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Social Phobia

Expert advice on dealing with social phobia...

by Thomas A. Richards, Ph.D.

What would it be like to sit in front of the telephone and agonize for hours because you're afraid to pick up the phone and make a call?

You're even afraid to call some unknown person's office although you know that the person will never know who you are. Still, you just can't seem to lift the receiver and make the call. If you were to make it, you're certain that your voice will falter, you will begin stammering, and you will sound weak or silly. You don't want to sound weak or afraid, so you don't make the call.

You want to go to parties and other social events--indeed, you are lonely--but you don't go because you're nervous about meeting new people. Too many people will be there and crowds bother you anyway. If you went, you know you'd be afraid and embarrassed, so you don't go to the party.

You dread meetings at work because you know you'll be "on the spot," tense, and anxious. You're intelligent, but you won't be able to discuss matters freely in front of other people because you're so worried about what they will think about you. You stare at the ground or fix your eyes on the table. When you have to speak, your voice sounds hesitant. You know you sound weak and sometimes you even stammer. Other people are probably thinking you're dumb or just plain weird. The tension, anxiety, and fear continue to mount. It's humiliating to feel this way, but the fear in the pit of your stomach won't go away.

Finally, the meeting is over. A big wave of relief spills over you and you begin to relax. But the memory of the meeting is still with you. You are convinced you made a fool of yourself and that everyone else in the room saw how afraid you were and how stupid you acted in their presence.

In public places, such as work, meetings, or shopping, you feel that everyone is watching and staring at you. You can't relax and enjoy yourself. In fact, you can never relax when other people are around. It feels like they are evaluating you, criticizing you, or making fun of you. They don't do this openly, of course, but you still feel the judgment in their presence. So you avoid other people.

Many times you simply must be alone--closeted--with the door shut behind you. Even when you're around familiar people, you feel overwhelmed and have the feeling that they are noticing your every movement, critiquing your every thought. You feel like they stare at you and that they're making negative judgments.

What seems to be the very worst circumstance, though, is meeting new people who you think are "authority figures"--people such as bosses, supervisors, principals, and doctors. You feel that these people are more important than you are. You get a lump in your throat and your facial muscles just won't work up into a smile when you meet them.

A job interview is pure torture; you know your anxiety will give you away. You'll look funny, maybe you'll even blush, and you won't be able to find the right words to answer their questions. It is especially infuriating because you know you could do the job well if you could only get past the interview.

Welcome to the world of the social phobic.

Social phobia is a relatively common problem that affects millions of people--men and women almost equally. Unlike some other psychological problems, social phobia is not well understood by the general public or even among practitioners. Because few social phobics have heard of their problem and have never seen it discussed on the television talk shows, they think they are the only ones who have these symptoms. Unfortunately, without some kind of knowledge and treatment, social phobia continues to wreak havoc on their lives. Adding to the dilemma, social phobia does not come and go like other psychological problems. If you have it, you have it every day.

The feelings I described to you at the beginning of the article are those of people with "generalized" social phobia. That is, their symptoms apply to most social events and functions in almost every area of life. I suffered from social phobia myself for eighteen years before I ever saw the term or read about its symptoms in a textbook.

Luckily, my social phobia has, for the most part, been under control since I learned how to deal with it. I do not say that I'm "cured"--that term is too strong. I do say, though, that life is much easier, more bearable, and even enjoyable compared to how it used to be.

As with all problems, everyone with social phobia has slightly different symptoms. Some people, for example, cannot write in public because they fear people are watching and their hand will shake. Others are so introverted that they lack normal social skills, thus making it impossible to "fit in" with any social group. Still others have a severe phobia about eating or drinking in the presence of other people.

One thing that all social phobics share is the knowledge that their thoughts and fears are basically irrational. That is, social phobics know that people are really not critically judging or evaluating them all the time. They understand that people are not trying to embarrass or humiliate them. Yet, despite this head knowledge, they still continue to feel that way.

It is the automatic "feeling" and thoughts that occur in social situations that must be met and conquered in therapy. Usually, these feelings are tied to thoughts that are entwined in a vicious cycle in the person's head.

What can be done about social phobia? Many therapeutic treatments have been tried, but cognitive-behavioral techniques have been shown to work best. Some of these techniques are the ones used for panic attacks, agoraphobia, generalized anxiety, and post-traumatic stress problems. Other techniques are entirely different.

Attacking irrational thoughts, role-playing real-life events that will occur, and imagining problems and learning to cope with them are therapeutic techniques that work for some anxiety problems. However, many social phobics benefit from shame-attacking exercises, role-playing and learning new social skills, realistic assertion-skill development, and an all-out campaign to ferret out the inaccurate thinking that is tied to anxiety.

Many times the results are dramatic. If therapy is structured toward teaching the patient to be responsible for thoughts and feelings, then progress generally continues after treatment. This is not to say that social phobics become anxiety-free after treatment. But quality of life is greatly enhanced, and people often find they can do things that they never would have considered before treatment.

Social phobia responds to relatively short term treatment, depending on the severity of the condition. I have seen significant progress in just six sessions, although most people respond better with ten to twelve meetings.

What social phobics do not need is years and years of therapy. In fact, social phobics who learn to "analyze" and "ruminate" over their problems usually make their social phobia worse.

There is hope for a better life for all social phobics. Without treatment, social phobia is a torturous emotional problem; with treatment, its bark is worse than its bite. Many of us have been through the crippling fears and constant anxiety that social phobia produces--and have come out healthier on the other side.

Thomas Richards, Ph.D. is a psychologist in private practice in Phoenix, Arizona and specializes in the treatment of anxiety disorders. Dr. Richards can be reached at (602) 952-9846.