Fear, pain and isolation: where does social phobia come from and what to do about it

Social phobias include a whole group of phobias associated with public actions or communication. This could be a fear of speaking or other situations where a person is the center of attention, a fear of large crowds of people, fears associated with public evaluation, which include the fear of looking ridiculous or funny.

A person may be afraid of attention from other people, for example, experience severe discomfort in cases where they have to use a public toilet or eat in the company of other people. Social phobia can also manifest as excessive shyness when interacting with strangers or people of the opposite sex.

Social phobia is an anxiety disorder. If a person finds himself in a frightening situation, symptoms such as sweating, rapid heartbeat, flushing of the face, difficulty breathing, etc. may be observed.

When does social phobia develop?

Most often, a phobia begins to form in adolescence or adolescence, when the child faces various social difficulties. Teenagers are very dependent on public opinion. During this period, the fear of “being different from everyone else” intensifies, a craving for communication with the opposite sex appears, and with it the fear of being rejected. Public activities (reports, speeches, etc.) give rise to the fear of being worse than everyone else, of seeming funny, stupid or ridiculous. If the situation is unfavorable for the child, then fears are reinforced and transferred into adulthood.

Unfortunately, many people simply have not heard of such a disease as social phobia. They explain their conditions by excessive shyness and personal characteristics.

Imagine the worst case scenario

Play out the worst-case scenarios for a conversation with another person in your head. What's the worst thing that could happen? Will your interlocutor think badly of you and not want to continue the conversation? Then think about how qualitatively this can affect your life. Most likely, this will not turn your life upside down, or force you to change jobs or move to another city. In this case, you shouldn’t attach much importance to it, and your interlocutor won’t even remember about the unsuccessful conversation the next day.

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Why is social phobia dangerous?

If social phobia is not treated, the patient’s condition may worsen over the years, leading to serious impairments in social adaptation, including loss of ability to work. Social phobia is often accompanied by depression and decreased self-esteem. People suffering from social phobias often seek solace in alcohol or drugs, and cases of eating disorders are common. Social phobia, especially in combination with other mental disorders, leads to complete isolation of a person and increases the risk of suicide attempts.

In 90% of cases, social phobia is cured using various psychotherapeutic methods.

If necessary, along with psychotherapy, medications are used. You shouldn’t self-medicate or give up - just make an appointment with a specialist .

A psychotherapist will help you cope with your problem and select effective treatment methods. You will definitely cope with your fears and gain self-confidence.

Social phobia: how to get rid of social fear?

PsychologySocialphobiaPhobia

Social phobia is strong, persistent, unreasonable fear and anxiety of various social situations: situations of communicating with other people, meeting other people, the need to speak, speak publicly, etc. More precisely, strong anxiety and fear of evaluation, observation, careful examination of oneself by other people when performing some social action.

Social phobia is on a par with other phobias, but since its influence on people’s lives is quite strong, it needs to be considered separately. In this article I will talk about the symptoms of social phobia, the causes of social phobia, and the existing modern methods of treating social phobia, how social phobia can be dealt with. Let's start with the last one.

Treatment methods for social phobia

There are 4 possible treatments for social phobia:

1. Personal (individual) psychotherapy.
2. Group psychotherapy.
3. Psychotherapy online, psychotherapy from books, you can also add self-help here.
4. Medicines.

I will not consider all possible variations of psychotherapeutic treatment. They undoubtedly exist in any direction of psychotherapy that exists in science today. In this article I talk only about cognitive and cognitive-behavioral psychotherapy for social phobia, because that’s what I do, that interests me, and that’s what I’m good at.

Symptoms of social phobia

Social phobia comes in a variety of forms and variants, and the degree of its intensity and the degree of its impact on the quality of life vary. But all these options have one thing in common: a persistent and noticeable fear of situations when you are forced to face one or another form of public speaking, talking with people, or face one or another form of evaluation of you by other people. This fear is accompanied by the fear of being publicly humiliated, embarrassed, disgraced, looking bad, etc. This is symptom number one.

• Symptom number two: if such a situation does happen, then with a high probability, before, after or during the situation, severe anxiety arises, up to a panic attack.
• Symptom number three: the fear is actually excessive or unreasonable.
• Symptom number four: avoidance behavior is taking place, that is, the person is somehow trying in every possible way to avoid getting into such a situation, and if it doesn’t work out, then he experiences intense stress with anxiety.
• Symptom number five: all of the above significantly affects normal life, work, classes, studies, communication with other people, etc.
• Symptom number six: all of the above occurs in an individual over 18 years of age and lasts for at least six months.

