Social phobia should not be confused with panic disorder. Panic patients think that their panic is caused by some serious physical reasons, and often go to the hospital or call an ambulance during or after the attack. People with social phobia may experience panic attacks, but they will realize that they are experiencing great anxiety caused by irrational fears. Few people with social phobia are willing to go to the hospital at that time because they are afraid of rejection or the judgment of authoritative people. For most people with social phobia, it is especially difficult to deal with authority figures, such as making phone calls, attending appointments, parties or job interviews.
Social phobia is a neurosis. Among the most psychological disorders in the United States, the number of patients with social phobia ranks third after depression and alcoholism, and the number of patients in China is also increasing rapidly.
[Edit this paragraph] Classification
Social phobia can be mainly divided into two categories:
(1) General social phobia:
If you suffer from general social phobia, you will be afraid to be the focus of attention anywhere and under any circumstances. You will find that people around you are watching you and observing your every move. You are afraid of being introduced to strangers and even eating and drinking in public places. You will avoid shopping malls and restaurants as much as possible. You never dare to argue with your boss, colleagues or anyone to defend your rights.
(2) Special social phobia:
If you suffer from special social phobia, you will be particularly afraid of certain special situations or occasions. For example, you are afraid of speaking in public and performing in public. Still, you are not afraid in other social situations. Salesman, actor, teacher, musician, etc. Often have special social phobia. There is nothing unusual in their general communication with others, but when they need to perform on the stage or make a speech in public, they will feel extremely scared and often become tongue-tied or even stand on the spot.
People with social phobia are always worried about making a fool of themselves in front of others and feel extremely anxious before attending any social gathering. They will imagine how they make a fool of themselves in front of others. When they are really with others, they will feel more unnatural and even can't say a word. When the party is over, they will relive the scenes in their minds over and over again, reviewing how they handled every detail and what they should do correctly.
Both social phobias have similar physical symptoms: dry mouth, sweating, rapid heartbeat, and want to go to the toilet. The symptoms that people around you may see are: blushing, stuttering, and slight trembling. Sometimes, patients will find themselves short of breath and cold hands and feet. The worst result is that the patient will go into a state of panic.
Social phobia is a very painful psychological obstacle, which seriously affects the life and work of patients. Many things that ordinary people can easily do, but people with social phobia are afraid. Patients may think they are boring people, and others will think so. In this way, patients will become too sensitive and even unwilling to disturb others. Doing so will make patients feel more anxious and depressed, which will further worsen the symptoms of social fear. Many patients change their lives to adapt to their symptoms. They (and their families) have to miss many meaningful activities. They can't go shopping, establish a normal relationship between men and women, take their children to the park to play, and even have to give up good job opportunities and avoid dealing with people.
Social fear can be subdivided into many kinds, and the most common ones are as follows.
▲ red face fear
Ordinary people often blush in front of people because of shyness or embarrassment. However, patients who are red-faced and fearful are overly anxious about this and feel that it is very shameful to blush in front of people. Finally, because the symptoms are fixed, I am very afraid of being in front of people. The patient has been trying to hide his red face and try not to be noticed, so he is very upset. Patients are afraid that when they take the bus in front of others, they always feel that they are under everyone's gaze, and finally they even dare not take the bus. For example, if a frightened student feels painful about going to school by bus, he always gets on the bus in a hurry when others have finished getting on and the bus is about to leave, so as not to attract people's attention. Because sitting down will face others, so I simply stand at the door of the car to cover my naked face. Another example is a student patient who can't take a bus because of his red face fear, so he has to take a taxi or simply walk. When you have to take the bus, you should drink a glass of wine in advance to make others think that his blushing is caused by drinking, so as to comfort yourself, or run hard and get on the bus quickly, unbutton your clothes, and fan the wind with something to make others believe that his blushing is caused by running, so as to cover up your blushing. Another doctor suffering from blush wears a red tie to hide his blush, and others grow a beard to reduce the area of his blush. There was a famous sculptor who blushed when talking to people, so he left his seat temporarily on the pretext of urinating. This kind of patient even finds it inconvenient to ask someone for directions. They would rather hide in a place where no one is around and try to look up the map, even if it takes more time. The above symptoms are ridiculous to normal people, but they are as painful to patients as falling into hell. They feel that if they don't cure the symptoms of red face fear, they can't talk about how to be a man.
