Social phobia: features, types and methods of struggle

In our daily life in recent years, the concept of "social phobia" has become firmly established. And many of us often use it in speech, not quite accurately imagining what it is, and how this concept differs from introverts and sociopaths.

Sociophobia is a fear of society, a fear of society. The name comes from the Latin word "socius" (common) and the ancient Greek "φ? βος ", which means" fear "," fear ". Sociophobia is a type of anxiety disorder of personality that manifests itself in an inexplicable and unreasonable fear of doing something in society - to speak to the public, to perform some actions under the watchful eye of others. Sometimes fear arises even in front of strangers who do not care about a person, for example, in front of passers-by on the street. A socialophobe can be afraid of both real observation from the outside, and of the circumstances he imagined (it seems to a person that everyone on the street or in a shopping center is watching him).

Most social phobes are well aware of their problem, they are aware that fears have no reasons, but they cannot cope with them. Some are afraid only of certain situations (for example, the need to speak in front of an audience), while others are afraid of a wide range of situations related to society.

I'd like to say that social anxiety is not born, but this, alas, is not so.Up to half of all people with this problem have a genetic background, and they show signs of social phobia in childhood, usually before the age of 11.

In most cases, fear of society is not the only problem, because when it appears relatively early, social phobia leads to other personality disorders as well as mental disorders. Often, social phobes become drug addicts and latent alcoholics, addicted to computer games, and become clinically depressed. In the world medical literature, the phenomenon has another name - "missed opportunity disease", later you will understand why.

It is difficult for sociophobes to realize themselves in the profession, creativity, to build strong and trusting relationships with people. They constantly experience the strongest anxiety when there is a need to leave their "shell" and contact with the outside world, or rather, one of its components - other people like themselves.

Social phobia is a persistent disorder that recurs many times. And among the great variety of phobias known to mankind, this is one of the most common. In different situations, individual manifestations of fear of society are found in about 5-16% of people, but fear of their own kind spills over into the clinical form only in 1-3%. There are no gender differences - both men and women are equally susceptible to this fear. In severe form, this form of social fear leads to disability.

Social phobia can only be called a mental illness with a big stretch, more often experts attribute it to mental disorders of an anxious type. But this does not in any way diminish the need for treatment. Quite often, those around the social phobia are not taken seriously., and the refusal of a person to go shopping or talk to a neighbor who flooded the apartment the day before is perceived as an excuse, a manifestation of laziness. Specialists in the field of psychology and psychiatrists are unanimous on this issue: social phobia is not a pretense, not a whim, but a real problem, a personality disorder.

Like neurosis, social phobia needs diagnosis and treatment, however, no one can guarantee complete deliverance. Like all mental anxiety disorders, social phobia tends to recur when a person is suddenly in a traumatic emotional or psychological situation. But correction allows you to live better and even achieve considerable success in a certain narrow specialization.

It's hard to imagine, but the famous Hollywood comedian Jim Carrey suffered from social anxiety as a teenager and received treatment from a psychotherapist. Actress Kim Bessinger and Robert Patinsson had a similar problem during puberty. The great scientist Lev Landau could not get rid of social anxiety, which did not prevent him from achieving the highest results in physics and becoming a Nobel Prize winner. Suffering from social phobia, according to historians, the writers Nikolai Gogol and Hans Christian Andersen.

The most famous social phobia of recent years is the mathematician Grigory Perelman. He is satisfied with his St. Petersburg "Khrushchev", in which he feels safe, and therefore categorically refuses offers to take part in international conferences. He was awarded a million dollar prize for achievements in the exact sciences, but the man never came to Paris for it.No one has ever been able to interview the great mathematician - he runs away as soon as he sees a journalist or someone who is clearly heading for him.

In other words, social phobes cannot be considered stupid, their reason and consciousness do not suffer. When the phrase "mental illness, disorder" is used, many imagine an insane person, with difficulty understanding who he is, what he is and why. This is not about social anxiety. They clearly see their purpose, they are often very talented, have extraordinary abilities, but they can only reveal them when they are not paid attention to.when their life is hidden from prying eyes.

Don't confuse social anxiety and introverts. A good quarter of the world's population is introverted. These are healthy people who are completely self-sufficient, they are not bored alone with themselves, they are immersed in themselves and their business and do not need wide social contacts, their favorite book, remote work, a warm cat by their side in their favorite chair are enough for them. But if circumstances require, an introvert easily, albeit reluctantly, leaves his comfort zone, contacts people without fear, communicates, and establishes social ties. Another question is what he is waiting in the shower, so that everyone will finally leave him alone, so that he can go back to his "shell".

