Coping with Blushing
By Professor Robert Edelmann - a Sheldon Press book

For many people blushing isn't just a natural reaction to the minor social embarrassments of life. Blushing can make you miserable, wary of any situation that will make you feel everyone's looking at you, and perhaps scared to go out at all. And because other people don't realise that it's a real problem, you don't get the sympathy you deserve.

It's a vicious circle. You feel yourself blushing, so you get more embarrassed, so you blush more. And other people's comments don't help either, even when they're meant to be friendly.

But it needn't be like that. If you follow Dr Edelmann 's method you can break out of the circle and face each situation in a new way. Step by step, you can unlearn the feelings of embarrassment and failure, and take control of your life.

Professor Edelmann is a psychologist who specializes in the problems of blushing and embarrassment.

• Acknowledgements
• Preface to the second edition
• Introduction
• Embarrassment and blushing
• What is blushing?
• Who suffers?
• Coping with blushing: Some preliminary comments
• Calming yourself down
• Re-evaluating and redirecting thoughts
• Developing confidence
• Putting the package together and monitoring change
• Blushing: A personal account
• Useful addresses
• Further reading
• Index

Preface to the second edition

When the first edition of Coping with Blushing was published in 1990 the available research literature was extremely limited. Since then a great deal of research has been published and our understanding of fear of blushing has increased accordingly. In a book chapter I wrote in 2001 reviewing the available literature in relation to blushing (see Further reading section), two-thirds of the 95 references cited had been published since 1990. Various studies have now been published examining the bodily or physiological processes thought to underlie blushing, although the exact mechanism involved is still poorly understood. New material has been included in Chapter 2 in relation to this. A number of studies have also been published in the last decade examining individual differences in 'blushing propensity' - that is, the extent to which people report that they blush in everyday situations. Reported tendency to blush has been shown to be related to fear of blushing. However, the most interesting finding to emerge from this research is that there does not seem to be a perfect relationship between reported tendency to blush and fear of blushing with actual measured changes in skin temperature. Blushing as a problem is not necessarily to do with purely external signs that are visible to others but seems rather more related to our internal thoughts and evaluations. New material has been included in Chapters 2 and 3 in relation to this. Of particular importance in this regard is the question of the appropriateness of surgery as a cure for blushing (endoscopic transthoracic sympathectomy). If, as the research evidence suggests, problems relate to anxiety about blushing rather than visible blushing per se then surgical intervention may well be inappropriate. This is discussed further in a new section in Chapter 2.

Finally, when I wrote the first edition of this book in 1990, there were virtually no published studies evaluating the effectiveness of psychological therapy designed to help people overcome a fear of blushing. Those that have been published in the past decade all point to the benefits of such treatment. Perhaps one of the most important findings of such studies is that during the first few weeks of therapy improvements tend to be negligible. However, as treatment continues so improvement steadily increases. It seems that, although those being treated recognized psychological factors as important in relation to their difficulties, most in fact hoped for a 'cure' that would mean they would never blush again. It was only later in therapy, as they began to think in terms of accepting and coping rather than cure, that distress decreased and improvements occurred.

As sufferers will be all too aware, fear of blushing can lead to severe restrictions to one's life. Fear of blushing is a very common and distressing problem. It is thus gratifying that the research community is beginning to answer some of the key questions relating to both our understanding and treatment of this distressing difficulty. While great strides have been made in the last decade many gaps in our knowledge remain; we hope even more of these gaps can be filled in the next decade.

Introduction

Everyone blushes and we can all no doubt recollect an embarrassing event or experience that has caused us discomfort. For some people, however, the very thought of blushing can totally disrupt their lives. This may be because they think they blush more readily, are more sensitive to the possibility that they might blush or are more sensitive to the views of others. Whatever the initial reasons, blushing in its extreme or chronic form stops being a natural reaction and becomes a reaction to be feared, a reaction that causes many people untold discomfort. The extent of this distress is evident in the many letters sent to me by sufferers, often prompted by some reference in the press to my research interest. The first article, which appeared over 20 years ago, dealt mainly with my work on embarrassment. I received a few letters asking if help could be offered for chronic blushing. As a result I produced a brief fact-sheet, 'Blushing: What it is and what to do about it'. Then, more articles appeared in the press and the trickle of letters began to turn into a flood. One article alone produced over 600 letters and I have since received thousands.

