OVERCOMING SOCIAL PHOBIA
CONTENTS:
Social phobia is the fear of scrutiny and negative evaluation by others. Everyone feels social anxiety sometimes. Social phobia is when your life is disrupted by social anxiety. The socially anxious person rates their social behaviour as more inadequate and their anxiety as more obvious than do independent observers.
Social anxiety sufferers may be excessively anxious when observed by others, having a conversation or speaking in public. Those suffering from social phobia assume that others are assessing them negatively. They are apprehensive that they will do something shameful or disgraceful in public.
The symptoms of social phobia have effects on:
Thinking (e.g. worrying about the opinions of others).
Behaviour (e.g. avoiding eye contact).
The body (e.g. visible signs of anxiety such as blushing).
Emotions (e.g. feeling inferior).
Social phobia leads to people avoiding problematic circumstances, distancing themselves from risk, being anxious about situations both before and after they occur. They may experience anger, depression, inferiority as well as anxiety.
See Program 1: Coping Strategies Counselling Advice – Troublesome Emotions.
Social phobia can be an obstruction to a person’s professional and private life. It may be limited to one aspect of your life or it may have more general effects. You do not need to know the precise cause, in order to alter social phobia.
2. The Important Function of Thinking in Social Phobia
Thinking has an important function in social phobia. Your thoughts affect your feelings which then impact on your behaviour – the foundation of cognitive behaviour therapy. There are many sorts of thinking/cognition, and thoughts are often hard to verbalize. There are three levels of cognition: automatic thoughts, conditional beliefs/assumptions, and core beliefs.
Imagery can trigger powerful feelings and plays a central role in social phobia. As social phobia alters, the meaning of social problems also alters to become less distressful.
Social phobia is not caused by other people although the things they do can set off the symptoms.
Some contributory factors are:
Biological factors – a more reactive arousal system and personality.
Environmental factors – relationships with parents and childhood carers; experiences of being (criticized, praised etc.); need for social learning opportunities; learning from the experience of problems.
Bad traumatic experiences.
Problems dealing with what is required of different life stages.
Stresses that affect relationships with others.
4. Understanding Social Phobia
A model for social phobia is that a trigger situation activates beliefs and assumptions then the situation is seen as socially dangerous. This leads to cycles of safety behaviours, signs and symptoms of anxiety with self-consciousness and attention focused on self at the centre of the model. The socially anxious person tends to underestimate the quality of their performance and overestimate how anxious they appear in feared situations.
The patient sees negative evaluation as highly probable and the consequences as catastrophic. Anxiety symptoms ensue which feedback leading to disruption in social performance and actual negative evaluation by others; this then increases the patient’s anxiety symptoms and perpetuates the cycle of anxiety.
Self-consciousness means that people with social phobia tend to form a biased view of themselves as seen by others. Safety behaviours hinder a person from learning that social situations are not to be feared. Patterns of thinking reflected in a person’s beliefs and assumptions decide the manner in which social events are seen and explained. The different cyclical processes maintain social phobia. Breaking these cycles can lead to an increase in self-confidence.
Procure a notebook or folder and find a place to keep your social phobia work. Make a note of your symptoms of social phobia. Write down at least one from each affected area – your thinking; your emotions; your behaviour; your body.
Define your aims: How does social phobia affect you? What are the symptoms that trouble you? How do you want things to be different? Consider how you will find time for your social phobia work. Set yourself regular tasks and proceed at your own pace.
Keep in mind that beneficial strategies are with no long-term disadvantages. To get a new perspective on the problem involve yourself in more things you enjoy that are stress free.
See Program 1: Coping Strategies Counselling Advice – Planning an Activity Schedule.
It is healthy to spend time alone so make a list of solitary activities and if you feel you have too much time on your own, try to make some of these activities interesting and enjoyable.
Learn to identify the vicious cycles that maintain the problem so that you can break them. You need to persevere and not let the problem control your life. Start with easy things first and build up to difficult ones.
If you want to you should work at becoming socially skilled. You will acquire social skills as you progress but you do not need to be socially skilled to be successful. When you are more at ease you may find that social skills come naturally. Being adaptable will enable you to do things from natural impulse rather than learning set rules.
You can learn about social conventions by asking, using information given, watching, listening and looking out for how other people do things in particular situations.
See Program 1: Coping Strategies Counselling Advice – Communication Training, Negotiation Training, Social Skills Training and Program 13: Overcoming Destructive Relationships.
A severe bout of anxiety will not do physical harm. The signs of anxiety and panic alone, no matter how strong, do not mean that a serious mental illness is developing. Anxiety will leave you feeling tired and if you are also depressed see your doctor about it.
See Program 1: Coping Strategies Counselling Advice – Forgiveness, Program 6: Overcoming Anger, Program 8: Overcoming Anxiety and Program 12: Overcoming Depression.
You should avoid taking a break to rest if it is a way of not facing your problem. If you do not learn how to overcome the problem it might disappear by itself but will take longer than if you do take action against it.
See Program 1: Coping Strategies Counselling Advice – Problem-Solving.
