the bold and the bashful shyness

Shyness and Social Phobia

Introduction

This leaflet is for anyone who finds shyness a problem, or who suffers from a social phobia. It may also be helpful for friends or family who want to be able to understand and help.

What is a social phobia?

Shyness is a common sort of mild fear – if it's mild, it doesn't really spoil life. Many of us get a bit worried before meeting new people but find that, once we are with them, we can cope and even enjoy the situation. A phobia is also a fear. We all have fears about things such as heights and spiders but, for most of us, they don't really stop us from doing what we want to do. A fear becomes a phobia when it stops us from enjoying things or doing them easily.

If you have a social phobia, you get very anxious when you are with other people, usually because you worry that:

• they may be critical of you;
• you may do something embarrassing.

This can be so bad that you can't enjoy being with people or speaking in front of them. You avoid social situations altogether. This leaflet describes what it is like to have a social phobia, how you can help yourself and and some of the help you can find for this.

There are two main sorts of social phobia.

General Social Phobia

You:

• worry that other people are looking at you and noticing what you are doing
• dislike being introduced to other people
• find it hard to go into shops or restaurants
• worry about eating or drinking in public
• feel embarrassed about undressing in public, so you can't face going to the beach
• can't be assertive with other people, even when you know you need to.

Parties can be particularly difficult. Many of us hesitate slightly before going into a room full of people, even if we have been looking forward to it. If you have a social phobia, you may tend to hover around the entrance or outer rooms - because you feel unable to 'go in'. This leads some people to believe that they are claustrophobic. If you do finally get into the room with other people, you feel as though everybody is looking at you. You may have to have a drink before you go to a pub or party, so that you can relax enough to enjoy it.

Specific Social Phobia

This affects people who have to be the centre of attention as part of their way of life such as salesmen, actors, musicians, teachers, or union representatives may all feel like this. If you have a specific social phobia, you may find that you can mix and socialise with other people without any problems. However, when you have to get up and talk or perform in front of others, you become very anxious, stammer or 'dry up' completely. It can affect even people who are experienced at speaking in public and do it regularly. At its worst, it can make it impossible for to speak in public at all, even to ask a question.

What does it feel like?

The feelings of anxiety are similar for both types of social phobia. You find yourself:

• worrying a lot about making a fool of yourself in front of other people
• feeling very anxious before going into any of the social situations that worry you
• going through, in great detail, all the embarrassing things that could happen to you
• unable to say, or do, the things you want to
• after an event, worrying about how you handled the situation. You may go over, again and again, how you might have behaved differently or said different things.

People experiencing both of these types of social phobia also have many of the same physical symptoms.You may get:

• a very dry mouth
• sweating
• heart pounding
• palpitations (the feeling that your heart is beating irregularly)
• wanting to pass water or open your bowels
• feelings of numbness or pins and needles in the fingers and toes (this happens because you breathe too fast).

Other people may be able to see some of the signs of this anxiety - the blushing, stammering, shaking and trembling. These symptoms can be quite alarming and make your anxiety worse. It can become a self-fulfilling prophecy. You worry so much about looking worried that you actually do look worried. Your worry is your worst enemy.

Panic attacks

With either sort of social phobia, these feelings can end in a panic attack. This is a short period, usually only a few minutes, during which you feel overwhelmingly anxious, terrified of losing control. You may feel that you are going mad or dying. You will usually try to get out of the situation that has brought it on. These feelings reach a peak and then pass off rapidly, leaving you feeling weak and exhausted. Although these attacks are very alarming, they do stop on their own and cannot harm you physically.

Does it affect the way you think about yourself?

It can be very wearing to suffer from a social phobia - other people do things easily when you find them impossible. You may worry that others will think you are boring. You may be over-sensitive and reluctant to bother other people. It's easy to see how this can make you feel depressed and unhappy. This, in turn, can make the social phobia worse.

How can it affect people's lives?

Many sufferers cope by arranging their lives around their symptoms. This means that they (and their families) have to miss out on things they might otherwise enjoy. They can't visit their children's school, can't do the shopping or go to the dentist. They may even actively avoid promotion at work, even though they are quite capable of doing a more demanding and more financially rewarding job. About half of those with a severe phobia, particularly men, will have difficulty in making long-term relationships.

How common is it?

About five in a hundred people have some degree of social phobia, with women two or three times more likely to be affected.

Are there any complications?

Depression: Your may be so upset by social phobia that you become depressed - to the extent that the depression becomes a problem in its own right.

Agoraphobia: If you constantly avoid places where people meet, you may end up feeling afraid of those places even when there is nobody there. You may then find that you can't leave the house on your own - this is called agoraphobia.

Drug and alcohol use: You may use alcohol, drugs or tranquillisers to cope with your feelings - this runs the risk that you may become addicted to them.

Physical health: In spite of their anxiety and panic attacks, people with social phobia don't seem to have more heart attacks than anybody else.

What causes social phobia?

We really don't know. It seems to affect people who:

• have particularly high standards for their behaviour in public;
• who have stammered as a child.

Some experts think that it might be due to people getting stuck at the normal stage of shyness that all children go through between the ages of three and seven.

What keeps it going?

Thoughts: Certain thoughts tend to kick in when you enter a social situation and will make you anxious. These include:

• rules for yourself - “I always have to look clever and in control”
• beliefs about yourself - “I'm boring”
• predictions about the future - “If someone gets to know me, they will see how inadequate I am.”

They make you think about – and criticise - your behaviour from moment to moment. Such thoughts are so automatic that they feel true to you – although there is often no evidence for them at all. They can make you imagine that you appear to other people in a certain - usually rather unattractive way. Ths is almost certainly very different from the way that people actually do see you.

Safety behaviours: These are things that you do to make yourself feel more in control in a social situation. They include:

• drinking alcohol
• avoiding eye contact
• not saying anything personal about yourself
• asking too many questions of the other person.

The problem with doing this is that it doesn't allow you to experience the fact that dreadful things don't happen if you stop trying to control your behaviour so much.

TAKEN FROM THE ROYAL COLLEGE OF PSYCHIATRISTS.

SINCERELY

YAMIL AYBAR

CI3226