What is Social Anxiety?

Social anxiety (technically known as Social Phobia) is a fear of social encounters or situations. When faced with the prospect of a social situation, the individual experiences anxiety and will usually avoid the situation. Social situations may or may not cause panic attacks. Individuals with social anxiety are concerned that they will feel embarrassed or that others will judge their behavior or appearance negatively. While many people may be uncomfortable in social situations, individuals with social phobia experience excessive distress and the fear interferes with their normal everyday functioning.

Common fears include:

• Fear of social get-togethers, parties or events
• Fear of public speaking
• Fear of talking to strangers
• Fear of initiating conversations
• Fear of answering or talking on the phone
• Fear of eating, drinking or writing in public
• Fear of dating

How is Social Phobia treated?

The most effective treatment for social phobia is a form of cognitive-behavioral therapy called graduated exposure.

Graduated Exposure involves gradually exposing the patient to social situations that cause distress.  By repeatedly exposing oneself to social situations, the patient learns that their anxiety is irrational, their worst fears are not realized, and eventually the anxiety decreases.

Treatment for social phobia typically begins with education about the disorder and the treatment. Then the patient and the therapist build an anxiety hierarchy, in which social situations are identified and ranked from least to most anxiety provoking.  Cognitive therapy is used to challenge those beliefs that support the social phobia and help the patient prepare themselves for beginning the exposure.  With the therapist's support, and at a pace that is comfortable for the patient,  the patient is exposed to each situation on the anxiety hierarchy till that situation no longer provokes anxiety. Examples of sessions might be going into a store and asking for assistance, calling an acquaintance and making plans, or going to a happy-hour, all with the therapist's assistance. The therapist also assists the patient in confronting their fears of social situations using cognitive tools and skills that are appropriate to the situation. For example, the therapist might teach basic conversational skills or public speaking tips so that when the anxiety hits, the patient has a repertoire of tools to fall back on. Homework of self-monitoring to keep track of symptoms and at-home exposure is assigned to further facilitated symptom improvement.