【TED】为什么你在社交的时候会焦虑（你又该怎么做）
中英文稿
每个走进我们治疗诊所的人 都需要在接受治疗之前 回答一大堆问题。 在我多年的治疗师工作过程中， 我都会在和新客户会面之前 仔细考虑一个问题。 问题是这样的： 你人生的目标是什么？ 它的定义为激励你前行的 核心人生目标，即你想做成的事。
老实说，这是个很难的问题。 就说出那么一个人生目标 是很难的。 分量也很重。 很多人孜孜不倦地寻觅、 建立起自己的目标， 而有些人永远不会找到目标。 但是我们会收到一些常见的答案： 做更有参与感的父母， 为我的社区带来重大改变， 拥有令我自豪的事业， 也有简单的答案——活得久一点。
但有一位年轻的女性客户 给出了这样的答案。 在与她会面之前，按照惯例， 我翻阅了她对目标的描述。 她是这样写的： “不要被他人关注。” 这位年轻的女士，一位聪慧、开朗、 富有同情心的高中生， 把她的人生目标定为了 让别人都不知道她的存在。 这就是社交焦虑的力量。
社交焦虑的核心在于害怕被拒绝。 我们感到社交焦虑的时候， 会过分关注我们在别人眼里的样子。 我们环视周围， 试图寻找威胁和不满的迹象， 寻找我们不小心翻车， 受到别人拒绝的迹象。 然后我们会在支持、 微笑、点头、大笑等 行为中寻求安慰。 虽然社交焦虑让人精疲力竭， 但是它不是无缘无故出现的。 社交焦虑想保护我们 免受遭到拒绝的伤害， 它通过让我们适应社交集体的 细枝末节、规范标准、气氛动向， 校准我们自己的行为，融入环境， 从而避免遭到拒绝。 这是好事， 因为人类是社会性动物。 我们生活在集体中， 无论喜好，我们都得依赖他人， 但是更直白的原因就是 被拒绝很痛苦。 想一想你自己被拒绝的经历， 有多令人脚趾抓地， 我们都有过这样的经历。 也许是第一次约会后 人家跑路了。 我也有过。 也许是你没拿到梦寐以求的工作。 也许是被一群朋友踢出群聊。 被拒绝让人不开心。 社交焦虑在保护我们 不会再被拒绝。
但是如果社交焦虑开始影响 你理想中的生活方式了， 那它就有问题了。 这种现象出现的前提是 你对遭到拒绝的恐惧 与你对自己的看法交织在了一起。 如果你相信你会被人拒绝， 理由是你觉得你自身有一些缺点、 不足或者性格缺陷。 第一次约会以后人家跑了， 但是你觉得是因为你不可爱， 或者不够有吸引力。 你没有拿到梦寐以求的工作， 但是你觉得是因为你不够聪明， 或者不够有竞争力。 你被一群朋友踢出群聊， 但是你觉得是因为你没意思， 或者不够搞笑。 我们对被拒绝的恐惧其实是 对“达不到”的恐惧。 达不到我们理想中的自己， 达不到我们理应成为的自己， 或者达不到社会 想让我们成为的样子。
发展了一段时间， 这种思维会恶化成 社交焦虑失协症。 有社交焦虑症的人 会对别人端详他们、 严厉批评他们、 最终拒绝他们过分担心。 担心到他们的生活会绕着 避免被拒绝的这一想法转。 因为如果你可以 避免受到他人的注意， 那么，那些人就更不容易 找到拒绝你的点。
社交焦虑症 已经成为了 全球最常见的心理疾病之一。 单看美国， 超过 12% 的美国人 在人生的某个阶段中 都出现过可诊断级别的 社交焦虑症。 这大概有 4000 万人。 全球来看， 数值会小一些，为 4%， 这个数字本身很有意思。 但是基于现有人口估计， 世界人口的 4%， 大约为 3 亿人， 都可能在人生的某个节点 患上社交焦虑症。 虽然这种疾病非常普遍， 但是也普遍地遭到误解， 普遍地遭到误诊， 还总是会被完全漏诊。 这是因为我们的文化中 有许多关于社交焦虑的谣传。
第一个流言为患有社交焦虑的人 一个人待着会更开心。 这种刻板印象将社交焦虑患者 默认为喜欢独处的人， 宁可躲在自己的卧室里 也不愿出去与社会互动。 这完全是不正确的。 我的实验室做过这样的研究， 表明患有社交焦虑的人 需要坚实的、健康的、 亲密的关系， 与没有心理疾病的人相当。 他们确实会社交， 他们不是外星机器人。 而且当他们社交的时候， 他们也会乐在其中。 实际上，我们问社交焦虑患者 有多快乐， 他们表示和别人待在一起 会比自己一个人待着更快乐。 这是因为不是所有社交活动 都是让人紧张的。 也许有人和朋友在一起 会感到社交焦虑， 但是和爱人在一起就不会。 又或许他们在陌生人 和认识的人面前会感到焦虑， 但是在邻居或同事面前就不会。 因此，就算有些互动让人焦虑， 患有社交焦虑的人也不是 全无对人际交往的基本需求的。 他们只是很难在某些场合 和某些人进行人际交往。
好，也许患有社交焦虑的人 确实会进行社交， 他们社交的时候也享受其中。 但是，是和一小群关系密切的人。 而且说实在的， 社交焦虑就是在避免受到关注。
以下是第二个流言。 社交焦虑未必代表着害怕公开表现。 虽然有些人确实如此， 但是也有一些社交焦虑患者 发现在别人面前表现 比起小规模的、更亲近的对话， 比如一对一谈话， 更不容易引起焦虑。 很多社交焦虑症患者在 涉及社会评估和社会表现的 岗位上如鱼得水。 做模特、演戏、体育。
