CBT Therapy for Social Phobia or Social Anxiety


social phobia

Social Anxiety, Social PhobiaRelationship

Social Anxiety or Social Phobia has a the core the fear of being judged and evaluated negatively by other people. Free yourself from feelings of inadequacy, embarrassment, humiliation, and depression with Cognitive Behavioural Therapy, either face-to-face or online via Skype.

What is Social Anxiety?

Social anxiety is the fear of social situations and the interaction with other people that can automatically bring on feelings of self-consciousness, judgement, evaluation, and inferiority.

Put another way, social anxiety is the fear and anxiety of being judged and evaluated negatively by other people, leading to feelings of inadequacy, embarrassment, humiliation, and depression.

The anxiety becomes worse when the person fears that they are going to be singled out, ridiculed, criticised, embarrassed, or belittled. On occasion, the anxiety is so high that panic attacks may develop in response to some specific social event (e.g. giving a speech).

People with social anxiety realise that their fear is exaggerated, but they still cannot control it. They tend to avoid situations in which they need to perform in front of others, and this tends to interfere with life adjustment in some way. As you would expect, people with social anxiety disorder have an elevated rate of relationship difficulties and substance abuse. They also feel their self-worth is low, feel inadequate and have difficulty being assertive.

As many as 11% of the population may experience social anxiety to some degree, although not all seek treatment. Many people are fearful of public speaking, but manage to avoid it and cope well within a slightly more limited life sphere. Some individuals have more severe social anxiety, and are even fearful of talking to people in any capacity. These people have more serious adjustment problems, and are more likely to seek treatment. Social anxiety tends to develop during teen years, but often surfaces in children described as excessively shy.

Symptoms of Social Anxiety

Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, palpitations, intense fear, dry mouth, panic attacks and trembling. Other symptoms of anxiety include difficulty speaking, nausea and other stomach discomfort. These visible symptoms heighten the fear of disapproval and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle because as people with social phobia or social anxiety worry about experiencing the symptoms, their chance of developing the symptoms increases.

People with social anxiety disorder usually experience significant emotional distress in the following situations:

* Being introduced to other people
* Being teased or criticised
* Being the centre of attention
* Being watched while doing something e.g. eating, performing a task
* Meeting people in authority ("important people")
* Most social encounters, especially with strangers but it could be in the presence of relatives and family too.
* Going around the room (or table) in a circle and having to say something
* Fear of using public bathrooms or writing in public
* Interpersonal relationships, whether friendships or romantic

This is certainly not a complete list of symptoms and other feelings have been associated with social anxiety or social phobia as well.

Treatment of Social Anxiety with Cognitive Behavioural Therapy

In repeated trials, sponsored by the National Institutes of Mental Health, Cognitive Behavioural Therapy has been confirmed as the most effective treatment for social anxiety.

Cognitive Behavioural Therapy helps people deal with anxious situations. It involves understanding the problem and developing coping strategies such as changing thinking patterns in social situations and learning to focus attention on effective social behaviours.

CBT usually begins with a study of the disorder, examining the situations that provoke the anxiety and the accompanying somatic symptoms. This educational process sets the understanding for training in skills to alleviate and eventually conquer social anxiety. These skills include assertiveness training, relaxation techniques, diaphragmatic breathing, the cognitive restructuring of distorted and negative thinking that contributes to social anxiety, and behavioural experiments to test the catastrophic predictions a person makes about a possible social situation.

Recent research indicates that approximately 70% of people who complete a short term treatment program (10 to 15 sessions) are judged to be much or very much improved. The amount of improvement appears to be related to the amount of time and energy the person devotes to developing new coping strategies. If avoidance is extreme and generalised to many and varied situations, you may require more sessions.

John Dunlop specialises in the treatment of social anxiety, using techniques appropriate to the presenting symptoms. This depends what triggers the anxiety, whether the individual has panic attacks and the severity of the symptoms. Most often a combination of behavioural interventions is used with cognitive therapy. The behavioural treatment may include relaxation training, cognitive restructuring, surveys, assertiveness training, imaginal exposure and behavioural experiments (e.g. through video feedback ...).

Cognitive therapy helps you to develop cognitive blocking mechanisms when the anxiety begins to build, and also helps you understand why the social anxiety symptoms occur. This allows you to develop different ways of coping by changing the way you perceive the social situations triggering your anxiety.

If you think you are suffering from Social anxiety or Social phobia, do not delay the decision to address this limiting problem, make an appointment and start online therapy now.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994.
Hidalgo, R.B., Barnett, S.D., and Davidson, J.R.T. Social Anxiety Disorder in Review: Two Decades of Progress. Int J of Neuropsychopharm 2001, 4, 279-298.

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