|Year : 2018 | Volume
| Issue : 3 | Page : 271-272
The girl who wanted to stand-up in class and speak to her classmates
Basir Ah Karimi
Professor, Counselling Department, Herat University, Herat, Afghanistan
|Date of Web Publication||30-Nov-2018|
Basir Ah Karimi
Counselling Department, Herat University, Herat
Source of Support: None, Conflict of Interest: None
There are several factors that can lead to social anxiety disorder (fear of being judged or rejected), such as genetics, environmental factors, learned experiences, deficits in social skills, cognitive factors and/or culture. Considering all these factors, there are many people prone to develop social anxiety disorder in Afghanistan. In a recent study conducted at Herat University, it was shown that many students suffer from social anxiety disorder. The case described in this personal reflection concerns a student, who, upon assessment of her symptoms, the author diagnosed as having social anxiety disorder and provided several counselling sessions. After some time, positive results were achieved and the client recovered significantly from her disorder by the conclusion of the sessions.
Keywords: Humiliation and insult, low self-esteem, neglect, stepmother
|How to cite this article:|
Karimi BA. The girl who wanted to stand-up in class and speak to her classmates. Intervention 2018;16:271-2
| Introduction|| |
As a faculty member at the Faculty of Education at Herat University, with 14 years of experience, I have seen a lot of cases of social anxiety among the students. I think that one of the factors that has contributed to an increase of the disorder is cultural and relates to the accepted norm that that children and adolescents are expected to be quiet and not speak too much in the presence of their elders. If a teenager or a young person speaks too much in such a situation, it is considered to be a sign of rudeness and bad behaviour. When a child grows up under these constraints and then enters school, and teachers don’t pay attention to her/him, that person can often suffer from social anxiety.
Recently, one of the female psychology students inspired me to look more closely at this issue and to carry out quantitative research to determine prevalence of social anxiety among students at Herat University. The research was conducted in 2017 under the title ‘Prevalence of Social Anxiety among Students of Herat University’ (Karimi, 2017). The results showed that 6.55% of Herat University students have social anxiety, of which 3.85% are females and 2.7% are males.
| The student who inspired me|| |
She is a 20-year-old, highly talented, student of psychology. According to her, she felt overwhelmed with stress and experienced symptoms such as dry mouth and shaking in her hands and legs whenever she wanted to speak within a group, such as friends, peers at a party, in front of class or in a ceremony. When I asked about her past, she said her mother passed away when she was a child. After some time, her father married another woman. Her stepmother could not have any children, so she was the only child in the family. She said was neglected, and further, her stepmother regularly humiliated and insulted her.
At the university, she worked to complete her class projects, mostly working at home alone. When she was in a group work situation, she would never volunteer to deliver a presentation to the class. She rarely made friends with others and that was a big concern to her. When I reviewed her academic performance and results of her written examinations, I noticed that she had scored very high in most of her courses. She could analyse topics very logically and scientifically, and was a fully capable and knowledgeable person when considering this element of her studies. She was best in written tests, with highest marks among her classmates. However, in terms of her overall grades, she was always at the bottom of the class. This was due to the very low grades gained from class activities, conferences and practical work. She had never presented a paper at a conference and was passive in the classroom. As a result, her overall scores were very low, negatively impacting her educational development.
| Diagnosis|| |
My primary diagnosis of her condition was social anxiety as she showed an unwillingness to begin communication with others and avoided any situation that made her subject to judgment by others. Because she had many social anxiety symptoms, I searched for a tool to help me to confirm this diagnosis and found a social anxiety inventory (Watson & Friend, 1969) which has 58 questions. After piloting it on a group of nine students and conducting follow-up diagnostic interviewing, I was comfortable with the reliability of the test. Then I used that questionnaire for the above-mentioned student and asked her to complete the questionnaire honestly and accurately. She obtained a score of 48, which shows she was suffering from severe social anxiety.
| Intervention|| |
I decided to use reality therapy.1 At the first meeting, before beginning the intervention, I asked her to visit a qualified doctor to determine if there were any contributing factors coming from her physical health, inherited genetic and family factors or neurological factors that could be impacting her condition.
In her work with me, I talked to her about the realities of her life. I asked her to list all her strengths and weaknesses. When she did this, I then asked her to relate each weakness to a strength and helped her to use her strengths to eliminate her weaknesses, which she did. It was interesting that she had listed many strengths, far more than her weaknesses. I asked her what else she would like to do with all her strengths. I did this because I realised that her self-confidence was very low, and I wanted her to strengthen it. It was very interesting to her that she had all these abilities and had never really thought about them. She had always looked at her weaknesses and disabilities, and this focus on her weaknesses had made her feel weak. As a next step, I asked her to attend book reading sessions that had been set up by her classmates. There were a lot of students in these sessions, and everyone who had recently read a chapter of a book shared his/her understanding with other students. Although, at first, she did not want to attend, she finally agreed when I insisted.
After a few meetings, I asked her about the reading sessions and found out that she was very happy and had followed them with interest. The next homework for her was to ask a question in each of her classes every day, including my course, which she did. I realised that she asked logical and wise questions. Every time she asked a question, I encouraged her. For example, ‘you asked a good question, well done!’. After sometime, I saw that asking questions had become normal, and she was asking several questions in each session. Then I decided to ask her a question about the subject in each session to encourage her to speak more in front of her classmates and repeated that for a while. Each time she provided any answer to my questions, I would encourage her with comments like ‘you gave me a very good answer’, ‘well done!’.
After 3 months, when I was distributing group projects to students, she came to me and asked, ‘Who are my group members, Professor?’. I asked, ‘Which group do you want to work with?’. It was interesting for me to hear that she replied, ‘It does not matter, with anyone’. These changes were interesting and promising, and it proved to me that with accurate study and logical solutions, social anxiety could be addressed. When she was defending her monograph during the following semester, despite the presence of many jury members and students and the importance of the situation, she presented her monograph without suffering stress. Today, she is working as a counsellor in a clinic and has been able to establish good relationships with her colleagues.
| Conclusion|| |
It is known that many factors can contribute to development of social anxiety disorder, such as genetic factors and social conditions. From a social perspective, those who suffer from this disorder often consider their social skills to be weak and inadequate, and this − in turn − reduces their self-confidence. In addition, an unsuccessful social experiment from a previous life experience may contribute to development of social anxiety. The studies on this case have made it clear that the death of this students’ mother, the addition of the stepmother and lack of attention, humiliation and insults from her parents have caused social anxiety in the client, and further led her to even lower self-confidence. I wanted to encourage confidence by showing her own abilities to her and to improve her self-confidence by encouraging her in class activities and group work. In contrast, I searched for ways for her to strengthen her relationship with her classmates. By implementing these solutions, I was able to reduce social anxiety and achieve a positive result.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
1Reality therapy is the application of choice theory in counselling and psychotherapy. The theory of choice means that people are responsible for their own choices, decisions and goals, and in that sense, they are also responsible for their level of happiness.
| References|| |
Karimi B. A. (2017). Prevalence of social anxiety among students of Herat University
. Herat: Department of Counselling Faculty of Education Herat University.
Watson D., Friend R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 33