It's not my job to fix society"

Whew, that's a lot to unpack up there. 

As you might imagine, all four of the above have some level of merit if used respectfully and sparingly. This is not, not at all, what happens to the majority of "reality is the problem" attempts at reaching out.

Yes, sometimes we need a reality check. But victims are constantly being overly doubted and presumed as "making it up" and "not the correct perception". Constantly.

Yes, sometimes we can think about accountability for our own behavior. But not 100% of the time, which is often the current demand as seen in item B - change to suit others. If that fails, it's on to item C - find others. If that fails and no others are found, we arrive at D - not my job.

If we've agreed B is unfair and we've agreed C is rare to non-existent, then it's not therapy's job anymore. Which would be okay in one sense. Not everyone should be an expert at everything. It's okay to have all three of...

I. Situation 1 specialists (perception not match reality, you are safe) 

II. Situation 2 specialists (you are not safe), subset of - "what might you be able to do about it?"

III. Situation 2 specialists (you are not safe), subset of - "how can we hold others accountable?"

People need help for all of I, II, and III. People suffer various forms of emotional distress in response to all of those reasons. People are told, and it's expected and demanded of them increasingly in modern health systems and even lay society* to utilize mental health services to solve emotional distress.

But mental health services only address I and II. They often assume I as a starting hypothesis (you're actually safe and it's just your faulty perception). If you manage to convince them otherwise, they work extremely hard to convince you of II - that whatever the actual reality problem is, it's your job to somehow solve. If you manage to convince them otherwise, they'll disavow any responsibility themselves for even slightly helping with III - helping hold others/systems accountable.

But ... if III is causing you emotional distress, those others/systems will send you to therapy. At worst, they'll even lock you up in a psych ward. 

If improper accountability issues of what should, be any reasonable measure of fairness, be basic expected fair behavior of others/systems are distressing you, they don't hold themselves accountable. They convince you to go to therapy, where everything is done to convince you it's a I or II things, not a III thing, and will almost never assist, and often outright deny, attack and gaslight you, that maybe just maybe some of emotional distress experiences (not all, some), aren't a you problem at all.

And giving a person zero aid in holding others/systems accountable is a damn near impossible ask and expectation to place on individuals, especially those already in distress. 

Those in distress with item III issues (others/systems not being held accountable) deserve tools for just that - helping hold those things accountable. Those tools are sometimes claimed to exist. They mostly don't, and that's an article unto itself.

Getting Back To Analyzing Your Social Anxiety Condition

Given the above, what then do we make of social anxiety? What should be done if you're experiencing it. I would say a fair and useful approach is to give equal, rooted in social justice, analysis to each of three possibilities..

I. It might just be in your head

Example: Have past PTSD, try treatment such as exposure therapy, etc.

II. It might be something real that's a response to something you need to change about yourself

Example:  You have toxic self-behavior patterns hurting others and you could pursue personal work (hopefully with some empathy, sympathy, and support) in response to your self-owning your "needing to be fixed / be better"

III. It might be something others and systems need to change to accommodate you 

Example: Any sort of racism, sexism, ableism, etc. That's a them issue, not a you issue. In a better world, there would be broader mechanisms of accountability for problematic systemic and even individual behavior. There mostly aren't, and that needs to be highlighted and discussed. 

Within all that, a final tough lingering question gone unanswered is ... who decided what's fair? What's fair in accountability? If me chewing food loudly causes you a lot of distress, which of the three items above is that. Is that some "curable" past PTSD loud noise trauma (item I)? Is that something you could or should learn to adjust to (item II)? Is that something you could ask me to stop doing to accommodate you (item III)? 

I don't think there are perfect answers, especially on II versus III. The question becomes ... what's fair? And before we end this article, one initial thought on that is...

Who's Allowed To Decide What "Fair" Means? 

Fair is, near as I can tell, sometimes thought of as a universal law. Like gravity or the speed of light. But ... it isn't. It's not a neutral physical world science value. It's not socially neutral. It's an extremely value-laden concept and we need to ask whose value system is being used, who got a voice is why we're using that value system instead of another, and especially who didn't get a voice is which value system is being used.
Fairness is a fuzzy, subjective, culturally defined thing. And as such it, both as history and as ongoing life, people in power have defined it and enforced their values on the less empowered. 

It used to be "fair" to women to bar them from athletic activity. It would be unfair to force their frail bodies to suffer the rigor and break. Fairness carries cultural judgments. Who decided that? Mostly, it was men. Are men the best experts on what female physique can handle? Probably not. Was there bias is how we attempted to prove or disprove that? Absoutely.

So, that's a rough draft peek into fairness, cultural bias, and power dynamic issues. Much work still needs to be done exploring on that front, but it is a critically important point for unpacking questions over accountability in so many human interactions - including social situations.

