We live our lives with other people. Short of living isolated in some far off place, there isn’t much of a choice. But for many, other people are a source of great anxiety. Good psychotherapy can help in a number of ways.
Therapy for social anxiety
At its worst, social anxiety can produce anxiety that keeps those who seek therapy from leaving their homes. Classically termed agoraphobia by psychologists and psychotherapists, this sort of social anxiety is debilitating in obvious ways. For some, this anxiety is experienced with large crowds or at parties. For others, the anxiety comes from close contact with others, either in a small group or one-on-one. The commonality is that it’s the social aspect of the interaction (or anticipated interaction) that seems to produce an anxious feeling.
While the anxiety associated with social anxiety can be minor and easily managed (everyone gets a bit nervous in social situations from time to time), for many the anxiety is intense enough to be physically and emotionally painful, and this social anxiety can lead many to alter or altogether avoid plans with other people. And the impact is not just deleterious in casual interactions; individuals who struggle with social anxiety experience difficulty in finding and maintaining good jobs and in raising children.
Therapy for social phobia
Social phobia and social anxiety aren’t quite the same thing, though in most cases the two go together, and therapy for social phobia and therapy for social anxiety might often look the same. Social phobia refers to a specific fear and avoidance of certain or all social situations.
Options in psychotherapy for social anxiety and social phobias
Anxiety and fear (social or otherwise) are complex phenomena. Many psychotherapists overlook a critical first step in exploring the foundations for that fear. In other words, what currently present basis is there for this fear? After all, fear is, at least from an evolutionary standpoint, a physiological response designed to protect us from very real threats. We tend to think of social phobia or social anxiety as simply being “in our heads,” but that discounts the very real threats many experience. Does an individual live in an unsafe neighborhood, where violent crimes are ever-present? Is a child in danger because of abuse, harassment, or bullying? Is someone who doesn’t conform to gender stereotypes experiencing taunts and threats? Before we deal with the emotional aspects of social anxiety and social phobias, we need to explore the material conditions that may be quite appropriately causing fears and anxieties.
Even when threats are not immediately present, past harm or threats of harm (physical or emotional) are another frequent source of anxiety and fear. Often such anxiety could be classified as Post Traumatic Stress Disorder (PTSD) or an Acute Stress Disorder (in the case of more recently experienced stress or trauma). Finding comfort and safety and allowing one’s nervous system and emotional life to reach a calm, balanced state is the immediate objective of psychotherapy in these cases.
Regardless of the cause, once the work has been done to ensure real, consistent safety, psychotherapy needs to address the myriad ways social anxiety and social phobias can limit the living of a meaningful life. Some of this work includes finding practical ways of managing the anxiety. And if the anxiety has led to prolonged social isolation, getting out of the house or spending time in the particular type of situation that causes anxiety is a critical step. In this regard, the therapist or therapy group become partners in taking on the difficult feelings that come with creating a life.
Therapy is also a great context for developing closer relationships with people. In this regard, group therapy is a clear choice for those seeking therapy for social anxiety and social phobias. Difficult emotions associated with the thought of joining a group may be a good reason not to jump right into a therapy group, however. At its best, therapy for social anxiety and social phobias should begin with individual therapy for as much time as needed to build a strong, supportive relationship with the therapist, at which time that relationship can be brought into a group. Whatever difficulties arise in the process, the therapist can provide the needed support to temper the anxiety that may come up in transitioning to this more challenging setting.