Social phobia: recursive mechanisms and therapy
A self-feeding cycle
By investing all the energy in trying not to make a bad impression, for those suffering from social phobia the risk of feeling inadequate increases to a considerable extent.
Also avoiding the dreaded situation tend to isolate the person, who avoid to carry out so many small or big things because of shame. Other typical solutions put in place to contain the problem are protective conducts: those who feel ashamed to show themselves clumsy and struggling usually try to hide it and to control the visible symproms of anxiety and embarrassment .
For example, avoiding looking at others in the eye, or assuming a particular posture, often touching their own face, covering his hands to not show that they’re sweating. Actually the effects produced by these solutions do nothing but fuel the problem itself, since concentrating on controlling the symptoms increases the physical manifestations of anxiety and embarrassment.
Paradoxically the protective attitude increases the chances of putting the person in a bad light. The others may think that the lack of eye contact is due to lack ofsinterest, and could push them to react by going away; the inhibited posture, hiding the hands, could underline the embarrassment and awkwardness, provoking mockery or rejection in others.
In other words, we are faced with a problem of ‘ metashame ‘, that is the shame of being ashamed. Considering threatening and unacceptable the emotion of shame, a person with social phobia will wrap himself in the attempt to conceal his blushing, tremor, increased sweating, with opposite effects of those hoped for.
Feeling ashamed represent a threat because it visually expose an inadequate and negative self-image. Being ashamed causes the negative judgment by the others. This is the belief that’s under this problem.
Is it shyness?
Be careful not to confuse shyness with social phobia. In this case it is not only about being shy and feeling some situations as embarrassing .
A problem with social phobia has deeper roots in the history of the person, and above all it limits in an important way everyday life.
The mental activity and the behaviour are all oriented in order to avoid looking like a fool, the situations are avoided or tolerated with intense discomfort and ultimately the quality of life is affected.
Often people seek help from a psychologist for a secondary problem of depression, that arise from avoiding situations and the individual has already reduced his autonomy importntly, and he has began to judge himself as fool and incompetent because of his primary problem.
Can social phobia be treated?
A social phobia problem can be addressed and resolved with a psychotherapeutic intervention. Cognitive and behavioural therapy is a proven strategy of efficacy in reducing phobic manifestations. With the right motivation toward change, together with the therapist, the person can gradually regain a sense of security and effectiveness now wavering.
The first phase of the treatment aim at the knowledge of the problem, how it manifests itself and in what situations, with what intensity and what are the solutions that the person has already tried to solve it.
The investigation of life history and the events of childhood will help the discovery of the origin of the deep convictions underlying the disorder. Sharing the functional model of the problem creates a climate of trust and therapeutic alliance necessary for clinical work to take place.
The person no longer perceive himself as inept, inadequate, or stupid, rather as a person living with a solvable problem.
Through exposures to the dreaded situations it is possible to achieve concrete results in a short period.
On behavioral level, it increases the ability to face the daily life and resume activities abandoned because of avoidance;
On cognitive and emotional level, the dysfunctional beliefs about the danger of shame and judgment from the others get weakend.
In parallel, the therapist will guide the intervention with the goal of accepting the risk of looking like a fool, a necessary condition to give up to all the failed attempts to avoid it.
If you have found answers to your questions about social phobia, or if you know a person who lives with this problem, please contact Dr. Piera Briganti for a cognitive interview.