Fear, pain and isolation: where does social phobia come from and what to do about it

The term “social phobia” appeared in the early sixties of the twentieth century. This is the name for anxiety and fear that a person experiences in certain work or social situations. As a result, he tries to avoid them so as not to experience unpleasant sensations.

Previously, it was believed that such an anxiety disorder was a rare phenomenon, but over time it became clear that this was far from the case. Thanks to modern diagnostic criteria and methods, it has been proven that 13% of the population of our planet suffer from it constantly, and in 7% of males and 9% of females it is observed at least once during the year. However, it is more common in developed countries with a high standard of living.

Experts say: the prevalence of social phobia largely depends on what type of society is inherent in a particular state. If it is individualistic, that is, the uniqueness of each person is emphasized, then such pathology manifests itself more than where collectivism reigns and the individual is not the center of attention.

More about social phobia

This mental disorder debuts in adolescence, youth, disappears completely or continues for many years with varying intensity.

Potential situations in which social phobia makes itself felt:

the need to keep the conversation going;
public speaking;
participation in the play;
acquaintance;
meetings with the opposite sex;
playing in an orchestra;
communication with superiors;
reception of visitors;
eating at home in the presence of other people, even family members;
performing work in front of strangers;
medical examination;
use of a public toilet, etc.

A social phobe fears scrutiny, being humiliated by ridicule, and being criticized or judged if he does not live up to expectations. The themes of his experiences: how others think of him, his appearance seems unattractive to them, his words seem stupid, and he himself seems inattentive, unresponsive and rude. Added to this fear is the anxiety that others will notice that he is embarrassed, cannot find words, loses his thoughts, sweats, blushes, and shakes. The anxiety can be so severe that you may even vomit.

All this can happen to an individual only in relatively small groups, but never in a crowd.

Symptoms

There are two forms of this disorder:

Generalized social phobia - the individual is afraid of all social situations that affect him comprehensively. It is difficult and treatment is complicated.
Specific social phobia. In this case, the person reacts only to some cases, and anxiety manifests itself weakly.

Pathology demonstrates itself in a very diverse manner; each person will have their own symptoms.

Physiological manifestations:

breathing is difficult;
heart rate is accelerated;
nausea;
tremor,
coordination of movements is impaired;
heavy sweating.

The patient tries to avoid contact with people, does not look the interlocutor in the eyes, and feels awkward. When in society, he is extremely tense and wants to hide and run away from everyone.

Cognitive manifestations:

“emptiness” in the head;
inability to concentrate;
the train of thoughts is not controlled;
“playing out” the situation;
inflated demands on oneself;
focus on your behavior.

As for emotions, a social phobe panics at the thought of what people will think about him. His mood often changes, he gets irritated for no reason, gets nervous, and cries for no reason.

A person suffering from this disorder is overly demanding of himself and critical. The main thing for him is to make a good impression on others, saying that he is extremely cultured, well-mannered, and knows a lot. At the same time, the thought always “lives” in his head that they will still think badly of him.

A sociophobe, expecting a situation that will traumatize his psyche, thinks through ways of retreat and is sure that his plan will not succeed in any case. And when the disturbing moment passes, he reflects on the absurdity of his actions, which made everyone laugh at him. In fact, nothing like this happened, but the patient spends such sessions of self-analysis every day, sometimes not even able to fall asleep from his difficult thoughts.

Pathological fear forces a social phobic to behave unnaturally in the presence of colleagues, superiors, and partners. At this time he has a dull look, his eyes are lowered,

there is a bright blush on her face, her arms are crossed on her chest. He avoids people, can suddenly leave the room, and sometimes, in order to look respectable, he lies and tells fictitious stories. Then the patient has a hard time worrying about his behavior.

Those with social phobia are afraid of negative evaluation, and many admit that their fear is great and unfounded, but they cannot do anything. All these problems of adaptation in certain situations greatly affect the lives of patients, negatively affecting both their personal life and their professional sphere. Social phobes cannot meet people, develop relationships, or start a family. It is not for nothing that this disorder is called the “disease of lost opportunities.”