2021 年 5 月， 大坂直美 （Naomi Osaka） 拒绝出席法网公开赛的 新闻发布会。 她勇敢地直接表示 发布会会加重她的社交焦虑。 没过多久，她就遭到了 公众的强烈抵制和仔细审视。 她继续完成了第一场比赛， 当然，她赢了， 但是随后她退出了法网公开赛。 人们都很疑惑 一个人怎么可以 同时有社交焦虑症， 又是世界第一网球选手， 为耐克站台时尚活动， 真是个不错的选择， 并穿着泳装登上 《体育画报》的封面。 在谈论她的社交焦虑症的前一年， 她曾接受采访， 解释道： “站在球场上 完全是不一样的感觉。 我喜欢在亚瑟·阿什 （Arthur Ashe）球场打球， 因为是最大的球场， 你可以感受到人潮涌动的轰鸣。 你会觉得自己是个角斗士， 因为赛场太大了， 还有这么多人在观赏你的比赛。 但是在球场之外， 如果我被扔到一个 得在 100 人面前演讲的场合， 我会紧张得发抖。”
社交焦虑症患者并没有 一种统一的表现。 就像抑郁症患者可能会在 不同时间由于不同原因 出现不同种类的症状， 社交焦虑症也是因人而异的。
最后一个， 也可能是问题最大的流言。 有人认为社交焦虑症 转瞬即逝，而且不会造成伤害。 社交焦虑不会随着时间消失。 它不会在你初中或高中毕业的时候 就这么神奇地消失了。 如果不加干预，很多人会 长年累月受到社交焦虑的侵扰。 社交焦虑会影响一个人 生活的方方面面。 会影响他们选择的兴趣爱好， 也许会选择独自一人进行的活动， 比如阅读、写作， 而不是选择团体运动之类的活动。 它会影响人们选择的职业道路。 也许会选择工作更独立的岗位， 比如计算机相关的岗位， 而不是销售或客服之类的方向。 社交焦虑还会影响 人们的日常生活。 里奇·威廉姆斯 （Ricky Williams）， 美国国家橄榄球联盟 （NFL）的明星跑卫， 荣获海兹曼奖的跑卫， 每周在橄榄球场上， 在百万人面前光芒四射。 但是他说他饱受社交焦虑的困扰， 而且因此， 他很难与队友互动、 完成日常琐事， 因为他得和别人互动， 包括和他的女儿互动。
社交焦虑症真正造成的悲剧 是它剥夺了一个人最宝贵的资源： 其他人。 其他人可以帮助我们渡过难关， 比如从病痛中康复， 在面试翻车后平复心情。 其他人可以与我们分享 达成成就的喜悦， 比如见证我们孩子的诞生时刻、 我们的婚礼或者毕业典礼。 其他人可以帮助我们 排遣失去带来的痛苦， 比如哀悼挚爱之人的逝去。 我们对被拒绝的恐惧阻碍了 我们获取、享受 被人接受所带来的益处、 其他人的存在所带来的益处。
在现代社会中， 应对社交焦虑的难度 达到了最高点。 我们比人类历史上的任何时候 都更紧密地相连， 但我们没有这么孤独过， 没有这么抑郁过， 没有这么社交焦虑过。 我们有海量的社交工具， 但是我们眼前的是 愈发薄弱的社会联结。 在短短的一小段时间内， 我们的社会结构 已经被颠覆改写了。 科技和社交媒体 制定了社交关系和互动的新标准： “我要发吗？我要转发吗？ 我要点赞吗？我喜欢它吗？” 我们通过精心打理的个人简介， 现在会通过虚拟形象， 创建了这些奇怪的自我延伸。 我们试图搞明白 源源不断的反馈意见， 它们来自于我们通常 无法面对面交流的一大群观众。 社交失误的成本更高了。 你的一言一行 会永久地被保留在线上， 对你加以严厉的审视、 名誉损失， 甚至会让你丢了饭碗。 现在可不是患上社交焦虑的好时机。 但是世界会变得更加， 而不是更少地联结在一起， 科技和社交媒体的影响力 会继续扩大， 而不是缩小。
是时候谈谈应对社交焦虑的方法了。 我们该这么做。 我们能做的第一件，也可能是 最简单的一件事，就是早发现。 早期发现非常重要， 因为恶化成社交焦虑失协症的患者中 有过半在 14 周岁以前 就出现了这种症状。 过半。 社交焦虑还让人们面临着 之后患上其他心理疾病的风险。 在被诊断为 同时患有社交焦虑失协症 和情绪障碍， 如抑郁的成年患者中， 有 70% 的人 先患上了社交焦虑。 在被诊断为 同时患有社交焦虑失协症 和酒精使用障碍的成年患者中， 社交焦虑一马当先。 有大约 80% 的人 会先患上社交焦虑。 这些数据展现的是 社交焦虑出现得很早， 而且会让人们承担 患上其他心理疾病的风险。 好在仅仅通过问几个简单的问题， 就可以有效精准地识别出社交焦虑。 问题如下： “你害怕遭到拒绝， 这是你最害怕的事情之一吗？” 还有“你对被拒绝的恐惧 有没有阻碍你做一些 你想做或者乐在其中的事？” 问这些问题的成本 只有 30 秒和 0 美元。 我们不需要打造 全新的流程、平台、服务。 我们不需要颠覆既有的系统。 我们可以把早期发现项目 纳入已有的计划安排， 学校的场景里有新学年迎新、 和指导老师一对一谈话， 也可以在初级保健场景下进行。 因为如果医生 能够检查出抑郁症， 那么她也能检查出社交焦虑。 早期发现， 适当干预， 可以显著改变年轻人的人生轨迹。
