Diane speaks with Dr. Roger Kligler who is living with advanced stage cancer on why he's suing the state of Massachusetts for the 'Right to Die' and with Dr. Jessica Zitter, and intensive care and palliative care specialist on why better communication is so needed between doctors and patients facing end-of-life issues.
Many of us feel nervous if we have to make a speech in public. But for the more than 40% of Americans who are chronically shy, even ordering food in a restaurant can cause deep anxiety. Their palms sweat, their hearts race, and their faces grow flush. Medical treatment and therapy is widely available for social anxiety, but some argue that shyness is not a sickness. They say shy people listen better and have higher levels of empathy. A look at shyness, its evolutionary basis, and why it might be an asset.
- Dr. Liza Gold Clinical Professor of Psychiatry at Georgetown University Medical Center
- Susan Cain author of the forthcoming book, "Quiet" (2012) and The Power of Introverts blog
- Todd Kashdan Associate Professor of Psychology and Senior Scientist at George Mason University
- David Sloan Wilson Distinguished Professor of Biology and Anthropology at the State University of New York (SUNY) in Binghamton; director of The Evolution Institute;
MS. DIANE REHMThanks for joining us, I'm Diane Rehm. For people who suffer from social anxiety, even simple activities like buying groceries or asking for directions can cause panic. For others, a shy temperament can be a source of strength that allows for a deeper understanding of friends and family members.
MS. DIANE REHMJoining me here in the studio to talk about shyness and social anxiety, Todd Kashdan of George Mason University, Liza Gold of Georgetown University Medical Center and Susan Cain. She's the author of the forthcoming book titled "Quiet: The Power of Introverts in a World That Can't Stop Talking." Great title. Really, great title.
MS. SUSAN CAINThank you.
REHMAnd throughout the hour, we'll take your calls, 800-433-8850, send us your email to email@example.com, feel free to join us on Facebook or Twitter. And good morning to all of you.
CAINGood morning, Diane.
DR. LIZA GOLDGood morning, Diane.
MR. TODD KASHDANGood morning, Diane.
REHMYou know, let's start with this whole notion of the spectrum of shyness, which it seems to me, Todd Kashdan, can go from, you know that lovely bashfulness sort of quiet quality all the way to stressful, a social anxiety to phobia. Is there a continuum there?
KASHDANOh, absolutely and I would even say that so when we think of shyness, we're talking about a tendency to be reserved, to be inhibited, trying to be a little bit coy and not really expressing themselves openly with other people around you, not wanting to be in the social spotlight. And then, as you're saying, where it's a continuum, when you move a little bit further to the level of where it gets to become a problem, is that people we might describe as being socially anxious, where they're basically fearing the possibility that they might be scrutinized by other people.
REHMAnd what about the notion of needing help, Dr. Gold, as a clinical professor of psychiatry at Georgetown University, you must see a lot of people who feel that they can't quite make it because they are too shy or socially phobic.
GOLDWell, and it is a pretty common problem. Approximately 15 percent of the population would qualify for a diagnosis of social phobia and/or generalized anxiety disorder and they do kind of get mixed up with each other quite a bit.
GOLDBetween 12 and 15 percent, it's pretty common. It's one of the most common disorders that you see and it's also not necessarily recognized for its severity and impairment that it can cause. It can cause people to under-function in a variety of ways. And when it becomes problematic, people will often seek out help. Typically, people try to manage it on their own with a variety of compensating or coping mechanisms, but when those start to fail or are overwhelmed by a situation.
GOLDSo, for example, I've treated a college student who when she was going to high school and was familiar with the people around her and the teachers, whatever it was, a familiar environment, she had social anxiety, but she was able to function and do very well. When she got to college and had to walk into a new classroom, bigger setting, et cetera, she could not bring herself to walk into the room. Now, that's obviously going to be a problem.
GOLDAnd so at that point, she presented for some help. So it can be quite disabling.
REHMBut Susan Cain, in your book "Quiet: The Power of Introverts in a World That Can't Stop Talking," I gather what you're saying is that shyness or introversion can be not only acceptable, but desirable?
CAINYes, that's right. And there are so many different ways in which it can be acceptable and desirable. And just to tell you about a few of them, so looking at shy children, to start with, children who display fearful temperaments also display stronger consciences. So studies show that these kids are much more likely to be described by their parents as having very high levels of empathy.