That is: if someone avoids communicating with people because they irritate him terribly, and not at all because he becomes very anxious in their presence, this is not social phobia. If someone is nervous when they have to give a presentation in front of colleagues at work, but this nervous anxiety does not cause any particular problems and does not lead to a refusal to speak, this is not social phobia.

It's completely normal to worry that other people might not approve of you.

Social phobia can be specific: someone is afraid of public speaking in front of an unfamiliar audience, someone worries only when visiting restaurants or using other public places, someone worries when they write something and are being watched, someone is normal speaks in front of close and familiar people, but not etc. Other variants of social phobia can be generalized, in which case they include fear of a wider range of social situations: meeting new people, the inability to refuse others, difficulties with making and attending dates, etc. .P. However, whether with a specific type of social phobia or a generalized one, as a rule, there is always some degree of fear of public speaking.

Almost every person has such fears from time to time, and even such famous actors as Bruce Willis, Tom Cruise and others admitted that they have certain social fears.

There is a time-tested test for social phobia - the Liebowitz (Leibowitz) Scale - to assess the symptoms of social phobia, you can take it now (opens in a separate window).

Modern theories of social phobia emphasize the role of thinking and thought processes in the formation and maintenance of social phobia:

• Firstly, with social phobia there are well-defined typical beliefs and ideas that contribute to the development of social anxiety, and well-defined anxious thinking styles.
• Secondly, when a person with social phobia comes into contact with other people (or in some social situation), he tends to focus as much as possible on his internal sensations. Because of this overly attentive observation of one's reactions, a person becomes overly sensitive to the slightest changes in his inner fear or anxiety, exaggerating its degree and significance, as a result of which an incorrect image of himself is formed.
• Third, people with social phobia consistently engage in a variety of so-called “safety or defensive behaviors,” which allows them to reduce the risk of negative evaluation from others. There is very frequent avoidance of situations in whole or in part.
• Fourthly, they exaggerate how negatively others actually evaluate them, do not have certain behavioral skills, and tend to overestimate other people’s reactions to their behavior to their disadvantage.
• Fifth, before and after a social situation, people with social anxiety ruminate excessively about the situation, focusing on past failures, self-deprecating thoughts about themselves, and negative predictions for the future.

All these nuances are “processed” by the thinking of such a person in the smallest detail, and therefore are permanently fixed in memory, resulting in a “vicious circle”: social phobia “feeds itself.”

If you have the above symptoms, and you scored 30 points or more on the Liebowitz Scale, then read on. Perhaps this information is just for you.

Causes of social phobia

According to researchers, up to 12% of the world's population suffers from social phobia in one form or another, and approximately equally, both men and women. Scientific psychologists of various directions have long been trying to determine what can cause social phobia, but the cognitive-behavioral model of social phobia has received the most widespread and scientific substantiation. Accordingly, within the framework of the same model, the most effective methods of overcoming social phobia have been developed.

As a rule, generalized social phobia arises quite early in childhood (average age - 10.5 years, according to Manuzza et al., 1995), and specific social phobia arises later - on average at the age of 16.9 years.

So far there has not been a single scientific confirmation that it is the unsuccessful experience of public speaking that plays a significant role in the formation of social phobia. For example, Steinberg et al. examined 22 people with generalized social phobia, 16 people with specific social phobia, and 25 people without social phobia, asking them whether they had any experience of traumatic social interaction (for example, an objectively very bad public speaking experience). According to the results of this study, half of the subjects with generalized social phobia, 40% of the subjects with specific social phobia, ... and 20% of healthy subjects had such psychological trauma! According to other studies (Öst, Hugdahl), only 15% of those who had traumatic experiences developed social phobia.

It is believed that social phobia is most likely related to a person's innate ability to easily associate fear with angry, critical or rejecting faces of other people, or with direct eye-to-eye gaze, especially if the faces are directed towards the person rather than away from them. This hypothesis is confirmed by research by Öst & Lundh, where it was found that subjects with social phobia tend to interpret different photographs of human faces much more quickly and easily as aggressive or critical, rather than as approving and supportive. That is, there is an initial tendency to evaluate others as critical (while they may be neutral).