▲ line of sight fear
The patient complained that he couldn't look directly at others when meeting them, and he felt embarrassed when his eyes met, and he didn't know where to look. Patients blindly pay attention to what is in front of them and are eager to force themselves to settle down, but it often backfires. In the end, they can't concentrate on talking with each other, and the preface of the conversation is inconsistent, often losing their normal state. Some patients with line-of-sight fear complain that they can't pay attention to the opposite person when they are in a room with many people, but they are forced to pay attention to the line of sight of others next to them, or think that their line of sight is facing the person next to them, which makes them feel unhappy. In this way, the patient can't concentrate on the opposite person. Some students and patients always can't pay attention to their classmates in class, or always feel that their classmates are paying attention to themselves, which affects their classes and brings them great pain.
▲ expression of fear
Patients are always worried that their facial expressions will cause disgust or be looked down upon by others, which makes them feel panic and uneasy. The expression of fear is related to Otawa's eyes. Patients think that their eyes are intimidating to others, or that their eyes are dull. One patient had a look of fear. He stubbornly believes that his eyes are too big and his black eyes stand out, which makes people look down on him. He also thinks that his expression is often angry, which will definitely bring unhappiness to others. He thought hard and even stuck a plaster on the corner of his eye, thinking that it would make his eyes smaller, but his eyes were under great tension, which was very painful and difficult to last. Finally, the patient decided to have an operation. Of course, no ophthalmologist will do such an operation on him. There is also a patient who thinks that he is always crying, which must be ugly. He went to the doctor to discuss whether the lacrimal gland could be removed. Another civil servant thought that his lips were askew when he spoke, which brought unhappiness to people, so he considered resigning. Some patients think they are sad when they smile, while others think their eyebrows and nose look sick. A female classmate was joking with others when she heard that her face looked like a mask. Since then, her face has been concerned, I don't know what to do, and finally I don't even want to see anyone.
▲ Fear of the opposite sex
The main symptoms are basically the same as those in the previous situations, except that when the patient is in contact with the opposite sex or his own leader, the symptoms are particularly serious, and he feels extremely depressed, overwhelmed and even speechless. It's not a big problem to associate with people of the same sex and colleagues you are familiar with.
▲ stuttering fear
Stuttering fear can be classified as a kind of social fear. When the patient reads aloud alone, there is nothing unusual, but in front of others, it is difficult to speak, or it is difficult to pronounce or just halfway through, so I can't go on. Patients are worried about this, because they can't talk to people smoothly and feel that they are disabled, and finally they are very upset.
[Edit this paragraph] Etiology
From the perspective of psychoanalysis based on humanism, the causes of social phobia mainly include the following aspects:
1. Always can't get out of the quagmire of repetition in the past.
In fact, social phobia is often not sudden, but long-term It is often found that these visitors have some maladjustment and some potential social problems since childhood. These problems are not solved naturally with the growth of age, but always repeat the old model over and over again, which makes visitors very painful. What's going on here?
You can use a metaphor to answer this question. For example, if a person has an ulcer in his mouth, he will always lick it with his tongue over and over again, even if it hurts again. Why? To try to fix it. The same is true of people's growth. Visitors with social problems repeat the old pattern over and over again because they are thinking, "If you do this again, you may succeed!" " But doing it again often fails. To get out of the quagmire of repetition in the past, we need to have a clearer understanding of our life pattern through psychological counseling, so that the scars can finally heal.
2. Why are you always depressed?
There is a metaphor that human psychology is like an iceberg, with only a small part exposed on it and the largest part below the water. People suppress what they don't want to accept into the subconscious, just like the part of the iceberg under the water. So, what is repression? What is repressed is what you don't want to face or even realize. These things are suppressed below the water surface and play an important role in people's psychology in the dark, which is what people often call the subconscious. Knowing these subconscious minds, they will no longer be manifested in the form of symptoms. For visitors who are socially fearful, it is necessary to understand all aspects of themselves and let subconscious things float to consciousness, and social fears will be improved accordingly.
