Social Phobia:
The Largest Anxiety Disorder
Social Phobia (social anxiety disorder) is defined as the fear (anxiety) of being judged, criticized, and evaluated by other people. This fear is recognized as irrational by the individual; nevertheless, the fear of judgment in social situations persists.
People who have social phobia usually find it difficult to be introduced to other people ("I wonder what they're thinking about me; I'll bet they don't like me"), attracting attention to the self or being the center of attention, being watched while doing something ("They don't like what I'm doing; I must be making a fool of myself"), and feeling insecure and self-conscious in most public settings.
Life is difficult for the person with social phobia because they feel they do not fit in with every one else. Something is wrong with them. Therefore, it is easier to stay away and avoid all contact with people in social situations, whenever possible.
Dr. Richard G. Heimberg of Temple University, one of the leading researchers of social phobia, notes that people with social phobia experience many negative life problems as a result of their social anxiety:
1. they are less likely to marry than others
2. they have additional occupational difficulties
3. they may not be able to function academically and finish school
4. they report a higher incidence rate for substance abuse, and
5. depression and suicidal ideation seem to be higher than average.
Dr. Thomas A. Richards, a leading clinician in the treatment of social anxiety, specializes in this disorder, and has put these problems in context in the article, "What is Social Anxiety?" The article is filled with short case studies of people who have social phobia and it makes the statistics available come alive. The article also includes treatment options and a way to overcome social phobia and its effects.
Dr. Heimberg's reserach has found that an active form of psychological therapy, called cognitive-behavioral therapy, is most effective in helping people get over social phobia. In repeated trials, sponsored by the National Institutes of Mental Health, cognitive-behavioral therapy has proven the most effective treatment for social phobia.
The biggest problem today is that not many places exist where cognitive-behavioral therapy, including a behavioral therapy group, is being used to treat people with social phobia.
One of these places is in Phoenix, Arizona, where Dr. Richards has a practice catering to people with social phobia. He founded the Anxiety Clinic in 1994, which became the Social Anxiety Institute in 1999, and says, "Our entire program is now directed toward helping people with social anxiety overcome it." Dr. Richards runs groups for social phobia on Saturdays (all day long) and people travel from all over the world to his "comprehensive cognitive-behavioral therapy" sessions.
In a cognitive-behavioral group, participants work on their anxieties in a hierarchical, step-by-step fashion, working toward a goal they would like to reach in the future. "In our groups," says Dr. Richards, "we start slowly and gradually and move up our anxiety hierarchies. We do as much as possible in the group and spend as much time as we can so that the treatment is as comprehensive as possible.
Dr. Richards notes there are cognitive (thinking and belief) changes that must accompany the behavioral therapy to be fully effective. "I believe that cognitive therapy is much more important than behavioral therapy, although both are necessary," Dr. Richards responds. "To effect permanent changes in the brain's thinking patterns, cognitive changes must occur."
Hopefully, the treatment picture for social phobia will improve. We know from experience that there are few treatment centers in the United States that are effectively treating social phobia and producing results as shown by changed lives.
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