Many people describe themselves as shy, although there is no clear definition of what this means!
Shyness with others, or increased self-consciousness, occurs in phases through childhood. It is
common in the teenage years as an individual starts to think about how others might see them. For
most people, this type of social anxiety decreases with age.
Some social situations continue to cause a degree of anxiety for most people. Good examples are
public speaking, or arriving alone at a social gathering of unfamiliar people. Normal social anxiety
is not disabling, it settles quickly during or after the event, and it does not begin weeks before the
event. There is no expectation of negative evaluation. Things are different for the person with
social phobia. They tend to start worrying a long way in advance, the discomfort may well get
worse as they stay in the situation, and next time they may be even more worried. Afterwards they
may go over and over aspects of their performance with which they were unhappy. The reasons for
this will be discussed in detail in a later section of the manual. Severe shyness that causes
significant avoidance of social interaction or distressing anxiety in social situations is probably
social phobia.
What is Avoidant Personality Disorder?
Individuals with avoidant personality disorder are anxious in almost all types of social interaction.
They fear, and expect, not only negative evaluation, but also rejection or humiliation. There is often
a sense of inferiority to others, low self esteem, and considerable avoidance of social interaction.
Interestingly, looking anxious is often not the greatest concern of those with the avoidant
personality style. These individuals may be far more anxious about how they are relating to others,
and fearful that in some way they will be found inadequate or worthless and be rejected. The
problem has usually been present since early childhood, and involves deeply ingrained patterns of
thinking. Estimates vary greatly as to how common this problem is, but at least a quarter of those
with social phobia will also have the avoidant personality style. Avoidant personality styles can be
helped by the social phobia program because there is so much overlap between the two disorders.
If you have an avoidant personality, you must be prepared for the fact that it will probably take
some time to overcome your problems to a satisfactory degree because they have been present for
so long, and to such an extent. In many cases, you will find it helpful to seek ongoing help with
your problems after this program finishes. You can discuss this matter further with your therapist.
How Common is Social Phobia?
Social phobia has been documented across a range of cultures. It is estimated that between 1.5-
4.5% of the population has social phobia at any time. Slightly more women are affected than men.
However, probably more men are affected by avoidant personality disorder. Social phobia usually
starts in the teenage years and tends to be a chronic disorder that does not go away spontaneously.
Studies consistently indicate that most people have suffered with social phobia for many years
before they seek or find appropriate treatment.
What Causes Social Phobia?
We still don’t know for sure what causes social phobia. It seems that the most important factor
related to the development of social phobia is a genetic vulnerability to anxiety in general. This is
probably largely due to greater sensitivity and reactivity of the nervous system. Some people tend
to react more, often with anxiety or nervousness, when faced with any type of external event. These
people seem to be more vulnerable to developing anxiety problems. There is also an increased risk
of developing social phobia if a close relative has the disorder. It is unusual for social phobia to
develop from a specific incident, although this may happen more often in “circumscribed” social
phobia (where only one or a few situations cause anxiety). Aspects of the family environment do
not appear to be very important causative factors.
The Effect of Personality
Personality refers to habitual ways of thinking about ourselves, our relationships with others and
our environment, and the coping strategies we use in these situations. Individuals with social
phobia tend to describe themselves as sensitive, emotional and prone to worry. As we have seen,
this does tend to run in families. People who are very sensitive to criticism, or overly concerned
about creating a good impression may be more susceptible to social phobia. Some of these attitudes
are learned in childhood, but genetic and temperamental factors also influence personality
development in ways we do not fully understand.
Hypersensitivity, emotionality, and proneness to worry can be a handicap. You can’t radically alter
your personality – but nor should you want to! There are advantages to being sensitive: Sensitive
individuals care about others and can empathise readily, which are valuable characteristics. We can
teach people to be less sensitive but it is very hard to teach someone to be more sensitive! Those
with social phobia are “people people”. What you can change about your personality is the degree
to which you show various traits. This course aims to help you to learn to be less sensitive and less
worried about what others think.
Treatment of Social Phobia
Cognitive behaviour therapy has been shown to result in long term improvement. Cognitive
behaviour therapy is based on the principle that how we feel about a situation is determined by
how we think about it. It is based on the work of Aaron Beck and Albert Ellis. These principles
will be discussed in detail later in the program. The components of a cognitive behavioural
program for social phobia include:
· Knowledge about anxiety and social phobia
· Control of anxiety and panic
· Changing unhelpful thinking patterns
· Involvement in social interaction
Drug treatments are also available in social phobia but many people will not need medication.
When medication is necessary, it is still important to learn cognitive behavioural techniques for
managing social phobia, since this appears to give the best long term result. Your doctor can give
you more information.
The Aims of this Program
What you can expect by the end of this program is for your symptoms to have shown a noticeable
degree of improvement. You should have a good understanding of what is required to treat social
phobia and be confident that you can continue to apply the principles you have learned with a good
expectation of further success. Your therapist can discuss this with you in more detail.
