Social Anxiety Disorder

Social anxiety disorder (social phobia) is a persistent and overwhelming fear of social situations. It's one of the most common anxiety disorders.

Social anxiety disorder is much more than "shyness". It can be intense fear and anxiety over simple everyday activities, such as shopping or speaking on the phone.

Many people sometimes worry about certain social situations, but someone with social anxiety disorder will worry excessively about them before, during and afterwards. They fear doing or saying something they think will be embarrassing or humiliating, such as blushing, sweating or appearing incompetent. Social anxiety disorder is a type of complex phobia. This type of phobia has a disruptive or disabling impact on a person's life. It can severely affect a person's confidence and self-esteem, interfere with relationships and impair performance at work or school.

Social anxiety disorder often starts during childhood or adolescence and tends to be more common in women. It's a recognised disorder that can be effectively treated, so you should see your GP if you think you have it.

Signs of social anxiety disorder

A child with social anxiety disorder may cry more than usual, freeze, or have tantrums. They may fear going to school and taking part in classroom activities and school performances.

Teens and adults with social anxiety disorder may:

  • dread everyday activities, such as meeting strangers, talking in groups or starting conversations, speaking on the telephone, talking to authority figures, working, eating or drinking with company, shopping
  • have low self-esteem and feel insecure about their relationships
  • fear being criticised
  • avoid eye-to-eye contact
  • misuse drugs or alcohol to try to reduce their anxiety

Panic attacks

The fear of a social situation can sometimes build up to a panic attack, where you feel an overwhelming sense of fear, apprehension and anxiety. This usually only lasts a few minutes.

You may also experience physical symptoms, such as feeling sick, sweating, trembling and heart palpitations. These symptoms often reach a peak before quickly passing. Although these type of symptoms can be alarming, they don't cause any physical harm.


Other mental health problems:

Many people with social anxiety disorder will also have another mental health problem, such as:

  • depression
  • generalised anxiety disorder
  • panic disorder
  • post-traumatic stress disorder

Some people may also have a substance or alcohol misuse problem, because they use drugs or alcohol as a way of coping with their anxiety.


What causes social anxiety disorder?

As with many mental health conditions, social anxiety disorder is most probably the result of a combination of genetic and environmental factors.

Anxiety disorders often run in families, so you're more likely to have social anxiety disorder if a close family member is affected. However, the exact. Nature of the relationship between genetics and learned behaviour is uncertain.

The behaviour of parents may also have an influence on whether their child will develop social anxiety disorder. If you have worried or anxious parents, it can often affect your ability to cope with anxiety during childhood, adolescence and adulthood.

People with social anxiety disorder often describe their parents as:

  • Overprotective
  • not affectionate enough
  • constantly criticising them and worrying they may do something wrong
  • overemphasising the importance of manners and grooming
  • exaggerating the danger of approaching strangers

Case Study 1: Social Anxiety

The young man who was anxious meeting women and this affected his ability to develop a relationship.

This case study shows how I helped a young man overcome fears and anxieties that he had.

Tom came to see me with a presenting issue of anxiety and meeting women in social situations- social anxiety. The anxiety increased if there was more than one woman in a group. He had been unable to ever have a relationship with women. He noticed anxiety in situations with women from his teenage years.

Tom was a 32-year old man who, although a little quiet by nature, was very friendly and likeable. He had created all the usual avoidance techniques. His anxiety manifested itself by thinking that nobody would ever like him. He said that he wanted to be confident in himself in meeting women and get the chance of a second date.

My aim was to help him develop the belief in himself, look to his strengths, then to build on those in social situations. I used rapid and progressive relaxation inductions, and during the therapy I used hypno-analysis, suggestion, metaphor, timeline and NLP.

I saw Tom three times in all. Initially we worked on understanding the cause of his uncertainties and worries. In his case it had begun in his early teens with a lack of self confidence then with the opposite sex.  This had become compounded as time had gone on.

During the initial session, I worked with Tom on his strengths and abilities which he was confident with (football and running). During the initial interview, we discovered that he had an overwhelming fear of criticism by others.

Tom remembered that when he was approximately 10 years old his older brother got all the attention and he felt neglected. Because of this he felt small, neglected and not able to communicate very well. Because of his feeling of not being wanted he developed the belief that nobody wanted him and further on that nobody would want to have a relationship with him. We worked on the facts, and perceptions versus reality, and applying this into his everyday experiences.

We then spent the remainder of the session working on Toms strengths and integrating them into social situations so that he could then develop new ways of thinking, feeling and behaving.

During the second session Tom reported that he felt much calmer and resourceful around people. He said that something had shifted inside him. He also said that he was now getting to know the real Tom that he had long forgotten, or perhaps never even known.

We worked on his ability to be himself, calm and confident when meeting people. I applied various techniques and approaches for Tom to use after the session.

At the start of the third session Tom explained that during the past week he had put himself in situations whereby he casually talked with women and was amazed as to how receptive they were to him. Prior to the start of the therapy, he would never have done this.

Tom has now experienced changes in real life that for him is proof and certainty that he is confident with meeting women and also that people do like him. Toms challenge ongoing is more of a practical nature of how to conduct himself in social situations, especially with women. We worked on Tom developing new ways of behaving socially in terms of his body language, the words he used, questions to ask, the way he spoke, and what to pay attention to.

Post Sessions

Tom emailed me 2 weeks later saying how thrilled he was because he had met a woman and was now seeing her regularly. In doing so he said he was finding out more about himself that he never realized before, and how great it is to have a genuine relationship with someone.

Case Study 2: Performance Anxiety

Lyndsey is a musician, plays the Flugelhorn in an orchestra and after seeing my website, and knowing that I had great success working with performers with anxiety, approached me to help with issues of anxiety in relation to her musical performance.  Lyndsey wanted to reduce the feelings of panic, particularly shaking of her hands, when performing in public. Lyndsey commented that it was becoming obvious to the audience that she was shaking, and this was affecting how she felt about her musicianship and performing which she had loved doing for over 30 years.  Whilst she had the ability to play extremely well, she was psychologically reducing her ability to play well with confidence and certainty when it mattered most.

Lyndsey wanted to perform in public in much the same way as she did when rehearsing, with calmness, confidence, focus and enjoyment.

The work I carried out with Lyndsey concentrated mainly on her state of mind and emotions both before, during, afterwards and between performances. The reaction of shaking hands and consequently the increasing rate of anxiety within her body all happened automatically, so that by the time she realised she was having a reaction it was too late and the remainder of her performance went downhill. I decided to use various advanced NLP procedures in order to shift her mindset so that whatever was triggering the anxiety, would instead trigger feelings of confidence, and certainty.   

On subsequent performances Lyndsey’s ability to remain relaxed, calm and at the same time focussed and in control, having fun, continued to improve. Lyndsey started enjoying and looking forward to her performances.

The ability of the brain to change its structure is becoming of great importance in health, psychology and neuroscience. Under the right conditions the brain can become plastic in terms of altering how it functions, stores information and causes behavioural change.

The work I do in therapy, NLP and Hypnotherapy is geared towards behavioural change and how people feel. Under the right conditions, focus, effective therapeutic planning and the willingness of the client to take responsibility for change, great results andoutcomes can occur for the client.