A psychologist explains how to overcome social phobia
Anxiety disorders are very frequent today, and it is estimated, according to data from several studies, that 20% of the population will experience an anxiety crisis throughout their lives.
One of the most well-known anxiety disorders are phobias, among which we can highlight social phobia . But what is social phobia? What can we do to overcome it?
- Related article: "Types of phobias: exploring the disorders of fear"
Interview with a psychologist expert in social phobia
In this article we talk to Sandra Isella Perotti, a psychologist who has more than 20 years of clinical and psychotherapeutic experience, working at the Cepsim Psychological Center in Madrid, one of the most prestigious psychology clinics in our country, to help us help understand what the characteristics of this disorder are.
Fear is an emotion that has played a fundamental role in the survival of human beings. But when does it become a problem?
Yes, fear is fundamental in animals and in the human being for survival. It serves mainly to orient us about the dangers that can threaten us at a given moment, whether they are perceived in the external world or in the internal world. Activate in our body the responses of flight or fight, as it is more convenient.
It is very easy to see this in animals, for example, in a dog, when he is eating with a great appetite and he hears an unknown noise for him, stops, raises his head, sniffs, looks, that is to say, is oriented to see if the stimulus indicates that he has to go barking because there is someone, or flee to hide if he is very scared. In that orientation, the nervous system in a state of alert, serves to make those decisions. If, when orienting himself, he rules out that there is a danger to him, he will continue to eat calmly.
The fear in the human being is a kind of alarm that goes on to warn us that something can put us at risk, ourselves, someone from our immediate environment or maybe it can simply be seen at risk, our esteem, our image or our feeling of security.
The fear reaction originates in the oldest part of our brain, which is characterized by rapid activation, from 0 to 100, instantly. For example, if when crossing a street, we see that a car is coming, the scare activates our nervous system, first causing us to jump back, then giving us the sensation of startle and finally we may think "He could have killed me". We see there, as fear activates an immediate response to danger, even before we are aware of it, that is, we can think about it.
Fear becomes a problem when it activates in us so often or for such a long time that it stops discriminating really the risks and dangers, feeling scared in a more or less constant way, for example in new situations, that do not represent in themselves a danger, but living in a threatening way.
And also fear becomes a problem when it arises associated with a stimulus, object or circumstance whenever it appears or is contacted with it, and yet do not entail anything threatening or represent a real danger, but cause that the person dodges constantly to not feel the discomfort that fear produces. This situation is what we call phobia.
It is like living in a permanent state of alert or alarm, that being constantly on, no longer only warns about the dangers, but stops discriminating and therefore serving for orientation or for quick reactions in survival.
It thus becomes a very limiting problem that causes loss of freedom, excessive worry, anxiety, among other difficulties that have to do fundamentally with adaptation to the environment, to ourselves and to others.
So, what is a phobia? What are your symptoms?
A phobia is an irrational fear associated with certain external stimuli (phobia to fly, dogs, insects, heights, blood, needles) or certain internal stimuli (phobia of intimacy, contact social, to speak in public).
Its symptoms are varied and range from a panic terror, with tachycardia, sweating, psychomotor agitation to paralysis, freezing, uncontrollable tremors.
Psychologically, these symptoms have to do with not feeling able to face something, feeling overwhelmed and not seeing oneself in a position to face an object or situation, with a sense of risk of life or death and above all, with conviction. of not being able to successfully cross certain circumstances related to what causes the phobia, which leads the person to avoid everything that may mean an approach to the object or phobic situation.
What types of phobias exist?
Simple phobias are usually given to a single object. They have a source, from where they come, usually in childhood, where when we are children we are frightened by certain things or situations. Being adults and in similar scenarios, something acts as a trigger and makes us relive those terrifying sensations of the past, as if we were still small and helpless, developing a phobia of something.
There are complex phobias, which are related fears and intermingled with the characteristics of personality and character. They generally appear in the course of development in childhood, or associated with various traumatic experiences in adolescence that intensify already vulnerable aspects in the first years of life. Mainly, they make difficult the relation with the others, the intimacy, the commitment and aspects of the self-concept, like the own valuation. Social phobia is an example of complex phobias.
Differences complex phobias of the simple and speak of social phobia. What differentiates this type of phobia from shyness?
Shyness is a characteristic of introverted people, who are rather reserved, with a lot of inner life and who sometimes have a hard time showing up more socially, appearing, having a leading role and socially developing skills related to good conversation, being entertained or amused, be the soul of the party. They tend to be very reflective people with an intense emotional world that shines little outward.
