Shyness, Social Anxiety Disorder, and Social Phobia

Shyness, Social Anxiety Disorder, and Social Phobia

Shyness is a problem that is well known to many people. It is that all-too-familiar feeling of
discomfort, tension, or anxiety that a person may experience when he or she has to interact with
other people, or when he or she faces the prospect of doing something in front of others.
Shyness can be troubling and very uncomfortable. Up to 80% of people report that they were
shy at some time in their lives. Forty percent describe themselves as shy now. However, if you
think of yourself as shy, it does not mean you have a problem that requires professional help.
Most people feel some discomfort when thinking about social events (parties, for example),
when preparing to take a social risk (asking someone for a first date), or when called upon to do
something in front of others (public speaking). However, the typical shy person manages to get
along reasonably well. These situations may not be comfortable and there may be great
temptation to avoid them, but the shy person finds that he or she is still able to tolerate them
and to get a great deal of satisfaction out of life.

However, these feelings can sometimes be severe. If they are sufficiently intense; if the
person avoids doing things that are important to him or her because of these feelings; or if the
person's ability to function at home, at school, at work, or in his or her social circle is curtailed by
these feelings, the label of shyness is no longer appropriate. Then mental health professionals
call it social anxiety disorder (it is also known as social phobia).

Social anxiety disorder is the fear of being observed and evaluated by others. A person may
experience this fear in a single situation or in any interaction with other persons. Individuals with
social anxiety disorder are afraid that they will do something to humiliate or embarrass
themselves in social situations. They are afraid that other people will judge them negatively (that
is, wonder what is wrong with them). At the bottom of these concerns is the fear that other
people will reject them or conclude that they are incompetent. These fears may easily interfere
with a person's ability to function in everyday life.

The Effects of Social Anxiety Disorder

Because of these concerns, individuals with social anxiety disorder may become extremely
anxious in a number of situations or avoid them altogether. These situations may involve any or
all of the following: public speaking; eating or drinking with others; writing, working, or playing
while others are watching; initiating conversations with strangers; dating; parties; joining social
groups; interacting with authority figures; or asserting oneself with others. The list of potential
problem situations is long, because so much of what we do involves other people.

The effects of social anxiety disorder are varied, and many of the effects can be serious.
Individuals with social anxiety disorder, often very bright, talented, and sensitive people may find
themselves socially isolated and lonely because it is just too frightening to approach others.
They may compromise their educational goals because of the social demands of education or
because their classes may require them to speak in front of others. They may find themselves in
unfulfilling jobs because the exciting ones are also frightening. Importantly, individuals with
social anxiety may be vulnerable to depression if their anxieties persist over time. Similarly, they
may find relief from their anxiety in alcohol or tranquilizing medications, and these may create
serious additional problems.

What Causes Social Anxiety Disorder?

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Scientists do not agree on the causes of social anxiety disorder, which afflicts more than
12% of the general population at some point during their lives. It occurs a bit more frequently in
women than men, although men are more likely to seek treatment for this problem. This is
different from other anxiety disorders, such as agoraphobia or panic disorder, which occur much
more frequently in women.

Social anxiety disorder appears to run in families, but it is the environment in which one
grows up that may contribute the most to the development of social anxiety disorder. Individuals
with social anxiety disorder often report that one of their parents had significant social anxiety,
that their families did not socialize often with other families, that their parents did not encourage
them to interact with other children when they were growing up, and that there was a great
emphasis on the opinions of others in their families.

What Can Be Done to Help the Person With Social Anxiety Disorder?

A number of treatments are available for social anxiety disorder, and the chances that a
person with social anxiety disorder may find relief are very good. These therapies attempt to
teach clients cognitive (thinking) and/or behavioral skills for dealing with the situations they fear.
These treatments may be combined with each other to fit the needs of specific clients and may
be offered in either individual or group therapy settings. These treatments are described below.

Exposure Therapy, in which clients are asked to confront the situations they fear, starting
with the least frightening situations, mastering them, moving to more difficult situations,
mastering them, and so on until the most difficult situations lose their ability to interfere with the
client’s life.

Cognitive Behavioral Therapy, in which clients are taught to examine their ways of thinking
about feared situations. They do this by looking at whether their behavior is truly inadequate;
looking at whether other people are really likely to evaluate them negatively, and, if they do, how
important that is; and looking at their belief that feared negative consequences are likely to
occur. Armed with new ways of thinking, they may act out these situations with their therapist or
therapy assistants, or other group members. Thereafter, clients are encouraged to confront their
real-life feared situations (just as in Exposure Therapy), using their new coping skills and relying
on the successful experiences they have had in sessions.

Social Skills Training, which teaches new ways to act (like using eye contact and asking
appropriate questions) in many different situations through practice and rehearsal; and

Applied Relaxation Training, which helps clients to learn to relax while in the situations they
fear.

Several cognitive and behavioral therapies have effectively reduced the anxiety experienced by
persons with social anxiety disorder, and these benefits have lasted for a number of years after
treatment.

Medication Treatment

A number of medications have been scientifically studied; several classes of drugs have
proven useful for social anxiety disorder. Consult your doctor about medication treatment for
social anxiety disorder.

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We strongly encourage you to seek treatment for your social anxiety disorder and wish you
the best of luck in your efforts.

What Is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly
on research findings. These approaches aid people in achieving specific changes or goals.

Changes or Goals might involve:

• a way of acting - like smoking less or being more outgoing;

• a way of feeling - like helping a person be less scared, less depressed, or less anxious;

• a way of thinking - like learning to problem-solve or get rid of self-defeating thoughts;

• a way of dealing with physical or medical problems - like lessening back pain or helping
a person stick to a doctor's suggestions; or

• a way of adjusting - like training developmentally disabled people to care for themselves
or hold a job.

Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current
situation and its solution, rather than the past. They concentrate on a person's views and
beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior
Therapists treat individuals, parents, children, couples, and families. Replacing ways of living
that do not work well, with ways of living that work, and giving people more control over their
lives are common goals of behavior and cognitive behavior therapy.
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary
organization committed to the advancement of a scientific approach to the understanding and
amelioration of problems of the human condition. These aims are achieved through the
investigation and application of behavioral, cognitive, and other evidence-based principles to
assessment, prevention, and treatment.
For more information, please contact ABCT at
305 7th Avenue, 16th Fl., New York, NY 10001
Phone (212) 647-1890

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