In an attempt to overcome such difficulties, in order to give themselves courage, patients begin to take drugs and alcohol, which also does not lead to anything good.

And the further it goes, the worse it gets. Therefore, the need to start treatment in a timely manner does not require special explanation.

Every person experiences and worries. But if, out of nowhere, emotions overflow, aggression arises, and fear and anxiety overwhelm you so much that it causes discomfort, then this is a reason to consult a specialist.

According to research, social phobia contributes to the development of depression. In addition, the risk of suicide increases 6 times.

FAQ

The following are answers to questions often asked by people who talk about social phobia and even experience it.

How can I stop thinking that everyone around me is looking at me?

Sorry, but this is stupid. You are a person like everyone else. Try not to concentrate on it. Take care of yourself, but do not mentally make your appearance an object of close attention to others. Tell yourself often that other people are primarily concerned about their own affairs. Think about the pace of modern life. It is unlikely that even a single person, rushing somewhere or immersed in his own thoughts, is concerned about the assessment of others. Yes, there are such people, but if they evaluate, then they evaluate everyone at once. You alone are not of any special interest to them.

How many phobias are there?

Complex issue. Some say that there are more than 300 of them, others that there are more than 500. The most common ones are associated with social situations, fear of heights, and a number of animals (dogs, spiders). No less common are fears of the dark, loneliness, doctors, clowns and more. Every time you start to think that you are an abnormal person, remember that the people around you almost certainly experience at least one fear. And it can be so ridiculous that it simply pales in comparison to social anxiety. There are also much more serious disorders related to the feeling of fear. Remember: you need to fight any fears. They don't bring anything good into people's lives.

What is the fear of being watched?

Depends on the context and subtext of the situation, circumstances. In some cases it is customary to talk about persecution mania, in others about paranoia. In the first case, we are talking about a thinking disorder, a person’s delusional belief that he is constantly being watched by one person, a group of people, or simply everyone, even passers-by. In the case of paranoia, tied to the fear of persecution, we are talking primarily about systematized and deliberately constructed ideas and delusional ideas in the mind; in this state, a person begins to feel that those around him, even cameras in stores, are aimed exclusively at him.

How not to be afraid to enter into conflict?

Conflicts are bad in any case, but sometimes you have to go through them. If you are afraid of conflicting with people even when they are up to it, try using the following tips:

if a problem (conflict) requires overcoming due to the likelihood of uncontrollable developments, do not let everything take its course, take responsibility for overcoming the situation;
openness is not always a bad thing. If your opinion is objective and can put an end to the conflict, then it needs to be voiced;
reevaluate conflicts as such, reconsider them. They surround us and are sometimes necessary. For any healthy relationship, conflict is not a death sentence, but a way to solve a particular problem;
keep calm. Conflict is not always about aggression and shouting.

What should I do if I'm afraid of everything?

Here are 8 recommendations to help cope with fears:

Accept your fears. Without them, life would be boring. Without the feeling of fear, people would not exist. Sometimes fear is what gives direction. However, we are talking about natural and normal fears, not phobias.
Try to control your instincts. When some, even natural, fear begins to take the form of a phobia, fight it. An example is social phobia. We have already written about how to deal with it. Read the section “How to get rid of social anxiety?”
Look at situations as consequences of your choices. When the awareness of responsibility for actions and deeds comes, then fears will gradually begin to recede. Why? Because along with responsibility, the ability to control oneself will begin to develop.
Don't be afraid of objections and criticism. Especially objective ones.
Try to make your fears work for you. Do you not accept value judgments of other people towards you, are you afraid that they will be negative? Then carefully select your environment: let it contain only sensible and objective people who will rarely evaluate you adequately to reality. Subsequently, your self-esteem will increase. This is just an example. Any fear can be made to be useful if you cannot get rid of it.
Control your thoughts. When unnecessary and even trash thoughts take over the mind, this is bad. It’s good when, as if you were cleaning the house, you can always put things in order in your head.
Listen to your fears. Assess their impact on you. Is it positive? Then everything is fine. Is it negative? Then give fear a fight.
Always remain calm. Even in the most difficult situation, strive to find the strength within yourself to lean on the inner core that every person has. Tell yourself that stress is just a stimulus. Not to depression, but to fight irritants.

