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When A Child's Shyness Becomes A Medical Condition

Being overly shy isn't always a simple personality trait, something kids will "grow out of..." It can also reach the point of clinical illness. How to know when your child needs treatment.

For most kids it is indeed just a phase...
For most kids it is indeed just a phase...
Johanna Bruckner

MUNICH — As a two-year-old, Mia would hide behind her mother’s legs when other children or adults spoke to her at the playground. The child’s pediatrician assured her parents that this was a normal phase in her development. As a four-year-old, Mia loved going to the supermarket, but when her dad went to the meat counter to buy sausage, Mia buried her face in his shoulder to avoid looking at the sales lady.

“You were shy as a kid too,” Mia’s grandmother told her son. “She’ll grow out of it.”

But when Mia reached school age, the problem grew worse. When she was supposed to present her favorite book to the class, she got a stomachache. On the night before her flute recital, she cried so hysterically that her parents kept her at home instead of making her play at the concert. They started to wonder if their daughter’s painful shyness constituted some kind of illness.

“Normal behavior includes many more things than some parents think,” says Helga Ulbricht, head of the state school counseling service in Bavaria. “Children have a natural respect for the new and unfamiliar.” That includes social situations they are not used to, she says. For some children, that could be playing with kids their own age at the playground or a school event where kids are expected to perform for their parents.

It’s also normal to go through shy phases in childhood. “Just as kids display defiant behavior, 90% of them experience introverted phases, mostly during a growth spurt or a period of mental development, or if they’ve been sick for longer periods,” explains Ulrike Petermann, a professor for clinical child psychology at the University of Bremen. “They then go through a shy period during which they stick very close to their parents.”

Ulbricht, the school psychologist, notes that parents monitor their children’s development very closely — and critically — these days. “They want their son or daughter to have the best chances. Unfortunately, this can lead to overinterpretation of failures and concluding that there is some sort of deficiency.”

She points out that shy children are not necessarily unhappy. “Sometimes the parents suffer greater psychological stress than the children.”

Petermann too says that she sees extremely well-informed parents in her practice, but that this can sometimes lead them to “dramatize” their child’s condition. Shyness is one of several characteristics that are in good part genetically determined. “At least one parent tends to be reserved,” Petermann says. Scientific literature calls the physical dimension of shyness the “behavioral inhibition system.”

“Physiologically, shy people have a lower arousal threshold. Even mild stimuli get their sympathetic nervous system into higher gear,” says Petermann. “They get excited more easily than other people do.”

The science of bashfulness

This excitement can be measured — not visible but very present are higher levels of salivary cortisol and adrenaline, while redness, sweaty palms, and a trembling voice are among the outwardly perceptible signs. Shy people also develop avoidance strategies.

Shyness expresses itself in social withdrawal,” Petermann says. “Shy boys and girls try to avoid places and situations they don’t feel comfortable with.” When these kids are in familiar situations, their shyness all but disappears. “At home, you don’t notice it. They react intuitively with their parents, grandparents and siblings.”

But what if a child is not only shy but completely withdrawn, and displays symptoms in social situations like a racing heart or breaking out in sweat? “Social fear, the phobia of social situations, is a psychological disturbance that not infrequently is caused by their shyness,” Petermann explains. “Kids who suffer from this develop an overwhelming fear that all eyes are on them. It’s fueled by the anxiety that they might end up reacting in a humiliating way, or that they might be blamed, and they may as a result avoid all social contact. In some cases that leads to complete isolation.”

Shy people whose shyness has not gone that far do take part in social life, but they too feel unwell if they become the center of attention. Shy children fear two scenarios in particular. “One is meeting new people,” Petermann says. “For example, the mother is visiting an old friend whom the child doesn’t know. This friend has a child the same age as the shy child — the ideal playmate, or so one would think. But a shy child needs — even with a child their own age — an hour or more with that child before they can start to warm up.”

School exacerbates anxiety

Shy people also often fear of being judged, “which has nothing to do with the fear of exams,” says the child psychologist. These people constantly mirror their own behavior and have little confidence in themselves. “They are full of anxiety that in a social context they won’t react appropriately and that they will be judged negatively by others.” For shy kids, this can mean that the simplest communication becomes an insurmountable obstacle. “Shaking hands with somebody, or saying ‘hi’ — they won’t do that,” Petermann says. And as with Mia, the pressure on shy kids gets worse in school because they are expected to participate in class life.

Petermann makes the case for teaching kids a step-by-step approach to social situations that they can use their whole life long. “Parents should encourage — even pressure their child a little bit — to join a sports club or play in the orchestra,” she says. Teachers too can help shy kids. “They need to have a certain pedagogic feel for the situation. If they have that they can support the child and encourage him or her to surpass themselves, but it has to be in areas where the child can successfully manage to do that.”

For example, a teacher could call on a shy child in class to answer an easy question the child would have no trouble answering. “What’s important is for the teacher to stand near the child because the child will probably respond to the question in a very low voice. The teacher can repeat the answer to make sure the whole class hears it, but under no circumstances should the teacher say: ‘And now say that again so everybody can hear you, Katharina!’ That would make the child the center of attention, which is something shy kids particularly fear.” That’s why praise for the right answer also can’t be too effusive. “It’s better if the teacher just leaves it at ‘That was the right answer’ and then gets on with their teaching.”

Parents are part of the problem

Many parents react the way Mia’s did when they see how their child becomes stressed out in certain situations, says school psychologist Ulbricht. They want to protect their child. “For mothers and fathers, it’s naturally not easy to see their son or daughter suffer. Some of them start to wonder if they enrolled their child in school too early, if the child isn’t being over-challenged,” Ulbricht adds. “But focusing on school shouldn’t come before everything else, and the children should be helped with their social development.”

Petermann too is familiar with the problem of overprotective parents. “Studies show that parents who are themselves shy have a tendency to try and shield their offspring from uncomfortable social demands and tasks.” But they are doing their child no favors, she adds, because this sends the message to the child that he or she is not up to dealing with such situations on their own, and in the future they will depend on mom and dad to get them through. “That’s how you create problem behavior,” Petermann says. The result is deficient social and emotional development — the children don’t learn how to interact appropriately with others.

Petermann has developed a therapy program for socially insecure kids and their parents, and generally recommends encouraging shy kids to do stuff on their own from an early age. “That’s the only way the child will learn that, ‘Yes, I can!’ ”

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