In public places, such as work, meetings, or shopping, the person with social phobia feels that everyone is watching and staring directly at them.  They can’t relax and enjoy themselves.   In fact, they can never relax when other people are around. It feels like others are evaluating them, being critical of them, or making fun of them.

Other people don’t do this openly, of course, but they still feel the self-consciousness and the judgment in their presence. So it’s easier to avoid the pain by avoiding other people.

How is it ever possible to feel "natural" or "normal" under these circumstances?

Going to a job interview is pure torture: you know your excessive 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 the questions. It is especially infuriating because you know you could do the job well if you could only get past the interview.

Social phobia is a relatively common problem that affects millions of people -- about 8% of the population  -- 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 people with social phobia have ever 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 lives. Adding to the dilemma, social phobia does not come and go like other psychological problems. If you have it, you have it every single day.

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 their anxiety makes it seem like 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 this 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 persons’ head.

What can be done about social phobia? Many therapeutic treatments have been tried, but cognitive-behavioral techniques have been shown to work the best.

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 anxiety problems. However, many people with social phobia additionally benefit from shame-attacking exercises, role-playing and practicing social interactions, realistic assertion-skill development, paradoxical therapy, 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 people with social phobia become anxiety-free after treatment. But quality of life is greatly enhanced, and people usually find they can do things that they never would have considered before treatment.

Social phobia responds to relatively short-term therapy, depending on the severity of the condition.  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 a better life for all people with social phobia. Without CBT treatment, social phobia is a torturous emotional problem; with treatment, its bark is worse than its bite.

Social Phobia: The Largest Anxiety Disorder

Links to Websites on Social Phobia

This article appeared in alternate form in ENcourage, Fall 1994.
Pat Merrill, editor. Copyright 1994-2001, Used by permission.

MMML Productions, Chicago, IL.  Copyright 1998-2001, Jerry and Linda M. Booth.  

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Dedicated to Michael.

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