What are some strange phobias?

There are many of them. More than you can imagine. Here are 10 phobias, the strangest, in our opinion:

Fear of new knowledge.
Fear of objects located on the right.
Fear of receiving or giving gifts.
Fear of buttons.
Fear of belly buttons.
Fear of beards and stubble.
Fear of holes.
Fear of time.
Fear of chewing gum.
Fear of fears.

We do not use scientific and technical terms because they are almost impossible to read. However, the presented list already makes it clear how ridiculous and even far-fetched fears can be. The fear of belly buttons alone is worth it. How do you feel about the fear of objects located on the right?

What phobias do celebrities have?

Here are 10 strange phobias of stars:

Scarlett Johansson is afraid of germs and insects.
Matthew McConaughey is afraid of revolving doors.
Tom Hiddleston is afraid of sharks. Even if they are not around.
Penelope Cruz once admitted that she is afraid of the red carpet.
Orlando Bloom is afraid of... Pigs.
Johnny Depp is afraid of clowns.
Helen Mirren has a fear of phones.
Keanu Reeves is afraid of the dark. Who would have thought?
Megan Fox is afraid of paper.
Tobey Maguire hates spiders.

Which of the fears presented do you think is the stupidest?

Definitely a fear of belly buttons. I was also amused by my fear of buttons.

66.67%

Fear of holes. How is this in general?

Fear of fears. Being afraid of being afraid of something is a combo!

I laughed (laughed) very hard when I read (read) about the fear of objects located on the right. This is hilarious!

They are all stupid in their own way.

33.33%

Fear of time. I'm afraid of him too.

Voted: 3

Reasons for late detection of social phobia

Numerous studies have shown that the average duration of this anxiety disorder is about 23 years. Unfortunately, many people suffering from it consider their condition to be just character traits and do not seek help. They get used to it, which causes enormous damage to themselves, they do not realize themselves, and they do not demonstrate their uniqueness.

Teenagers are completely convinced that puberty is to blame for everything, they will simply outgrow it, and over time everything will get better.

This state of affairs leads to the fact that in the first year after the onset of symptoms of the pathology, only 5% of social phobes go to the doctor, and 20% – after 15–20 years, when their condition becomes literally unbearable.

In addition, the rare diagnosis of the disorder is also associated with labeling psychological help: I turn to psychiatrists, and they immediately recognize me as crazy and put me on the register. This is what frightens ignorant people.

It’s also bad that there is very little easily accessible and intelligible information about the dangers of social phobia and its successful treatment.

You should put aside silly fears and visit a psychoneurological dispensary or other specialized medical institution.

There is a prejudice that when examining and making a diagnosis in the ICP, a person is immediately registered as a psychiatric patient. This is wrong. Patients who are carriers of serious diseases that are dangerous both for themselves and for those around them are subject to observation, which implies, among other things, social restrictions.

Pathogenesis

There are several theories about the pathogenesis of social phobia.

The author of the psychoanalytic theory is Sigmund Freud, who argued that phobias are the result of too strong a psychological defense to control anxiety. Control is carried out through psychological defense mechanisms - repression and transference. Repression occurs when anxiety-provoking signals are pushed deep into the unconscious. Transference – fear is transferred to those situations and objects that are easily controlled. But this theory was not further developed.
There is also a behaviorist theory that states that fear of situations and events is formed through classical conditioning. Even after a person experiences such a feeling once, he begins to avoid certain objects and situations and does not control his fear.

As for the characteristics of nervous activity in social phobia, scientists have confirmed that this disorder is associated with a lack of certain neurotransmitters and an imbalance in them.

Diagnostics

The Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, specifies the criteria for diagnosing social phobia. The patient should exhibit the following symptoms:

noticeable anxiety or fear due to a social situation (one or more) where he will be under close attention;
fear of being in an awkward position, receiving a negative assessment from people, ridicule, insults, rejection;
active avoidance of the above situations;
fear about the same situations;
excessive fear that does not correspond to the threat (which, in general, does not exist);
fear and avoidance worsen the quality of life, interfere with normal social activities and work.