CAINThey're much less likely to cheat or to lie even when they think they can't be caught. And this is because part of the way that people form their consciences is by being very sensitive to disapproval. So if you're looking at a child who has that exquisite sensitivity, they are forming these strong consciences very early on and in very extreme ways and this continues all the way through so that when you look at these children when they grow up, often they are very high in traits like conscientiousness.
REHMAnd what we would normally say about a child who displays that kind of temperament is, oh, isn't she or he sweet, bashful. I mean, just bashful, not thinking so much about introversion or extroversion, but rather about a sweet, bashful child.
CAINYeah and I think that what we often do, well two things. What we often do is we tend only to see the shyness or the bashfulness and we're not thinking about the broader temperament that the shyness is a part of. So shyness itself is a painful thing. I don't think anybody likes to feel shy and I don't think anyone wants to see their children feel shy.
CAINBut when we look only through that lens, we're missing so much wider a part of the person and the temperament from which the shyness comes. And that's really the key. And then I wanted to say something else. When you're talking about introversion and shyness, just for the benefit of listeners, I want to distinguish between the two of them because they really are different.
CAINShyness is much more the fear of negative judgment, the fear of social disapproval, whereas introversion, an introvert might not have those fears at all. An introvert is merely somebody who prefers minimally stimulating social environments. So they would much prefer to have a glass of wine with a close friend instead of being at a raucous party, let's say.
REHMDr. Gold, would you agree with that kind of differentiation?
GOLDYes, as broadly speaking. Again, someone who is introverted, that is a personality type of characteristic and there are people who just prefer to sit at home and read rather than go out to a party, that kind of thing, and there's nothing pathological about any of it. We all have personalities, we all have personality characteristics and traits.
GOLDShyness becomes an issue because it is on -- or could become an issue because it's on a spectrum where at one end, you have shyness and at the other end, you have an extremely painful -- you know, the minimal shyness can be painful but you have an extremely painful and impairing condition that may actually interfere with someone's functioning and productivity and life.
GOLDAnd in fact, the incidence of suicide in people with various kinds of anxiety disorders is approximately as high as the incidence of suicide in people with mood disorders. The anxiety is so painful and people struggle so much with it that it can lead to the kind of despair and desperation that you sometimes see in depression.
REHMNow, Todd, can you once more differentiate between anxiety and phobia, full-blown phobia?
KASHDANSure, but let me just address something that Susan mentioned. And what we find in our research is that while people with high social anxiety might possess these interpersonal virtues such as empathy or generosity or gratitude, what we find is they end up being dormant and unused and the reason is, is that they're so self-focused. They're so worried about making a blunder. They're so focused on whether someone can see their anxiety that they have a difficulty actually being there when good things happen to other people.
KASHDANSo we bring romantic couples into the laboratory and we do this weird stuff where we ask them to share events they've never shared with each other before. So share something, a triumph or a joy you've never shared with a romantic partner before and we're observing them through a one-way mirror because we're psychologists, so we have to deceive people, that's our job. And what we find is, is that people with elevated social anxiety, is they tend to have difficulty sharing in their partner's triumph.
KASHDANInstead of saying, that's amazing that you got a new promotion, they tend to say, wow, that sounds like you're going to have to be working a lot more hours, so they're discounting it or they're moving the conversation to something totally different. That sounds really nice, but what are we having for dinner tonight? Now, here's the thing, when your partner is sharing a really beautiful thing that happened to them and you're not elaborating on it or expanding on that, what happens is they feel -- they don't feel valued, they don't feel cared for.
KASHDANAnd the partners recognize this. And one of the greatest predictors that we're finding six months later in romantic relationships is a decline in satisfaction, a decline in the commitment of the romantic partner, is that people with elevated social anxiety are showing a failure to attend to the enthusiasm of their partners. So they might have these strengths, but they're not being used, they're unrealized.
REHMSusan, would you agree with that?
CAINWell, yes. I think really the key here to be thinking about is the concept of a spectrum that we were talking about earlier. So sure, when somebody is on any kind of an extreme end of the social anxiety spectrum, it's going to cause all kinds of problems like the kinds that Todd was talking about and others as well. The real key, I think, is how can you move people towards the end of the spectrum where the shyness is merely a part of who they are, but it's not interfering in any significant ways and instead, it's actually leading to positive outcomes?