Social phobia, on the other hand, means that the person can not attend meetings, events, sometimes at school or work, in the most serious cases that he remains confined at home or needs to be drunk or drugged to establish a satisfactory interaction with others. , since social contact is experienced as something very threatening and very frightening. Fear and shame are the affects that prevail.
How does social phobia affect the lives of people who suffer from it?
It is very limiting. It can reach the extreme that the person has to live in seclusion at home, avoiding contact with other people outside his family. Or, it is observed when the person finds difficulties to go to usual social activities (study, work, shows) or exceptional (weddings, christenings, graduations).
The fear of being evaluated or being exposed is the predominant affect that these people experience, in addition to having many difficulties to show themselves publicly, to be the center of attention of others or to stand out for a particular reason.
It is a very great suffering that they suffer, reaching the point of not feeling worthy of being loved by others or having the feeling that there is a flaw or defect in them that they do not want others to see.
In what context does social phobia most affect?
Social phobia affects more in contexts with little appreciation of feelings, which are experienced as a sign of weakness, in environments of emotional deprivation, where children are not offered safety experiences within the family, so that later they become in children who succeed. Also in very overprotective and normative environments, where children do not develop self-assertive feelings of their own value, where everything is solved and they do not have to work hard and put their own resources at stake to get what they want.
Then a fear develops to go out into the world, to connect with others as we are, with our defects and our virtues, to deal with our limitations to overcome those obstacles that come our way. It can also happen that one of our caregivers in childhood, has this same problem and learn in some way those fears or other similar.
Anyway, even though we have grown up in an adverse environment, we can acquire from adults the security that we did not obtain in later life, develop new resources and strengthen ourselves to make our way in the external world. This sometimes happens because there are later in the development, new more favorable contexts (couple, educational or sports contexts, relatives of friends, gangs of college peers, work team) or because people ask for specialized, medical, psychiatric help or psychological to overcome those difficulties.
In Cepsim, what treatment do you do to people who suffer from this disorder?
At Cepsim, we first perform an exhaustive diagnosis during the first sessions to assess what the problem is and the context in which it is presented, we also value each person in particular and their way of being, case by case, in order to carry out the most convenient treatment.
In our team, we are trained in different approaches and know different therapeutic approaches that allow us to adapt the tools to each patient in particular and not vice versa, as well as combining different approaches to achieve recovery in the shortest time possible.
We use third-generation therapies, such as Brain Integration Techniques, Sensory-Motility therapy or SomaticExperience, Model of the Inner Family, Hypnosis, which are aimed at finding the source / s scenario of the phobia in the past, to "deactivate" it to say the least in some way, or process it, so that it stops igniting in the present every time a trigger recalls the emotion of fear experienced then. That in the case of simple phobias.
In the case of complex phobias, the treatments are longer since they work on aspects related to the way of being and the personality, focusing on how to establish emotional ties and manage the emotional world.
One of the most used techniques for the treatment of phobias is systematic desensitization. What exactly does it consist of? Why is exposure to phobic stimulation so useful?
Systematic desensitization consists in the planning of very gradual and progressive exposure to those stimuli that produce the phobia.
The person develops the possibility of approaching that which terrifies him with support to the therapist's principle, which sometimes acts as a counterphobic companion and through systematic repetitions, which increase the difficulty and the exposure time, it is justly desensitized, that is to say that no longer feel fear and that the object of this phobia becomes something not frightening for the person.
Is it possible to overcome a phobia without applying exposure techniques?
Of course. The exposure technique has been developed by the Behavioral Cognitive approach and certain patients do very well and thus solve their problem.
But we are very used to receiving people who, having experienced this type of punctual treatment on a phobia, based on exposure techniques, with the passage of time develop another similar or the same recrudece, for which it is necessary to apply here other types of treatments oriented at a greater depth that allows the problem to be worked on at its root, so that it does not reproduce again.
Can a person with social phobia recover completely?
A person with social phobia, or any other type of phobia, can recover. You can again experience much of its functionality, you can develop roles and resources that allow you to go out into the world feeling safe and protected, safely and fearlessly, recovering a normal relationship with what generated so much fear.
Many times our patients are surprised to discover that something they have suffered for so long can be remitted giving rise to new experiences and expanding the possibilities of experiences, which previously were not available.
