Social Anxiety and Social Phobia

Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have intense, persistent, and chronic fear of being watched and fear of being judged by others, in addition to being fearful of doing things that will embarrass themselves. They may worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and often leads to difficulty in making and/or keeping friends.

The following situations are often stressful for people with social anxiety disorder:

  • Meeting new people
  • Being the center of attention
  • Being watched while doing something
  • Making small talk
  • Public speaking
  • Performing on stage
  • Being teased or criticized
  • Talking with “important” people or authority figures
  • Being called on in class
  • Going on a date
  • Making phone calls
  • Using public bathrooms
  • Taking exams
  • Eating or drinking in public
  • Speaking up in a meeting
  • Attending parties or other social gatherings

Similar to OCD, those who suffer from social phobia often acknowledge that their thoughts and fears are generally irrational. That is, people with social anxiety know that others are not really critically judging or evaluating them all the time. They understand that people are not trying to embarrass or humiliate them. They realize that their thoughts and feelings are exaggerated, yet despite knowing this, they still feel profound anxiety.

As used in all other anxiety disorders, Cognitive-Behavioral Therapy (CBT) is very useful in treating social phobia, and the central component of this type of treatment is Exposure Therapy (ET). With a combination of CBT, ET, and at times medication, one can produce long-lasting relief from social anxiety.

With Exposure Therapy, there are three components to the treatment. The first involves gradual exposure to a feared situation while helping the person become more comfortable in dealing with the situation. Second, by deliberately inducing the risk of embarrassment or rejection, people learn that they can handle the situation. And third, people are taught coping mechanisms through generating constructive responses to effectively deal with their fears and perceived disapproval.

Cognitive restructuring is also incorporated into the treatment plan by teaching a person to challenge irrational thinking. This process gradually replaces maladaptive thoughts with more realistic ways of looking at anxiety provoking situations.