Articles

Social Phobia And Its Treatment

By Ms. Suja.K.K : Psychologist

“A woman hates to stand in line in the grocery store because she's afraid that everyone is watching her. Another person sits in front of the telephone and agonizes because he's afraid to pick up the receiver and make a call. A man finds it difficult to walk down the street because he's self-conscious and feels that people are watching him from their windows. A student won't attend her university classes on the first day because she knows that in some classes the professor will instruct them to go around the room and introduce themselves. Another young man wants to go to parties and other social events - indeed, he is very, very lonely but he never goes anywhere because he's very nervous about meeting new people.”

In public places, such as work, meetings or shopping, people with social phobia feel that everyone is watching, staring and judging them (even though rationally they know this isn't true). The socially anxious person can't relax, "take it easy", and enjoy themselves in public. In fact, they can never fully relax when other people are around. It always feels like others are evaluating them, being critical of them, or "judging" them in some way. The person with social phobia knows that people don't do this openly, of course, but they still feel the self-consciousness and judgement while they are in the other person's presence.
Social phobia is a persistent and irrational fear of situations that may involve scrutiny or judgements by others, such as parties and other social events. It means some extreme levels of fear against a social situations, it may be a small groups, and usually leading to avoidance of social situations. It is different from shyness. Shy people are able to participate in social functions but people with social phobia are constrained by their condition to the point that it affects their ability to function in work settings and maintain social relationship. People with social phobia may be quite comfortable with certain people or many people, but still feel intense anxiety in specific social situations. This fear may be so severe that it significantly impairs their work, social life and other activities.
Social phobia is the third largest psychological problem in the world today. Males and females are affected equally with this disorder. Physical symptoms often accompanying social phobia include excessive blushing, sweating, trembling, palpitations, nausea and stammering. People with social phobia are at high risk for alcohol or other drug dependence because they may come rely on drink drugs to reduce fears and inhibitions at social events. Phobias are usually associated with low self esteem, lack of self confidence and fear of criticism. The intensity of these feelings varies from person to person.

Some of the most common fears of social phobia include,
• Fear of speaking in public
• Meeting new people
• Eating, drinking and writing in public
• Using public rest rooms
• Attending parties and social gathering.

People with social phobia may have some or all of the following feelings in social situations.

• Fear that everyone’s attention is focused on them.
• Fear that they will make mistakes and everyone will notice
• Fear that they are being judged by others
• Fear that they will embarrasses or humiliated themselves in front of others

Research into the causes of social phobia is wide-ranging, encompassing multiple perspectives from neuroscience to sociology. Scientists have yet to pinpoint the exact causes. Studies suggest that genetics can play a part in combination with environmental factors. Certain people are a bit more likely to have problems with anxiety. Those whose parents or other close relatives have anxiety problems may be more likely to develop a problem with anxiety, too. This may be due to biological traits that family members have in common. Certain traits may affect the function of brain chemicals (neurotransmitters and certain stress hormones) that regulate mood states like anxiety, shyness, nervousness, and stress reactions. Some people are born with a cautious personality style and have a tendency to be shy and sensitive to new situations. This may contribute to social phobia. Others may learn a cautious style depending on experiences they have, the way others react to them, or the behaviours they see in their parents and others. Low self-confidence and a lack of coping skills to manage normal stress can also play a role in social phobia. Those who tend to be worriers, perfectionists, and who have a hard time dealing with small mistakes may also be more likely to develop it.

Usually social phobia can be treated with psychotherapy or medication or a combination of both. As with other phobias, social phobia will become worst without treatment. Therapists can help people who have social phobia to develop coping skills to manage their anxiety. This involves understanding and adjusting thoughts and beliefs that help create the anxiety, learning and practising social skills to increase confidence, and then slowly and gradually practising these skills in real situations. Systematic desensitization, social skill training and cognitive behavioural therapy are the techniques used to treat phobias. In systematic desensitization the person is asked to relax then imagine components of the phobia working from the least fear to the most fearful situation. Social skill training may involve social contact in a group therapy situation to practice social skills. Cognitive therapy helps them to learn how to cope with and change irrational repetitive thoughts which may proceed and intensify anxiety in feared situation. The therapy may also focus on self esteem, anger, assertiveness and other issues. Graded real life exposure has also been used with success to help people overcome their fears. Role playing and modelling are other techniques to help the phobic person to gain comfort in relating to others in a social situation. Anti-anxiety and anti-depressant medications have shown to be very effective in treating phobia along with psychotherapeutic techniques.