Am I accountable for accommodating you? Up to what point? Are you accountable for accommodating you? Up to what point? At what point do we go our separate way? What if "separate ways" means I'm left with absolutely no-one? What if "separate ways" means you're left with absolutely no-one? 

Do we start leaving people behind? Right now modern Western ideology says yes, we do leave people behind. And I take issue with that.

If you are suffering from item III - you are not safe, it's because of others, others aren't being held accountable, society's current answer is "tough shit, it's no-one's job at all to account for that". I'm not okay with that. I hope you aren't as well. And I hope to drive cultural change to give people a better help system than "no, we refuse to help you". 

Reminder side note: Another myth is that "help does exist". It's true that things labeled as help exist. It's true those maybe helped some people sometimes. It's also true that supposed help often actually isn't real help. Way more often that is discussed or validated as real. I'll keep trying to document and show that being true, and how often that truth is hidden, denied, and gaslit under the myth of "help exists". Yet another needed article and work that needs support. 


Friday, April 14, 2023

Social Services Report: Rebuking Individualism, Lack of Effective Services, Medical Racism/Ableism, and Proposed Solutions

If this work is helpful, please consider donating or hiring me for consulting work (see more below)

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Topic Areas and Resources List

Currently in early draft form. This report documents authentic, peer-centered perspectives on why individuals struggle to thrive in modern social systems and lifestyles. 

Challenges / Problems

1) Medical Racism, Ableism, Sexism (and other -isms)
Includes 20 minute segment of over a dozen impactful user stories of experiencing racism from liscenced counselors 

Bethany Morris's Work on Sexism in Psychology...

"Participants reported high levels of medical mistrust and high frequency of discrimination and microaggressions experienced in health care settings. Participants reported epistemic injustice as the most common manifestation of racism: silencing of their own knowledge and lived experiences about their bodies and illness by health care workers. Participants reported that these experiences made them feel isolated and devalued, especially if they had intersecting, marginalized identities, such as being underinsured or unhoused."

Article: The NFL's reversal on 'race norming' reveals how pervasive medical racism remains

Under the practice of race norming, retired Black players were assumed to have lower baseline levels of cognitive function than retired white players. Black claimants, then, had to demonstrate more impairment to receive the same financial awards as their white counterparts.

2) Services Not Meeting Needs

Instagram: Why we can't "just send them to Child Protective Services"

"[Programs] can't work if there's no affordable housing to place people into. Kushel said California is about 1 million units short for extremely low-income households ... There are only 23 units of housing for every 100 extremely low-income households, she said."

"In Mississippi last year, of roughly 190,000 children living in poverty, just 2,600 were receiving money from TANF, while, remember, of the roughly one Brett Favres in Mississippi, 100% of them managed to get $5 million for [a university] volleyball stadium"

3) Failure of Individuals to Succeed / Thrive Being Moralized as Individual Failure
Partly backed by "why aren't they just using the services and supposed opportunity on offer

"Just as we are trained to take a family history or assess early childhood experiences, we also have to consider our patients’ encounters with various inequitable structures. Mr. A’s experiences of trauma were individual and specific to him, but they were tied to the structures he interacted with. 

Lived Experience Story (Student Debt): Viral TikTok Shows Why Biden Must Cancel Student Debt

4) Critiques of Evidence-Based Approaches in Human Services Research

Planned Future Article: Compliance as a Metric Tracks Control, Not Authentic Thriving 

The Western tradition has tended to obscure the vital role of emotion in the construction of knowledge ... the myth of dispassionate investigation has functioned historically to undermine the epistemic authority of women as well as other social groups associated culturally with emotion.

5) Lived Experience (Peer, Expert By Experience, Self-Advocate) Exclusion From Health Knowledge Development and Health Services Design

Embedding voices of marginalized people at the heart of the entire process of a piece of work, crediting and remunerating them for their contributions of both time and knowledge.

Potential Solutions

1) Participatory Research Methods

Support Organization: Co-production Collective
Resource database, monthly support meet-up

2) Participatory Grant-making Methods

Support Organization: Community Centric Fundraising 
6000+ Slack channel, content creation

Support Organization: Participatory Grantmakers
Two monthly support meet-ups

3) Lived Experience (Peer, Expert By Experience, Self-Advocate) Inclusion In Health Knowledge Development and Health Services Design

- Involvement in Peer Recovery Support (PRS) decreased substance use significantly among peers. Peer attendance at voluntary self-help groups and support from family and friends increased as a result of PRS.

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This article brought to you by the Peer Voices Network, a grassroots and almost wholly unpaid and unfunded effort working to elevate the voice of lived experience in health services design and health research.

This work needs support. Please consider donating, hiring our team as consultants, or linking us to potential funding sources. We enjoy partnering with organizations on development of more accurate and culturally-competent understandings of the societies we live within.

Donate Link:

Find us on YouTube at:

We can be reached by email at

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