我们能做的第二件事就是 利用我们的平台。 生活在这个高度互联的世界里 有这么一个好处， 就是一人能有千钧力。 他们可以通过各种平台 创造出重要、持久的社会改变。 我提到了里奇·威廉姆斯和大阪， 他们通过自己的途径 分享了他们的社交焦虑。 仅仅是他们两个人的行动 就产生了连锁反应。 紧随大阪的宣告， 维奥拉·戴维斯 （Viola Davis）， 奥斯卡金像奖、艾美奖、托尼奖 获奖女演员， 分享了她受到社交焦虑困扰的境况。 这位女士的工作是女演员， 是以不堪一击、众目睽睽的方式 体现、传达人类的复杂。 但是这些名人并不是 社交焦虑的代言人。 他们只是三个和百万患者 受到同样折磨 但有勇气公之于众的人。 如果我们也可以 把大大小小的平台利用起来。 学校、 职场、 社区、家庭。 因为围绕心理疾病 进行定期、坦诚、随时的对话， 最终可以减少羞耻感， 终结有害的流言， 给予人们所需的帮助。
我们能做的最后一件事是 培养社交勇气。 解决社交焦虑的方式 并不是预防或者避免被拒绝。 解决社交焦虑的方式 是培养社交勇气。 社交勇敢意味着 即使知道你可能会被拒绝， 也勇敢去追求你想要的体验。 其实，在你人生中的某个阶段， 或是今年的某个时刻， 被拒绝的概率都是很高的。 更惨的是你可能会 因为你的本质被拒绝。 因为那些你无法改变的事情。 你的出身、 你的外貌、你爱的人。 社交勇敢意味着 因为这些经历对你很重要， 而且你知道它们的成功与否 都与你作为一个人的价值无关， 所以勇敢地去追梦。 社交勇敢意味着 了解你自己的价值， 找到一群人、一个社会集体， 愿意爱他/她，接受他/她。 社交勇敢意味着 邀请他/她去约会， 申请这个岗位， 在会议或者派对上大胆发言， 或者在大场面做一场大型演讲， 就算你遭到拒绝的可能性 仍在虎视眈眈。
但是成长和成就的机会 更加光彩夺目。 你的目标不该是 让世人不要再注意到你， 而是让你感受到最鲜活、 最有存在感、 最真实的自己。
谢谢。
Each person who entered our therapy clinic answer a stack of questions before beginning treatment. And during my years as a therapist there, there was one question I always reviewed before meeting with a new client. It asked this: What is your purpose in life? Defined as a central motivating life aim, something you're trying to accomplish.
Now, to be fair, this is a difficult question. Identifying a single purpose in life feels really hard. It also feels consequential. Many people spend years searching for and developing their purposes, and some never find it. But typically we see responses like this: to be an engaged parent, to make meaningful change in my community, to build a career I'm proud of, to live for a long time, just keeping it simple.
But then there was the answer of one young woman who I worked with. Before meeting with her, as I always did, I flipped to see how she described her purpose. And she wrote this: "To avoid being noticed by other people." This young woman, a bright, witty, compassionate high schooler, decided that her purpose in life was to make sure that other people did not know that she existed. This is the power of social anxiety.
