On October 23rd, 2014, we updated our
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What is it?
Social anxiety (also known as social phobia):
Social anxiety is the fear of social situations and the interaction
with other people that can automatically bring on feelings of selfconsciousness, judgment, evaluation, and inferiority.
About 15 million of adult Americans in
any given year are suffer from
The Third Largest Mental Health
In the United States, epidemiological studies have
recently pegged social anxiety disorder as the third
largest psychological problem in the country, after
depression and alcoholism.
It is estimated that 7-8% of the population suffers
from some form of social anxiety at the present
time. The lifetime prevalence rate for developing
social anxiety disorder is 13-14%.
Types of social
A specific social anxiety would be the
fear of speaking in front of groups
whereas people with generalized social anxiety are
anxious, nervous, and uncomfortable in almost all
People with social anxiety usually
experience significant distress in the
Being introduced to other people
Being the centre of attention
Being watched while doing
Meeting people in authority
high levels of fear
Classical psychoanalytic theory:
mental health problems arise as a result of
repressed unconscious desires from
Psychoanalysts treat social anxiety
disorders by helping the
individual understand what is
making them anxious.
Individuals talk freely about
themselves and attempt to
overcome inner conflicts.
Various traits combine = a personality that is unique to
Focused on identifying and measuring these individual
People with characteristics that fall at an extreme on the
chart are likely to have a psychological abnormality
associated with that trait.
They are then likely to select their environment in such
a way that this trait is brought out.
To keep this from happening, psychologists teach their
patients to come to terms with the flawed trait, allowing
the patient to break the cycle
show increased activity in the amygdala
(i.e., a structure deep inside the brain that generally
shows more activity in response to threatening or
show decreased activity in cortical areas
(i.e., the outer portion of the brain that is involved in
planning and the complex interpretation of events).
People who are very sociable tend to have increased levels of
There are a number of medications that
have proven useful for treating social
anxiety disorder. These medications
point the individual in the direction of inbuilt potentials
help them to build a stronger personality and self-concept
Therapist is considered a “guide”
Mindfulness and acceptance techniques + traditional
behavior therapy (humanistic approach) = effective
treatment (George, 2008)
Cognitive-Behavioral & Social
Learning Approach (CBT)
uncover the underlying causes of your worries and
learn how to relax;
look at situations in new, less frightening ways;
develop better coping and problem-solving skills
give patients the tools to overcome anxiety and teach
them how to use them.
Medical University of South
CBT was superior to biological
treatments (medication) in the long
CBT had more successes than the
other four approaches (Würz, et al., 2009).
Conclusion: Best Approach
Cognitive-Behavioral Therapy: Why?
Past higher success rates
Positive study results
More advantages compared to other
fewer disadvantages compared to advantages
No judgment, just programs geared towards
Does your therapist say, "Face
your fears and they’ll go away?"
Sorry, but this therapist does not understand
the dynamics of social anxiety.
But this can be stopped, quenched, and
killed in a relatively short period of time – by
finding a cognitive-behavioural therapist
who understands and specializes in the
treatment of social anxiety.
The most important elements in
overcoming social anxiety are
1. An understanding and awareness of the
2. A commitment to carry
through with cognitive
behaviour therapy even when it
is seems difficult.
3. Practice, practice, practice to get
that information (i.e., cognitive
methods, strategies, and concepts)
deep down into your brain - so that
these cognitive methods become
habitual and automatic.
4. Participation in a social anxiety
therapy group in which you can
slowly and gradually work on
problems that cause you anxiety in
the real world.
For social anxiety, research indicates use of the
anti-anxiety agents, and (perhaps) certain
antidepressants in conjunction with CBT have
proven most beneficial .
Medication without the use of active, structured
cognitive- behavioural therapy has no long-term
Only CBT can change the neural pathway
associations in the brain permanently.
Therapy groups for social anxiety should
always be encouraging, positive, and
If the right atmosphere is set, people can
make (and continue to make) progress up
their "hierarchy" of social anxieties.
Compliance with Cognitivebehavioural Therapy
Cognitive- behavioural (rational) therapy is not
difficult to do, and has not been seen this way by
The first factor in not complying with the therapy
is that "I can't remember to do it every day" and "I
have a hard time committing to something in
which I don't see immediate results".
The psychologist or group leader should have
time-tested solutions to these irrational
Prognosis is markedly good. People completing
CBT training report a high success rate, compared
to control groups.
In the National Institute of Mental Health
longitudinal studies, people continued to report
progress after CBT behavioural group therapy was
Studies repeatedly indicate that treatment
compatibility (i.e., did the person carry out the
prescribed therapy?) is the key element in success.
A Big Problem
Lack of professional and knowledgeable therapists
is the biggest and most relevant problem to
overcoming social anxiety. While it can be done,
and a vast amount of clinical and research
evidence supports this, overcoming social anxiety
is difficult because of the scarcity of treatment
facilities for people with this persistent anxiety