Social Phobia

Resolving Social Phobia

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A phobia is avoidance of a situation or object which is the result of persistently growing anxiety. The affected person will go to great lengths to avoid the source of anxiety.

Phobias are divided into specific phobias, social phobia, and agoraphobia. Social phobia is driven by fear of judgement. Agoraphobia is when anxiety about a situation occurs because it is felt that escape would not be possible. The sufferer avoids situations or environments where they perceive they have little control. Often agoraphobia manifests as fear of leaving one’s home. Social Anxiety sufferers often fear they have little control in interactive situations. This social anxiety evolves into social phobia when interactive avoidance is present. The social avoidance or social phobia often is a precursor to agoraphobia.

Panic attacks are a common symptom which drives social phobia. Fear of a panic or anxiety attack often leans to avoidance. Anxiety is fear. When fear creates avoidance a phobia is present.

Examples of social phobia include public speaking in formal situations, speaking in public in social situations, which includes variations of selective mutism, dating, socializing in general, relationship development, sports, performing arts, school, and any venue where performance is at risk of being judged. Often the fear of being noticeably nervous drives social phobia. Common symptoms that drive the fear of being noticeably nervous include blushing, sweating-hyper-hidrosis, voice stammering, verbal freeze, muscle tics, and avoidance of eye contact.

In order to resolve a social phobia it is crucial to understand that the phobia has a substantially ingrained architecture. It’s one thing to have anxiety which occurs in varying degrees. It’s a completely different phenomenon when anxiety evolves into a phobia.

By far and away the biggest confusion that sufferers bring into treatment is a lack of understanding how ingrained the problem has become when a phobia is present. Adding to the confusion is the trivialization of social phobia by many of the behavioral therapies. This is because focusing only on cognition and behavior without integrating emotional and physiological dynamics will, in most cases, prove to be ineffective. In order to facilitate productive treatment the following domains must be considered. Think of F.A.T.E. (See Figure 1)

In addition, while there are numerous manifestations of social phobia there are two basic types of people who suffer. These are people with “initiative” and those without “initiative.” Initiative does not mean ability. It means the motivation to start up or motivation to get help. When an individual of any age does not have initiative, treatment begins with parents, given the avoidance-dependence dynamic.

It is also important to consider the over-use and over-dependence on technology as an avoidance enabler. I have worked with countless individuals of all ages who are socially phobic whose lives are based around video games, social media, and other internet pursuits. Obviously there is a positive and important side to technology. The dark side manifests when the technology is the most important endeavor at the expense of social skills and relationship development. Technology over-dependence can be considered a compulsion.

In my 38 years plus clinical experience treating literally thousands of individuals of all ages with social phobia I have seen everything from a total cure to the problem being permanent and everything in between.

Another important variable to integrate into treatment is the functioning level and emotional intelligence of the sufferer. For example the six figure earner who has a public speaking phobia and the developmentally challenged individual with pervasive social phobia both have a social phobia. While the dynamic of anxiety and avoidance are common to both, treatment protocols vary significantly.

There is a tendency with common existing therapies to fit social anxiety disorder into the narrow confines of one specific approach. The Berent Treatment Method for Social Anxiety is based on adapting treatment to the specific needs of social anxiety. The treatment architecture includes transactional analysis-based mind state training, core work based on the Sarno method, and the paradoxical technique of adrenaline control. Very importantly, the method is customized for the individual with and without initiative.