REHMSusan Cain, she's author of a forthcoming book and its titled "Quiet: The Power of Introverts in a World That Can't Stop Talking." Short break and we'll be right back.
REHMAs we talk about shyness and indeed social anxiety, joining us now from an NPR studio in New York, David Sloan Wilson, he's Professor of Biology and Anthropology at State University of New York in Binghamton. Good morning to you, Professor Wilson. Thanks for joining us.
PROF. DAVID SLOAN WILSONGood morning to you.
REHMTell me, isn't some amount of anxiety necessary for survival? What's the role of evolution here?
WILSONWell, there's two roles. All of us need to feel pain and anxiety and depression. All of these things don't feel good, but they do help us survive, so that's part of the equipment of every individual, but there's also individual differences to consider. And it's fascinating that not just in humans, but in many other species, there's individual differences that we associate with shyness and boldness.
WILSONSo we have to think beyond our own species to other creatures, such as primates and birds and even fish, as strange as that might seem, also have these personalities that we associate with shyness and boldness.
REHMSo what determines whether shy animals or bold animals survive in nature?
WILSONWell, just as there's many species out there and they all survive and reproduce in different ways, have different niches, it turns out that's also true for individuals within a species. And you can well imagine the advantages of boldness and the cost of boldness. Because if you take risks, you know, if you grab life by the horns, sometimes you get gored.
WILSONSo -- and on the other hand, if you're shy and you hang back, then you're not going to be the one that's grabbed by the predator, so it's pretty easy to think about the cost and benefits associated with both of these personality types. But something else has emerged which is more subtle and that is the degree to which individuals pay attention to their environment. This is something that never occurred to us until we started to -- it started to emerge from studies.
WILSONBut some individuals are kind of on automatic pilot, we know people like this. And other individuals are really, you know, acutely sensitive to their environment. And what that means is that sometimes they get overwhelmed by that ability, but sometimes that leads to great accomplishments basically, which the inattentive ones tend not to achieve. So there's good news and bad news associated with both.
REHMSusan Cain, do you want to comment?
CAINOh, yeah. You know, I just think it's interesting what Prof. Wilson is talking about with animal behavior and you see this in -- translated into human behavior almost automatically. You go in, for example, into your typical mommy and me music class and you will see a group of children around the room, each one on their mothers' laps. And you'll see the bold children automatically getting up from their mothers' laps and marching around the room and banging their drums and exploring and shaking around their maracas.
CAINAnd then you see the more sensitive or quiet children and they are sticking closely to their parents. And it might look as if they're not getting as much at first out of that music class, but really what they're doing, to Prof. Wilson's point, is they are closely observing very alertly everything that's going on. And then you'll often see them days later or weeks later performing some of the...
REHMInteresting. Prof. Wilson, give us an example from your own research. Tell us about the rovers and the sitters in the pond of sunfish.
WILSONWell, we were among the first people to study this and we went to a pond where there were little sunfish and we threw in minnow traps. Most of your listeners know what that is, shiny funnel-shaped traps. And, you know, you'd think that would be scary and indeed, some fish ran the other way, but some were just so curious that they were sucked into the traps just by their own curiosity. So we retrieved those fish and then we caught the ones that didn't go into the traps with a net.
WILSONAnd then we examined their individual differences in the laboratory. And what we discovered were just enormous, enormous differences between these fish that we caught in different ways. So that was our own way of starting to study shyness and boldness. Other researchers in birds will catch birds like our chickadees and bring them into an aviary where there's trees and things like that.
WILSONAnd they'll simply put them in and they'll measure how long does it take for them to start hopping around. And some begin very quickly and others hang back. And they're precisely like the children that Susan just discussed. So they're just -- so that the -- this is a difference which is extremely general, not only between species, but also kind of across sensory mode so that the same individual that hangs back also tends to have sensitive skin, is especially sensitive to coffee, is likely to be overwhelmed by a symphony. So we're talking about people that are wired in very different ways.
REHMInteresting. Susan Cain, you are a self-described sitter. Were you always that way? Describe your own growing up.
