What is social phobia? - Social phobia

Anxiety: A Very Short Introduction - Daniel Freeman, Jason Freeman 2012

What is social phobia?
Social phobia

It’s like a camera zooming in on a horrible, red, panicky face … I look really put-on-the-spot and nervous.

Picture of me looking guilty, nervous, anxious, embarrassed. It’s my face — features distorted, intensified, big nose, weak chin, big ears, red face. Slightly awkward body posture, introverted body posture, turning in on myself. Accent more pronounced. I sound stupid, not articulate or communicating well.

See the room — big room — tables all the way round in a square, people sitting behind the tables. I am sitting at a table. Everyone else is looking at me, really staring. I look petrified — can see it in my eyes, shaking, I am talking but can’t hear myself. I am leaning forward, hands in front, fiddling with my ring. The people are closer to me than they would really be.

The first of these vivid descriptions comes from a woman who fears blushing in public. Next are the words of a man who dreads being thought stupid, inarticulate, and boring. The final comment is from a woman who worries about shaking and appearing nervous in social situations.

All three individuals suffer from social phobia. They believe that they are not up to the task of social interaction; that they will fall short of the standards they and everyone else expects; and that they will pay a high price for their incompetence, being dismissed as foolish, inadequate, or unintelligent. In a stressful social situation, their thoughts automatically turn inwards. Rather than concentrating on the world around them, they focus on their own failings. Yet the images that spring up in their mind have little connection with reality; in fact, they are often wildly distorted and brutally unkind.

What is social phobia?

Social phobia — sometimes called social anxiety disorder — takes many forms. Some people find all social situations distressing. For others, the fear only kicks in when they have to perform a particular activity in front of others. Most often, that activity is public speaking, but social phobia can concern everything from dating to eating to using a public toilet.

These are the criteria for social phobia listed in the Diagnostic and Statistical Manual of Mental Disorders:

• Having a marked fear of a social situation in which the person is exposed to unfamiliar people or in which other people might judge them. The person is afraid that they will show their anxiety or do something humiliating or embarrassing.

• Almost always getting anxious in particular situations.

• Recognizing that their fears are unreasonable or exaggerated.

• Avoiding the feared situations or enduring them with distress.

• Finding it difficult to function normally because of the anxiety.

Social phobia can seem rather like shyness. The two share many features: for example, anxious thoughts about social situations; the desire to avoid those situations; and, if forced to endure them, a tendency to tremble or sweat or blush. Is social phobia simply an extreme form of shyness? Research indicates that, to some degree, this is true. When scientists compare the experiences of many highly shy and socially phobic people, they are sufficiently similar to suggest that shyness and social phobia occupy different positions on the same spectrum. On the other hand, some shy people report no fear of social situations such as parties, conversations, meetings, formal speaking, or eating in public. This implies that their form of shyness isn’t simply a milder version of social phobia. So ’shyness’, it seems, is a fairly broad category.

Social phobia is found worldwide, but the precise forms can vary from culture to culture. Common in Japan, for example, is the disorder taijin kyofusho (TKS), which translates literally as a fear of interpersonal relations. TKS and Western social phobia are alike in many respects: for example, the belief that other people will think badly of us, the feeling that we are not up to the task of social interaction, and the desire to avoid certain social situations. But there is a major difference. Rather than fearing that they will embarrass themselves, the individual with TKS primarily dreads embarrassing or offending other people. As a result, they may worry about their appearance (their facial expression, perhaps, or a supposed deformity), body odour, or an imagined tendency to stare inappropriately at others.