What is social phobia and how does it manifest itself?
Social phobia or Social Anxiety Disorder is an anxiety disorder, in which the characteristic fear consists in believing to be observed and judged negatively in social situations or during the performance of an activity in public.
The person affected by the disorder generally has this fear when talking to others, when doing or saying something while others are watching him or even simply if there is a chance to attract the attention of others; for example, he is afraid to be misjudged by others if they should notice that he is anxious (he blushes, sweats, trembles). Or he fears to say or do something wrong or embarrassing, to look clumsy, or to have a panic attack (e.g. he often has thoughts like "....now I'll look clumsy, clumsy...I'll start shaking and sweating...the others will notice and laugh at me!"). Still others may feel anxious to think that others may find it unpleasant and/or criticize their own appearance.
Generally the most commonly feared situations are: speaking in public, going to a party, writing or signing in front of someone, queuing, using the phone in public, using public transport. Some people are afraid, for example, of having embarrassing physiological reactions (e.g. losing control of the bladder, vomiting, belching, etc.). And again, some are more afraid of situations in which they are asked to perform, others, instead, of opportunities for social interaction: typical examples of this last case are situations in which the person affected by the disorder fears to have nothing to say or to say something wrong, to be boring or, however, inadequate.
It is also typical the so-called "anticipatory anxiety": anxiety in itself has an evolutionary "anticipatory" function, in the sense that it is an emotional signal that warns us, in terms of forecasting hypothesis, that one of our aims could be compromised; in fact, before facing a feared event (e.g. a student who has to take an exam) a person may feel anxiety because in advance he repeatedly imagines the occurrence of that event, perhaps with images of himself in which he will make a bad impression, he will be awkward, he will seem stupid. Images of what you fear may appear for days before you have to face the feared event, thus increasing the level of anxiety. On some occasions, the anxiety can become so intense as to really hinder the subject in the performance of his tasks. During a meeting, for example, he may be so anxious that he is really unclear about the concepts. Those who suffer from social phobia, therefore, when they have a high level of anxiety, may actually have poor performance. The realization of what is most feared usually causes further embarrassment, shame or humiliation. In this way, a vicious circle can be established which feeds the disorder itself, as it maintains over time the fear of negative judgment and anticipatory anxiety.
Another condition that is usually associated with "avoidance" behaviour is represented by so-called "protective" behaviour. These are the "safety measures" that the person takes to avoid anxiety or misjudgement by others. For example, if the person is at a work meeting and feels ashamed because if they remove the jacket they will notice that they are sweating, in which case they will keep the jacket on and such protective behaviour, paradoxically, will only increase sweating and thus, consequently, embarrassment, creating a vicious circle. Therefore, the most problematic emotions present in social phobia are anxiety, embarrassment, shame and sense of humiliation; when the person is in this particular state of mind it is even more likely that he has images of disapproval, derision, rejection or pain of others feeling, sometimes, a real terror.
Symptoms of social phobia:
-Marked fear or anxiety about one or more social situations in which the individual is exposed to the possible judgment of others
-The individual fears to show symptoms of anxiety and that will be assessed negatively (humiliation, embarrassment)
-Social situations are avoided or endured with intense fear or anxiety
-Fear or anxiety is disproportionate to the real threat posed by the social situation and the socio-cultural context
-Fear, anxiety or avoidance cause clinically significant discomfort or impairment in the social, work or other important areas of functioning
This disorder is quite common: scientific studies indicate that in Europe, for example, it affects on average 2.3% of the general population. Since people suffering from social phobia hardly ask for help from specialists because they underestimate their problem or are ashamed of it, it is likely that this disorder is even more widespread than what is indicated by research.
Social phobia generally appears more or less abruptly in adolescence, around the age of 15, after a childhood characterised by inhibition and shyness. Afterwards, it tends to maintain itself over time, with variations in severity linked to life events.