Social Anxiety Disorder

Social fears are similar to other fears in that they too cause automatic Robot Responses to specific situations, people, events. If the possibility exists that the dreaded situation may arise, you try to avoid it. If you can’t escape from it, you become tense and even more fearful. However, social fears are also different from other fears. It is these differences that make your fears hard to recognize and that allow them to have such a clutch on your life.

Social fears produce a wide variety of disturbed reactions. Besides the fear response, the reaction can be guilt, anger, resentments and depressions. All these reactions lead to avoidance, escape and/or disruption and can influence your whole social life. You can change these in exactly the same way you change the automatic fear and anxiety reactions.

Your human fear object responds back to your behavior, complicating the situation and worsening social skills deficit. No matter how frightened or jumpy you are, the elevator, plane, small room stay the same. However, with social fears, people react to your reaction. The result: Many times you needlessly bring on the very thing you fear will happen.

EXAMPLE ONE: Because you fear rejection, you do not reach out to people. Soon they stop reaching out to you, and you are rejected.

EXAMPLE TWO: Your parents always criticized you. To avoid that “naughty boy/girl” attack, you always reacted by being docile and good. Now this has become an automatic response. In your marriage, when your spouse criticizes you, you are al¬ways placating and super nice. Thus you reinforce the criticism and, in essence, train your spouse to criticize more.

Because people do react back, even mild, disturbed reactions may have big consequences. They tend to snowball. Your mild discomfort may communicate itself and make the other person uncomfortable. In turn, this makes you still more upset, and, before you know it, a little incident has assumed major importance.

‘Even low-level disturbances can become pervasive. Social sit-uations are complex. Even with the simplest, you can experience an array of feelings. One or several of these feelings may be anxious ones. As long as you experience the other more positive feelings along with anxiety you can keep the anxious feelings in perspective and remain in command. You can act to reach your specific interaction goal, such as to express an opinion, enjoy a party, negotiate a disagreement. When low-level anxiety reactions spiral, they spread and mask other feelings. Your disturbances influence your actions.
Situation: You’re going to a cocktail party that will be full of strangers.

Constructive approach: You walk into your neighbor’s living room feeling tense, but you’re also aware of a feeling of excitement at meeting new people, curiosity about who’ll be fellow guests, the hope you’ll meet someone “special.” Keeping your tensions in perspective, you call on your social skills and begin to talk to various people. Soon you find someone who shares your interest in travel, skiing or rebuilding old barns. You become more spontaneous and the tension disappears. To a greater or lesser extent (depending on the party and the people), you begin to enjoy yourself.

Destructive approach: You focus all your attention on your mild tension and lose sight of your feelings of excitement, curiosity, hope. Because you are aware only of being disturbed (even though this may be mild), you begin to anticipate disaster even before you get to the party. As you circulate, you concentrate so much on your fear reactions that you can’t use the social skills you have. Your spasmodic attempts at desultory conversation don’t work. Your error: Instead of aiming at having a good time, you have made it your goal to minimize your anxiety.

As a first point in change you must pinpoint the specific social fears you want to eliminate.

Common Social Fears

In interpersonal relationships you can be anxious with authority figures, peers and subordinates; large groups and in one-to-one situations; same sex and opposite sex; old and young, deformed people, sick people, rich people, poor people, fat people, thin people. I have seen patients who had automatic anxiety reactions to tall people and others made fearful by short men and women. Despite this wide range, some fears are more prevalent than others. Here are the seven most common categories I see in my practice.

1. Fear of being looked at. Often this fear possesses no real content. Purely and simply, you become aware that another person is looking at you (not staring, just looking) and get frightened. For example, in a group conversation you utter some remark and the others start to look at you. You feel uncomfortable and stop talking. Next step: avoidance. In order to minimize the chance that people will look at you, you don’t participate in conversations. Your fear may not confine itself to social situations. To avoid being looked at, you may hide behind a newspaper on trains or busses. Despite your continual avoidance attempts, people may still look at you. For this reason, in public places you continually go around in a high state of tension. This same fear sometimes leads to difficulty in public speakng.