CAINOh yeah, sure. So I can remember being shy as a child and my parents say that when people used to come to the house, people who I didn't know, I would run upstairs 'cause I didn't want to see them. So I really was a classic sitter in these ways. And I'm also, I would say, a classic introvert in the sense of really enjoying my time alone reading and that kind of thing. I've always had a lot of friends, but I've also, at the same time, had always the initial period of needing to get comfortable before plunging ahead in classic sitter style.
CAINBut, you know, I really started to think about the advantages of this kind of a disposition when, through a strange set of circumstances, I found myself practicing corporate law on Wall Street for seven years when I was in my 20's and 30's.
CAINYeah, and at first when I did this, I had the idea that as a sitter, I would be disadvantaged. You know, that a powerful corporate lawyer had to be very bold and alpha and comfortable in the spotlight. And I quickly found that that was completely not true. And that, yes, that's one way of being powerful, but there was a completely different constellation of traits that you could bring with you that would also make you very powerful.
CAINYou know, traits like listening carefully to people and asking questions and building alliances one on one behind the scenes with people. You're not so comfortable in groups? Fine, you do it one on one and that can be much better.
REHMLiza Gold, what do you think of the personality trait she just outlined?
GOLDWell, what Susan's talking about is, you know, finding fits. You know, we all have personalities, we all have strengths. We all have things that if we're challenged to do, we may not do as well as other people. And if you know yourself and you understand what fits well for you, people who can adapt, who find an environment which is adaptive to their strengths will do well, even if it's something that you think of as not necessarily straightforward a strength, like shyness.
GOLDSo it sounds like what Susan did was know herself, know what worked for her and then adapt in the environment that she found herself.
REHMBut how often do you think today's young people, middle-aged people, older people need medication to be helped with that?
GOLDWell, that's a very difficult and different kind of question...
GOLD...because first of all, medication's not the only treatment for anxiety disorders and it's not even necessarily the first line treatment. It really depends on the severity of someone's symptoms and presentation and the degree of impairment that it's causing. There are other treatments, cognitive behavioral therapy, exposure therapy, meditation, relaxation, even acupuncture, which I've seen work very well for people. Some people need to do those things in combination with medication to get the best effect.
GOLDYou know, the more impaired someone is and the more physically uncomfortable they are in their own skin, the more one thinks about whether medication is another tool to put in their toolkit to manage anxiety.
WILSONI would like to reinforce that.
WILSONI think that medication is a second or third line of defense and that the proportion of people that require meditation is more in the range of 3 to 5 percent, not 12 or 15 percent. There's many environmental solutions and so I simply want to reinforce that point.
KASHDANAnd building on what David said, I mean, one thing that we -- this big question I've been interested in is even if you have a disorder, schizophrenia or eating disorder or social anxiety or -- the fact is, you're going to have some days that are good. So we've been asking, well, what makes for a good day for someone with extreme shyness or social anxiety problems? And what we found is there are natural therapeutic processes in everyday life that ameliorate difficulties, that enhance our positive experiences.
KASHDANAnd for example, if you were to have -- there are very few situations where we objectively know that somebody cares for us and is actually interested in us, except for maybe a warm embrace by our parents and then maybe a really caring sexual experience.
KASHDANAnd so what we were interested in is, well, if someone with social anxiety had really intimate sexual experiences, felt close and connected to their partner, would this sense of belonging carry over into the next day where they wouldn't feel that they had to make a good impression on other people. They wouldn't feel that they had to make -- compare themselves to other people and see themselves as not as attractive or interesting.
KASHDANAnd what we found was with more pleasurable intimate sex with a romantic partner led to less shyness, less social anxiety symptoms the next day and they were functioning better. And we also found -- and this I think is really relevant to thinking about therapy beyond medication -- that on days when people find that they're committed to a profound purpose in life -- it doesn't have to be religious, it could be caring for your kids, it could be making the world a better place, it could be putting your personal signature on your work.
KASHDANOn days when people commit to a purpose in life their self-esteem, their sense of self-worth looks no different than the most healthy alpha male on the top of the social hierarchy.
GOLDCan I add, though...
GOLD...that a lot of these techniques which are incredibly useful and research supports how helpful they are, there are still a category of people who are unable to tolerate or engage in the anxiety that even these techniques produce without some decrease in the amount of anxiety they feel on a minute to minute basis. And there's a lot of generalization of anxiety. It can start a social anxiety and then one becomes anxious generally...