At its core, social anxiety is about the fear of being rejected. When we feel socially anxious, we become hyper-focused on how we are appearing to others. We scan the room looking for signs of threat and disapproval, signs we might have slipped up and are at risk for rejection. And then we seek comfort in signs of approval, smiles, head nods, laughs and so on. And while social anxiety can be exhausting, it exists for a reason. Social anxiety tries to protect us from rejection, and it does that by tuning us in to the nuances and norms and dynamics of a social group so we can match our behavior to fit in with them and ultimately avoid being rejected. This is a good thing because humans are social. We exist in social groups, we rely on each other whether or not we like that, but also more simply because rejection is painful. Take a moment to think about your own rejection experiences, however cringeworthy, we all have them. Maybe you were ghosted after a first date. Been there. Maybe you were rejected from your dream job. Maybe you were ousted from a friend group. Rejection's unpleasant. And social anxiety tries to protect us from it.
But social anxiety becomes problematic when it begins to interfere with the life you want to live. And this happens when your fear of rejection becomes intertwined with your view of yourself. When you believe you will be rejected because you think you have some inherent flaw, deficiency or failing of character. You were ghosted after that first date, and you believe it's because you were not lovable or attractive enough. You were turned down from your dream job, and you believe it's because you were not intelligent or competent enough. You were ousted from that friend group, and you believe it’s because you were not interesting or funny enough. Our fear of rejection is really a fear of being less than. Less than we want to be, less than we think we should be or less than we believe society wants us to be.
