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Re: social phobia...sigh:( jonh kimble

Posted by JonW on November 6, 2002, at 16:19:03

In reply to social phobia...sigh:(, posted by jonh kimble on November 4, 2002, at 20:44:37

Hi Tom,

I think I've written to you before, but I'm not sure. Anyhow, when I read your post I felt I was reading about myself. The unfortunate reality is that, with the exception of perhaps Nardil for some, medication seems to offer response rather than remission for people with social phobia. If it were possible to sustain the initial high from dexedrine its use could be justified, but as it seems to be for you it's just that -- getting high, and perhaps an unrealistic expectation of what happiness should be.

I would urge you to work with both the best psychopharmacologist and therapist you can afford. I'd go so far as to say CBT is crucial to beating this horrible illness. It works, and CBT + medication is extremely effective. Many of the clinical trials currently going on are based on this idea. It's very important that you are working with the right people, though. Even if you have to travel some, it's worth it. If you are anywhere near NYC, I highly recommend Dr. Michael R. Liebowitz (pdoc) and Carla Daichman (therapist). They are both part of the same group, and work together to provide me with the best care available. I was initially very skeptical about getting involved with a therapist because I was so focused on medication. I had a bias and had seen some real wack jobs in the past. Besides the CBT, the other benefits I get from working with a therapist is the emotional support and she asks me about medication and makes observations that can help Dr. Liebowitz make decisions about medication. I really think you should take advantage of this type of a situation. A good pdoc and CBT can make all the difference in the world. Doing CBT on your own or with an average therapist is worlds apart from CBT under the guidance of an expert therapist who's been trained in treating people with social phobia. I don't want to sound like I'm trying to tell you want to do, but I thought I'd let you know that I was in the same situation as you not too long ago and the decision to get better care has made a huge difference in my life. I had been on practically every psych. medication known to man (except for most of the TCAs) and several combinations and drugs from overseas and had read a lot about CBT and had done CBT with a therapist for some time. I had failed on all of the big meds for social phobia -- Nardil, Klonopin, Paxil, etc. In spite of all of this (and needless to say, a lack of hope) seeing Dr. Liebowitz in NYC has changed my life. I'd also recommend the Adult Anxiety Clinic at Temple run by Dr. Richard Heimberg or The Anxiety Clinic at the university of Penn, both in Philly. If you don't live near NYC or Philly, I'm sure there is something comparable not too far from you. Well, think about it... Social Phobia is the loneliest illness in the world and I really empathize with you. It's such a silly thing, but causes such serious problems. Hang in there!


p.s. I really admire how you haven't given up hope! If you ever do lose hope, remind yourself that it's part of the illness.




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