If you look at social phobia from a medical point of view, as psychiatrists, psychotherapists and psychosomatic specialists do, then the mechanisms of such irrational fear will become clear. At the end of the last century, neurophysiologists from Italy discovered "mirror cells" - special groups of neurons that are responsible, as the name implies, for imitation. This is what lies at the heart of the human ability to empathize with others, to empathize, that is, it is the basis of empathy.... Without empathy, a person is not able to fully interact with their own kind, to build trusting relationships with other members of society.

Any abnormalities, paradoxes and disturbances in the work of mirror cells cause impairment of empathy. A person is isolated - he cannot exchange with other emotions, and then he realizes that he cannot exchange information either. Even a simple conversation that “the weather is great today” is, first of all, not only an exchange of words, but also an exchange of emotions. One interlocutor sends another positive emotions of admiration (even if not the most sincere) on a sunny morning, and the other either supports them, accepting and empathizing, or has a different point of view, in which case he also accepts the interlocutor's emotion, but he has a different response. It’s not like that with a social phobia. Mirror neurons do not provide imitation, do not cause "transmission and reception" of emotional messages.

If someone decides to laugh at a healthy person, to make fun of, with a high degree of probability those parts of the brain that are responsible for aggression, anger, ancient zones responsible for protecting their territory from outside threats will be activated in response. In a social phobia, the brain works differently: in response to a ridicule or a sting from another, brain zones that are responsible for fear and anxiety are immediately triggered, and the center of pain is often activated, which causes real physical pain.

Thanks to popular TV shows such as House, Sherlock, and others, people began to use quite widely another concept - "sociopath". At the same time, in the overwhelming majority, we do not represent the difference between social anxiety and sociopaths, believing that these are just different sides of the same coin.

Sociopathy is a completely different diagnosis. If fear is at the heart of sociophobia, then sociopathy is more likely to be absent. A sociopath deeply does not care about society, he will undoubtedly go over his head to achieve his goal, he does not care about social norms and rules, he is capable of impulsive actions "to spite others." They are aggressive towards their own kind, but charming like no one else. Therefore, they successfully manage to find admirers, admirers, and also invariably cripple the lives of everyone to whom they approach.

A sociopath doesn't care about your problems - he doesn't know how to empathize in principle (mirror neurons suffer here too, but in a slightly different way). He can pretend that he is interested in your problems, but only if he needs you to achieve his goals. If not needed, he will not make efforts on himself and portray a lively human participation.

Sociopaths don't feel guilty... Even if they have done a lot of unsightly and even frankly vile things, they will always find a million excuses for their actions, dumping all the responsibility on those around them (“Yes, I beat up the seller in the store, but he is to blame, because he looked at me impudently, he made a remark , did not breathe like that ").

To make the difference more understandable, it is worth talking about the most famous sociopaths in the world. These include Adolf Hitler, one of the most famous maniacs on a world scale - Andrei Chikatilo, the most famous child murderers John Venables and Robert Thompson, who were sentenced to life in prison at the age of nine.

Cruelty is almost always characteristic of sociopaths to one degree or another, as well as pathological lies, even in small things, as well as sudden mood swings. But don't think that you easily recognize a sociopath in a crowd. It is much easier to calculate a social phobia - by his fear and strange behavior. It is more difficult with a sociopath - these are, as a rule, very intelligent, well-educated, intelligent and very charming personalities, egoists, but very convincing - when they speak, you involuntarily believe them.

The main difference is that a sociopath cannot live without society. He needs to be pushed around by someone, to scoff at someone, it is vital for him to dominate his own kind, to feel like the only ones who have been given almost divine powers - to dispose of the lives and destinies of others. A socialophobe feels much better without society.

According to the severity of manifestations, several types of social phobia are distinguished. With pronounced forms of violation, they manifest themselves as uncontrollable panic attacks, and with a moderate course of the violation, a person has internal reserves in order to assess his feelings more or less sensibly and even cope with some manifestations of fear, although this is very, very difficult.

Anxiety is almost constant in social phobia. But some of the nuances of the perception of reality allow us to distinguish two groups of social phobia:

• outlined form - fear appears only in certain situations of the same type, for example, when it is necessary to speak with a cashier in a supermarket or when speaking in front of the public, to be interviewed for a job, to pass an oral exam;
• generalized form - panic and fear appear in a huge number of very different situations created by society.

There are phobias that appear temporarily, but may worsen in the future, and there are long-term and persistent types of disorders.And one social phobia is just afraid to read poetry in front of the class, while the other will refuse to leave the house altogether. For some, fears tend to subside, while for others they are constant, daily.