GOLD...about any situation or certain kinds of situations and things get very tangled up and very difficult for these individuals. And so sometimes you do have to start with the medication in order to move them into some of these other things, although I would like to find out how to prescribe the sex...
GOLD...as a cure for...
GOLD...that would be very useful.
REHMLet me read this email from Maggie who says, "My husband is an introvert, I am not. We balance each other out. I believe this may have been one factor that actually brought us together. On the other hand, at the end of the day at home with our baby, I'm dying to chat with an adult while he's exhausted from a day communicating with colleagues and wants quiet time. This," Maggie says, "is a challenge." And you're listening to "The Diane Rehm Show." Susan, do you want to comment?
CAINYes. Maggie, in doing the research for my book, I must have spoken to hundreds of couples just like you and to hundreds of extroverts who have the same frustration. It's very common for introverts and extroverts to come together in marriage because the two -- people understand that they can complement each other in a very beautiful and fulfilling way. And then it's also very common for that to lead to these kinds of...
CAINExcuse me -- I think the first thing to do is -- and it sounds like you've done this already, to really -- pardon me -- to really understand where your partner's coming from and for he to understand you. And then maybe to take it a step beyond that and to really come up with concrete practices that you're going to follow together.
CAINLike we're going to understand, both of us, that -- this is just by way of example -- when your husband comes in from his day of work, he takes half an hour by himself and no one's asking any questions and he's taking the time that he needs to recharge from all the energy he's had to spend in his workday. And only after that half hour do you -- does he come together.
REHMIt sounds like couples therapy is an appropriate approach at that point. But, you know, it does seem to me that we have sort of a beautiful example of this in our own history, David Sloan Wilson, and that is in Eleanor Roosevelt, certainly a shy young woman.
WILSONThat's right. And so she rose to the occasion. One point that I've been wanting to make during this interesting conversation is that people do have a remarkable ability to rise to the occasion. Even if it's not what they would prefer, they do manage and they manage in their own way, as Susan did as a corporate lawyer.
WILSONAnd also research shows that if you take these highly sensitive people, these ones that are so attentive to their environment, whether they become shy or bold actually depends on their experience. About 80 percent become shy, as we've been describing, but 20 percent figure things out so well that they become bold. And you actually might not recognize them for being the sensitive people that they are. I think we've all met people who seem to be outgoing and, in fact, are outgoing, but when they talk to you about it, they say, well, you know, I'm really a shy person on the inside.
REHMI'm really shy, yeah, yeah.
WILSONAnd I think Eleanor Roosevelt is an example of a person who was clearly a very sensitive introverted person and yet she was kind of called to greatness...
WILSON...and she rose to the occasion.
KASHDANAnd just to agree with David's point is we need to look beyond the veneer of how people overly define themselves as one or the other. I'm pessimistic or optimistic, I'm introverted or extroverted. All of us are some degree of both and that if you look at people's behavior, you find that everyone tends to exhibit some of these behaviors some of the time. And hitting what David said, what we find is when you look at people, whether they appear extroverted and social and aggressive, sometimes the motivation for that is, I'm going to reject you before you have a chance to reject me.
KASHDANAnd so you find that a lot of people that are shy, they tend to be hypersexual, aggressive, substance abusers and what this is, is it relieves their anxiety in a very different way than a shy person who might walk away from a social situation because it's too stimulating. These are people that, I'm going to take what I desire and in this way, I'm -- if I want to find -- to satisfy this need to connect with other people, I'm going to go seek out very quickly and find a sexual partner. And if someone's going to potentially harm me, I'm going to harm them before they get a chance to harm me.
REHMTodd Kashdan, he's Associate Professor of Psychology at George Mason University, Dr. Liza Gold, she's Clinical Professor of Psychiatry at Georgetown University, Susan Cain, she's the author of a forthcoming book titled "Quiet." And joining us from an NPR studio in New York, David Sloan Wilson of State University of New York.
REHMAnd we're back. It's time to open the phones. We've got lots of shy people on the phones. Let's go first to Fort Lauderdale, Fla. Good morning, Tony, you're on the air.
TONYGood morning, everybody. This is a very exciting conversation and I'm really glad at everybody that we're talking about this.