It may be that you were born with a higher sensitivity to stress but you can still learn to overcome social phobia.
See Program 22: Overcoming Stress and Program 23: Overcoming Stress At Work.
You cannot totally cure yourself of anxiety since it is normal to feel anxious sometimes but you can alter your thoughts and behaviour so that you cope better with social situations.
Take care of your health.
See Program 1: Coping Strategies Counselling Advice – Nutrition, Exercise, Managing Your Time and Sleep Management.
For further coping strategies:
See Program 1: Coping Strategies Counselling Advice – Competitiveness and Perfectionism, Frustration, Procrastination and Persistence.
6. Altering Patterns of Thinking
Thinking affects your feelings, and how you feel affects your behaviour. By altering your thoughts you will feel better. You need to recognize the different types of thoughts which include ideas, expectations and attitudes.
Try to become aware of the thoughts that enter your mind when you are anxious. Consider a recent situation in which you suffered from social phobia. What were your thoughts when the anxiety began? What thoughts followed these? What were your thoughts after the situation was concluded? What might have been the worst-case scenario at the time? What is it about the event that is important to you? Think about both what this incident means to you and about you. Identify any thoughts that made you feel worse and the thoughts that are important for you.
To help you identify your thoughts when anxious, record:
The specific situation.
Your emotions.
Note separately each of your different thoughts.
It is necessary that you recognize bias in your thinking so that you can rectify your thoughts. Types of biased thinking:
See Program 1: Coping Strategies Counselling Advice – Modifying Maladaptive Thinking.
Next, look for alternative ways of thinking. Write down the answers to the following questions about your upsetting thoughts - consider both supporting and contradictory evidence for the way you think:
What do the facts suggest is the best way of thinking? What are the alternatives? Consider how being more confident would affect your thinking and how someone else might see things. What would you say to someone who had the same thoughts? What advice might a friend give you? What is the worst-case scenario? What is the best-case scenario? Which is more realistic? Is your thinking biased? What helpful things can you do? What are your skills, strengths and experience of coping with similar difficulties? What support is available to you?
Record separately each of your upsetting thoughts and possible alternatives such as: ‘Perhaps I cannot tell people’s real thoughts’. A good alternative is moderate and balanced. When you have pressurizing and extremist thoughts such as: ‘must’ and ‘always’- look for more moderate and balanced ways of thinking.
Doubting yourself – the ‘Yes but’ syndrome makes searching for alternatives difficult; try using ‘Yes and’.
By adopting the approach you would use when aiding someone else you will find it easier to come up with alternatives.
Now record your change in feeling for each of the situations for which you have identified upsetting thoughts and possible alternatives, giving a score between -10 to +10 (with +10 being feeling much better and 0 as no change at all).
Write down an action plan of what you would like to do differently. You will achieve more if you practise your new ways of thinking so that you alter your behaviour as well as your thinking. Make flashcards to help you remember new patterns of thinking.
Altering your behaviour is the most effective way of improving your confidence. Consider what you would be able to do if you were not anxious and what it would mean if you could, so that as you change your behaviour you keep in mind the implications.
Carry out small experiments to discover what occurs when you alter your behaviour. Experiments that help you give up safety behaviours and face things rather than avoid them, break cycles maintaining social phobia.
A small experiment has four steps:
You need to become aware of your safety behaviours – what do you do to protect yourself?
Think about exactly what could go wrong – what do you predict would occur if you abandoned your safety behaviours?
Find out what happens if you alter your behaviour – create an experiment for yourself in which you find out what occurs if you enter a situation without the protection of your safety behaviours.
Evaluate what happens – what occurred when you altered your behaviour and what does this mean to you? Were your predictions correct? Try to remember that the worst is more likely to happen if you keep using safety behaviours than if you abandon them.
Record each specific situation in which you use safety behaviours. Write down your prediction – what will happen if you abandon the safety behaviour? Note your experiment – how will you alter your behaviour? Write down what actually happened and your conclusions.
In experiments to face things rather than to avoid them:
Recognize what you avoid.
What do you predict would happen if you no longer avoided these things?
Find out what happens if you alter your behaviour – face your fear rather than avoid it.
Evaluate what happens – what occurred when you altered your behaviour and what does this mean to you? Were your predictions correct?
Record each specific situation in which you face your fears rather than avoid them. Write down your prediction – what will happen if you face your fear? Note your experiment – how will you alter your behaviour? Write down what actually happened and your conclusions.
It may take some time for progress to become noticeable. Acknowledge your achievements and do not be discouraged by setbacks as these are a normal part of progress. Changing behaviour involves taking risks but in time you will find you no longer react to these situations as if they were really frightening.
You need to expose yourself to a hierarchy of problem situations to overcome your fear.
See Program 1: Coping Strategies Counselling Advice – Controlled Breathing and Relaxation Techniques, Eye Movement Technique (EMT), Mood Induction Procedure, Rational Emotive Imagery (REI), Imago Graded Exposure and In Vivo Graded Exposure.
Self-consciousness arises when you concentrate your attention on your inner experience and what is happening to you. It is at the heart of all vicious cycles that maintain social phobia. It also exacerbates the problem. Concentrating your attention inward makes you notice the things inside yourself but deprives you of accurate information about what is going on.
