Social phobia is an anxiety disorder that often begins in adolescence and develops within the framework of the fear of being examined by people in small groups, causing behavior to avoid social environments. It is usually accompanied by low self-esteem and fear of criticism and can have serious effects on the individual's daily life.
Physical symptoms such as facial flushing, hand tremors, anxiety, sudden feeling of urination, and sweating in socially phobic individuals; Fearful thoughts such as vomiting, disgrace, and humiliation may be seen in public.
Situations from which Individuals Fear/Avoid Social Phobia:
*Introducing others
*Talking/introducing people in authority
* Using the Phone
*Being watched while doing something
*Eating at a Restaurant
*Using public toilets
*Receiving guests
* Going to a party
*Being the center of attention
*Shopping
*Public speaking etc.
The lifetime incidence of social phobia is between 10-13%. It is one of the most common mental disorders in society. Social phobia is seen almost equally in men and women.
CAUSES OF SOCIAL PHOBIA?
Adverse childhood experiences are important in the development of social phobia. Overprotective, critical, rejecting, emotionally cold parental attitudes are important in the development of social phobia. Apart from this, the perfectionist attitude of the parents can also be effective. Being excluded or judged by peers for various reasons in early relationships can also be considered among the factors affecting the formation of social phobia. However, genetic transmission plays a role, although not as much as other factors.
TREATMENT OF SOCIAL PHOBIA
Although it is a common disorder, the rate of seeking treatment is low due to symptoms such as shyness and fear of negative evaluation of those suffering from social phobia. In addition, due to the somatic symptoms of anxiety, individuals attempt to seek help from other medical units rather than a spiritual professional. This delays the treatment of social phobia
Many drugs are used to relieve and reduce anxiety in the pharmacotherapy of social phobia. Although most of these are effective, the success rate is much higher when combined with psychotherapy.
Cognitive-Behavioral Therapy is a therapy method with high success in this field. Gradual confrontation with anxiety, cognitive restructuring and social skills training are of great importance in treatment.
Confronting Anxiety Technique
In this technique, the social phobic patient enters into social situations or interactions that he fears and avoids, It is intended to remain in this state until it gets used to the anxiety-provoking situation and extinction occurs. The first step is to make a list of anxiety-provoking situations. However, the patient may have difficulty making this list due to the intensity of avoidances. In this case, it can be overcome with behavioral testing, role playing or imagination techniques with the help of the therapist. After the list of anxiety-provoking situations is made, the anxiety rating of each situation is made together with the patient. When moving to confrontation, a gradual path is followed, from the least anxiety-provoking to the most anxiety-provoking, and confrontation continues until the anxiety in each stage disappears.
More than one method can be used at each stage in confronting anxiety. For each item, the patient is enabled to confront the worrisome situation through imagination and then in vivo. When necessary, a stage can be divided into more than one small section.
Cognitive (Thoughts) Restructuring
Cognitive restructuring increases the success rate in the confrontation technique, and the confrontation trials that follow the structuring are also included in the treatment. It increases the success rate.
The first stage in cognitive restructuring is to explain to the patient what the disorder is with a cognitive-behavioral framework. For this purpose, information, videos, conferences or additional reading resources may be useful. After this stage comes the investigation and analysis of the faulty way of thinking that causes social phobia. Negative/erroneous thoughts seen in social phobia can be grouped into three categories.
These are;
*Thoughts of being humiliated and humiliated
*Thinking about one's own performance in social interactions negative evaluation
*People with social interaction notice the anxiety and have negative thoughts about the individual
The questions that need to be asked in defining the thoughts are as follows:
“If… happens, this What does it mean to you?”
“What evidence does….have?”
“Could there be another interpretation of…?”
“This Is it real, or do you assume it is real because it suits your feelings?"
"Is this real, or do you give examples that suit your beliefs and leave out other examples?"
Thinking with questions similar to these Its lines are determined and analyzed, and thus the difference between the real thought and the distorted thought that does not reflect the truth is reached. The next step is to create a more realistic thought instead of the erroneous/distorted/negative thought and try it. “Do not escape from this situation, stay here”, “Anxiety will gradually decrease”, “Focus on what you will do, not what others think”, “Don't judge yourself” are some examples of thoughts close to reality.
Social Skills Training
The treatment will not be successful if the social skills of individuals who understand how social phobia occurs and change their erroneous thoughts are lacking. It is necessary to say here that this training is not valid for every social phobic. Today, failure in this field may be related to the high standards that individuals set for themselves regarding social environments and interactions, rather than a lack of social skills.
Role-playing technique is essential in social skills training. The therapist visualizes the skills he/she aims to teach together with the client and provides information when necessary. After the behavior rehearsal and role-playing technique, verbal behavior is given to the individual as homework and he is asked to try the acquired skill in his social life.
Topics Covered in Social Skills Training:
* Starting a conversation, maintaining and terminating
* Expressing, accepting or rejecting a request
* Expressing an appreciation or reacting
* Self-referential
* Specifying an interview on any subject
In summary, in the treatment of social phobia, pharmacotherapy, confrontation with anxiety, cognitive restructuring and, when necessary, social skill training are used. Conducting data training together has the highest success rate.
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