Cognitive Behavioural Therapy

Sarah Webb - BABCP accredited

Crawley, Horsham and surrounding areas

07929 587036    

What is social phobia ?

Social phobia  (or social anxiety) is surprisingly common and it is fair to say that we all have a bit of it at times. Social phobia is the fear of being in social situations, usually the fear of being judged or publicly humiliated in some way. This fear can be extreme and often gets in the way of people leading their lives and interacting with other people.

What are the symptoms of social phobia ?

These are the same symptoms as for all anxiety (see my page on Anxiety). When we get anxious we can become aware of a range of physical and emotional symptoms including:

  • Feeling nervous, anxious or frightened
  • Heart beating faster (or heart flutters)
  • Shortness of breath
  • Sweating
  • Trembling
  • Muscles tense up
  • Dry mouth
  • Feeling sick
  • Butterflies in the stomach
  • Feeling dizzy or light-headed
  • Tingling sensations in the hands and feet
  • Blurring or changes to vision.

Understanding social phobia

Social phobia affects thinking

People who have social anxiety often believe that other people are judging them and often harshly. Someone with social anxiety will think that they are being scrutinised or watched closely by other people. This often goes hand-in-hand with self-critical thinking and a belief that they are not good enough. This thinking leads to feelings of anxiety and to some or all of the physical symptoms of anxiety outlined above.

Someone with social phobia will think that they look a certain way and may have a negative image of themselves. This will lead to further feelings of self-consciousness and of looking inward. At the same time not looking at other people and paying attention to what is being said might reinforce social awkwardness. This happens because the person is not aware of the social signals that might make their interactions easier and more flowing. They might then make negative assumptions about how they are coming across to others.

As with other types of anxiety, a fear of fear may creep in where the person predicts that they are going to be anxious in certain situations and that things are going to go badly.

Social phobia affects our behaviour

If you experience some symptoms of anxiety such as blushing, shaking or stammering then this will heighten your self-consciousness. Some people will begin to avoid certain situations, often leading to loss of a social life and isolation. Others start using safety behaviours to avoid being embarrassed. Typical safety behaviours are: avoiding eye contact, sitting in particular places to avoid others or to enable a quick escape, holding on to something, staying close to a familiar person or persons. These safety behaviours prevent the person from finding out that they can cope and feel fine.

How can CBT help with social phobia ?

Managing the physical symptoms of social phobia

It can be helpful to learn some specific exercises and techniques to help manage the physical symptoms of anxiety. During my sessions we would talk about thinking, feeling, physical changes and behaviour. We would look at finding a shared understanding of your social phobia and of what keeps it going. It is often helpful to talk about the beliefs that you hold about how you should be in social situations and whether you have higher standards for yourself than for other people.

Managing thinking

By drawing out a vicious cycle of your social phobia we will begin to see what effect your thinking has on maintaining your social anxiety. As already mentioned someone with social phobia will tend to hold a belief that they are not very good in social situations, they might hold an image of themselves as bumbling or embarrassing. This thinking is biased against yourself and is reinforced by only observing what fits in with this view of yourself. In therapy it will be possible to explore an unhelpful thinking styles, for example, mind-reading, for example, he/she thinks I am boring.

Managing Behaviour

Similarly to other sections on managing behaviour, this will involve identifying your habits and getting rid of your safety behaviours. Again this will be done once a shared understanding has been formulated. You need to understand why it is important to change your habits before you try to change them. It will be hard work and will almost certainly make you feel anxious at times. You will be changing habits that might have been with you for a considerable time, and which were designed to make you feel less anxious. We usually start with a hierarchy of feared situations and tackle something near the bottom of your list before working our way up. The process will allow you to learn new methods of coping and of hopefully gaining confidence.