TONYI identify as an introvert and I'm known by others as such and I'm very comfortable with this. I don't -- I don't suffer from social anxiety, I'm really not going to talk about that, but I just feel there are a great deal of benefits to this type of being the way I am and I'm -- it's always been my belief that there's two types of people.
TONYYou either have going an extrovert or you're an introvert and it's been my experience that people who are extroverts tend to think that there's something wrong with people who are more shy and I've actually had one person tell me it's a disorder, a personality disorder, and I just don't understand that. But one that -- you've covered a lot of the advantages and the benefits, such as empathy, which I'm known for and the like.
TONYOne of the great things about is that seeing that I don't talk all that often, when I do speak, people really pay attention. You know, they'll sit up and, oh, my gosh, he said something, you know, and they'll listen to me (word?) more -- (laugh) more of an impact and it's -- as opposed to someone who's always yakking away, so.
TONYThe other advantage is I have a really fair amount of very good friends, people who are very close to me, and they all tend to be extroverts, which is good for me because they draw me out -- out of my shell and force me to engage. That's what I get out of it. What they get out of friendship and relationship with me is someone who they can confide in that they don't talk to other people about certain things and I'm very flattered by that and I'm very honored -- you know, I feel very fortunate that they tend -- they feel that way about me because I do listen.
REHMThat sounds very much as we were talking earlier about the empathetic listener, the person who is shy who's not demanding the attention all the time, but is willing to sit back and listen.
WILSONI would like to add something to that, that interesting comment which is that it makes an enormous difference how something is framed by the culture. And if something is characterized as a disorder as opposed to a strength, of course that makes all the difference. I think that we could make a huge contribution right away by saying that with some exceptions in which -- rare exceptions in which social anxiety is a disorder, in most cases, you know, what you are is somebody with enormous strengths that you need to develop and you need to develop that in certain ways.
WILSONYou need to avoid some situations, not others. But what you have is a strength and not a disorder.
WILSONThat all by itself is going to be huge.
GOLDAnd I was thinking along the same lines. As a society, we have developed a tendency for all kinds of reasons which would form the basis, I think, of another hour of discussion to pathologize what are really basic, normal human traits and characteristics. Even anxiety. When people say anxiety, we think, oh, anxiety is bad. Anxiety is not a bad thing. If a lion is about to eat you, you should be anxious and you should run as far as you can go.
GOLDYour anxiety should not just suddenly disappear...
GOLD...to not be tense, so you want to run and run and run until you're sure that that lion is not going to eat you, okay? That is what anxiety is for, speaking of evolution, I mean.
REHMFight or flight.
GOLDWell, right. It's there to help us protect ourselves, so to say that, you know, that's -- that a situation makes someone anxious is not necessarily a negative comment, although it is typically construed, you know, as a negative comment just because of the word. And I would comment on the caller that -- very small part of his -- what he said was that, you know, someone even said he had a personality disorder.
GOLDI think that's a very slippery slope, this pathologizing of, you know, who we are in our personality traits and our characteristics, I think it's hard to define where the line is sometimes, but generalized anxiety disorder, generalized social anxiety, people who really suffer from that are really suffering from that.
REHMAll right. Let's take a caller in Hyattsville, Md. Good morning, Carol.
CAROLYes. Thank you for taking my call.
CAROLI wondered if your guests would discuss Emily Dickinson and her withdrawal.
WILSONI have to confess that I don't know that much about Emily Dickinson, per say, so I need to pass that to somebody else.
REHMAll right. And Susan.
CAINWell, yeah, I mean, Emily Dickinson is a classic example of a poet who was known for he occlusive ways and used that to fuel her poetry. And, you know, it's funny, we've got a strange cultural current going on right now. It used to be that we an idea of creativity as something that kind of happened alone on a hillside romantically, you know, when you were out wandering among the clouds, the way William Wordsworth spoke of.
CAINAnd now, we're in this strange cultural moment where we think of creativity as being something that is group oriented and that emerges from a group-based collaborative process, when in fact, 40 years of research on brainstorming tells us that groups brainstorm horribly and individuals almost always will come up with better and more innovative, more creative solutions to problems than groups will.
WILSONI have to -- I have to respectfully disagree and I look forward to talking, having a wonderful conversation with Susan about that particular topic, but we move on.