3. The influence of family
Family has an influence on disease. Parenting style, family structure and siblings all play a certain role in the occurrence and development of social fear. Children who are always criticized for being unloved at home tend to distrust others and have social problems when they grow up. There are many situations that will also have an impact on social problems.
There is another situation. On the surface, visitors are well adapted to the society, but they lack the ability to establish close relationships with others, so they can only communicate with others on the surface, which is a hidden manifestation of their inability to integrate into the society. Although such people may not have social fears, they will also have their own social problems. This phenomenon is also related to the family he grew up in.
4. Cognition and emotion of social fear visitors
Psychoanalytic therapy based on humanism attaches importance to emotion, opposes emotion and also involves cognition. Visitors with social horrors often have a strong sense of self-guilt, and often think that they can't do this or that. In short, there is nothing good, they feel depressed. But they will think that they are better than anyone else in some important aspects, and others are not as good as him. Why is this?
Have the problem of inferiority. Because of inferiority, I feel that I can't do anything; Because of inferiority, we need pride to compensate. There are many psychological mechanisms that vary from person to person.
The reasons for social fear are complicated, and this is just a starting point. To solve the problem of social fear, we need to go to a professional psychologist for formal psychological consultation and treatment.
Since human beings existed on the earth, they have inevitably formed contact with others. In real life, people inevitably have to deal with all kinds of people. Women in the office, in particular, may need to talk to important people, may express their views in public, and may appear in various social places such as negotiations, cocktail parties and dinners. However, you always shrink back involuntarily, or crustily skin of head, but let the great opportunity slip away because of your gaffes. You are upset and regretful, but when the next opportunity comes again, you start to be timid, hesitant, flustered and trembling. Over time, your self-confidence is exhausted in embarrassment again and again. I met such a visitor.
Social phobia is a comprehensive psychological disorder characterized by anxiety, fear and autism. Mainly manifested as: self-enclosed, afraid to make friends, afraid of socializing; Social desire is not satisfied, resulting in anxiety and loneliness; I dare not face setbacks, thus escaping from reality, and feel that it is only safe to hide in a place where no one is there. However, social phobia is not only manifested in the face of strangers, but also in extreme behaviors such as not being able to make phone calls in public, not drinking with people in public, not meeting strangers alone, and not working under the gaze. When this kind of fear and anxiety appears, it is often accompanied by symptoms such as palpitation, trembling, sweating and difficulty breathing. According to statistics, on average, 1 person suffers from social phobia, but there are very few patients. Many patients suffer from mental illness such as alcohol addiction, drug addiction or depression due to long-term interpersonal communication barriers and loss of social skills. We have to deal with people every day. How can we isolate ourselves?
Causes of social phobia:
① physiological reasons. In 2000, a seminar on social phobia was held in Shanghai. The speaker, a famous American psychiatrist, Mr. David Western Han, said that the attack of social phobia was caused by the imbalance of a chemical called "5- hydroxytryptamine" in the human body. This substance is responsible for transmitting information to brain nerve cells. Too much or too little of this substance will cause people's fear;
② Psychological reasons. People with social phobia generally have strong self-esteem, fear of being rejected by others, or have no confidence in their appearance;
③ Family reasons. Personality has been suppressed since childhood, or parents have not taught them social skills, or families have moved too often;
④ Social reasons. I live in a bad social environment, and I will encounter setbacks when I interact with people.
⑤ mode of thinking. Personality is actually the external expression of people's own way of thinking, and the incorrect way of thinking has created social phobia. For example, the over-self-reflection brought by the attack on the over-perfectionist, every social phobia patient should have a full understanding of the "self" (ID, ego, superego).
Pathogenesis of social phobia
With the popularization of psychological counseling and social guidance, cognitive behavior theory has been developed. Some authors believe that social terror is mainly due to the lack of social skills and abilities. Lack of social skills will leave a bad impression on others, cause bad reactions from others and lead to embarrassing situations. At the same time, I realize that my social clumsiness can easily cause tension and fear.
