Let's say you try the suggestion above and it doesn't seem to work. You break out in a cold sweat, freeze up whenever someone you don't know comes by, and feel so traumatized by the whole experiment that you're even less inclined to leave the house. I hope this won't happen, but it could, and if it does, I think it's time to take things to the next level.

Counseling can be very helpful for people with social anxiety disorders. You could learn some strategies to help you relax in these situations and practice some techniques for managing the cognitive aspects of your apprehension. You might also develop some social scripts and practice them with your counselor until you are confident you can handle some of these situations. These strategies and techniques may provide some resources to better manage situations that you've been avoiding.

I also think there is value in using counseling to try to understand yourself better. This is an old-fashioned idea, but actually one of the major benefits I see clients getting from treatment. You clearly still feel hurt by the "douche bags" who mistreated you long ago. Treatment could help you understand why this has affected you so deeply and help you learn to let it go. While these idiots messed up your childhood, it would be far worse if you let them ruin the rest of your life. At the very least, if you are seeing the right person, you will get some emotional support and a neutral perspective that can really help.

If you're still not making much progress, you could consider medicine. As a psychologist, I don't write prescriptions and strongly prefer people solve their problems without meds. But I have seen some clients with severe social anxiety for whom nothing else seemed to help. There is a wide selection of drugs used to help with social anxiety these days. They tend to reduce tension and inhibition, allowing people to relax and engage more easily with others. I can't guarantee they would work for you - even a great drug only helps a small percentage of people who try it - but if it did help, it could make all the difference.

Many people have strong opinions about psychotropic medication. Pharmaceutical intervention might make you reliant on a foreign substance and some patients certainly experience unpleasant side effects. This is not the case for many and the medicine creates the potential for a different and more satisfying social experience. If nothing else helps, it is worth a try. Spending the rest of your life this way doesn't do anyone any good.

For me, your question raises a larger issue: is intensive videogaming mostly a boon to people with social anxiety, providing them a new and more comfortable way to connect, or does it just provide another way to dodge the tension-provoking situations, which, after all, need to be confronted if the person is going to overcome their social anxiety?

While groups of professionals and parents would tend to answer that gaming is more obstacle than asset, I think most gamers see it differently. For many, gaming can serve as an important bridge to others, but it's certainly possible to get stuck on that bridge.

Dr. Mark Kline spends most weekends traipsing around remote suburban Boston as a marginally attentive youth soccer spectator. Since recovering from a year-long intensive WoW habit, he sticks to computer Risk and casual word games, but is still trying to figure out why his children like The Sims.

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