Shame or What Makes Irrational Social Anxiety Rational.

Social anxiety disorder (SAD) is defined as a pathological fear of social interactions in which an individual may be negatively evaluated by others. The crucial component of assessing the state as clinical is the 'context-insensitivity' of the fear-i.e., the negative evaluation does not have any tangible repercussions, or the evaluation is not as detrimentally negative, as the patient presumes. However, this model excludes the role of self-conscious emotions, specifically shame, in aggravating social fears. This article models shame as an emotion that is highly aversive, unpredictable, and resistant to metacognitive regulation, which entails a perspective that SAD is the product of high shame-proneness and the inability to voluntarily mitigate it. The evidence of mutual correlates, such as socially prescribed perfectionism and treatment outcomes of cognitive and behavioral therapeutic modalities, is used to justify the argument. The article suggests the possibility of implementing humor as a supplement to a standard SAD-treatment self-regulation strategy that would allow subjects to control the emergence of their shame more efficiently. Finally, a potential randomized control trial study design is proposed to test the perspective outlined.