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Do you have a social phobia?

The main feature of social phobia disorder is a persistent fear of one or more situations in which the sufferer is exposed to being the focus of attention of other people. The fear is that he or she may do something or act in a way that will be humiliating or embarrassing.

A good example of a social phobia is a fear of public speaking which is very common and something that I used to experience. If you are nervous about speaking in public your nerves may affect your voice, your breathing, your heart rate and possibly your ability to access your memory. If you are speaking to a group of people, their attention is focused on you and what you have to say, so if you have a tendency to feel self-conscious, this can be a recipe for a dry mouth, croaky voice, shallow breathing and even possibly a trembling body and even worse, forgetting what you wanted to say.

If you are a fan of the TV programme called ‘Dragons Den’ you will have seen this happen on a number of occasions when people, ‘pitching’ to the ‘Dragons,’ completely ‘dry up’ and forget what they wanted to say.

Another common social phobia relates to eating in public whereby the phobic is worried that they might choke or vomit in front of other people. Being unable to urinate in a public lavatory is also quite common; a condition known as ‘bashful bladder syndrome.’

A simple social phobia could just be a reluctance to socialise with other people because they fear that they might say something foolish or not be able to answer questions or concerns that others won’t find their conversation interesting.

Whatever the specific trigger, exposure to the specific phobic stimulus usually provokes an immediate anxiety response. Someone who fears speaking in public, and is forced to do so, will almost invariably have an immediate anxiety response; such as feeling ‘panicky’, sweating, experiencing a racing heart and difficulty in breathing whereas someone with ‘bashful bladder syndrome’ may just feel embarrassed and frustrated that they are unable to empty their bladder even when they can feel a full bladder and are desperate to empty it.

It’s one thing being scared during the performance but you may also suffer from anticipatory anxiety which causes you to feel the anxiety symptoms for days or even weeks before the event which often results in adopting an ‘avoidance strategy’. Occasionally, you might force yourself to endure the social phobic situation and then experience intense anxiety during the activity. You might then fear that others will detect the signs of anxiety that the situation arouses and a vicious cycle may be created in which this fear generates anxiety that impairs performance, which then increases the motivation to avoid the situation. When I feared public speaking I became very devious with my avoidance strategies and created a long list of excuses to avoid confronting my fear and hoped that no one else would notice.

Someone who is a social phobic is most often afraid of; blushing, humiliation, job interviews, using public toilets, being in crowds and at parties etc.

The good news is that you don’t need to use alcohol, tranquillisers, beta-blockers or any other types of medication to appear calm or to calm your nerves in order to handle the situation; we can teach you some highly effective natural techniques to boost your confidence and to stay calm.

If you suffer from public speaking anxiety or any other form of social anxiety and would like to know how we can help you send us your contact details at http://www.thespencepractice.co.uk/contact-us/

For a definition of Agoraphobia see http://en.wikipedia.org/wiki/Agoraphobia

In a previous blog, I described how disabling panic attacks can be and how you can develop a fear of panic attacks (‘fear of the fear’). In many cases, panic disorder can progress to a more advanced form of the condition known as ‘Agoraphobia’. As well as suffering from the distressing symptoms of panic attacks you might begin to fear being in places or situations where escape might not be possible or somewhere that would cause embarrassment should you have a panic attack. As a result you might begin to, either, restrict your travel or find that you must have someone with you when you leave your home.

If you suffer from Agoraphobia you might have developed a fear of being in crowds, standing in a queue, entering a shopping centre or when travelling in a car or on public transport. The level of avoidance can vary considerably from one individual to another ranging from mild to severe. For example, you might restrict yourself to a safe distance that you allow yourself to travel from home, maybe within a one to five mile radius.

A severe version of this condition can be extremely disabling and limit you to your home for many years at a time, which means not being able to work and relying on other family members or friends to do the shopping and carry out other errands for you and you may have to totally rely on them for emotional support.

If you have a severe form of Agoraphobia it can and usually does lead to a life of extreme dependency as well as great discomfort. This tends to a have a detrimental impact on family and friends and in some cases prevents the support person/carer from enjoying their life and can even destroy relationships. However, I have come across a situation where the condition managed to strengthen a relationship. An elderly lady visited my clinic many years ago with her husband. She needed help with Agoraphobia but admitted to me that she didn’t really want a cure because it gave her husband a purpose in life since he retired from work.

Research indicates that approximately one third of all people suffering from panic attacks will go on to experience mild or severe Agoraphobia and that in 75% of cases, panic attacks came first before the onset of the phobia. This suggests that Agoraphobia panic disorder is more often than not brought on by a fear of suffering a panic attack in a public place.

One of the best forms of treatment for Agoraphobia is a gradual de-sensitisation, by slowly building up confidence, literally step by step, combined with advice and guidance on how to control and defuse a panic attack should it happen. Therapy can be a challenge in extreme cases as the sufferer is unlikely to leave home to visit a therapist and therefore will require a therapist who is willing to do home visits.

