What is social phobia and how to deal with it

What is social phobia, signs and treatment – in the material “Kommersant”.

Social phobia is a widespread mental disorder that manifests itself in a strong irrational fear of various types of social interactions (fear of using catering places, public toilets, the inability to do anything when observed from the outside, etc. In general, social phobia is expressed in the fear of being in the spotlight , manifested in painful fears of a negative assessment of others and in the avoidance of such situations.

In this disorder, intense fear occurs constantly and interferes with daily tasks, such as studying, working, and using public transport. This disease greatly reduces the quality of social life and prevents a person from realizing and developing.

Sociophobia is often confused with introversion and sociopathy, but these three concepts mean fundamentally different states and personality traits. Introversion is a person’s tendency to focus on their inner world and recuperate in solitude. It is believed that an extrovert is charged with energy when communicating with others, while an introvert, on the contrary, spends most of it. Sociopathy (dissocial personality disorder) is a type of psychopathy characterized, among other things, by antisocial behavior, impulsiveness, a limited ability to form attachments, and observance of social norms only as long as it is beneficial.

Social phobia often manifests itself as one of the symptoms of another disease, such as generalized anxiety disorder, and Russian doctors prefer to view it from this point of view. It can also be combined with depression, affective pathology, alcoholism, drug addiction, eating disorders.

Signs of social phobia

There are several main signs that can indicate the presence of social phobia in a person:

– unreasonable fear, hatred, rejection, disgust in relation to situations in which it is necessary to do something under the supervision of other people;

– the desire to avoid stressful situations by all means: dates, shopping trips, speeches at work meetings, visits to government agencies, and so on;

Low self-esteem and fear of being judged by others. Social phobes are always focused on themselves, have an inadequate idea of ​​their capabilities, tend to see themselves only in a bad light;

With social phobia, physiological effects are common, similar to those observed in other disorders of the anxiety spectrum: tearfulness, excessive sweating, nausea, difficulty breathing, tremors in the limbs, heart rhythm disturbances, and others.

Choice of treatment methods

There are two main forms of social phobia:

– isolated, single monophobia, when fear arises only in a specific social situation, for example, the fear of talking on the phone, eating in public, doing certain work in the presence of other people. Isolated phobias also include ereitophobia – the fear of appearing awkward, embarrassed or blushing in front of someone;

– generalized social phobia, when the list of situations that frighten a person includes almost all possible circumstances that require communication with people. The increased reaction of avoidance leads to the fact that the psychosocial orientation is violated, inadequate adaptation to fears is formed, social ties are broken and all spheres of human activity suffer. It is with such an extended social phobia that it is no longer possible to fight on our own – complex medical intervention is necessary, especially when comorbid (combining) mental disorders appear.

Causes of social phobia

For most people, social phobia is formed in childhood or adolescence, when the traumatic experience is fixed in the subconscious and becomes part of the life program. An important role in the formation of social phobia is played by hereditary predisposition.

Also, social phobia occurs as a result of excessively strict upbringing, excessive requirements for the achievements of the child, inadequate assessment of the child’s capabilities, lack of moral support, and emotional coldness of parents. Social phobia can also be the result of overprotection (excessive parental care for the child) or underprotection (lack of care for the child).

However, social phobia can arise not only in childhood, but also at any age after experiencing severe stress: emotional or sexual abuse, betrayal of a loved one, divorce of parents.

Separately, socio-cultural factors of social anxiety are noted, which are associated with the presence in society of extremely high standards and ideals that many people seem unattainable and inaccessible in advance, which makes them capitulate at any, even the most insignificant mistake. The more a family or national culture is built on feelings of guilt and shame, the more likely it is to develop social phobia and the fear of not living up to the expectations of others.

How to deal with social phobia

Social phobia, like many other phobias, refers to borderline conditions that, with the right approach, can be significantly corrected. Sometimes this is possible even without drug treatment, but more often in combination with it, especially in the initial stages of therapy.

Basically, the treatment of social phobia involves the use of various psychotherapeutic areas. These are mainly cognitive behavioral therapy (CBT), hypnosis and group therapy. With the help of CBT techniques, the psychotherapist tries to understand what thoughts the patient has in difficult situations when the mechanism of social phobia is triggered. He then questions these thought patterns step by step and asks the patient to put himself, over a long period of time, specifically in those circumstances that cause fear and panic, in order to finally fully realize that nothing bad is happening.

Group therapy usually provides the ideal environment for social skills training and exposure therapy, providing people with the opportunity to face feared social situations in a supportive and caring environment.

None of the above guarantees the absence of relapses in the future. So with a high probability you will have to finish treatment regularly for many years.

Olga Molchanova, Professor, Department of Psychology, Faculty of Social Sciences, National Research University Higher School of Economics:

– We easily label ourselves and others, one of these is social phobia. It’s a good reason to let go of difficult situations that require social interaction. In the everyday sense, we are all a little “sociophobe”: we are afraid of public speaking, negative assessments, we are worried that our actions, ideas, feelings will be condemned or ridiculed. In fact, these are completely normal emotional experiences. The key point that distinguishes a true sociophobe from other people is that the sociophobe avoids such situations, he cannot cope with his fears – they are of an outrageous, excessive nature, which greatly complicates his life.

Social anxiety and the level of its severity can be determined using interviews or other methods: the questionnaire of social anxiety and social phobia (O. A. Sagalakova, D. V. Truevtsev), the Liebowitz social anxiety scale and the scale of fear of negative assessment (short version; adaptation by S. N. Enikolopova, I. V. Grigorieva).

There is an opinion that social phobia is largely determined by genetics. Its rudiments are already visible from childhood: one child happily runs to unfamiliar children, the other prefers to stand on the sidelines, longingly watching the others. But social anxiety is most clearly manifested in adolescence, which is due, on the one hand, to the formation of reflection, the discovery of one’s “I”, and on the other hand, a high dependence on the opinions of others. Teenagers are so preoccupied with themselves that they automatically begin to believe that others are constantly thinking about them and, most importantly, “see through them.” The so-called illusion of transparency works. As a result, this can lead to an increase in shyness, the development of anxiety before contacts and, as a result, a withdrawal from social interaction.

How to stop worrying about other people’s evaluations? The simplest thing is to realize that people around do not care about us. During the experiments of Thomas Gilovich, it turned out that, on average, a person overestimates the attention of others twice. People do not even notice those awkward situations for which we are ashamed for a long time. The advice is simple, but hard to follow. In difficult cases, psychotherapy is needed: individual (I would focus on cognitive-behavioral) and / or group, training to strengthen self-confidence, independence of self-esteem, and development of communication skills.

Vladimir Alexandrov, Direct Speech group