Psychology Today: Social Phobia, Social Anxiety, and Paranoia

"Feeling nervous in social situations is something we all experience from time to time, more often happening in situations where we may face criticism, or experience rejection or evaluation. For most of us, this feeling may be little more than a dose of the "butterflies" or "nerves," however with social anxiety disorder, also called social phobia or what we might call paranoia, everyday social interactions or even contemplating them can cause significant impairment, anxiety, fear, and intense self-consciousness.

SAD is equally common among men and women and, according to most research, it typically begins around age 13. Social anxiety can be an extremely painful experience, but the good news is it can be overcome with effective therapy

Signs and symptoms of social anxiety disorder can include:

• Fear of situations in which you may be judged.
• Worrying about embarrassing or humiliating yourself.
• Intense fear of interacting or talking with strangers.
• Fear that others will notice that you look anxious.
• Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling, or having a shaky voice.
• Avoiding doing things or speaking to people out of fear of embarrassment.
• Avoiding situations where you might be the center of attention.
• Having anxiety in anticipation of a feared activity or event.
• Enduring a social situation with intense fear or anxiety.
• Spending time after a social situation analyzing your performance and identifying flaws in your interactions.
• Expecting the worst possible consequences from a negative experience during a social situation.

An Alternative Approach to Social Phobia and Paranoia

Through painstaking clinical research (Gibson et al., 2018, 2021,2022; Portelli et al., 2016; Nardone 2013), we have redefined social phobia as a form of paranoia. Paranoia is a belief that the person holds that seems to become true, not because it was inevitable, but because the person has made it become inevitable through the behaviours that they have put in place.

The objective for treatment, as with the other disorders, is to interrupt the patient's ineffective and dysfunctional attempts at solving their problem. Treatment once again is achieved through direct, indirect, and paradoxical strategies, which are part of what is known as "non-ordinary" logic.

Feelings of Incompetence

In social phobia, the fear of not being good enough, funny enough, or interesting enough in social situations often finds patients perceiving others as judging them harshly and this is especially true where one is "convinced" that they are not interesting.

In such situations, people may become nervous of signing their name on official documents, while some fear sweating, blushing, or making a mistake. The very attempt to control that which cannot be controlled by force leads to the very loss of control the person is most fearful of.

In such situations, the patient’s obsessive attempt at control is actually the thing that drives their problem and so their phobic problem grows by virtue of the fact that they are so capable of trying to stop it.

For the socially paranoid individual, where the problem has taken on a pathological rigour, they can either adopt strict avoidance measures of all social relations or else suffer the humiliation of being forced to push through them, feeling like a white "knuckle-ride" and experiencing failure each time. These experiences leave the person with an unpalatable "reality" in their mind's eye that they are "actually" incapable, weak, or uninteresting.

Prophecy of the Event

In social relations, if we truly expect a person to be cold or aloof, sociable or extroverted they will tend to condition themselves to act in this way. These social and personal expectations highly influence our self-perception and the effect can be both positive or negative. Those who expect to do well will often do better, and those that expect to fail in life tend to fail more often. It is for this reason that we tend to avoid talking about social phobia and instead talk of paranoid disorder. However, the paranoid disorder can transform into a phobia because of the person's avoidance and can eventually become a form of delusional paranoia.

When working effectively with patients, we have observed these main ways in which people try, unsuccessfully, to resolve their problem and it is these mechanisms that we must act on in therapy if treatment is to be successful.

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Reflection:

Do you have social anxiety? How do you cope?

#SocialAnxiety #SocialPhobia #Paranoia #MentalHealth