Heredity also plays a certain role in the occurrence of social phobia. People are three times more likely to develop social phobia if they have a family member with social phobia. One twin has a 15% to 24% chance of developing social phobia if the other twin develops social phobia.

Early precursors of social phobia are shyness, which is inherited genetically, and a kind of “suppression behavior” in childhood: avoidance of contact, avoidance, fear of unfamiliar people and situations, overexcitation of the sympathetic nervous system, which is responsible for controlling breathing, pulse, and other physiological reactions.

Results of cognitive behavioral therapy for social phobia

Well, finally, we got to the most interesting thing: how does social phobia treatment occur in such a “miraculous” way in cognitive behavioral therapy (in any format: group, individual format) that its effectiveness is equal to the effectiveness of medication?

Various details and scientific justifications are presented in the relevant professional literature, here I will tell you in general. The essence of this therapy is that each participant is given individual opportunities to learn and understand that in fact social situations are not so frightening, their mistakes do not look so terrible, and their inability to behave can be corrected. Over the course of session after session, the therapist encourages these opportunities to be explored, ensures that the information is assessed and processed correctly, and provides support and encouragement to participants to become active in improving their lives. As therapy progresses, the effects extend into the long term because participants learn to be their own therapists, trying different skills after therapy ends.

The first part of therapy is devoted to informing, explaining why social phobia exists, what supports it; the second part is actually a variety of exercises aimed at getting rid of social phobia, and the third part is devoted to preventing relapses and consolidating acquired knowledge and skills.

The main gains after cognitive behavioral psychotherapy can be described as follows:

• skills of behavior in social situations are acquired;
• there is a chance to allow anxiety to “melt away” on its own and naturally;
• a chance to become calmer in social situations, and stop considering social phobia a nightmare of a lifetime;
• self-learning and self-instruction skills for the future are acquired.

A few words about the treatment of social phobia with medications

Drug treatment for social phobia is also possible. Currently, the most common prescribed drugs are: serotonin reuptake inhibitors, MAO inhibitors, benzodiazepines, tricyclics and other antidepressants and beta blockers. In the United States, only some SSRIs (selective serotonin reuptake inhibitors) are approved for use for social phobia. Other types of medications, especially benzodiazepines and beta blockers, have not been proven to be effective. In addition, there is a danger of addiction to benzodiazepines.

In this article, I am not going to discuss in detail the effectiveness and differences in the use of these drugs; for prescription medications, please contact your doctor, psychiatrist or psychotherapist. For me as a consulting psychologist, it is important that the effectiveness of medications is almost the same as the effectiveness of cognitive behavioral psychotherapy.

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How to identify the presence of anthropophobia?

Only qualified specialists with relevant experience can make a correct diagnosis.

They will be able to take into account all the features of the disease, which is similar in many ways to autism. If a person does not want to communicate with anyone, this does not indicate pathology.

There are certain periods of life when socially successful, psychologically and physically healthy people are in a depressed mood and feel tired after an overly busy work week. This applies to professions that involve constant interaction with people (doctors, psychologists, teachers).

The specialist must collect anamnesis and communicate with both the client himself and his relatives and friends.

It is important to take into account a person’s lifestyle, living conditions, and actual occupation. Quite often there is no need to rely solely on medical tests, given that they only reflect overall health.

Most often, psychoanalysts use the following types of diagnostics:

• The use of computed tomography, MRI, ECG to assess the panic state in a situation of discomfort, the condition of the blood vessels of the brain. This is really relevant in the presence of personality disorders of different spectrums, if we talk about the presence of similar symptoms;
• A well-conducted survey and testing, which can be called the main and universal diagnostic method.

Anthropophobia most often affects people who are:

• extremely weak type of nervous system;
• the presence of various neuroses;
• increased level of anxiety;
• excessive self-criticism and low self-esteem (see How to increase self-esteem)

A person who is afraid of other people is not considered a full part of society. They believe that they are of no use to society.

This can be called a truly exaggerated reaction of the psyche to the likelihood of repetition of various types of violence, aggression and ridicule of surrounding people. They could come from parents, strangers, and strangers.

There is another point of view regarding the causes of anthropophobia. The disease can manifest itself due to extremely difficult childhood experiences. The psyche is simply not capable of withstanding difficult trials.

For example, this applies to victims of sexual violence, who subsequently find it difficult to build relationships with members of the opposite sex. People who were able to radically change their appearance deserve special attention.

