Interpersonal Psychotherapy for Social Anxiety Disorder


Paula’s voice trembled as she described the experience that led to her seeking treatment. During a meeting two months before with an important client, Paula, an attorney, experienced the most intense state of panic she had had ever endured. Her hands became cold and clammy. Her heart was beating so loudly it seemed like others could hear it, and she felt beads of sweat forming on her forehead. Most distressing of all was the tightening in her throat, which made her feel she would not be able to finish her sentence. Paula remembered looking around and everyone appearing to be distant and unreal except for a young associate who appearing to be smiling—“as if he were laughing at me" She excused herself and went to the restroom to splash water on her face. Returning to the meeting, she managed to get through, avoiding eye contact and speaking as little as possible. Afterward she felt exhausted and got nothing done for the remainder of the day.

paula: I’ve had this stage fright problem for as long as I can remember, and I am kind of shy around people I don’t know well, but I usually managed to work around it. In college I got a C in speech class because I read every speech word for word from the text. In law school I dreaded the mock trials and would have knots in my stomach for weeks. I loved law but I knew all along that being a trial attorney was definitely not an option for me. Most lawyers don’t do trials, so this was not a big problem. Since this happened, though, I feel like I’ve completely lost whatever confidence I did have. Every meeting feels like I’m on trial and everyone around me is the judge and jury. I’m really not sure how long I can go on like this!

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