“I choose to be an outsider, I’d rather be alone,” was the unanimous stance of the members of my short-term, weekly group of young adults with a diagnosis of “social anxiety.” Not a tear was shed, just a statement of fact.

Still, even as they shared their all too similar stories of being bullied by their peers throughout childhood and their subsequent loss of faith and trust in humanity—they did join a group. At some level all recognized that while “choosing to be an outsider” helped them cope, it has also limited them.

The group ranges in age from 17 to 30. It is rare that I will run a group based on a psychiatric diagnosis. I’m a founder of a radically humanistic, non-diagnostic therapeutic approach, social therapy, which promotes the developmental value of heterogeneous groups. I decided in this case to try a short-term group and address my patients’ social isolation directly before putting them in more demanding social environments. It’s been touching for me to be part of this group’s growing comfort with each other. They are finding each other interesting, wanting to learn more about what the other is saying, and at the same time discovering that they have something to say. They are responding to the experience of being listened to and taken seriously.

My job in this process has been to confront the challenges I triggered by constructing a group around a shared diagnosis. Initially, the glue of their bonding was their shared social isolation, with the assumption that their pain and isolation was unique to those who share the social anxiety diagnosis. They have a tendency to identify with and assume their emotions, their life experiences and the responses to their life experiences are the same; that they avoid people for the same reasons. Sporadically I let the group know that I too share many of their experiences and anxieties. I have had to urge the group to become more curious about each other rather than identifying with and assuming they know. They have begun to create an environment to have harder conversations. They have been discovering that they are quite different people with a variety of worldviews, interests, pain and joys.

This past week, the group expressed its pride when one of the members announced that she had been offered an internship, which she said she gained the confidence to apply to because of for her experience in the group.

We are now in our ninth week. The group has become a social context to take risks and explore ways of being together. They are more relaxed and open. They are beginning to discover that others can become important parts of their lives. That choosing to be an insider may be risky but it also opens the door to new possibilities. This group will end soon and I look forward to inviting them to join one of my heterogeneous groups.


Ann Green is a psychiatric nurse practitioner and certified social therapist and has been in practice offering individual, couples, family and group therapy for over 3 decades. She is a founding member of a radically humanistic, non-diagnostic, non-problem oriented therapeutic approach called social therapy, which is integrative, collaborative, relational and holistic. She has helped people from all walks of life and all ages with particular expertise in helping people with depression and anxiety.