2. Fear of people seeing you are nervous. Unlike the above fear, this possesses content. You show your nervousness with out-ward manifestations like hand trembling, blushing, tremulous voice. Afraid others will notice these signs, you refuse invitations where you know the hostess will serve coffee, tea, liquor. If you accept, you take the cup or glass, place it carefully in front of you and do not pick it up again. You agonize over the worst thing that could happen—someone says, “Your hand’s trembling. How come you’re so nervous?” With this fear, you don’t have to show the outward signs. Even a subjective feeling of anxiety can trigger the upset reaction.
Note: Sometimes labeling the outward manifestation helps counter avoidance. For example, with patients who had the hand-shaking symptom, I suggested they explain it in terms of “tennis strain.” At a party when they became aware of their hands trembling, they were to say, “I strained my arm at tennis.” Whether they used it or not, having this crutch available helped get them to the party. For several other patients who had sweating as the outer manifestation, I came up with the label “suderific allergy”— instead of stuffing their noses or making their eyes tear, this “funny allergy” caused them to sweat. While this labeling didn’t solve the problem, it made it possible for them to get into the fear situation.

3. The fear of being trapped in a relationship. Victims often rationalize this as “not wanting the responsibility” or “not being able to do what I want to do.” They believe they have no choice. In actuality, this fear is a social claustrophobia. Earlier in their lives many of its victims had a fear of being trapped in a small room. They overcame that, but the fear of being trapped generalized to interpersonal situations.

4. Fear of being “found out.” You think if people “really know” you, if you are exposed for “what you really are,” they will recoil and reject you. Many times you aren’t even sure what qualities would be “exposed.” However, some people can be quite specific: “They’ll find out I’m stupid” … “silly” … “evil” … “inept.” Even if to some extent you are these things, that doesn’t cause your fear. Fears aren’t that reasonable.

This fear leads to avoidance of closeness. Your tender feelings frighten you because they may lead to closeness. When you get close to others and share your feelings, the threat of social exposure grows. The result: The expression of tenderness and love by others as well as the expression of your own tender feelings may trigger the fear reaction and avoidance pattern.

5. Fear of negative feelings. Within this category fall a whole series of fears that can influence your whole life-style. Most important, it includes the fears of anger and criticism. You may fear expressing anger or criticism or having either directed against you. Your fear can be general or specific, involving authorities, members of the opposite sex, people to whom you are close. Says one sixty-year-old woman, “I’ve always been so terrified of criticism that I’ve never done a thing with my life.”

6. Fear of doing things alone. This fear is often associated with loneliness and depression. Usually it takes the form of a mild feeling of discomfort rather than intense feeling. For example, on a weekend afternoon you’d like to go to a movie or take a walk. But no one is available to go with you and you feel uncomfortable at the idea of going by yourself. Often you don’t know what you’re uncomfortable about, but you give in to the discomfort feeling. Rather than do something alone, you stay home. If you’re depressed, staying home will make you more depressed. If you’re lonesome, it will not increase your chances of meeting someone new.

In this fear area, if you start a new pattern of doing things alone and keep at it for a period of time, dramatic results often occur. Many people can’t or won’t do that. Instead they remain house-bound with the thought, “Someone may see me alone and think I’m unpopular.”

7. Fear of not getting along with others. This includes such fears as the fear of being ignored and the fear of a lull in the conversation. With the latter you get such a panic reaction that you actually may blurt out something completely inappropriate or start to avoid any conversational participation. There are many more such specific fears. However, within this category five fears merit special attention because they are so common and destructive.

*Fear of not being liked. This is the most common inter-personal phobia and the most destructive. Often when people dis¬like you, you respond with guilt, reasoning, “I did something wrong. There must be something wrong with me or they wouldn’t dislike me.” To avoid this situation, you become the patsy, the “always nice person.” You do everything you can to keep people