REHMAll right. But...
GOLDAnd I -- and I would add one quick thing to that, which is, you know, the larger the group, of course, the more difficult it is to get anything done, but that overlooks -- and I think Todd brought it up -- that overlooks the role of relationship in creativity and the role of connectivity. If you have a good connection with someone, can bounce things back and forth, I have found that some of the most creative people, they do create alone, but they have a small group of people that they go back and forth with and talking things and it stimulates them, et cetera.
GOLDSo I wouldn't necessarily just say, you know, the group thing is -- I would refine it.
CAINYeah, and can...
CAINIf I can add to that, I think that what ends up happening is the best creative processes often come with an individual working on their own and then coming back and talking about it with a group, but the germ of the idea happens on one's own. And if you look at many artists describing their creative processes, they'll often describe themselves being inspired by kindred spirits, but when you look at where they actually did the work, their often working on their own.
WILSONBut there's a -- there's an alone...
KASHDANAllow me to make a -- let me try and get a quick point in...
REHMGo ahead, Todd.
KASHDAN...which is, you know, the nature of this conversation is worth focusing on one personality trait, shyness and social anxiety. And these things don't occur in vacuums. In the real world, there's a lot of variety and so it can have -- you're going to find creative people that are shy, you're going to find sociopaths who are shy, you're going to find people who are incredible parents, you're going to find people who should not have that -- any exposure to kids whatsoever in their lives.
KASHDANWe have to remember that everyone's personality is like a 16-sided dye and we don't want anyone to over identify with shyness or extroversion.
REHMAll right. Here's a question for you, David Sloan Wilson. Rick sends and email saying, "Where do we think shyness comes from? Is it a product of the environment, something inherited or both?"
WILSONWell, of course, it's always both. And in order to make that interesting, we need to specify more about the interaction. There is a big genetic component to especially this processing sensitivity and we've even identified some of the genes, some of the well-known genes that affect, for example, dopamine systems and serotonin systems. So enough science has been done to know that if you have certain (word?), then you are more likely to be this sensitive type which has both good news and bad news associated with it.
WILSONBut you don't want to underestimate the environmental component, either, and I'm most impressed by the capacity of everyone to rise to the occasion, as we've described earlier, and to do things that they were most unsuited for and to be good at it. And then the genetic differences are kind of follow that, but you have to be most amazed by our flexibility.
REHMAll right. To Aurora, Ill. Good morning, Mark.
MARKGood morning. I'm afraid to have to report -- I'm sad to have to report that dictionaries are not fair, either. They tend to leave you feeling that introverts are the ones with the problem and I acknowledge that introverts do have a gentle touch, which often makes them excel at hospitality. And when an extrovert ingratiates people in order to get them to do what they want, they're never called pathological, they tend to be called smooth or shrewd, which is not fair (laugh).
MARKAnd I like the Myers Briggs formulation because it focuses on psychic energy flow and manner of processing, but remains neutral while doing so and I'd like to ask your guests what they make of King George in "The King's Speech." Would he be someone who was pathologically shy or introverted by temperament or was it more true to say that his speech impediment had a major impact on the way he turned out, independent of all that other stuff.
REHMExactly. In other words, did the speech impediment in some way help him to grow?
GOLDWell, I think as it's portrayed in the movie, it did. As he was able to overcome it, it gave him a new sense of himself, but it clearly -- I think again, at least as portrayed in the movie, I'm not personally familiar with the circumstances of the situation, but in the movie, certainly at the beginning, it was a source of extraordinary family difficulty, social difficulty, educational difficulty.
GOLDIt seems to me that had he not had the speech impediment, it's impossible to know who he would've been because the speech impediment was such an overwhelming part of his life and so poorly understood by the others around him, he got no support, et cetera. But in the end as certainly, it became a strength through a connection that he was able to make with another human being and I thought it was a beautiful story (word?).
KASHDANAnd just to add to that point is we have stigmas here about shyness, about social anxiety, about seeking help, which, you know, if we described it and said, a coach was going to help you improve your social fitness, we would have a very different attitude than the idea of a therapist is required...
KASHDAN...to improve your mental health because you have a disorder.
KASHDANAnd so the system is designed in a way to pathologize, but the fact is, is when somebody goes to see a personal trainer to reduce the amount fat on their body or increase the leanness of their muscle fibers, we don't say that there's a problem, they're just working on themselves.