To clarify how self-consciousness increases your vulnerability, consider for specific situations the evaluations you made of yourself after you felt self-conscious and what evaluations you think others would have made at the same time. In order to reduce self-consciousness you need to be aware of how it affects you and learn to focus your attention outside yourself.
First decide not to think about unpleasant experiences. Always keep in mind that the danger is more in your imagination than real. Use the thinking skills you learned in Altering Patterns of Thinking to find a new perspective for your thoughts about social danger and catastrophe. Ask yourself if there is anything to gain from dwelling on unpleasant experiences and write down the advantages of not thinking about these unpleasant experiences.
Next, fill your mind with something else – focus on what is happening around you. If your mind wanders repeat your original plan and turn your attention outward again. Think about things outside yourself and do things to help occupy your attention.
Carry out a two-way experiment:
Focus your attention inward for a while then note how you felt and what you noticed.
Focus your attention outward for a while then note how you felt and what you noticed.
Compare the two: How did they differ and in what ways were they the same?
Summarize your evaluations: Which way made you feel better? Which way provided you with more helpful social information? Was focusing externally hard to do? How did you do it? Could you do it again, in more demanding circumstances?
It will take courage to stop withdrawing into you and instead to concentrate on what is happening externally. As you work on your self-consciousness and start to focus on what is happening externally, your perceptions will change. Altering your thoughts will change your interpretation of what occurs and doing things differently will give you new memories.
9. Consolidating Your Confidence
Confidence is not inherited and whatever your experience, your self-confidence can increase. Confidence varies from moment to moment and even confident people can have doubts sometimes.
Build your confidence by behaving ‘As if’ you were confident. When you behave confidently you will feel better and your different behaviour will draw out different behaviours from others. Seek out success as this will consolidate your confidence. Try participating in altruistic activities which will enable you to forget yourself and your anxiety, and boost your confidence. Confidence comes from doing difficult things.
You may have underlying beliefs and assumptions which hinder your progress. They have formed from life experiences and can be altered. They supply the window through which you see the world.
There are three levels of thinking: automatic thoughts, conditional beliefs/assumptions, and core beliefs.
What you believe and assume affects your thoughts and what you notice. By learning to alter your beliefs and assumptions you will bring about the other changes you desire.
Identify your underlying beliefs. Think of a particular situation in which you recently felt socially anxious. How do you think you are at fault? How are you judging yourself? What did the extent of the difficulty mean to you? What is the importance of this about you? What are the ways other people are thinking and behaving? What does this reveal about them?
Write down a sentence about how you are and another about how are others. Next, change your beliefs by learning how to re-examine and make them less severe. It is necessary to separate facts from opinions.
How would you judge and advise someone else who had your belief? Are you treating yourself justly? Are you aiming for perfectionist standards? Are you concentrating on your weaknesses and failures while disregarding your strengths and successes? Is your thinking biased? Are your conclusions based on your early experiences? Are you judging yourself as others have in the past? If so, who knows best, you or other people?
Using the questions and format in Altering Patterns of Thinking, write down your belief, possible alternatives, and change in feeling and action plan. You need to search for new information since you tend to not notice information that does not fit with your beliefs.
Start by writing down your belief and rating the strength 0-100%. Think of a future event relevant to your belief that you are anxious about. Before this event, consider how it will be problematic for you and what you predict will happen based on this belief. Define what you should look out for so that your belief no longer filters your view of the event. After the event, note what actually occurred and what you can conclude from this. Have you noticed things you would not have otherwise noticed? Has it shown how your belief hinders your thinking? Has it shown any of your predictions to be wrong? Rate your belief again 0-100% in strength. Does your belief need to be made less severe? If so, how?
Your belief rating will change as you find more new information. Building more positive beliefs gives your confidence a firm foundation.
To change your assumptions you need to behave differently. Identify your assumption, usually expressed as ‘should’, ‘must’, ‘ought’, ‘have to’ and word it as an ‘If… then…’ statement. Identify the behaviour that fits with the assumption then behave differently to break the old rule. Evaluate what occurs and re-think your assumption. Make a flashcard with your belief or assumption on one side and a summary of new ways of thinking on the other.
Develop a positive body image.
See Program 1: Coping Strategies Counselling Advice – Criticism, Countering Self-Criticism, Coping with the Need for Approval and Improving Your Self-Image and Combating Self-Harm.
Build your confidence.
See Program 1: Coping Strategies Counselling Advice – Building Confidence I, Building Confidence II, Building Confidence III, Building Confidence IV, Assertiveness Training, Neuro-Linguistic Programming (NLP) and Program 16: Overcoming Low Self-Esteem.
Start with easy tasks then progress to more difficult things. Be realistic and repeat your successes. Give the strategies time to have an effect on your problem. You may find it useful to enlist the help of other people.
Assertiveness training and learning relaxation techniques may be options you wish to consider to include to the strategies given to enable you to overcome your social phobia and move forward.
See Program 1: Coping Strategies Counselling Advice – Relapse Prevention.
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