The psychiatrist must make sure that the patient does not have other phobias that cause fear: PTSD, agoraphobia, body dysmorphic disorder, etc.

What is a social phobe afraid of?

What social phobics are afraid of can be divided into several large groups.

What is a social phobe afraid of?	Example situation.
Fear of being judged.	Anna draws well, but does not bring her works to participate in the school exhibition, because she is afraid that her classmates will respond unflatteringly to her drawings.
Fear of being disgraced, humiliated.	The guys invited Kirill to a party, but he immediately rejected the invitation. The real reason is that the young man has never been to a party. He is afraid to behave in the wrong way, because of which they might laugh at him or call him names.
Fear of accidentally offending another person.	Christina always prefers to remain silent and not express her own opinion about books, films or games, as it may offend someone.
Reluctance to be the center of attention.	Pavel naturally has a fairly good ear for music. Relatives persuade him to go to music school and not be afraid of others. Pavel, it seems, doesn’t mind studying, but refuses because music schools practice reporting concerts, and during a performance at one, he will be forced to be the center of everyone’s attention.
Fear of any communication.	Svetlana is afraid of any social contacts, so she prefers not to leave the house unless absolutely necessary.

Treatment

The doctor develops a treatment strategy depending on the patient’s condition. Today, the most effective method is considered to be a combination of medication and psychotherapeutic treatment. The first eliminates the tip of the iceberg and relieves vegetative manifestations, and the second – the cause of fear.

Tranquilizers and antidepressants are used to relieve anxiety. Tension and other physiological symptoms are treated with beta blockers. But “pills for social anxiety” alone will not help the matter. The action of pharmacological agents is supported by various types of psychotherapy. This combination allows you to achieve an optimal sustainable result.

Cognitive-behavioral (behavioral) therapy

The psychotherapist selects techniques depending on the symptoms of the disorder. The specialist’s goal: to change the patient’s thinking so that he responds adequately to circumstances that previously caused him fear and anxiety. A social phobe must understand how wrong his perceptions and feelings are. By learning to resist such beliefs, he can get rid of the problem.

Sessions can be conducted individually or in a group. Between them, the patient does homework, which becomes more and more difficult each time.

The most effective group therapy is in such forms as training in self-affirmation, increasing self-confidence (assertiveness), and social skills. A person suffering from social phobia is helped by an environment that has the same problems. He realizes that there are many like him, a lot of people face such a problem at a certain period of life.

An unpleasant situation is created for the patient, but he manages to overcome his fear thanks to the presence of other patients, their sincere support and care. For example, a person who is overcome by fear at the thought that his hands will tremble while performing some action is asked to pour tea for everyone in group classes.

Group members, with the help of a therapist, play roles, and “rehearsals” continue until their new behavior is established. In order for the patient to see himself from the outside, video recording is often used. Patients, together with a specialist, discuss role-playing games, their mistakes and achievements.

Here are 3 behavioral therapy provisions that are either combined or used separately:

Cognitive therapy or working with thoughts that cause anxiety. First, negative thoughts are monitored and it is determined whether they are true. Then they are transformed into realistic ones.
Acquiring social skills, which are usually not enough for a social phobe, since he is not able to start a conversation, etc. This can be achieved with the help of the above-mentioned role-playing games in a group.
Overcoming alienation. Without it, healing is impossible. Patients perform so-called disclosure exercises: attend a party, return a purchased defective product to a store, get to know someone, etc.

The social phobe accepts responsibility for complying with these provisions. He keeps a workbook in which he writes down negative and positive points and constantly re-reads them. At the beginning, there will be more unfavorable notes, this may even lead to some despondency and doubt. But in the future, the positive will prevail and this will become a visible result of treatment.

Some exercises will take a lot of energy at first and cause anxiety. But the more effort you expend, the greater the benefit. Moreover, there are also relaxation exercises that reduce physical stress and give you the opportunity to relax.

Psychotherapy, depending on the patient’s condition, can take from three months to a year, or even more.