KASHDANSo the idea of enhancing wellbeing should be a fundamental aim of people and pretty much almost everyone in humanity should be having psychological fitness checkups and not just people -- we're talking about these, you know, King James and these extreme examples.
REHMKing George, actually.
WILSONI love that. I second that (word?).
REHMAll right. Let's go to...
GOLDAnd I -- I would agree with that as well.
REHM...Rachel in Syracuse, N.Y. Good morning, you're on the air.
RACHELGood morning. I have a child who was recently diagnosed with selective mutism and I was wondering your guests could touch upon that and maybe give me some ideas on how to help him as he enters formal schooling. He's an incoming kindergartener.
REHMBe a little more clear, if you would, about what you're calling selective mutism.
RACHELSelective mutism, right. It's a disorder that usually occurs when they're young and it's when a child chooses not to speak in social settings, but in other situations, they are just your normal, typical child.
REHMInteresting. At -- and just to remind our listeners, you're listening to "The Diane Rehm Show." Sounds like shyness to me. What's it sound like to you, David?
WILSONLet me pass that on to some of the people that are more familiar with a clinical setting.
REHMOkay. How 'bout you, Liza.
GOLDWell, with the caveat that I don't work with children and selective mutism is not a problem that I typically work with, it's not simply shyness if it's become an impairment. So a child who cannot speak at school is going to have a problem and that problem is going to have an educational impact.
REHMOf course. Does your child speak at school, Rachel?
RACHELRarely. Usually, it takes a lot of prodding to get him to speak. A lot of head nodding is what he usually uses.
GOLDSo that's going to be a problem. And again, I can't really speak to the treatment of selective mutism because I don't treat children, but in answer to your question, it's not -- at that point, that's a good example of where you have likely crossed a line from shy to an impairment and I don't know if that impairment's based on social anxiety or if there are some other some other issues this child may be having, but that's would you would need to sort out in order to help.
REHMAre you getting help for your child?
RACHELWe are. Our school system has been very generous in getting us the help we're going to need.
REHMGood. I'm glad to hear that. Good luck to you, Rachel. And finally to Jacob in Raleigh, N.C. Good morning.
JACOBHi, thank you for having me.
JACOBWell, I just wanted to touch on a topic that is kind of I would say plagued me for most of my life since I was a child. I've always been I feel outgoing, I love being the center of attention, I love talking about myself and -- but I was a shy child and even as an adult, I feel it in certain situations, you know, often when I'm on the spot. You know, my face will turn red and I can -- I can feel it, I can feel being flushed and often that, you know, comes with it, the anxiety of, you know, the other person there just kind of what they're thinking and it can kind of...
JACOB...you know, I feel jeopardize my, you know, opportunity (unintelligible) I guess.
REHMTell me what you question is, Jacob. We're almost out of time.
JACOBSorry. Is that something is there anything that can be done about that or is that just something I have to deal with?
KASHDANI mean, one thing is that this is a very common occurrence, whether it's blushing or sweating, the idea that people can see everything that's going on inside me, so I can look calm and serene walking down the street with my chest out, but inside, I feel like I'm going to explode and everyone notices.
KASHDANAnd one of the things is, is to actually do these little behavioral experiments in your everyday life, which is to kind of to ask people, what did you just notice of what you liked and didn't like, in terms of your close friends. And what you'll probably find is, this is my hypothesis, is that most people don't see nearly the amount of blushing or redness or anxiety as you think they see.
REHMLiza, quick comment.
GOLDYes, I think that that in itself is a kind of exposure therapy or behavioral therapy...
GOLD...where you overcome the anxiety by exposing yourself to it over and over again in an attempt to extinguish.
REHMAnd sadly, we're out of time. It's clearly a subject that touches the hearts and faces and minds of many people. Todd Kashdan of George Mason University, Dr. Liza Gold of Georgetown University Medical Center, Susan Cain, her forthcoming book is titled "Quit: The Power of Introverts in a World That Can't Stop Talking," and David Sloan Wilson, Professor of Biology and Anthropology at State University of New York in Binghamton. He's author of "Evolution for Everyone."
REHMThanks to all of you. Thanks for listening, I'm Diane Rehm.
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