Other authors emphasize the role of cognition. They think that the social behavior of patients with social phobia can be completely appropriate objectively, but the patients' evaluation of themselves is inappropriate. In the social process, patients' self-mockery plays an important role. Many patients are people who lack self-confidence and are easy to feel inferior. There are also some patients who demand too much of themselves, hoping that they can't be praised and liked by everyone with their superior eloquence and demeanor. This will inevitably lead to repeated self-frustration, and finally make people nervous and afraid. Of course, many authors combine social skills with self-evaluation and emphasize the interaction between cognition and behavior.
Leary( 1983) thinks that all the existing theories are helpful to understand social phobia, but none of them can fully explain the known pre-illness situations (pioneers and induced events) and post-illness manifestations. Leary's theory is called self-recommendation theory. The main point of this theory is that social interaction must have motivation. Generally speaking, only when a person wants to create a special impression in other people's minds will he feel nervous or even afraid. If I don't care what others think of me, I won't be nervous and afraid. It can be seen that the same factor that determines all social horrors is motivation, that is, the motivation to leave a good impression in others' minds. There are two factors that determine motivation: one is the situation and the other is the personality.
Let's start with the situation. For example, if you want to make friends or fall in love with the opposite sex, the more beautiful or talented the other person is, the stronger the motivation, and the easier it is to be nervous. For another example, if there are many people competing and the selection criteria are strict, we will easily feel nervous. For another example, the person you want to meet is in power, and the interview will play a key role in your life. It is easy to be nervous when meeting. Generally speaking, it's easy to be nervous when meeting people for the first time, because we all know that the first impression is particularly important. It can be seen that in terms of incentives or pioneer events, it is often a certain situation based on specific motives. Of course, there are exceptions, that is, there is no specific purpose in advance, but the occasional embarrassing situation frustrates the motivation of patients to gain the favor of others, or it can be an induced event.
Let's talk about the other side that determines motivation, that is, a person's personality characteristics. If a person tends to control the impression of others on him, or, especially loves face, it seems that everyone likes him, so as to have face; In other words, perfectionism tends to be strong, and people who want to be perfect in front of others are prone to social phobia.
Generally speaking, the prognosis of social phobia is good. As long as patients live long, social phobia will be alleviated or even disappeared sooner or later. However, without effective psychotherapy, social phobia can be delayed for many years, and the most precious age of life is wasted in pain and inaction.
We can see some extreme cases in clinic. Some patients have relatively sound personality before they get sick, and they are terrified in a strongly traumatic situation. In this case, systematic desensitization therapy is effective. At the other extreme, the patient has personality disorder. He was shy and afraid of meeting people since he was a child, loving face and being competitive. He lacked social training and had no hobbies since he was a child. At best, he just eats and reads books, and he is always among the best in exams. As soon as this kind of person reaches puberty, social terror is obvious, and there is often no clear incentive.
More commonly, the interaction between situational factors and personality characteristics leads to the development of social terror. Why does social phobia spontaneously ease after middle age? Quite simply, the special opportunities for social interaction decrease with age. In layman's terms, social phobia loses its growing soil when its skin thickens. Broadly speaking, socialization includes communication with parents, but no patient has suffered social terror in front of their parents. There are three reasons for this:
(1) Parents regard their children as the apple of their eyes, geniuses or dutiful sons, and they appreciate and love them themselves, so fear cannot happen;
Parents always keep saying that when children grow up, they know everything like the back of their hands and can see their own shortcomings and deficiencies clearly. Children don't think that their parents will have any other views and comments on themselves, and they don't need to pretend or hope to get a particularly good impression from their parents;
(3) Children are full of resentment and hostility towards their parents. Anger makes fear impossible, or parents and children feel indifferent to each other, so they lack social motivation.
[Edit this paragraph] Incidence rate
Experts estimate that in China, due to the general lack of understanding of the disease, a large number of patients are regarded as "timid and introverted" and neglected, resulting in a conservative statistics of the number of patients with social phobia.