Hypnotherapy

Hypnosis helps to immerse the patient in the past and understand what happened in his life, what terrible incident gave impetus to the development of social phobia. An altered state of consciousness (trance) helps to extract from the most hidden depths of memory an unpleasant fragment that is “hidden” so well that it is completely inaccessible in a waking state.

While in a trance, the individual for the second time finds himself in a situation that once significantly affected him and caused a strong destructive emotion. But this time everything happens differently than before: the patient interprets what happened differently and it does not receive a negative connotation. And, as a result, he no longer feels anxiety and fear about this.

As a rule, in the treatment of social phobia, the method of deep immersion is used - somnambulism. In this state, the brain works in such a specific mode when all processes of higher nervous activity are subordinated to a single experience.

The patient can be put into a state of mild somnambulism if he is completely ready for such a procedure, unconditionally trusts the specialist, and has no prejudices about hypnosis.

Why face fear

Social phobias cannot be cured without serious and thoughtful psychotherapy.

To overcome social phobia, you need to start communicating, that is, face your fear.

In the case of social phobia, a person can work through his traumas with a psychologist as much as he wants, do exercises and read motivating literature, but without real communication practice nothing will happen.

Previously, fears and conditions can be alleviated by performing special preparation. Communication will become much easier. Cognitive behavioral therapy helps with this. And then, just gain experience.

Detailed instructions for conducting independent cognitive behavioral therapy in the video.

List of sources

Barlow D. Clinical Guide to Mental Disorders / 3rd ed. - St. Petersburg: Peter, 2008. - 912 p.
Wittchen G.-U. Encyclopedia of mental health / Trans. with him. AND I. Sapozhnikova, E.L. Gushansky. - Moscow: Aletheia, 2006. - 552 p. — (Humanistic psychiatry).
Zalevsky, G.V. Fixed forms of behavior of individual and group systems (in culture, education, science, norm and pathology) / GV. Zalewski. - M.; Tomsk, 2004.
Sagalakova O.A., Truevtsev D.V. Social fears and social phobias. - Tomsk: Publishing house Tom. University, 2007. - 210 p.

Possible prerequisites

When thinking about how to overcome and cure social phobia on your own, it is important to take into account one more nuance - the prerequisites for its development.

Factors influencing the development of social phobia:

authoritarianism and cruelty of parents;
inflated demands and expectations towards the child;
bullying;
comparing the child with other children in a negative way;
ridicule by parents, teachers, peers;
psychotrauma received in childhood or adulthood (a failed public performance, a painful breakup, etc.).

Important! Social phobia hides the fear of being rejected and the fear of not being liked or pleasing others. Social phobia is haunted by the question “What will people think/say?”

Consequences and complications

In the absence of proper therapy, there is a risk of other mental disorders, in particular depression and anxiety, joining social phobia. Such patients are at risk of developing suicidal tendencies.

People with this disorder may use alcohol and drugs to cope with communication barriers. Consequently, there is a high risk of developing addiction and associated physical illnesses.

Often such patients create special rituals to overcome attacks of fear. Accordingly, in difficult situations they can constantly repeat these rituals, which ultimately leads to the development of obsessive-compulsive disorder.

Diet

Diet for the nervous system

Efficacy: therapeutic effect after 2 months
Timing: constantly
Cost of food: 1700-1800 rubles per week

Nutrition should be rational, nutritious, and contain foods and dishes that are beneficial to the nervous system.

There is scientific evidence that consuming fermented foods that contain probiotics . They have a positive effect on intestinal microflora , which, in turn, affects the body’s perception of stressful situations. It is recommended to include in the diet:

yoghurts, fermented milk products;
soy milk;
sauerkraut;
seaweed;
black chocolate.

It is important to completely avoid alcoholic beverages.

Prevention

As primary methods of prevention, it is recommended to follow the following rules:

Try to avoid serious stressful situations and increase stress resistance.
Develop communication skills.
Raising children correctly: avoiding excessive care and harsh criticism.
Lead a healthy and active lifestyle.

As for how to prevent a relapse of this condition, it is important for a person to follow all the doctor’s advice, attend psychotherapy sessions, and not drink alcohol or drugs.