Causes of Social Phobia
There is no specific reason that causes social anxiety disorder. Many factors are effective in the formation of social phobia. It is observed that hereditary transmission, the brain's predisposition to phobia formation, the family's child-rearing style and childhood experiences have an effect on the development of the disorder. Therefore, it can be said that biological, psychological and environmental factors, which do not have a single cause, are effective in the development of social phobia, and these factors play a role at different levels.
Biological Factors
The role of the hereditary transmission factor in the problem of social phobia is not significant. It is thought to exist, although it is not strong. It is suggested that if there are socially phobic people among the individual's relatives, the individual's risk of experiencing social phobia is slightly higher. When it is questioned whether there is a similar problem in the family, the fact that close relatives also have a similar problem supports this.
One of the most important factors that stands out is that it has been observed that there are some chemical and electrical disorders, irregularities and imbalances in the structure of the brain. What needs to be emphasized in particular is; It is whether the chemical called serotonin is lower than normal or there is a disruption in its transmission. Generally, this chemical is proportionally less in the brain of socially phobic individuals and there are deficiencies in transmission. Therefore, this decrease can cause different reactions in the brain in stressful situations, for example, it can cause anxiety, worry and anxiety. In other words, social phobia can be called an infrastructure preparation.
When looking at biological factors, one of the issues that stands out is that the part of the brain called amygdala, which controls the fear part, is extremely active. This excessive activation seriously triggers the formation of social phobia. It may be perceived as if there is a threat, causing overstimulation in the autonomic nervous system. In this case, something close to a panic attack may be experienced, such as a serious acceleration in heart rate and excessive movement in the gastrointestinal system. There are also some cases where fainting is observed.
Psychological Factors
Social phobia is actually a problem whose mental infrastructure is already prepared. This pleasure However, it may sometimes occur after a certain situation or event and may have become conditioned and established by a traumatic experience. If an example of this mental infrastructure is given; A student makes a mistake while explaining a topic in class and his friends laugh at him. In such a situation, the student feels ashamed because he may think that he is humiliated and disgraced, and he shows physical symptoms. The next time he comes to the board again to explain the subject, this previous negative experience will most likely lead to negative expectations and the environment he is in will trigger his emotions, and the previous physical symptoms will accompany this situation. Therefore, it can be said that the development of the social phobia problem occurred as a result of an embarrassing or humiliating incident experienced in the past. It may occur as a result of such events that traumatize the individual. Again, as an example of psychological factors; It can be said that children with shy temperaments are at risk for social anxiety disorder in adulthood. The social phobia problem that occurs in an individual may also be related to a history of abuse or bullying experienced in childhood. People with social phobia may have developed this phobia by observing what happened to them as a result of the behavior of others (for example, being ridiculed). Some events that are important in human life and cause distress and sadness to the person (such as death, separation) can also cause social phobia.
Although thousands of thoughts pass through the minds of socially phobic individuals when they enter the social environment, these can be grouped under two headings as follows:
“The same things will happen every time”
“You call me stupid, abnormal, useless, etc. "They will say"
In addition to these two thoughts, the thought "I will disturb others" has been added by research conducted in recent years.
Environmental Factors
In societies where people do not express themselves much, individuals with low self-confidence and lack of self-confidence experience the problem of social phobia. The onset of the problem is often seen in childhood. It is even seen in preschool age. It is more common in individuals who have had health problems related to their physical appearance or voice. ürke Children who are isolated and afraid of approaching others are children who should be on alert. Children who cannot learn some social skills that should be learned during normal development and cannot develop them adequately are among the children who should be on the alert.
The way of raising children is also an important factor in the formation of social phobia. In general, children of controlling, overprotective, or rejecting parents are likely to be socially phobic individuals. Again, if there is pressure in the family, if it is a family environment with low emotional warmth, if it is a family with oppressive and strict parents, the child is likely to have social phobia. If there are high expectations from the child and the child is punished for not reaching these high expectations, this may develop a fear of failure in the child. Fear of failure can also cause social phobia. It has been said that behavioral inhibition, defined as excessive fear of unfamiliar environments, people and objects, is a precursor symptom in the development of social phobia. If parents have a critical attitude, the risk of the child becoming socially phobic increases. A child whose every move is controlled can become anxious, and even well-intentioned actions can negatively affect the child. The risk increases in children who are controlled in every detail of daily life and exposed to psychological and physical violence. Feelings of guilt may settle in, one may see oneself as worthless, and experience insecurity. This causes failure in expressing oneself in school life in the future.
