How To Overcome Social Phobia

Social phobia is, like all phobias, an anxiety disorder. Social phobia is defined as a intense and persistent fear of social situations in which the person is exposed to the evaluation of others and which they think will be negative.

It is worth mentioning that we are social beings and we appreciate being well valued by others and being part of the group, so it is normal to take into account the reaction and perception of others. However, in social phobia, the worry is much higher than one would expect in relation to the situation. The anguish and discomfort felt by the person with social phobia are not justified by real danger.

The symptoms presented by a person with social anxiety are the following:

• Avoidance of social situations. A person with social phobia will do everything possible to avoid events that cause anxiety.
• Great discomfort. If she cannot escape the situation, she will experience it with great anguish and discomfort. The typical symptoms of anxiety are: tachycardia, feeling of suffocation, muscle tension, nausea, chills, dizziness, diarrhea, flushing, sweating, trembling, urgency to urinate or defecate…, which can lead to a panic attack.
• Blocking. The anguish makes them unable to speak fluently.
• Affectation at an academic or work level. We speak of a disorder when the symptoms presented negatively and significantly affect the person’s life.
• Impact on a social level. People with social phobia have great difficulty interacting, so it will be difficult for them to make and maintain friendships. It will also be more difficult for them to meet new people and have a partner.
• Intention to go unnoticed. People with social phobia do not want to stand out, something that also affects their social and work life.
• Unsafety. The lack of security is the origin of the fear of being judged.
• Fear of rejection. Exaggerated fear of criticism from others.
• Catastrophic thinking about social situations. An irrational belief that provides an extremely negative evaluation to social interaction situations.
• Error in performance perception. The person with social phobia considers his performance in social situations much worse than it really is.
• Anticipation. Anxiety does not only occur at the moment of the feared situation, but also when thinking about it.

This reaction occurs in situations such as having a conversation, attending a party, being in a group, making a phone call, talking to strangers, conducting an interview, speaking or acting in public, being exposed, talking to superiors…

Like most psychological disorders, the cause or causes of social phobia are not yet known. There are various factors that increase the vulnerability to presenting it. Next, we will see the variables and factors that are related to the origin and maintenance of this anxiety disorder:

• Genetic heritage. Studies with twins, such as that of Nelson et al. (2000) demonstrate that genetic inheritance influences and predisposes the development of phobia.
• Psychopathology of parents. Whether parents have a mental disorder is also related to the predisposition to present social phobia, especially if it is the same.
• Tendency towards high activation of the autonomic nervous system. A greater production of adrenaline and norepinephrine in the face of stress produces the typical symptoms of anxiety such as tachycardia, sweating, tremor…
• Behavioral inhibition. This temperament trait consists of isolation and quietness, and is also related to social phobia.
• Anxiety sensitivity. In relation to the activation of the autonomic nervous system, sensitivity to anxiety also refers to the importance given to these bodily symptoms.
• Education. The information transmitted about how behavior should be forms beliefs and thoughts that can be distorted, such as the need to please others.
• Traumatic experiences in childhood. For example, a loss or separation from parents, an abusive situation…
• traumatic event. Whether it has happened in the first person, by observation or by transmission of information.
• Avoidance. After an unpleasant experience, if similar situations are avoided, fear is reinforced and the physiological anxiety response is maintained.
• Threat perception. The situation is associated with threats such as rejection or humiliation, so the body responds with the activation of the autonomic nervous system.
• High stress levels. Exposure to high levels of stress increases vulnerability to future stressful experiences and also sensitivity to current stressful experiences.

Some authors propose differentiating between various types of social phobia depending on the context in which the symptoms occur, although there is controversy in this regard. Some of the types are:

• In formal contexts
• In informal contacts
• When they require assertive behavior to express annoyance
• Observational
• Acting
• Interaction
• Interaction with the opposite sex
• Interaction with superiors

It seems that the most accepted classification is the one that differentiates:

• Social performance phobia: in cases where fear occurs only in situations of acting or speaking in public.
• Generalized social phobia: if the symptoms occur in the vast majority of social situations.

