What Maintains Social Phobia?by Jerry Kennard, Ph.D. Medical Reviewer
It isn't easy to overcome social phobia but like most things we can take the edge off the problem, and start the process of healing, by understanding what makes a social phobia tick. In my previous post - social anxiety and social phobia: what's the difference? - I pointed out that social phobia is really an extreme form of social anxiety. However, although each person will have their own experience of social phobia we also know about the issues that keep a social phobia going, and these seem universal.
The three essential ingredients we need to consider are (1) self-consciousness (2) ways of thinking and (3) ways of behaving that help us feel safe. These three elements will be embedded within situations we find troubling. So, for a situation to be troubling we first need a trigger, that is, something that gets the ball rolling and which will lead to the symptoms associated with social phobia. In my last post I introduced Jake, a 30 year-old social phobic who can't connect with attractive people of the opposite sex. Jake feels self-conscious, he stumbles over his words, he blushes and inevitably finds a quick reason to get away. Let's unpack the processes underpinning his phobia:
First there's the trigger. In Jake's case it will be something like finding himself in a situation where he's speaking to a woman he finds attractive. This activates the beliefs and assumptions he holds about such encounters. Maybe he thinks he's unattractive both physically and socially. Maybe he feels nothing he says will be of the slightest interest. In activating these beliefs Jake sees danger in the situation and perhaps fears he'll be shown up or laughed at. He becomes rapidly and increasingly self-conscious. His thoughts become muddled, he feels tense and shaky and he begins to blush. His safety behaviors kick in. He avoids eye contact, says as little as possible and looks for reason to get away. Jake is as uncomfortable as he can be. His heart is racing he's sweating, tense and fidgety. In short, he is experiencing the symptoms of social phobia.
Jake's experiences may not be shared by others in a similar situation. Jake's way of coping is to avoid eye contact and say as little as possible but another person may speed-talk, filling any potential space by babbling away about anything and everything.
Self-consciousness is a key factor in understanding how social phobia is maintained so I'll be looking at this in more detail in my next post.