Social Phobia

What is social phobia?

A social phobia, also known as social anxiety or social anxiety disorder, is a type of anxiety disorder in which a person feels excessive fear of the (negative) reaction, criticism or judgment of others. This fear is related to social situations and can be a hindrance in daily life.

Recognizing social phobia

A social anxiety disorder is characterized by the fear of a negative reaction or judgment by others. That it will be embarrassing and humiliating or lead to rejection. You therefore have difficulty in (some) social situations. And you may also increasingly avoid social situations as a result.

Exactly what situations trigger anxiety varies from person to person. If you have social phobia, for example, you have a fear of:

• People in general;
• Large groups or crowds;
• Unknown people;
• Social contacts;
• Parties;
• Talking to other people.

This means you are so nervous or tense that you have difficulty in social situations where you are exposed to possible critical judgment from others. Think of social interactions as:

• Having a conversation;
• Meeting unfamiliar people;
• Being observed (for example, while eating or drinking);
• Asking for something in a store;
• Asking for directions;
• Giving a presentation.

Difference from other anxiety disorders

Social phobia differs from other anxiety disorders in terms of the trigger for the anxiety. Although the anxiety symptoms are very similar, in a social anxiety disorder it is social situations that trigger your anxiety. Specifically, the thoughts of what might happen during those social situations.

Social phobia or shyness?

Also, shyness is not the same as social phobia. This is a personality trait. If you are just shy, it does not affect your daily life the way a phobia does. Only when it causes you to avoid social situations, there is excessive anxiety and obvious hindrance in your daily life, we may speak of a social phobia.

Physical reactions

In social anxiety disorder, the following physical reactions may occur:

• Blushing;
• Stuttering;
• Not getting out of your words;
• Having a blackout.

If anxiety increases further, you may experience a panic attack. This includes symptoms such as excessive sweating, trembling, heart palpitations, dizziness, nausea, tingling in hands and feet and dry mouth.

How does social phobia develop?

It is not clear exactly what causes social phobia. What we do know is this:

• A social phobia often develops during childhood in elementary school;
• There may be a hereditary factor involved. If your parents have a social phobia, you are more likely to get it too by heredity or by copying parents’ behavior;
• Environmental factors play a role: For example, past experiences, such as being laughed at or bullied at school. But also, for example, your upbringing. You learn from your parents how to deal with anxiety and how to deal with social contact. In addition, other psychological symptoms (for example, depression) can also create more fear of social situations and a social anxiety disorder can then be developed.
• Character also plays a role: social phobia is more common in people who feel more inhibited, shy or insecure;

Types of social anxiety

Social phobia can be divided into two subtypes: social anxiety disorder and stage fright.

1. Social Phobia

With social phobia, you experience anxiety symptoms in multiple social situations.

2. Stage fear

In addition to anxiety symptoms in multiple situations, there are also people who have anxiety symptoms in one specific situation; the fear of public speaking or performing in front of an audience. With this specific social anxiety, you do not panic in other – less exciting for you – social situations.

The effects of social phobia

When anxiety negatively affects your daily life, it can lead to:

• Emotional exhaustion
  Functioning with anxiety symptoms takes a lot of energy. In some cases, this leads to emotional exhaustion.
• Impediment at school, study, work
  If social phobia interferes with your ability to perform tasks, it can lead to problems at work or at your school.
• Social isolation
  You increasingly avoid social contact.
• Depression
  Avoidance behavior due to social phobia can give feelings of loneliness, gloom and helplessness.
• Misunderstanding from others
  Some people with social phobia experience little support from their social network. This can make you feel misunderstood. Relationships can also come under pressure; You feel insecure in your relationship with your partner.
• Uncertainty
  People with social anxiety disorder are more likely to experience shame. This can have an effect on self-esteem.
• Substance abuse
  Sometimes people with social phobia turn to substances such as alcohol or drugs to deal with their symptoms.

What can you do? 

Taking good care of yourself helps you feel more comfortable in your own skin. There are several (lifestyle) recommendations that help with social anxiety:

• Try to talk about it;
• Engage in exciting situations. Try not to avoid as much as possible;
• Try to focus your attention externally rather than on yourself;
• Ask yourself what is the worst thing that could happen. Check afterwards if it actually happened that way;
• Bring regularity into your life, in terms of bedtimes and meal times;
• Provide adequate relaxation. Yoga, meditation, relaxation exercises or walking, help you clear your head;
• Know that you are not alone. About 5 – 15% of people experience social anxiety disorder in their lifetime.

Tips for my partner or loved one with social anxiety

The following advice will help you and your loved one with social phobia:

• Delve into your partner’s anxiety
  It is good that you are reading this information, that means you are showing interest in what your partner is going through.
• It’s good to keep doing fun things together
  Take your partner with you. It doesn’t have to be an exciting party right away. A walk is also good;
• Provides distraction
  Going out together? Then make sure you offer your partner distractions.
• Accept that you can’t do everything together
  But at the same time, don’t go into avoidance mode too much either. Avoidance causes a temporary decrease in anxiety, but does not help your partner. It also keeps you from leading an enjoyable life.

Treatment

Treatment at iPractice

1. Cognitive Behavioral Therapy (CBT).

2. Exposure in vivo

In exposure in vivo, you expose yourself to a situation that is frightening to you. In this, you start out easy, but it becomes increasingly challenging. It is all about negating the fearful expectation. You may remain fearful, but that which you fear does not come true. As you gain new experiences, an alternative thought becomes more and more powerful. The anxiety decreases as a result.

3. Acceptance and Commitment Therapy (ACT)

In ACT you learn that fear is a part of life (acceptance). You also learn to distance yourself from your thoughts associated with your social anxiety and dwell on what you find important in life.