Social phobia, like the rest of psychopathology, is evaluated through the general clinical interview, the diagnostic interview (such as the International Diagnostic Interview (CIDI) or the Anxiety Disorders Interview (ADIS-IV)), measures of self-report, specific social phobia questionnaires and self-records (in which the situation, thoughts, emotions, discomfort and behavior are captured).

Within the specific social phobia questionnaires, which we could call social phobia tests, we can find the Social Anxiety and Phobia Inventory (SPAI), the Liebowitz Social Anxiety Scale (LSAS), the Social Phobia Scale (SPIN), the Social Anxiety Questionnaire for Adults (CASE-A30) or the Watson and Friend Social Anxiety Scale (SADS). Here you will find an online adaptation of this social phobia test so that you can clarify if you identify with the symptoms of social phobia.

The most studied and validated psychological treatment for social phobia is Cognitive Behavioral Therapy (CBT), although Acceptance and Commitment Therapy (ACT) has also been shown to be effective for anxiety disorders. CBT defends that by changing behavior, we change thoughts and vice versa. For its part, the ACT proposes accepting the discomfort. In phobias, one of the main symptoms is avoidance and, precisely, ACT obtains especially good results with avoidant patients.

We are going to see several techniques and strategies to overcome social phobia coming from different psychological perspectives.

1. Group support

Due to the characteristics of this disorder, the effectiveness of the treatment increases with group sessions. Groups are usually between 4 and 9 people. The group also serves to practice the social skills learned.

2. Psychoeducation

It explains what an anxiety disorder is and what social phobia is. The cognitive and behavioral factors that cause and maintain anxiety and how psychology addresses it so that it does not disable are also explained. Treatment techniques, procedures and objectives are explained. The objective is for the patient to understand that avoidance maintains the symptoms and to understand why it is so important to expose oneself to situations.

It is also important to demystify some of the myths related to anxiety: anxiety is not dangerous, the anxiety attack ends, anxiety is not a sign of weakness, anxiety is not “bad”, sometimes it is adaptive.

3. Identification of automatic thoughts

What activates and increases the level of anxiety are the beliefs and thoughts about the situation, and not the situation itself. Therefore, it is vitally important to identify these automatic thoughts that run through your mind. To identify them, the person needs to pay attention to the internal dialogue and record the automatic thoughts that appear. Normally, supported by irrational beliefs about the world, about others or about himself or herself. For example, that he will never be able to express her opinion or that others will judge him. Irrational thoughts are illogical, cannot be proven, are absolutist, and produce disturbing emotions.

4. Cognitive restructuring

Once automatic thoughts and the irrational beliefs that support them are identified, they can be discussed and replaced with more rational and adaptive beliefs. Through debate and the application of logic and evidence, it is intended to change those beliefs. In this article, you can see the technique of discussing irrational ideas. It is one of the best exercises to overcome social phobia.

5. Behavioral experiments

Reality tests and behavioral experiments can also be used, such as asking other people for evaluation or videotaping a social interaction of the patient. Other ideas are to make a small mistake or expressly reveal yourself to verify that the consequences that occurred do not correspond to the severity of the imagined consequences. In this way, the person can verify that his or her anticipations do not occur.

6. Acceptance of discomfort

The treatment of anxiety disorders, such as phobias, involves accepting the symptoms of anxiety. Acceptance is about stopping fighting anxiety symptoms. Anxiety is an activation mechanism of the body that aims to put the body in optimal conditions to face a danger (which may be real or imaginary). Therefore, anxiety is a phenomenon that helps our survival. The problem is that when this information is not known and anxiety is not understood, it can generate a lot of fear because it is an unpleasant sensation. It is necessary to accept anxiety symptoms, as well as accept discomfort and discomfort as part of life.

