Social Phobia

Introduction
Social phobia is a treatable condition. This manual takes you step by step through a cognitive
behavioural program. By working through it you will learn about the nature of social phobia,
anxiety, and panic. Not only will you learn skills that will enable you to develop more control over
your anxiety, you will also learn to worry less about appearing anxious and about being evaluated.
To learn these skills will require time and effort. To be effective, they will need to be practiced
regularly. The more you put in, the more you will get out of the program. However, you are
unlikely to be completely cured by the time you get to the last page, or even to the last session of
your treatment program. To get lasting improvement you need to be prepared to go on working.
Research around the world has demonstrated the possibility of long-term achievements, as well as
continued improvement.
What Is Social Phobia?
Social phobia is a fear of being scrutinized, evaluated, or the center of attention. However, the real
underlying fear is of being evaluated negatively. People with social phobia commonly fear that
others will find fault with them or think that they are incompetent or strange. They may worry that
this will occur during social interaction with one or more other people, when they are doing
something under observation or even in situations where there is just the chance that they may
attract attention. Sometimes, this may involve just being with others.
The person with social phobia believes that being judged negatively may result from being seen to
be anxious (for example, blushing, sweating, trembling, or shaking), from saying or doing
something embarrassing, appearing awkward or making a mistake. Some also believe that there is
some aspect of their appearance or behavior that may attract criticism.
Feared situations include public speaking (including tutorials and presentations), parties, writing or
signing one's name under scrutiny, standing in a line, using the phone with others around, eating or
drinking in public, using public toilets, and public transportation. Some individuals fear that
embarrassing bodily functions will occur inappropriately, for example, losing control of bowel or
bladder, passing flatus, vomiting, stomach noises.
The main fears in social phobia may relate more to performance situations or more to social
interaction. There may be great anxiety about looking anxious or even having a panic attack in
these situations. The individual may believe that this anxiety will be obvious and will lead others to
evaluate them negatively. When social interaction is the main fear, the individual often worries
about having nothing to say, being boring, saying something inappropriate or being judged as
inadequate in some way. In any case, social situations are either endured with intense anxiety and
discomfort (during which, panic attacks may occur) or are avoided. Anxiety and avoidance may be
linked to only one situation, (circumscribed social phobia) but commonly occur in many situations
(generalized social phobia).
The fears in social phobia are excessive and unreasonable. While in the situation, feeling acutely
anxious and convinced that things are going badly, it may not seem that the fear is unreasonable.
However, most individuals with social phobia realize that their anxiety in social situations is much
greater than for those who do not suffer from the disorder. Thinking about things more calmly once
out of the situation it is usually possible to accept that the anxiety triggered by the actual
circumstances was excessive. More about this later.