Why social phobia develops, science is not known for certain. Researchers who at different times tried to investigate the essence of this phenomenon, came to approximately the same conclusions - there is a certain hereditary predisposition. But the specific gene that could be “assigned” to be responsible for this mental disorder has not yet been identified. Psychiatrists have noticed that family members with someone with social phobia are 70% more likely to face the same problem. And here teachers and psychologists have already made their contribution, who suggested looking for the cause not only in the paradoxes of nucleotides and the genome, but also in education. It has been absolutely proven that a parent with social phobia or other anxiety disorder transmits his model of perception of the world to a child.

A study was conducted involving twins who were adopted by different families. Surprisingly, if one of the twins fell ill with social anxiety, similar problems were soon found in the other. Also, shy and anxious foster parents gradually developed similar qualities and anxiety disorders in foster children (studies conducted in 1985 and 1994 by Bruch and Heimberg and Daniels and Plomin).

A child and adolescent with established social phobia usually, as shown by psychiatric practice, authoritarian, demanding parentswho are emotionally detached from him. There is another extreme - mom and dad who are overly protective of the child. In both cases, the starting mechanism for triggering the disease is a lack of emotional closeness and a lack of basic security. The longer a child lives in fear of punishment, disapproval from adults, the more dangerous the world begins to seem to him. Overly caring parents lead the child to the same denominator by other actions - they take care of him too much, try to protect him from the world, because of this, the child develops a clear attitude towards the future - the world is very dangerous, scary, nightmare, it is impossible to survive in it.

If in the first case, the parents by and large do not care what the child feels, then in the second - quite the opposite. Mom will come up with a lot of reasons why you can't talk to strangers, you can't go out without a hat, you can't be late home from a walk, you can't pet cats on the street. As a result, imaginary and real dangers mix together for the child and become one black, threatening mass of evil, from which there is only one way to escape - by hiding away.

But these are prerequisites. As for the provoking reasons, it should be noted that in most cases the disease started in a child after he entered into a tough or even cruel confrontation, a conflict with others, and became a victim of public ridicule (both peers and adults). Most adult social phobes claim they were social outcasts as children., they were laughed at - because of their appearance, the financial situation of their parents and for other reasons. In adults, social phobia can develop after being in similar situations for a long time.

Another interesting study conducted by specialists from the UK showed that in newborn babies it is possible to identify such features of the nervous system as behavioral inhibition. This means that such children are more focused on themselves than on the perception of the world around them. About 10-14% of people have such a temperament from birth, and it is among them that those who fall ill with sociopathy are then found (this does not happen for everyone).

An important role in the occurrence of a violation is also played by experience, and not only personal, when the person himself was humiliated and offended, but also a stranger, when the sick person became only a witness to someone else's public humiliation or persecution. The transfer of this experience to oneself also provoked the development of the disease.

There are several groups of signs that are characteristic of true social anxiety disorder. They are divided into:

• cognitive;
• behavioral;
• physiological.

Cognitive symptoms: a person experiences real horror at the mere prospect that someone will evaluate him or what he is doing. They are extremely self-centered, watch their appearance, and constantly control their words and behavior. They have inflated demands on themselves. They are trying with all their might to make a good impression, but at the same time they do not doubt in the least that they will never succeed under any circumstances.

They are in tension, replaying in their heads hundreds of times possible scenarios of events, dialogues, analyzing and sorting out "by cogs" what and where they did wrong. Thoughts are obsessive, it is almost impossible to get rid of them, to switch to something else.

The notions of the classical social phobia about himself are not distinguished by their adequacy: they see themselves worse than they really are. Sociophobes remember the bad, not the good, longer and more in detail, and this is one of the striking differences from a person with a healthy psyche (in a healthy person, bad memories are quickly forgotten, while good memories can be retained in memory for decades in all details).

Behavioral symptoms are something that others can notice, since only the social phobia himself knows about cognitive symptoms. To say that such a person is shy is somewhat erroneous. Social phobia differs from the shyness inherent in many children and adolescents, because with shyness in general, a person's life does not suffer, which cannot be said about social phobia. The sociophobe stubbornly avoids contact, most zealously refrains from communicating in small or small groups. Going on a date is torture for him. A true social phobia does not talk to strangers, even if they turn to him, but at the same time he is not aggressive, he simply speeds up his pace and avoids answering in the literal sense of the word. If you press him against the wall, you will notice that the social phobia never looks the other person in the eye.

The physiological symptoms of social anxiety disorder are very similar to those of any anxiety disorder: this is increased sweating, quick tears, bouts of nausea in an alarming situation, shortness of breath, trembling of hands and feet, changes in heart rate. Often, patients have a disturbed gait (they constantly control themselves, and therefore watch their steps as if from the side). The gait can be different depending on whether one person is walking by a group of people.