I am sure that there will always be a minority of people who will seek to gain from their condition, such as the lady I described earlier, or perhaps someone who is too lazy to work and lives on benefits.

The longer you avoid confronting your fears the more difficult and challenging it will be to cure Agoraphobia.

I was recently sent a testimonial by one of my clients Chris who has overcome his phobia of having dental treatment. To read what Chris has to say see here. This reminded me of just how relatively easy it is to conquer a phobic reaction through a process of what is known as ‘Desensitisation.’

To understand how de-sensitisation works it is useful to understand how a phobia is triggered in the first place. You may feel uncomfortable when you see a spider crawling down the wall towards you or you might feel tense and clench your fists when sitting in the dentist’s chair; or you might clench your teeth and start to sweat when the plane you are on is buffeted by turbulence.

These could be described as natural everyday fears; but what if these fears become so intense that normal life becomes difficult or impossible. What if you runaway in panic at the sight of an insect or refused to see the dentist or board an airplane under any circumstances. Then the fear has crossed the line into phobia which could be described as;

“unrealistic fear that is all out of proportion to the actual threat”

The most common fears people have, are of animals or insects, natural elements like storms and water, heights or closed in spaces such as lifts. I have never felt comfortable around dogs ever since I was bitten by one when I was 5 years old, but I don’t go out of my way to avoid them so I don’t have a phobia. I may have developed one, if say, the bite had caused an infection and I had needed life saving surgery.

Phobias are often triggered by one traumatic event or may have been learnt from a parent or sibling. If you were 3 years old and witnessed your mother standing on a chair screaming at the sight of a spider; the chances are that you may have learnt a phobic response and subsequently every time you then responded in a similar way your brain has created what is known as a ‘pattern matching response’.

A person who is afraid of dogs will have an immediate anxiety response upon seeing one. They might feel panicky, sweaty, have a pounding heart and difficulty breathing. The knowledge that the person is terrified of dogs will often result in the avoidance of places where dogs might be encountered such as parks or in extreme cases not be prepared to leave the safety of their home in case they encounter a dog out on the street.

Someone who is afraid of flying does not experience that fear except when required to get onto a plane. Someone who fears snakes simply avoids them which is very easy to do in most places where humans live.

Simple phobias are quite common and do not normally create major problems unless the feared object or situation cannot be easily avoided. The anxiety is usually focused on a specific external object or situation, such as snakes, spiders, dogs, driving, flying, lifts, heights and bridges etc, and is only present when that specific thing, object or situation is encountered.

It is possible for the phobia to spread in certain situations. Someone who has a fear of being in a lift because they feel trapped might start to get the same kind of feeling when they are on a plane. An individual with a fear of spiders might also develop a fear of other crawling insects or even insects of any kind.

There are different approaches to treating phobias. The one I tend to favour most of the time is called de-sensitisation, which involves gradually building up the phobic’s confidence by having them ‘feel the fear’, but limiting the exposure to small doses of fear initially until they get the confidence to be exposed more and more to the situation they used to find frightening. This can be achieved initially with a client in the safety of the therapy room, using hypnotherapy/NLP techniques before they are exposed to a real life situation. These methods are highly effective because the subconscious part of the mind can’ t tell the difference between what is real and what is imagined.

Fiona had a fear of spiders and other crawling insects for most of her life and managed it by having her family, partner or neighbour remove any offending spider from her home. It wasn’t until she had the opportunity of a lifetime, to travel to Australia, that she had the motivation to overcome her fear. See Fiona’s story on video here.

My next blog will be on the subject of Agoraphobia.

If you suffer from Agoraphobia you may have seen a TV programme on Channel 4 this week called ‘House of Agoraphobics’ and witnessed what was billed as ‘a ground breaking treatment’. I’m not sure what was ‘ground breaking’ about it. A combination of Cognitive behaviour therapy and exposure is hardly new. The results appeared mixed and there was no follow-up months after treatment, so we don’t know how effective it was.

When you ask someone to jump in at the ‘deep end’ of a swimming pool before they have learnt how to swim one of two things tend to happen. You panic and become traumatised and never want to go swimming again (This happened to me in my childhood and i developed a fear of going out of my depth) or your survival mechanism ‘kicks in’ in a positive way because you expect to float to the service naturally.

In my opinion, the 2 main elements missing from the treatment were a lack of attention to the emotional part of the brain, which in all 3 cases appeared to have been traumatised many years ago. All of the therapy appeared to be directed towards the rational part of the brain which was constantly being challenged by the therapists. I believe that their rational brain knew that their thoughts were irrational. Unfortunately the emotional part of the brain was overriding the rational part. Another key element missing was a structured strategy for coping/dealing with panic-attacks. There are some simple and easy to learn techniques that can turn anxiety and panic into a more relaxed state.

If you want to know more about how we can help Agoraphobics or any kind of phobia call 01273 509793 now.