How to Treat Social Phobia
Social phobia treatment It is among the psychological disorders that are not difficult to treat and can be treated successfully. Depending on the individual's level of social phobia, psychotherapy can sometimes be applied alone or sometimes in combination with medication.
Social phobia is a psychological problem that can usually be completely cured with correct treatment. However, many factors can affect the success of treatment. These factors
· along with different psychiatric diseases. It can be counted as its occurrence,
· early age of onset,
· the person's desire for treatment,
· the person's effort towards improvement during the treatment process.
In light of these factors, expectations should be realistic.
Treatment for social phobia is of two types: medication and psychotherapy. Depending on the severity of the disease, sometimes only psychotherapy is applied, but it is generally preferred to apply both treatments together.
Psychotherapy
Psychotherapy is used for people with social anxiety disorder. It improves symptoms in most people. The most effective treatment model is cognitive-behavioral therapy. As a result of the research, cognitive-behavioral psychotherapy has been shown to be significantly beneficial in the treatment of social phobia. If what the therapist says is followed exactly, the treatment process will accelerate and a successful result will be achieved.
When drug therapy is added to this therapy model, the added medication can make the therapy more effective by gradually reducing the symptoms. In cognitive therapy, there are stages such as recognizing feelings of anxiety and the physical symptoms that occur against this feeling of anxiety, understanding the thoughts in situations that cause anxiety, and developing coping strategies against them. The person is taught to react differently to situations that trigger anxiety symptoms. In behavioral therapy, there are different methods that can be applied to each individual, such as modeling, addressing complaints, role playing to perceive physical symptoms more clearly, relaxation training, and social skills training.
The aim of therapy is for the person to recognize and change negative thoughts about himself. He is also guided to develop skills that will help him gain confidence in social situations. The aim of CBT is to direct the thoughts of the person diagnosed with social phobia to a more logical place and to ensure that the person does not avoid situations that have previously caused the person anxiety. In this therapy, the cause of the anxiety of the person with social phobia is investigated and they are helped to confront their fears. It enables the person to recognize his or her previous reactions to any event that causes anxiety and to react differently than before.
Fog. Cognitive behavioral therapy based on thematic desensitization, that is, exposure, is one of the most important goals of cognitive therapy. As a result of systematic desensitization, the person works step by step to face the most feared social situations. This can improve coping skills and help build self-confidence in dealing with anxiety-provoking situations.
Participating in skills and role-play training to gain comfort and confidence in social situations will also be beneficial. Practices of exposure to social situations are especially useful for challenging anxieties.
When physical symptoms are not experienced, the person can also control his mind more easily. But it is important to eliminate the underlying thought through therapy.
Perfectionist people who do not want to make mistakes may actually have irrational thoughts, and these are corrected in therapy. The underlying negative thoughts, such as that I will be criticized or excluded, need to be replaced with healthier ones, and these are achieved through therapies. Therapies must be accompanied by a psychologist.
To make the person aware of his illness, to increase his motivation, to understand what kind of tensions the behavioral changes gained in individual psychotherapy create in his body, differences in temperature and heart rhythm, and what kind of bioelectrical appearance in his brain. The ability to control one's thoughts is gained by giving feedback about what one has achieved.
Drugs
There are a wide variety of medications used in the treatment of social phobia. Among these, the antidepressant group is selective serotonin reuptake inhibitors (SSRIs). These medications are often the first types of medications tried. When considering drug treatment, drugs that can especially affect the serotonin system are chosen. When it is decided to use medication, it should be acknowledged that in the first days of treatment, mild nausea, mild headache, sleep disturbance, stomach upset and similar temporary side effects may occur. Informing the patient that the body can get used to similar symptoms over time may make the individual more comfortable. It is recommended to wait two to three weeks for the effect of the drug used to appear. use again
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