Often the face of a social phobia turns red evenly or in spots when he is worried, and he himself notices all these symptoms, and therefore becomes even more nervous, realizing that others see it too.

As already mentioned, social phobia rarely "walks" by itself. Statistics show that every fifth social phobia has problems with alcohol. 17% of social phobia additionally suffer from severe forms of depression, 33% of patients additionally experience panic disorder, and 23% of people with social phobia have attempted suicide. In some cases, social phobia "coexists" in one person with Asperger's syndrome and autism, sometimes with bipolar personality disorder.

The first signs of the disease are usually found in adolescence, and at first they look insignificant, barely noticeable.And if you pay attention to this at this stage and provide timely assistance, there is a possibility of a complete cure. But for the majority, the disorder nevertheless becomes a chronic persistent form or progresses.

The most noticeable symptoms of social phobia become in people aged 30-45 years. Such patients carefully plan their day so as not to go to the toilets in a public place, and do not eat in the presence of others. Many people are forced to quit their jobs in order not to meet with colleagues and clients. For some, it can be difficult even to communicate on the phone and Skype (although most social phobes are quite capable of a telephone conversation).

There is a special test for social phobia. It consists of 24 question-situations for the last week. If the situation described in the test happened over the past 7 days, the person describes it, if this was not the case, he describes his possible behavior in such a situation. For each item, the level of anxiety is assessed in points. It is called the Leibovich test. It is available for free on many resources.

Do not diagnose yourself on your own. Only a doctor who will not only listen to complaints but also receive data from special questionnaires can recognize a person as a social phobia. It is noteworthy that not always people with such a problem come to an appointment directly to a psychiatrist or psychotherapist. Sometimes they turn to an ordinary district therapist or even a cardiologist with complaints of palpitations, dizziness. An experienced doctor of any profile will quickly be able to distinguish somatic pathology from anxiety disorder. In this case, he will direct the patient to the correct address.

It is customary to treat social phobia on an outpatient basis. If a person with fear of society is placed in an unfamiliar hospital environment with other patients and a large team of unfamiliar health workers, his condition can only worsen. For treatment, cognitive-behavioral therapy is used, in which a specialist helps the patient find his erroneous attitudes and thoughts and, with the help of special exercises, eliminate or reduce them. Then they begin to deliberately gradually and carefully immerse the person in situations in which he previously experienced horror. This part of the treatment is carried out in groups in the form of role-playing games, trainings.

With concomitant depression, similar treatment is carried out simultaneously with the intake of medications - antidepressants or tranquilizers. Tranquilizer pills are needed to stabilize the mental state in the moment of fear. They try to prescribe such strong medicines in courses of a maximum of 3-4 weeks. Antidepressants help to normalize appetite, mood, and improve sleep. They can be taken in courses of 4 months or more at the discretion of the doctor.

It should be warned that experts do not speak too flatteringly about the drug treatment of social phobia. Both antidepressants and tranquilizers, as well as benzodiazepines, which are recommended for severe forms of the disorder, only treat the symptoms, but in no way treat the underlying cause. Without a psychotherapeutic course, the pills will only help for a time limited by the time they are taken. The course will end and the fears will return. The stronger the drug, the higher the likelihood of a relapse of the disease after you stop taking it.

Hypnosis, relaxation methods, and physiotherapy are widely used in treatment. But no medications and doctors will help get rid of the problem if the person has no motivation. Therefore, only with their own desire to overcome fear of society, the forecasts are assessed as favorable.It is difficult to say how long the struggle will go on: some manage to overcome their phobia in a few months, others have to continue treatment for several years. This is individual and depends on the person, on his desire to cope with the problem and on the form and type of mental disorder.

Cases of social phobia are considered to be unfavorable in medicine, when a person turns to late, after many years of fear. For such a long period of time, the phobia causes severe social maladjustment and, as a rule, is already combined with one or another concomitant mental diagnosis, with alcoholism, drug addiction.

The question of how to treat social phobia on your own is not very correct. It doesn't occur to you to remove your appendicitis at home or to correct an open fracture yourself. Mental disorder is not psychological instability. Here the advice of psychologists to urgently love your neighbor and appreciate every day you live does not work. A mental disorder requires qualified correction after a doctor and only a doctor can establish all the circumstances and severity of the disorder.

The task of relatives and friends, friends and comrades of a social phobia is not home-grown motivation with the demands to "stop pulling rubber", "pull yourself together" and "do it right now." He cannot pull himself together, even if he would be glad to do it. The most appropriate help is to convince the person to go to see a psychiatrist or psychotherapist. This will be the first step to healing. During long-term therapy, the social phobia also needs support and approval.