Now, over time, this belief system can develop into social anxiety disorder. When a person has social anxiety disorder, they become overly concerned about other people scrutinizing them, evaluating them harshly and ultimately rejecting them. So much so that they begin to construct their lives around avoiding rejection. Because if you can avoid being noticed by other people, then those people have fewer data points on which to reject you.
Now, social anxiety disorder is one of the most common mental illnesses in the world. In the United States alone, more than 12 percent of Americans at some point in their lives will have diagnosable social anxiety disorder. That's roughly 40 million people. Now worldwide, the estimates are lower, they're four percent, which in and of itself is interesting. But based on current population estimates, four percent of the world is roughly 300 million people that will potentially have social anxiety disorder at some point in their lifetime. And despite how prevalent it is, it's widely misunderstood, widely misdiagnosed and often missed entirely. This is because several myths about social anxiety pervade our culture.
The first myth is that people with social anxiety are happier alone. The stereotype of someone with social anxiety as a recluse who'd rather be hiding away alone in their bedroom than out interacting with the world. And this is simply not true. In research conducted in my lab, we find that people with social anxiety disorder desire strong, healthy, intimate relationships to the same degree as those without mental illness. And they do socialize, they’re not robotic aliens. And when they socialize, they often enjoy doing so. In fact, when we ask people with social anxiety how happy they are, they report feeling happier when they are with other people than when they're alone. This is because not all social interactions are stressful. Maybe someone feels socially anxious with friends but not their romantic partner. Or they feel anxious with strangers and acquaintances but not people like their neighbors or coworkers. So even though some interactions are stressful, people with social anxiety are not devoid of the basic desire for human connection. They just have trouble obtaining it in certain situations with certain people.
OK, so maybe then people with social anxiety do socialize, and when they do, they enjoy it. But it's with a small, tight-knit group of people. And really, social anxiety is about avoiding the spotlight.
And this is the second myth. Social anxiety is not necessarily about a fear of public performance. While this is true of some people, other people with social anxiety find performing in front of others less anxiety-provoking than smaller, more intimate conversations, like when they have to carry a conversation one on one. Many people with social anxiety excel in careers that are intertwined with social evaluation and social performance. Modeling, acting, sports.
In May of 2021, Naomi Osaka declined to participate in press conferences of the French Open. She courageously and preemptively shared that they exacerbated her social anxiety. Shortly thereafter, she received a wave of public backlash and scrutiny. She goes on to play her first match, of course, wins, and then she withdraws from the French Open. Many people were perplexed about how someone could have social anxiety and also be the number one ranked tennis player in the world, lead a fashion campaign with Nike -- good choice -- and don the cover of Sports Illustrated in a swimsuit. In an interview the year prior discussing her social anxiety, Osaka explained: "On the court is completely different. I love playing at Arthur Ashe because it’s the biggest stadium, and you feel the rumble of the crowd. You kind of feel like a gladiator because it’s super-big and there are so many people watching your match. But off the court, if I was ever thrown into a situation where I had to speak in front of 100 people, I feel like I would start shaking."
There is no one-size-fits-all profile of social anxiety. Just like people who are depressed have different collections of symptoms at different times for different reasons, social anxiety looks different in different people.
And last and maybe the most problematic myth. That social anxiety is fleeting and harmless. Social anxiety is not just something you grow out of. It doesn't magically disappear when you graduate middle school or high school. Without intervention, many people struggle with social anxiety for years, for decades. And social anxiety can influence every aspect of a person's life. It can influence the hobbies they choose, maybe opting for solo activities like reading, writing, rather than things like team sports. It can influence the careers people pursue. Maybe opting for careers with more individual, like computer time, versus things like sales or customer service. And social anxiety could influence people's everyday lives. Ricky Williams, star NFL running back, Heisman-winning running back, dazzled millions of people on the football field every week. And yet he shared that he struggled with social anxiety, and because of it, he had difficulty interacting with teammates, running everyday errands where he'd have to interact with people and even interacting with his own daughter.