The First Edition of this book, published in 1990, was as a direct result of the letters I had received. I have since offered psychological treatment to many people who suffer from a chronic fear of blushing. Many of these have developed full-blown social phobia. That is, a marked and persistent fear of social situations; a fear of behaving in a manner that is embarrassing or humiliating. Indeed, it is now widely recognized that for an important sub-group of social phobics a fear of bodily reactions such as sweating, muscle tremors and most importantly blushing is the main cause of their social fear. Unfortunately, social phobia and fear of blushing remain an under reported problem within society. Most fear that their problem will not be taken seriously by the medical profession, so they continue to feel isolated and alone.

Indeed, a common theme in the letters I have received is one of relief. Relief that someone took their problem seriously, relief that they were not alone, and relief that there were strategies for overcoming their difficulties. The following three comments are typical:

It was with great interest and enormous relief that I read your recent article on blushing. Perhaps consolation is a more appropriate word than relief. Consoled that other people do, seriously, consider blushing a real problem, and relieved that I am not totally alone in feeling this. Mrs C, 31, Leeds

I have suffered from severe blushing for years and had given up hope of ever being 'normal' again. I thus read with great interest your article on blushing. It was such a relief to know that there are ways to help yourself overcome this. Miss G, 22, clerical assistant, Huddersfield

While reading an article on the subject of blushing I felt enormous relief. For years now I have felt burdened by my blushing problem. Feeling very desperate, I very recently visited my doctor for help and advice but didn't feel as though I was being taken seriously. Mr B, 35, teacher, Cheshire

These comments illustrate the emotional dilemma faced by chronic blushers — blushing after all is a common reaction, as common as laughter or tears. Everyone blushes and yet this very reaction can cause some people untold misery. How can such people seek help for a reaction that seems to cause others little discomfort at all? Will they be taken seriously? Because of these fears many people will suffer their chronic blushing in silence for years, afraid to tell anyone of their distressing problem and the devastating effect it is having on their lives.

Despite the magnitude of the problem, it is only within the last ten years that fear of blushing has been referred to with any frequency in psychology books. Prior to that the only occasional reference was to erythrophobia (from the Greek words eruthros meaning to be red and phobos meaning fear). This book explores the nature of chronic blushing, explaining why it can cause some people such distress and outlining methods for coping with the problem. Where possible I let sufferers tell their own story by drawing upon the many letters I have received and comments from people I have seen in my clinic. Chapters 1—3 examine the links between embarrassment and blushing, and explain the thought processes that give rise to chronic fear of blushing and the bodily reactions associated with it. Understanding the nature of the problem can take you half-way to defeating it.

Chapters 4—9 explain what you can do for yourself to cope with chronic blushing. While explanations can be given and strategies and techniques explained, you are the only one who can put them into practice. This inevitably takes a great deal of work; but persevere as you can get there in the end. With practice you can use the coping strategies described in this book to control your fear of blushing. However, do not expect to stop blushing, after all, everyone blushes; the aim is to reduce your fear of and concern about blushing. Remember also that social embarrassment is not entirely negative. Imagine a person who was never embarrassed — we would no doubt think of them as brash and insensitive. A little sensitivity to one's own reactions, and empathy and sensitivity towards others can be a positive characteristic; it is too much sensitivity that needs to be controlled.

About the author
Professor Robert J. Edelmann is a Chartered Clinical, Forensic and Health Psychologist working in private practice. From 1986 until 1997 he was involved in Clinical Psychology training at the University of Surrey. His most recent academic appointment was to a Research Chair at the University of Surrey, Roehampton, where he currently holds an Honorary Chair. Professor Edelmann is a Fellow of the British Psychological Society and a registered Cognitive Behavioural Therapist with the United Kingdom Council of Psychotherapists. He is the author of The Psychology of Embarrassment as well as many articles and book chapters on embarrassment and blushing. Professor Edelmann lives with his wife and three daughters in Putney, London.