George Hartwell M.Sc. Agape Christian Counselling, Toronto, Ontario, Canada
I feel anxous around people.
Social phobia is a disorder characterized by overwhelming anxiety and excessive self-consciousness in social situations. People with social phobia have a persistent, intense, and chronic fear of being scrutinized by others and of being embarrassed or humiliated by their own actions. Although it is common for many people to experience some anxiety before or during a public appearance, anxiety levels in people with social phobia can become so high that they begin to avoid social situations. While many people with social phobia recognize that the fear may be excessive or unreasonable, they are unable to overcome it. In addition, they often worry for days or weeks in advance of a dreaded situation.
The British Medical Journal (BMJ 2002;324:886-891) exposed examples of pharmaceitical companines sponsoring and promoting awarness of diseases such as social phobia in order to sell drugs. More than promotion.,the article suggests that the boundaries of treatable illness are expanded in order to expand markets and sell treatments.
One example they give is: "When Roche was promoting its antidepressant Aurorix (moclobemide) as a valuable treatment for social phobia in 1997, its public relations company issued a press release, picked up by some of the media, announcing that more than one million Australians had an underdiagnosed psychiatric disorder called social phobia.11 The release described a "soul destroying condition" and quoted a clinical psychologist strongly endorsing the role of antidepressants in its treatment. At that time, government figures suggested the number of people with the disorder might be closer to 370 000."
A senior Roche official recently conceded that company promotion exaggerated the prevalence of social phobia in Australia. "A lot of disease estimates are blown out of all proportion . . . The marketing people always beat these things up" said local managing director Mr Fred Nadjarian.
1.Beck, Aaron & Emery. Anxiety Disorders and Phobias, 1985. Outlines a treatment program based on cognitive therapy. Tends to be for the clinician.
2.Benson, Herbert. The Relaxation Response, 1975. Presents a specific strategy for reducing stress - learning how to relax.
3.Benson, Herbert. Beyond the Relaxation Response, 1984. Describes a strategy of harnessing faith in a healing power inside or outside oneself.
4.Bourne, Edmund. Beyond Anxiety and Phobia, 2001. A self-help book focusing on life style changes needed to help combat anxiety and panic attacks. Library.
5.Carrington, Patricia. The power of letting Go. Helpful self-help book with a new approach to overcoming anxiety involving releasing of control. Recommended.
6.Clarkson, Michael. Intelligent Fear, 2002. A clearly written study on fear and on training and harnessing one's fears to enhance performance. Highly recommended to expand on the concept of high performance fear or 'smart fear.'
7.Donovan, Denis, and D. McIntyre. What did I Just Say!?! Insights into children's thinking and adult language and how to communicate with your child. Includes some examples how adult talk created childhood fears. Recommended.
8.Gallwey, Timothy. The Inner Game of Work, 2000. The Inner Game of Tennis. The Inner Game of Golf. An innovative understanding of how we need to get our mind out of the way in order to maximize work, music and sports performance. His work help's one to understand how to structure work and play, management and coaching so that one is able to access full potential. Recommended.
9.Hartwell, George. Listen to God, 2002. An outline of some of the methods used in Listening Prayer Therapy to deal with different topics. Listening Prayer Therapy is a treatment method harnessing the power of prayer to penetrate root memories and bring healing to the negative beliefs resident in these memories.
Hartwell, George. Overcoming Fear (416) 234-1850, www.HealMyLife.com
10.Maltz, Maxwell. Five Minutes to Happiness, 1962. Thoughts to Live By, 1975. Self-help in relaxing, positive thinking and establishing a new self-image.
11.Peurifoy, Reneau. Anxiety, Phobias, and Panic, 1995. A well-rounded self-help book covering good variety of topics. In Toronto Public library system.
12.Siegel, Robert. Six Seconds to True Calm, 1995. A self-help book based on a training program for relaxation and relief of stress with innovative components.
13.Seligman, Martin. Learned Optimism, 1990. An excellent self-help book focused on positive thinking based on psychological research. Encourages one to develop a more optimistic life style.
14.Watson, David and R. Tharp. Self-Directed Behavior: Self-Modification for personal Adjustment, 1972. Includes instructions for self managed desensitization.
15.Wilson, Reid. Don't Panic: Taking control of Anxiety Attacks, 1986. This book is highly rated by clinicians and is considered an easy to read self-help book. The book provides specific instructions on relaxation techniques similar to those referred to in "Overcoming Fear."
Here are some positive Affirmations for People Dealing with Social Anxiety
It doesn't matter what other people think about me.
I don't need anyone else's approval of anything I say or do.
There will almost always be people out there who don't like me.
This is totally normal.
I don't need to be everyone's friend, or try to please other people so they will like me.
I just need to be myself -- and if people don't like me for it, tough luck!
It's O.K. I don't care. They really aren't worth knowing anyway.
I no longer want to feel ashamed about how I have reacted to situations in the past.