We can see some extreme cases in clinic. Some patients have a relatively sound personality before they get sick, and they will have fear in a strong traumatic situation. In this case, systematic desensitization therapy is effective. At the other extreme, the patient has personality disorder. He was shy and afraid of meeting people since he was a child, loving face and being competitive. He lacked social training and had no hobbies since he was a child. At best, he just eats and reads books, and he is always among the best in exams. As soon as this kind of person reaches puberty, social fear is obvious, and there is often no clear incentive.
[Edit this paragraph] Treatment
Treatment of social phobia: The general procedure is to increase the tolerance of fear by gradually increasing social situations, so as to achieve the effect of eliminating social fear reaction.
First of all, keep telling yourself that this fear can be eliminated. And correctly understand the procedures and methods of interpersonal communication.
Secondly, we should find out the types of things that cause social fear and try to dig deep into our inner roots.
Then in an imaginary space, constantly simulate the scene of social phobia, constantly practice the plot of recurring symptoms, and constantly encourage yourself to face this scene bravely and adapt to this anxious and tense environment from imagination.
Finally, take compulsory treatment, step by step. Stand on the busy street first; Reduce the number of people shopping in shopping malls after adaptation; Then reduce the number of people and attend some large parties; Then attend small gatherings and try to express their views; Finally, associate with people you are afraid of and always reward yourself. By using this method and practicing constantly, the disease will be greatly improved.
The treatment methods of social anxiety disorder mainly include the following.
1, Hypnotherapy: Psychoanalysts hypnotize you, dig deep into your heart or memory, see if you have experienced some embarrassing events, and try to find the root of your illness. This treatment takes a long time and costs a lot.
2, forced treatment: the doctor let you stand in the bustling street, or let you stand in front of the opposite sex that you are very afraid of, using huge psychological stimulation to force you to treat.
3. Situational therapy: Let you constantly simulate the scene of social phobia in an imaginary space and practice the plot of recurring symptoms. Psychoanalysts will continue to encourage you to face this scene and let you adapt to this environment that produces anxiety and tension from imagination.
4. Cognitive therapy: This is a therapeutic method of indoctrination. Doctors keep telling you that this fear is abnormal, so that you can correctly understand the procedures of interpersonal communication and teach you some methods of interpersonal communication.
5. Drug therapy: This is currently considered to be the most effective treatment. Mainly because your illness is caused by a chemical imbalance in your body, so you should use some drugs to adjust this balance.
Common treatment methods
In social situations, you don't have to care too much about the impression you make on others. You should know that you are just a nobody and won't attract much attention. The correct way is to learn to focus on what you want to do.
When you are too nervous or anxious, you might as well ask: How bad can it be? What can I lose in the end? What's the worst result? The big deal is to go back to the original starting point, what's the big deal! When you figure this out, everything will become easier.
In order to overcome the fear, the pendulum method might as well think like this: if the pendulum wants to swing to one side, it must first exert force on the other side. I blush like a red cloth; What's the big deal about my heartbeat? I want to dance faster than a rock drum! In this way, people will find that the actual situation is far from as serious as originally thought, so their attention is shifted to the topic.
Systematic desensitization can overcome psychological barriers step by step in the face of the girl you love. One: first make up your mind to look at her clothes; Two: look at her face and eyes; Three: smile at her; Four: take the initiative to talk to her when a friend is around; Five: Have the courage to contact her alone. This method of avoiding direct collision with sensitive centers makes a seemingly difficult social behavior easy. This method generally has immediate effect on mild social phobia.
However, when the adverse reactions are serious, it is necessary to apply appropriate drug treatment, which has a certain effect on eliminating psychological tension and relieving physical discomfort. This kind of treatment must be carried out under the guidance of a professional doctor to avoid adverse consequences such as addiction and drug dependence.
[Edit this paragraph] Self-treatment
1, don't deny yourself, keep telling yourself "I am the best me" and "Since God has given talents, let it go and be hired!" .
2, don't be hard on yourself, do what you can, as long as you try your best, it doesn't matter if you don't succeed.
Don't recall the unpleasant past, let bygones be bygones, nothing is more important than the present.
