Social Anxiety / Social Phobia – Symptoms and Treatment

The primary distinguishing feature of Social Anxiety, also known as Social Phobia, is an intense, recurrent fear of social or performance situations. Individuals with Social Anxiety / Social Phobia are excessively afraid of acting in a manner that will be perceived as embarrassing, or of exhibiting anxiety symptoms that others will observe and judge negatively (e.g., sweating, blushing, stammering, shaky hands, trembling voice). Exposure to the feared social situation results in an immediate and intense level of anxiety, sometimes to the extent of having a panic attack. This anxiety and its associated avoidance behaviors cause significant emotional distress, and may considerably interfere with daily functioning and interpersonal relationships.

Symptoms of Social Anxiety / Social Phobia

The primary symptoms of Social Anxiety / Social Phobia are the intense fear of being negatively evaluated in social situations, and the subsequent avoidance of those situations. The specific feared situations vary widely from person to person. Some examples of situations feared by those with Social Anxiety / Social Phobia include:

• public speaking
• job interviews
• business meetings
• speaking to strangers
• speaking on the telephone
• eating or drinking in restaurants
• writing in public
• reading in public
• speaking with authority figures, such as
• teachers or supervisors
• dating
• parties, weddings and other gatherings
• public venues (i.e., concerts, stadiums)
• shopping
• movie theaters
• class outings
• speaking in class
• public restrooms (paruesis)
• situations in which performance is observed, such as dancing or team sports

For the individual with Social Anxiety / Social Phobia, the obsessive fear is often not just of being evaluated negatively – it is often a more specific fear of being viewed as being inept, incompetent, awkward, or clumsy. People with Social Anxiety / Social Phobia are also often specifically concerned with being judged as being socially inadequate or awkward in situations such as parties, dating, or simply conversing with others. As a result, for those suffering with Social Anxiety / Social Phobia, the most common behavioral response to these types of social situations is avoidance.

Furthermore, individuals with Social Anxiety / Social Phobia also tend to compulsively ruminate about their performance in social situations in which they fear negative evaluation. A party or a trip to the mall can result in hours of anticipatory anxiety as the individual worries that strangers may evaluate them as being socially awkward. Likewise, after having completed these basic social encounters, individuals experiencing Social Anxiety / Social Phobia often spend hours, even days, analyzing their social performance and how they believe others may have responded negatively to them. Those with Social Anxiety / Social Phobia also frequently misinterpret minor events, such as someone looking away or excusing themselves to go the bathroom, as evidence of being rejected because of their social ineptitude.

As the above suggests, Social Anxiety / Social Phobia has features that are quite similar to those of Obsessive-Compulsive Disorder (OCD). Social Anxiety / Social Phobia and OCD both involve intense, irrational fears of specific anxiety-provoking situations, and repeated compulsive avoidance of those situations. In fact, recent studies indicate that approximately 11% of those with OCD also have Social Anxiety / Social Phobia. Furthermore, the Diagnostic and Statistical Manual (DSM-IV), published by the American Psychiatric Association, classifies both Social Anxiety / Social Phobia and OCD in the same category of anxiety disorders. Perhaps the most significant similarity linking Social Anxiety / Social Phobia and OCD is the cyclical process by which the symptoms of both conditions worsen. In this process, called the Obsessive-Compulsive Cycle, the compulsive and avoidant behaviors that individuals employ in an effort to reduce their anxiety actually reinforce and worsen their obsessions. To learn more about this Obsessive-Compulsive Cycle, click here.

Treatment of Social Anxiety / Social Phobia

Because of these many similarities, some of the Cognitive-Behavioral Therapy methods that are so effective in treating OCD are also employed in the treatment of Social Anxiety / Social Phobia. Among these techniques, one of the most effective is “Cognitive Restructuring”, in which individuals with Social Anxiety / Social Phobia learn to challenge the validity and importance of their thoughts about being negatively evaluated. After having learned to more effectively challenge these thoughts, clients with Social Anxiety / Social Phobia use another Cognitive-Behavioral Therapy technique called Exposure Therapy, in which they learn to more comfortably enter into social situations which have previously resulted in anxiety and avoidance.