The real tragedy of social anxiety is that it robs individuals of their greatest resource: other people. Other people help us overcome adversity, like recovering from illness or after you bomb a job interview. Other people help us celebrate milestones like showing up to the birth of our child or a wedding or a graduation. And other people help us overcome loss, like grieving the death of a loved one. Our fear of rejection gets in the way of obtaining and appreciating the benefits of being accepted, the benefits of other people.
And in our modern world, it is harder than ever to manage social anxiety. We are more connected today than any time in human history, and yet we are lonelier, more depressed and more socially anxious than ever. We have endless tools to socialize, and yet we're seeing a decaying social connection. In a rapid amount of time, our social structures have been upended and rewritten. Technology and social media have created new standards for social relationships and interactions: "Do I post it, do I share it, do I like it, do I love it?" We create these bizarre extensions of ourselves through curated profiles and now avatars. We try to make sense of unlimited feedback from a massive and often invisible audience. And the costs of social blunders are higher. Things you do and things you say can live online forever and subject you to unforgiving scrutiny, reputation loss and even job loss. It is a tough time to have social anxiety. But the world will become more, not less, connected, and the influence of technology and social media will grow, not shrink.
Now is the time to address social anxiety. And here's how. The first and maybe easiest thing we can do is identify early. Early detection is critical because of those who go on to develop social anxiety disorder, more than half will have developed it before their 14th birthday. More than half. And social anxiety puts people at risk for developing other mental illnesses later on. Of adults who were diagnosed with both social anxiety disorder and a mood disorder like depression, social anxiety came first 70 percent of the time. Of adults who were diagnosed with both social anxiety disorder and alcohol use disorder, social anxiety came first. It was developed first approximately 80 percent of the time. What these data suggests is that social anxiety starts early, and it puts people at risk for developing other mental illnesses. But here's the incredible part. Social anxiety can be reliably and accurately flagged by asking just a few simple questions. Questions like: "Is your fear of rejection among one of your worst fears?" And "Does your fear of rejection get in the way of doing things that you'd otherwise want to be or enjoy doing?" The cost of asking these questions is like 30 seconds and zero dollars. We don't have to create new infrastructures. We don't have to upend existing ones. We can embed early detection programs into our existing structures like at schools, new year orientation, one-on-one counselor meetings and in primary care settings. Because if a doctor can screen for depression, then she can also screen for social anxiety. Early detection and then appropriately intervening can significantly alter the trajectories of young people.
The second thing we can do is harness our platforms. One of the benefits of living in this hyperconnected world is that a single person can have a ton of power. They can use their platforms to create meaningful and lasting social change. I mentioned Ricky Williams and Osaka, who have used their platforms to share about their social anxiety. And just from these two people, we’ve seen a ripple effect. In response to Osaka's announcement, Viola Davis, Oscar, Emmy, Tony-award winning actress, shared that she struggles with social anxiety. A woman whose job it is as an actress to embody and express the complexities of people in very vulnerable and very public ways. But frankly, these celebrities are not the poster children for social anxiety. They're just three of the millions who suffer, who were brave enough to talk about it. And we can do the same with our platforms, however big or small. In our schools, in our workplaces, in our communities and in our homes. Because regular, candid and forthcoming conversations about mental illness ultimately reduce stigma, correct harmful myths and get people the help that they need.
The last thing that we can do is foster social courage. Addressing social anxiety is not about preventing or avoiding rejection. Addressing social anxiety is about fostering social courage. Being socially courageous means pursuing experiences and knowing that your chances of rejection are not zero. In fact, the chances that you get rejected at some point in your life, at some point this year, are high. And worse, you may be rejected as a function of who you are. Things about yourself that you cannot change. Where you come from, what you look like or who you love. Being socially courageous means pursuing experiences because they are important to you and knowing that the successes of those pursuits are not contingent on your worth as a human being. Being socially courageous means knowing your worth and finding people and social groups that love and accept that person. And being socially courageous means asking that person out, applying for that job, speaking up at that meeting or that party or giving that big talk on that big stage, knowing that rejection lurks around the corner.
But the opportunity for growth and for purpose shines brighter. A purpose not defined by ensuring that you go unnoticed in this world, but a purpose that makes you feel most alive, most present and most authentically you.
Thank you.