Being friendly to others and helping others is the foundation of happiness. When helping others, you can forget your troubles and prove your value.
5. Find someone to talk to. If you are in trouble, you must say it. Find someone you can trust to talk about your troubles. Maybe others can't help you solve the problem, but at least they can let you vent.
6. Give yourself 10 minutes to think every day and constantly sum up yourself, so as to constantly face new problems and challenges.
7. Go to a crowded place, let people walk in front of you and try to give people a smile.
Self-prevention and treatment of social phobia
Social phobia is mainly caused by a kind of "fear" psychology, such as fear of meeting strangers, fear of embarrassment and fear of expressing oneself. This disease is formed in many years of daily life, work and study. Therefore, prevention and treatment need to gradually cultivate the ability to adapt to the outside world and consciously contact people and things around. Although I am not used to it at first, sometimes I will be rude and feel embarrassed, but I have to understand that no one is born with that kind of good social psychology and means, and people need to be cultivated in the social activities the day after tomorrow to become comfortable.
To prevent social phobia, we should psychologically remove the inferiority complex in social interaction. If you have negative psychology, you will often make yourself unwilling to talk more and do more activities. In fact, everyone has their own advantages and disadvantages, and they are not as good as others socially. Not to say that there is nothing worse than others. We should think more about our strengths. People who are not used to socializing, in particular, should get rid of inferiority complex and establish the spirit of self-improvement, self-confidence and self-reliance. Only in this way can they overcome their negativity psychologically and become positive and natural in their communication with others.
To prevent and treat social phobia, we should also remove the word "fear" psychologically. Normal social activities are not mysterious, but the communication and entertainment between people in society. Therefore, in social activities, you don't have to pay too much attention to your manners. You are easy-going, generous and natural, and you do what you say and do at ordinary times, even in social activities. After a long time, you will get used to social activities.
Prevention and treatment of social phobia should also pay attention to social forms, such as taking explicit social content to participate in social activities before social activities. Psychologically, with certain social content, we can shift our attention from ourselves to things without being too nervous. The first social interaction can be accompanied by people who are experienced in social activities, and their peers can sing "leading role" and "supporting role" by themselves, so that they can learn from others' social styles and exercise their social skills to prevent embarrassing situations in social interaction.
[Edit this paragraph] Self-test
How do you know if you have social phobia? The doctor pointed out the following three points for self-test:
One: Are you afraid of being shy or embarrassed in front of others, so you won't talk to others or do something?
Two: Don't want to be the focus of attention?
Three: Are you afraid that others will think you are stupid or that you will look shy?
If you have two of the above three points, you may suffer from social phobia; If these circumstances make you want to stay at home and avoid contact with any strangers, you may need counseling or treatment.
The treatment of social phobia is divided into two parts: psychotherapy and medication. People with mild illness only need psychological treatment. Doctors will do psychological construction for patients during the consultation and understand the main reasons of patients' social phobia, and enlighten them from the crux to help patients build their self-confidence. If the condition is serious, the doctor will cooperate with drug treatment.
Some people hate or are afraid to face the crowd. They are not only shy and embarrassed, but also have a strong sense of unease and rejection of the world outside themselves. This kind of anxiety and social disorder caused by not adapting to social life and groups is called social phobia.
Social phobia is a mental illness, but because of their introversion and shyness, it does not mean that they really suffer from social phobia. People with social phobia usually have a very negative view of this group. It is difficult for them to communicate with the outside world except a few close people. These people can't take the initiative to go out of their own world, and they don't want to join the crowd. These people will feel uncomfortable in crowded places, fearing that others will pay attention to them, be criticized and be out of place. People with mild illness can still live a normal life. If the situation is serious, it will cause obstacles in life and lead to the inability to study or work normally.
Social phobia has become the third major mental illness after depression and alcoholism, and the number of people suffering from social phobia is increasing because of the increasing pressure now. Moreover, for doctors, the difficulty in treating these patients is not that there are more and more patients, but that people with social phobia are often unwilling to see a doctor because they are afraid or unwilling to contact strangers or are afraid of being labeled as "mental illness".