Social Phobia

By Brian Robinson.

Before we look at social phobia in any detail, we need to first understand what a phobia is and why it exists. In a nutshell, phobias exist to help us avoid danger. Under normal circumstances, the avoidance of danger is something that happens consciously and naturally. For a phobia to emerge then, a system in the brain has to reach the conclusion that we are not very good at recognising or dealing with danger. And when that happens, the phobic mind steps in and takes over control. It then has a stab at what the problem might be. And it always gets it wrong.

So, we might ask then what is inherently dangerous about being in social situations? Why would the brain fix on that as involving danger? After all, isn’t there safety in numbers; or isn’t there such a thing as getting lost in the crowd? That’s often how it works in the animal world, isn’t it? We have to understand, however, that the phobic mind is not evolved to appreciate modern conditions and situations. To understand the phobic mind properly, we have to apply Stone Age logic. And that logic suggests that when you stick your head above the parapet; when you become noticed; or when you become the centre of attention, there is automatically a greater risk of finding yourself in the line of fire.

Dealing with a simple phobia can be quite straightforward. The sufferer exposes himself or herself to the danger repeatedly via what is known as Exposure Therapy, and the brain subsequently becomes desensitised. This is a tried and tested method and it works. But with social phobia, desensitisation doesn’t seem to happen like that. The sufferer may place themselves in the social situation repeatedly, yet nothing seems to change. Exposure Therapy fails to register with the phobic mind and the phobic state of affairs persists. So we need to ask why that is?

To understand why nothing changes we first have to know a bit more about phobias.  Firstly, they are not all the same. They can be different, not only in type, but in their intrinsic nature. Phobias can be simple or complex; short or long lived; and specific or general. Let’s take the example of a man with a supermarket phobia. He had a bad panic attack in a supermarket, and thereafter going into a supermarket triggers a phobic reaction. To become desensitised, he has to face his fear and enter the supermarket repeatedly. His brain is then encouraged to reassess matters and so the phobia weakens and gradually dissolves away. The thing to note here is that in this example there is no psychological element involved. The man knows that supermarkets are not inherently dangerous, and so there are no psychological issues to wrestle with. Social phobia isn’t always like that. And it can be far more complex.

Social Phobia, like most labels we apply, is a blanket term. In fact, the phobia can present in a variety of forms. For example, some people become anxious by merely being near a crowd, or even being among a small group of people. Or it may be that the sufferer becomes anxious when someone gets too close and enters their personal space. In other words, there may be a strong proximity element and that may be the only trigger. However, provided there are no other psychological elements in play, then in theory there is no reason to suggest why simple Exposure Therapy would not work. The more the person places themselves in the social situation, the less of a problem it becomes. And this happens because Exposure Therapy works consistently well when the phobia is simple. In fact, this type of phobia would probably be better described as a proximity phobia, and not social phobia at all.

There are three fundamental characteristics which set most types of social phobia apart. Firstly, the sufferers enter the social situation bearing the burden of a problem relating to ‘self’. The person might feel they perform poorly in social situations; they may be very shy or self-conscious; they may have low self-esteem; they may have little or no self-confidence, or they may feel inadequate in some way. There is always a reason why they may not fit in or why they might stand out.

A second significant difference is that there is always an element of ‘the others’ involved. This is self-evident of course, but none the less it lies at the very heart of things. The sufferer may feel threatened by the others; he may think that other people will discover his fundamental flaw or innermost secret; or he may feel he is being judged.

Then there is a third difference. This relates to interaction problems between ‘self’ and ‘others’. The phobic person may blush in social situations; they may begin to blink or twitch; they may start to sweat or act as if on edge. This may lead them to believe they make others feel uncomfortable or anxious. They may even think they cause others to blink, twitch or swallow too. These interaction problems only serve to exacerbate an already difficult situation making it even more problematic and challenging. The man in the supermarket has none of these issues to contend with.

So, dealing with social phobia must involve dealing with these additional elements. And it goes without saying, that solving these types of problems will not be straightforward. Working away from a socially phobic mindset, towards a mindset that is less sensitive, is not something that happens overnight. It’s something we have to continually chip away at. However, it is possible to make progressive headway.

So, what then is the way forward? It has to be emphasised that everything starts with dealing with any core anxiety. Changing a mindset is extremely difficult when set against a background of constant fear. Ideally, we would want the phobic person to initiate a proper programme of relaxation and be coping with stress and tension better.

Problems relating to confidence and self-esteem are common amongst anxiety sufferers. Some people argue that we should learn to love ourselves. A better suggestion would be to get to know ourselves better. To feel comfortable in a social situation, we should have a clear view of our strengths and weaknesses; we should be aware of our talents and qualities; and we should focus on the principles we’ve adopted and the values we hold dear. These are the things that lie at our core view of self and these are the things that will allow us to become more relaxed about who we are.

Many people who suffer in social situations will also have a distorted view of the way other people see them. To overcome this, we cannot simply say we shouldn’t care about what others think. That would be taking things too far. However, we can say that we should care a bit less about the disapproval of others; and we should be less sensitive to what may or may not be going on in the minds of others. Our expectations should also be realistic. No matter who we are or what we stand for, the odds are we will not be universally liked or loved. If others have a problem with who we are, then that is for them to stress over. It is not a problem we have to take on ourselves.

The interaction problems like blushing or twitching can act as a distinct obstacle. They work to sabotage all attempts to appear relaxed and so the cycle of discomfort continues. The first thing to say is that these are not things you can easily switch off or escape from in the way we would like. We have to be realistic about that. And indeed, trying to control them is not even the obvious place to start. However, there may be some things we can do that might help. We could, for example, be a bit more open about our phobia. We could tell others about our discomfort.  Sometimes having a distraction like a newspaper or a phone handy can help switch the focus away from the people around us. And when in the company of others, it may help to be doing something together, like a crossword or a word puzzle. This can help take the emphasis away from having to keep the conversation going. These are only a few ideas, but there will certainly be other things we can do to help.

So, where does this leave us? Social phobias can be a bit tricky, and the things we need to do will surely take time. But if we move towards a clear and positive view of self; and if we adopt a realistic view of others and begin to care less a bit less about them, then the chances are the interaction problems will become less and less of a feature.

What happens in practice, is we become more and more desensitised as we deal with these contributing factors, and then, when we then enter the social situation, there is less and less of a phobic reaction. Then, spending more and more time in the social situation works to reinforce the new mindset.