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Originally Posted by
dl20 
I can't really respond without just reposting everything I have already said but I will try.
Again, the fear of being evaluated negatively is IRRATIONAL. Most people are so wrapped up in themselves they don't notice others non-verbal responses to anxiety. Social phobics see themselves as being under societal scrutiny which isnt so. As I said again, alot of people present as totally normal looking, they only imagine everyone can "see" their anxiety.
The patient is hot, but she is a patient. I don't "try" anymore with her than I do with anyone else.
The point was not a personal attack. It was to illustrate that human nature makes almost anyone treat others differentially based on their looks, often without their knowledge. Sometimes it's very subtle, like slight changes in body language. There is some research on patient attractiveness in a clinical setting.
Click for an example.
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The persons presentation is insignificant which for some reason you are having a hard time grasping. However, for your entertainment say the patient is hideously ugly, what would you suggest to them, get a makeover and then you'll feel less anxious? They look the same as everyone else.
Though significant unattractiveness usually cannot be changed with just non-invasive approaches such as clothes, looking more attractive might help. BBC America has run a special called "Too Ugly to Love." It seemed to be about social anxiety caused by perceived unattractiveness. One male featured was genuinely unattractive and was shown being called "minger" on one of his leave-home exercises, which of course impeded his progress. In cases that don't involve obvious mental health problems, appearance changes often help with socializing comfortably. Just watch Dr. 90210 or What Not to Wear to hear what individuals report after looking better. It's notable that many individuals featured on the latter go on there thinking they look okay. What might be happening is de facto positive exposure therapy, with makeovers garnering positive reactions that lower anxiety.
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I study and use empirical approaches to treatment that are well supported in the literature. I havent read anything in the journals about social phobia and "looks" lately.
There's not nearly as much out there as there should be, but clearly you could and should read more. It's unfortunate if you are one of those individuals who believe that appearances have little effect on social interactions. That belief isn't any more "rational" than social anxiety or blanket condemnation of psychotherapy.
By the way, the literature on social anxiety disorder suggests that, in addition to first-person mistreatment, witnessing others being mistreated (for their looks, maybe) can trigger social anxiety and also that it often begins in childhood. A mental health professional might only see the adult patient and not realize that, for example, the patient used to be bullied. Maybe, like with seeing a classmate teased, the patient doesn't recall the specific trigger. Maybe the "invititation" for bullying was never clear and actually was something about the person's appearance. There's probably a rational component to more than a few cases.