““ Adam: Of course, the pressure Adam was feeling was not just related to the math test. The roots of his anxiety went much deeper. Still, the physical symptoms of anxiety became so debilitating that he eventually quit going to school altogether. Naturally, his parents were extremely concerned but also uncertain what to do. It took almost a year before Adam was sufficiently in control of his symptoms to return to school. Clearly, he was working to avoid the pain of any kind of interaction, because he was so afraid of rejection or humiliation. His social anxiety became so extreme that he feared the symptoms as much as the stressor itself; in fact, his fear of interaction developed into a full-blown phobia. Adam’s anxiety profile obviously featured all the physical symptoms on the list (especially shortness of breath, accelerated heartbeat, dizziness, and depersonalization). They surfaced almost daily and were extremely incapacitating, affecting him to a high degree whenever he was actually in the situation that caused them. Of course, when Adam avoided these situations, their frequency and severity diminished, but their degree of interactive interference increased until it was at level 5. The symptoms were so bad that they were preventing him from interacting, all the way to the point of incapacity. Obsessive thought patterns were a contributing factor as well: “Am I good enough?” “Will they like me?” Adam even had these recurring thoughts when he was alone in his room, looking out on the street at the neighborhood kids playing below.””