7. Relaxation techniques

There are many relaxation techniques and they serve to reduce the activation of the prasympathetic nervous system, responsible for physiological symptoms. They are techniques that must be learned and practiced regularly for them to have benefits. The most used are:

• Abdominal breathing, which consists of performing the breathing movement with the diaphragm instead of with the thorax. It is learned by placing one hand on the chest and the other on the abdomen, inhaling slowly, taking the air to the end of the lungs and noticing how the abdomen swells and not the chest. When exhaling, try to empty the air slowly, noticing how the abdomen deflates.
• Jacobson’s progressive muscle relaxation involves learning to relax the body through tension-relaxation exercise. It is learned by tensing and relaxing each area of ​​the body, making these areas progressively wider, to finally be able to relax and relax the entire body.

8. Social skills training

It is important to know all the elements that come into play in social interactions: gaze, facial expression, smile, body posture, orientation, gesticulation, distance, physical contact, intonation, volume, fluidity , the speed, the words…

The main social skill, which will allow the other social skills to be developed, is assertiveness. Let’s look at the 3 communication styles:

• Aggressive style: This communicative style is characterized by lack of respect for the opinions and feelings of others. The person who practices aggressive communication does not take into account what the other person wants to express. There is a raised tone of voice, a rigid body posture, the personal space of others is invaded, gesticulation can be offensive…
• Passive style: This communication style is characterized by fear of conflict. The person who practices passive communication gives space to other people to express themselves, listens and understands, but is not able to express their opinion. It is observed that the person keeps his distance, speaks little and with a low voice, does not gesture…
• Assertive style: This communication style is between the previous two and is characterized by respect for both parties. The person who practices assertive communication is able to express his or her own thoughts and feelings, but also to listen to and respect those of the other person. The objective of assertive communication is to reach agreements and approach positions based on respect and understanding. A friendly facial expression, a smile, a relaxed and confident body posture, gentle gesticulation, a correct distance, adequate volume, intonation and speed are observed…

The objective of training is to have assertive behavior in social interaction.

9. Role-playing

These experiential exercises consist of representing social behaviors such as:

• Personal presentation.
• Start, maintain and end a conversation.
• Receive or give compliments.
• Express an opinion or complaint.
• Make an agreement or negotiation.

The actions should be gradual, at first they may last only a few seconds and the goal is to reach several minutes. Furthermore, a good strategy is to record the performances to be able to visualize them and improve with the feedback received. Role-playing is one of the most important exercises to overcome social phobia.

10. Attention training (mindfulness meditation)

Another important strategy in terms of anxiety management is attention training. Mindfulness meditation is a training that will allow you to direct your attention to the present moment or towards a specific stimulus.

11. Gradual Live Exposure

Exposure tasks in real life.

• Interaction with strangers.
• Expression of annoyance, anger or displeasure.
• Be exposed or make a fool of yourself.
• Speaking or acting in public.
• Interact with people of authority.

12. Self-esteem and self-compassion work

Another important aspect to work on in cases of social phobia is self-esteem. Through self-image restructuring techniques, we can ensure that the person has a more realistic and healthy self-concept. In this article, we explain what healthy self-esteem is.

On the other hand, it is also important to take care of how you treat yourself and that it is compassionate. Self-compassion is treating yourself in a friendly and kind way, both in actions and language. In this article, we explain how to work on self-compassion.

13. Drugs and natural remedies

To accompany psychotherapeutic treatment, it is sometimes necessary to resort to other treatments, both natural and pharmacological remedies. These work as a helpful tool to reduce anxiety symptoms, but they do not cure the disorder. If you need pharmacological treatment, the psychiatrist will be the one who will prescribe it. Self-medication is something that should be avoided, since we do not control the effects that drugs have on our body.

The anxiolytics They are the main medications for anxiety symptoms. Among the best-known anxiolytics, we highlight Lorazepam, Bromazepam and Diazepam.

Among the natural remedies for anxiety, we find valerian. Valerian root is a well-known natural remedy to alleviate anxiety or nervous symptoms. This can be taken as a tea or from an extract. Valerian has relaxing and sedative effects that reduce the symptoms of social phobia, this helps us better manage our emotions and, thus, try to improve social skills. In this article, you will find several natural Anxiolytics to calm anxiety.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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