Another valuable tool for the treatment of Social Anxiety / Social Phobia is imaginal exposure, in which the client writes short stories about specific, anxiety-provoking social situations, and uses these stories to challenge their fears. When combined with standard exposure therapy and other cognitive-behavioral techniques, imaginal exposure can greatly reduce the frequency and magnitude of obsessions about negative social evaluation, as well as the individual’s sensitivity to the thoughts and mental images experienced in Social Anxiety / Social Phobia.

One of the most effective CBT developments for the treatment of Social Anxiety / Social Phobia is Mindfulness-Based Cognitive-Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem – our attempt to control and eliminate our discomfort is the problem. For those with Social Anxiety / Social Phobia, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without responding with social avoidance.  To learn more about Mindfulness Based CBT for the treatment of Social Anxiety, click here.

Using these CBT tools, clients learn to challenge their fear of social situations, as well as the compulsive and avoidant behaviors they use to cope with their excessive fear of social rejection. If you would liketo learn more about Cognitive-Behavioral Therapy for the treatment of Social Anxiety / Social Phobia, click here.

Individual Therapy for the Treatment of Social Anxiety / Social Phobia

The OCD Center of Los Angeles offers individual therapy for the treatment of adults, children, and adolescents with Social Anxiety / Social Phobia, with a strong emphasis on Cognitive Behavioral Therapy (CBT). As part of our treatment program, we also offer clients the option of having exposure sessions in the field to address their fears of negative social evaluation. Such exposures might include accompanying a client as he/she visits a restaurant, initiates contact with a member of the opposite sex, or performs some public speaking.

We have 14 therapists on staff, and offer services six days a week, including evenings and Saturdays. If you would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.

Group Therapy for the Treatment of Social Anxiety / Social Phobia

In addition to individual therapy, the OCD Center of Los Angeles also offers a weekly online Social Anxiety therapy / support group on Wednesday evenings. This group meets online via webcam from 7:00 pm – 8:30 pm, and is limited to a maximum of eight (8) members.  The group follows the same Cognitive-Behavioral Therapy protocol as our individual therapy program, and uses the same treatment manual.  Group sessions are led by one of our professional staff therapists, Daniel Safavi, MA, and require an assessment prior to participation.  Please note that this group is limited to adults over the age of 18 who reside in California. To learn more about our weekly low fee group for adults with Social Anxiety / Social Phobia, click here.

Telephone and Online Therapy for the Treatment of Social Anxiety / Social Phobia

The OCD Center of Los Angeles also offers webcam based online therapy and telephone therapy to clients around the world suffering with Social Anxiety / Social Phobia. Telephone and online therapy are cost-effective options for clients who have physical and/or psychological limitations that restrict their ability to come to our office, and for those in remote areas who cannot find specialized Social Anxiety / Social Phobia treatment close to their home. Telephone and internet therapy have repeatedly been found to be safe and effective in numerous research studies, and have been legal in California since 1997. If you would like to learn more about our telephone and online therapy program for Social Anxiety / Social Phobia, please click here.

Intensive Treatment for Social Anxiety

We also offer intensive Social Anxiety treatment for adults, adolescents, and children. This program is designed to meet the needs of those for whom standard outpatient Social Anxiety treatment is either unavailable or insufficient. Our intensive outpatient program is ideal for clients from other states or countries who cannot find effective treatment near to their homes, and for those whose symptoms require a more rigorous treatment protocol. To learn more about our intensive outpatient treatment for Social Anxiety, click here.

About the OCD Center of Los Angeles

The OCD Center of Los Angeles is a private outpatient treatment center specializing in Cognitive Behavioral Therapy (CBT) for the treatment of OCD and related conditions, including Social Anxiety. We have 13 therapists on staff, all of whom are either licensed or registered, and all of whom specialize in CBT.  We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays.

Our Southern California office is located in Brentwood.

If you are experiencing any of the above Social Anxiety / Social Phobia symptoms, and would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.