Subsequently, they feel mental discomfort when they are next to a person who has the same appearance features that they managed to get rid of. This applies to excess weight, squint, and uneven teeth.

Biopolar personality disorder, which can cause anthropophobia, should not be underestimated.

Are you afraid of people? What is anthropophobia?

You should not consider yourself to be a mentally abnormal person. This is a fairly common phobia. Psychologists have identified over forty thousand phobias. Some people are afraid of insects, others are afraid of getting hit by a car.

• Factors and causes of risk
• Anthropophobia most often affects people who are:
• Forms of fear of people
• Symptoms and manifestations
• How to identify the presence of anthropophobia?
• Is there a chance to heal on my own?
• Complex treatment of anthropophobia

A special fear is people. A person may experience discomfort when seeing a representative of a different race or refuse to speak in public or be in society. Situations when a person is afraid to start a conversation and doesn’t want to leave the house again so as not to run into other people deserve special attention.

Scientifically, this phenomenon is called anthropophobia. It should not be confused with social phobia (see How to recognize a sociopath).

If we talk about the first, a person is afraid of communication, of any situations related to the people around him. In the second, the subject simply does not want to be the center of attention.

It is easy for him to interact with a small group of people, most often acquaintances. This is the difference between anthropophobia and social phobia.

Is there a chance to heal on my own?

You should think about self-healing from fear of people:

1. Understand that the problem actually exists. You need to be attentive to yourself, analyze in what specific circumstances they will appear. This applies to meeting a specific type of people, being in a public place (shops, city squares). It is important to make an attempt to be the first to make contact. This applies to meeting members of the opposite sex, visiting busy places, helping the elderly and children.
2. You cannot do without the services of a psychotherapist if a person is afraid to even leave his home. It is best to chat with a specialist via Skype or go to a face-to-face meeting with a trusted relative.
3. If you want to overcome anthropophobia yourself, you should begin treatment by writing down your own feelings in a notebook. For example, you can write down that you are no longer afraid to go to the store near your home to buy bread and milk. Another step is to ask a passerby where the nearest cafe is.
4. The guarantee of getting rid of an existing disease is an active search for the causes of its occurrence. It is necessary to remember when fear arose for the first time. It is possible that the reasons extend from childhood. Then you should analyze your relationship with your parents, forgive them, and start moving on with your life.

Principles of treatment

Treatment of anthropophobia, like other fears, cannot be done with medication. This condition can only be eliminated through long-term psychological therapy. You need to start by identifying the causes and attempts to overcome difficult situations. Therefore, there is no way to do without the help of a specialist.

In the process of treating anthropophobia, you can try auto-training and meditative practices. A large amount of specialized literature and resources have been published from which information can be gleaned. It is worth noting that you should not expect a quick effect, because the correction of any mental disorders is a long-term process, in which a methodical approach is maintained, exercises and recommendations are regularly performed.

A person must understand the problem, be aware and identify the desire to overcome it. Only then will therapy be effective. Relatives should also help and support. Modern society has not yet learned to perceive fear of people as a real problem. Misunderstanding and criticism can only make the situation worse. Relatives should know that patients themselves will not seek support.

As their condition improves, patients will be able to decide to make contact with society: they will go out into the yard, board public transport without fear, go grocery shopping, ask for directions from a passerby without fear of talking.

Folk remedies

Although a phobia cannot be eliminated with the help of medications, folk remedies can overcome unpleasant symptoms, cope with increased anxiety, have a calming effect, and improve sleep.

Anthropophobia can be treated with neuroleptics and antipsychotics , these are the rules of the traditional method. They can cause side effects on almost all systems and organs. Traditional treatment has a much gentler effect on the nervous system; the body does not get used to such remedies. In particular, you can drink juice from beets and carrots, infuse mint and lemon balm, juice from fresh motherwort herbs, decoctions from hawthorn berries and aster chamomile.

How to deal with sudden attacks

In case of acute panic, you first need to monitor your breathing: take slow and shallow breaths in and out, trying to hold it for a few seconds. You should continue until the respiratory rhythm is completely normalized. A healthy person at rest takes from 8 to 16 breaths per minute.

After such simple exercises, fear will gradually go away. Relaxation and meditation techniques can also help manage attacks.

The main thing to remember is that if you discover a phobia of fear of people, you should not postpone a visit to a specialist .

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