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Social Phobia

Social Phobia

Social Phobia

Social phobia involves fear of situations in which the person feels they may be closely watched and judged by others.

Understanding Social Phobia

For a general introduction to fear, anxiety, and phobias see the Fears and phobia and Phobia sections of this website.  You will learn about fear, the difference between fear and anxiety, what is a phobia, what causes phobias, the types of phobias, the most common symptoms of phobia, how a phobia  is diagnosed, a comprehensive listing of all phobias, and information on phobia treatment.

Social phobia is a persistent fear of one or more situations in which the person is exposed to possible scrutiny by others and fears that he or she may do something or act in a way that will be humiliating or embarrassing.

Social phobia involves overwhelming anxiety and excessive self-consciousness in everyday social situations. It is both a persistent and irrational fear of situations in which the person feels they may be closely watched and judged by others, as in public speaking, eating, or using public facilities. Feared activities may include most any type of social interaction, especially small groups, dating, parties, talking to strangers, restaurants, etc. Physical symptoms include "mind going blank", fast heartbeat, blushing, and stomach ache.

People with social phobia are concerned about being embarrassed or humiliated by their own actions.  A social phobia can be a generalized fear where the person experiences symptoms almost anytime they are around other people or it can be limited to only one type of situation.  Social phobia can severely disrupt normal life, interfering with school, work, or social relationships.  

Social phobia (also sometimes called social anxiety) is so intense that someone with social phobia will avoid these situations whenever possible. And just like with other phobias, this fear is out of proportion to the actual danger that's present. Although many people fear being embarrassed in certain social situations, some find it incredibly difficult to cope with this embarrassment. Someone with social phobia is usually overrating the danger of embarrassment while underrating his or her ability to get through the situation.

Social phobia is much more than just normal shyness or the awkward feelings most people have from time to time. Social phobia is shyness to the extreme, and this shyness is accompanied by anxiety that causes people to avoid doing things they might like to do or to avoid situations that might result in having to be with, or to talk with, or in front of, others.

Causes

The precise cause of social phobia is not known but it is believed that both environmental and biological factors can be involved.  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 behaviors 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.  Certainly biological and chemical brain processes may play a part.

Treatment

A therapist can help a person who has social phobia to develop coping skills to manage their fear and anxiety. This involves understanding and adjusting thoughts and beliefs that help create the anxiety, learning and practicing specific behavioral social skills to increase confidence, and then slowly and gradually practicing these skills in real situations.

Worry and "self-talk" can play a significant role in social phobias. A persons worry and thoughts are often in the form of a question that begins "what if . . ." and tend to be negative rather than positive. These self talk and worry "what if'"s" tend to get worse and worse, until the person having them expects not just bad things, but the worst possible outcome.  A psychologist or other trained mental health professionals can help people identify, examine, and modify these thoughts.

Systematic desensitization, which is a type of cognitive behavioral therapy (CBT), is the preferred behavioral technique used to treat a social phobia as well as other phobias such as agoraphobia, claustrophobia, acrophobia, and monophobia. It based upon having the person relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Gradual exposure to real life phobias has also been used with success to help people overcome their fears.  According to the National Institute of Mental Health, about 75% of people with specific phobias overcome their fears through cognitive-behavioral therapy. 

Relaxation and stress relief techniques are frequently used along with other therapeutic approaches.  Relaxation techniques may include things like specific ways of breathing, muscle relaxation training, guided mental imagery, or soothing self-talk. Pairing a relaxing sensation with an object that has triggered fear can help the brain to neutralize the fear the object used to be associated with.

Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help the person gain comfort in relating to others in a social situation.

Anti-anxiety and anti-depressive medications are sometimes used to help relieve the symptoms associated with phobias. Certain medications that help to regulate the function of serotonin (a brain chemical that helps to transmit electrical messages having to do with mood) are sometimes used. Though medication doesn't solve the whole problem, it can reduce anxiety so the person can more easily deal with their problem.

Hypnotherapy can also be very effective for a social phobia. This usually consists of systematic desensitization and other therapeutic techniques conducted under hypnosis by a clinical hypnotherapist.

Additional Resources

For more information about social phobia and other mental health problems, please click on the linked websites listed below.

For a list of the many phobias please visit the page List of Phobias.

NIMH: phobia facts
American Psychiatric Association
National Institutes of Mental Health
Mayo Clinic on social anxiety disorder
American Psychological Association
Anxiety Disorders Association of America

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