I've had some very painful experiences in my life, some as a result of social phobia and some not.
The memories of these experiences no longer have the power to hurt me as they once did.
I can benefit from these experiences, because now I can look back at them like old photographs.
I will use them to learn and grow. I have become a better and stronger person because of these experiences.
Even though I'm going through therapy right now, I need to realize that there will still be times when I'm going to feel anxious.
Just because I'm feeling anxious doesn't mean I've messed up or failed in any way.
I need to have patience with myself and continue to practice what I'm learning in therapy.
Many wonderful changes have already occurred in me.
I'm getting better and stronger everyday.
Social phobia can be limited to only one type of situation (such as a fear of speaking in formal or informal situations, or eating, drinking, or writing in front of others) or, in its most severe form, may be so broad that a person experiences phobic symptoms in any social setting. Social phobia can be very debilitating - people with this illness often avoid forming or maintaining close relationships or they turn down chances to advance their careers. Some even become housebound.
Physical symptoms often accompany the intense anxiety of social phobia. People with social phobia experience symptoms that include blushing, profuse sweating, trembling, and other symptoms of anxiety, including difficulty talking and nausea or other stomach discomfort. These visible symptoms heighten their fear of disapproval in social settings and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: as people with social phobia worry about experiencing the symptoms, the greater their chances of developing the symptoms.
Social phobia often runs in families and may be accompanied by depression or alcoholism.
oAt least 7.2 million Americans experience clinically significant phobias in a given year, many having social phobia.
oSocial phobia occurs in women twice as often as in men, although a higher portion of men seek help for this particular disorder.
oThe disorder typically begins in childhood or early adolescence and rarely develops after age 25.
o researchers are investigating the environment's influence on the development of social phobia. People with social phobia may acquire their fear from observing the behavior and consequences of others, a process called observational learning or social modeling.
oAnimal studies are adding to the evidence that suggests social phobia can be inherited. In fact, researchers supported by the National Institute of Mental Health (NIMH) recently identified the site of a gene in mice that affects learned fearfulness.
oSome investigations implicate a small structure in the brain called the amygdala in the symptoms of social phobia. The amygdala is believed to be a central site in the brain that controls fear responses.
oOne line of research is investigating a biochemical basis for the disorder. Scientists are exploring the idea that heightened sensitivity to disapproval may be physiologically or hormonally based.
Cognitive-behavior therapy is also very useful in treating social phobia. The central component of this treatment is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. The exposure process often involves three stages. The first involves introducing people to the feared situation. The second level is to increase the risk for disapproval in that situation so people build confidence that they can handle rejection or criticism. The third and final stage involves teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.
Cognitive-behavior therapy for social phobia also includes anxiety management training - for example, teaching people techniques such as deep breathing to control their levels of anxiety. Another important aspect of treatment is called cognitive restructuring, which involves helping individuals identify their misjudgments and develop more realistic expectations of the likelihood of danger in social situations.
Supportive therapy such as group therapy or couples or family therapy to educate significant others about the disorder is also helpful. Sometimes people with social phobia also benefit from social skills training.
Medications include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and high-potency benzodiazepenes. Some people with a form of social phobia called performance phobia have been helped by beta-blockers more commonly used to control high blood pressure. Remember that natural herbal and nutritional remedies have been shown to be just as effective as the more dangerous and toxic drug and hormonal interventions. For example, Prozac can trigger violent or suicidal behaviour in some people - See "Talking Back to Prozac" - (Topics include: Cases of sexual dysfunction from Prozac. The truth about serious and life-threatening reactions. If Prozac can lead to violence, murder, or suicide. The panic and anxiety Prozac can cause--not cure. What Prozac has in common with cocaine and amphetamines. ) The body will naturally adjust to drugs that manipulate serotonin levels (homeotatic adjustments toward balance) by reducing the production of serotonin which leaves one vulnerable to depression and anxiety when discontinuing the drug. Of course this helps the continuing sale of pharmaceuticals because you, in effect, have become addicted to the SSRI. So buy stock in the pharmaceutical company so you can benefit from your drug addiction. Herbal remedies are reviewed at www.tnp.com and when used faithfully, correctly and with persistence can be as effective without toxic reactions.
What Other Illnesses Co-Occur with Social Phobia?
Social phobia can cause lowered self-esteem, depression, and in extreme situations, suicide attempts. To try to reduce their anxiety and alleviate depression, people with social phobia may use alcohol or other drugs, which can lead to addiction.
Many people with social phobia may also develop other anxiety disorders. In particular, people with social phobia may become so anxious that they experience panic attacks (intense bursts of terror accompanied by physical symptoms) when in dreaded social situations. As more situational panic attacks occur, people with social phobia may take extreme measures to avoid situations in which they fear another panic attack may occur or in which help may not be immediately available. This avoidance, similar to that in many panic disorder patients, may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety.