Social phobia is the fear of interaction with other people that brings on self-consciousness, feelings of being negatively judged and as a result leads to avoidance of one or more social situations. Commonly feared situations include any social situation where there are groups of people and can also include meeting new people, being at parties, asking for dates, eating in public, using public restrooms, speaking to people in authority, and disagreeing with others. People with social phobia are afraid they will act in ways that will make other people think badly of them. They often fear that others will see some sign of anxiety, such as blushing, trembling, or sweating. People with social phobia usually try to stay away from the situations that make them anxious. When they cannot, they tend to feel very anxious or embarrassed. Sometimes they may have panic attacks. Social phobia is a severe, disabling form of shyness and can cause problems in people’s lives. Sometimes the problems are minor, such as not being able to speak up in class. Sometimes, however, the problems can be very serious and can limit life satisfaction and hold individuals back from achieving important milestones eg having a relationship. People with severe social phobia often have few friends, feel lonely, and have trouble reaching their goals in school or at work. Others can navigate their way around what makes them anxious and therefore it can appear that everything is fine, however when avoidance becomes rigid, generalised and impacts the quality of someone’s life its time to seek professional help.

Who Gets Social Anxiety?

Social anxiety is very common and can effect anyone. More than one out of eight people will suffer from social anxiety at some point in their lives. Many more people have symptoms of shyness that are not severe enough to be called social anxiety. Social anxiety is twice as common for women as for men. However, men are more likely to try to find help for the problem. Social anxiety usually starts when people are in their early teens, but it can begin much earlier. If people do not get help, the problem can last for years.

What Causes Social Anxiety?

The exact causes of social anxiety are not known. However, several things are believed to contribute to the problem:

 

  • Genetics. People with social anxiety often have relatives who are shy or have social anxiety
  • Prior experiences. Many people with social anxiety remember having been embarrassed or humiliated in the past. This leads them to be afraid that the same thing will happen again. Soon they start avoiding social situations. Over time, this tends to make them feel even more afraid and avoid even more.
  • Negative thinking. People with social anxiety often have negative automatic thoughts about what will happen in social situations. Common thoughts are “I won’t be able to think of anything to say,” “I’ll make a fool of myself,” and “People will see I’m anxious.”

 

  • High standards of self. They also tend to have standards that are hard to meet, such as “I should never be anxious,” “You have to be beautiful and smart to be liked,” or “I have to get everyone’s approval to be ok.”

 

  • Low self-esteem. People with social anxiety will often suffer from low self-esteem and have harsh evaluations on themselves. They judge themselves easily, don’t recognise their positive attributes and think others will do the same. Often they have negative beliefs about themselves, such as “I’m boring,” “I’m weird,” or “I’m different from other people.”

 

  • Lack of social skills. Some people with social anxiety never had the chance to learn social skills. This can cause them to have problems in social situations. Other people with this disorder have good social skills, but they get so anxious that they have a hard time using them.

 

Effective treatments

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy helps you change the thoughts that cause your fear. Your therapist will teach you how to recognise your negative thoughts and to think more realistically. He or she will also help you gradually face the situations you have been afraid of in the past. This allows you to discover that your fears usually do not come true, and you can become less fearful of these situations and more confident as a result. In addition, your therapist can teach you social skills and ways to relax, which can help you feel cope better in social situations.

Interpersonal Psychotherapy (IPT)

IPT aims to improve your interpersonal functioning and aims to change problematic interpersonal patterns that may be part of maintaining the social anxiety problem. IPT seeks to improve your social supports and create meaningful supports with others. The therapist will review your past and current relationships, including the relationship you have with the therapist, in order to gain a better understanding of relationship patterns that assist or impede the formation of quality relationships. The aim is to re-connect with old and establish new relationships, ultimately reducing anxiety symptoms and restoring confidence.

How Long Does Therapy Last?

For people with mild to moderate social anxiety, progress can be achieved within 10 sessions however it is likely that further sessions may be required to maintain progress made. People with fear of just one social situation, such as public speaking, may need fewer sessions. People with more serious symptoms may need more.

Can Medication Help?

Several different types of medication are used to treat social anxiety. Your physician or a psychiatrist can recommend the one that would be best for you. Talk to your health professional about the medication plab, benefits and possible side effects. It is usually recommended that if you do take medication, you also get some form of therapy.

What Is Expected of You as a Client?

Many people feel anxious at the beginning of therapy and wonder whether they can be helped. All you have to do is to be willing to give therapy a go and commit to your improvement. Your therapist will teach you things you can do to help yourself and ask you to practice them between sessions. Early exercises may be quite easy, but they will become more challenging, as therapy progresses. The more you work on these exercises, the more likely it is that your social anxiety symptoms will reduce. Ask your therapist if you have any concerns about your treatment.