Shyness with others, or increased self-consciousness, occurs in phases through childhood. It is
common in the teenage years as an individual starts to think about how others might see them. For
most people, this type of social anxiety decreases with age.
Some social situations continue to cause a degree of anxiety for most people. Good examples are
public speaking, or arriving alone at a social gathering of unfamiliar people. Normal social anxiety
is not disabling, it settles quickly during or after the event, and it does not begin weeks before the
event. There is no expectation of negative evaluation. Things are different for the person with
social phobia. They tend to start worrying a long way in advance, the discomfort may well get
worse as they stay in the situation, and next time they may be even more worried. Afterwards they
may go over and over aspects of their performance with which they were unhappy. The reasons for
this will be discussed in detail in a later section of the manual. Severe shyness that causes
significant avoidance of social interaction or distressing anxiety in social situations is probably
social phobia.
What is Avoidant Personality Disorder?
Individuals with avoidant personality disorder are anxious in almost all types of social interaction.
They fear, and expect, not only negative evaluation, but also rejection or humiliation. There is often
a sense of inferiority to others, low self esteem, and considerable avoidance of social interaction.
Interestingly, looking anxious is often not the greatest concern of those with the avoidant
personality style. These individuals may be far more anxious about how they are relating to others,
and fearful that in some way they will be found inadequate or worthless and be rejected. The
problem has usually been present since early childhood, and involves deeply ingrained patterns of
thinking. Estimates vary greatly as to how common this problem is, but at least a quarter of those
with social phobia will also have the avoidant personality style. Avoidant personality styles can be
helped by the social phobia program because there is so much overlap between the two disorders.
If you have an avoidant personality, you must be prepared for the fact that it will probably take
some time to overcome your problems to a satisfactory degree because they have been present for
so long, and to such an extent. In many cases, you will find it helpful to seek ongoing help with
your problems after this program finishes. You can discuss this matter further with your therapist.
How Common is Social Phobia?
Social phobia has been documented across a range of cultures. It is estimated that between 1.5-
4.5% of the population has social phobia at any time. Slightly more women are affected than men.
However, probably more men are affected by avoidant personality disorder. Social phobia usually
starts in the teenage years and tends to be a chronic disorder that does not go away spontaneously.
Studies consistently indicate that most people have suffered with social phobia for many years
before they seek or find appropriate treatment.
What Causes Social Phobia?
We still don’t know for sure what causes social phobia. It seems that the most important factor
related to the development of social phobia is a genetic vulnerability to anxiety in general. This is
probably largely due to greater sensitivity and reactivity of the nervous system. Some people tend
to react more, often with anxiety or nervousness, when faced with any type of external event. These
people seem to be more vulnerable to developing anxiety problems. There is also an increased risk
of developing social phobia if a close relative has the disorder. It is unusual for social phobia to
develop from a specific incident, although this may happen more often in “circumscribed” social
phobia (where only one or a few situations cause anxiety). Aspects of the family environment do
not appear to be very important causative factors.
The Effect of Personality
Personality refers to habitual ways of thinking about ourselves, our relationships with others and
our environment, and the coping strategies we use in these situations. Individuals with social
phobia tend to describe themselves as sensitive, emotional and prone to worry. As we have seen,
this does tend to run in families. People who are very sensitive to criticism, or overly concerned
about creating a good impression may be more susceptible to social phobia. Some of these attitudes
are learned in childhood, but genetic and temperamental factors also influence personality
development in ways we do not fully understand.
Hypersensitivity, emotionality, and proneness to worry can be a handicap. You can’t radically alter
your personality – but nor should you want to! There are advantages to being sensitive: Sensitive
individuals care about others and can empathise readily, which are valuable characteristics. We can
teach people to be less sensitive but it is very hard to teach someone to be more sensitive! Those
with social phobia are “people people”. What you can change about your personality is the degree
to which you show various traits. This course aims to help you to learn to be less sensitive and less
worried about what others think.
Treatment of Social Phobia
Cognitive behaviour therapy has been shown to result in long term improvement. Cognitive
behaviour therapy is based on the principle that how we feel about a situation is determined by
how we think about it. It is based on the work of Aaron Beck and Albert Ellis. These principles
will be discussed in detail later in the program. The components of a cognitive behavioural
program for social phobia include:
· Knowledge about anxiety and social phobia
· Control of anxiety and panic
· Changing unhelpful thinking patterns
· Involvement in social interaction
Drug treatments are also available in social phobia but many people will not need medication.
When medication is necessary, it is still important to learn cognitive behavioural techniques for
managing social phobia, since this appears to give the best long term result. Your doctor can give
you more information.
The Aims of this Program
What you can expect by the end of this program is for your symptoms to have shown a noticeable
degree of improvement. You should have a good understanding of what is required to treat social
phobia and be confident that you can continue to apply the principles you have learned with a good
expectation of further success. Your therapist can discuss this with you in more detail.
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