What is the psychological treatment of social phobia?

We are all susceptible to feeling more or less shy in social situations. Especially those who are prone to shyness, they will live moments that can generate some trouble in which they have to relate to others, but there are more extreme cases.

Let's see what it is and what is the treatment of social phobia, which has to do with intense fear of social interactions.

The keys to understanding what is social phobia

Social phobia is linked to an intense and disproportionate anxiety reaction to social situations, which can cause anxiety attacks and lead to low self-esteem, low mood and avoidance of social situations. Over time this can lead to serious losses and limitations in daily life.

The person suffering from social phobia knows that the fear of it is disproportionate, but can't help but get carried away by fear even knowing it's irrational.

Like any phobia, the physiological reaction of anxiety is so strong that at first it is costly to face feared social situations without running away, even when thinking adjusts and trying to rationalize.

Symptoms

These are the main symptoms of social phobia, to take into account in your psychological treatment.

Physical symptoms

The physical symptoms of social phobia are basically the symptoms of the anxiety crisis, and they appear in the dreaded situation and even when thinking about it:

• Tachycardia.
• Hyperventilation
• Stuttering or difficulty speaking
• Cold sweats and usually on the hands.
• Tremors.
• Blush.
• Muscle tension, nausea, etc.

Cognitive symptoms

Thoughts related to the fear of being disqualified, not being liked or feeling humiliated predominate, denoting low self-esteem:

• Personalization distortions: believing that everything other people think is negative and is about you.
• Divination Thought Distortion, type: "I'm sure if I go to the party they will reject me," "I'm sure I'm going to turn red," "I'm sure I'm going to stutter and they'll laugh at me."
• Thought-reading thought distortion: “they don't want me to go”, “they're thinking I'm boring”, “they sure think I'm going badly dressed”.
• Generalization distortion: “if I fail an exam it is because I do everything wrong”, “if I have few friends it means that I am a bad friend”.
• Catastrophic thoughts and extremely negative.

Behavioral symptoms

Faced with this intense fear of relating to others, the person with social phobia presents tendency to avoid social situations like asking for information, asking in public, participating in conversations, going to meetings, etc.

Avoidance will be greater the less control you feel over the situation. Thus, avoidance will be greater the more people there are in a social gathering.

The person with social phobia may have high anxiety in a group of two or three people, but it will be much more intense the larger the group, so it will always try to relate to a single person considering it more controllable and less risky.

• You may be interested: "What is fear for?"

What is the treatment of social phobia?

In therapy it is common to attend to people who suffer from social phobia. Nowadays, social networks and the virtual also make avoiding relationships easier, so they can live a long time without facing their fear.

Suffering is high and frustration, low self-esteem, sadness, and feelings of hopelessness are some of the emotional symptoms they suffer. For our team of psychologists these are the symptoms to be treated most urgently, in addition to the progressive exposure to social situations in the most controlled way possible, so that social relationships are considered spaces insurance.

Treatment from cognitive-behavioral psychology has proven to be very positive and efficientas well as third-generation acceptance and commitment therapies.

During therapy, special importance is given to how interaction with others is interpreted, learning to adjust thinking when it is very negative. It is very important to recognize the cognitive distortions that provoke emotions of shame or intense fear that lead to avoidance, in order to learn to think in a tight and realistic way.

Deepening the causes is also part of the therapy, so it is important to de-traumatize old situations that still weigh to unblock on an emotional level.

It is essential to reestablish self-esteem and confidence, reinforcing the patient's capacities while giving training in progressive exposure to social situations, without haste and from less to more level of coping. With all this, it is sought that the mood improves as achievements are achieved and self-perception improves.

Work on social skills is also essential; relativize the opinion of others and not give them so much power; lose the fear of conflict by learning to get angry and express opinions, rights or needs in an assertive way; be aware that we cannot meet all the expectations of others to be loved and learn not to take responsibility for everything for fear of being angry with us or judging us.

Causes

Social phobia usually has its origin in more or less traumatic situations, usually occurring in early stages, especially in adolescence, and in relation to social situations that are experienced as unpleasant or humiliating.

A bad experience in class speaking in public, feeling that others laugh every time you speak, having made a mistake in front of others, having felt judged or criticized... are some of the examples of possible triggers of social phobia.

To this is added a certain susceptibility due to fear of criticism, of being judged, fear of conflict, an excessive need for approval and a need to like me and a tendency to internal attributions or feel responsible for everything.

It can also influence having grown up in family environments where personal disqualification has been abused without promote good self-esteem or, on the contrary, have hardly developed social relationships due to an excess of protection.

Social phobia usually occurs at an early age (Kendler et al, 1992) and the appearance of other possible disorders is usually after the development of this alteration; This is why at Avance Psicólogos we are aware that early detection and treatment is essential.

Bibliographic references:

• Cervera Enguix, S., Roca Bennasar, M., Bobes García, J. (1999). Social phobia. Barcelona: Masson.
• DSM V. Diagnostic and Statistical Manual of Mental Disorders.
• Olivares Rodríguez. J., Alcázar, A.I.R. and García, L.J. (2004). Social phobia in adolescence: the fear of relating and acting before others. Madrid: Solar Eyes.