Social phobia is evident in about 2% of the population and involves the fear of being observed or evaluated by others, with a corresponding desire to avoid humiliation or negative judgment. The social phobic may feel uneasy in one or in many different social or performance settings, including school, parties, public speaking, dating, job interviews, etc. These situations are likely to be avoided if possible. A social phobic will often ruminate obsessively (predicting the worst) before engaging in social interactions, and then ruminate afterwards regarding performance. Social phobia is only diagnosed in those whose avoidance, anxious anticipation, or distress regarding social contact interferes significantly with a desired routine, work, or with social situations/relations, or, if there is considerable distress about having these fears.
Cognitive behavioral treatment for social phobia appears to be quite effective. My work has a behavioral focus, with an emphasis on practicing social behavior in real-world settings. Patients are encouraged to take the risk of being embarrassed or of performing badly, actively approaching, rather than avoiding life's challenges. The quality of life that is restored is typically sufficient to ensure that learned skills and a tolerance for social discomfort endure after therapy comes to an end.
This short-term treatment includes:
- Social Skills Training - the skills to succeed,
- Relaxation Training - the ability to remain calm, and
- Exposure Therapy - the opportunity to practice social behavior.
The anxiety in social situations will decline as beliefs about abilities change and the willingness to take chances increases.