Illness of Opportunity: What is social phobia and how to cope with it
IN RUSSIA, IT IS ADOPTED TO CARE FOR YOURSELF and pay attention to your own emotions. We constantly hear that depression is “just laziness and unwillingness to work on yourself”, and psychotherapy is “whim”. In such an atmosphere, it is not easy to pay attention to the symptoms for which help is needed.
One of the mental features that stigma directly affects is a social phobia: its manifestations are often taken for constraint, and the cause is sought in introversion and a closed character. In fact, panic-stricken excitement over performances, trembling, redness and anxiety, even during everyday communication, is not what we are accustomed to be considered congenital modesty, but a reason to turn to a psychotherapist: such states can be markers of social phobia.
Sit in the corner
Social phobia is one of the types of anxiety disorders. It is included in the International Classification of Diseases, sometimes it is also called the “disease of lost opportunities”. In this case, the person is afraid of social interaction, public spaces, large companies, and sometimes - personal communication. Trying to extinguish anxiety, a person often begins to avoid situations causing it: public events (even if they are interesting to him), parties or meeting new people.
Statistics of people experiencing social phobia varies: different organizations talk about numbers from 3 to 7%, depending on the country and time of research. Olga Razmakhova, a psychotherapist and founder of the Psychology for Human Rights movement, is preparing a book on social phobia: about 40% of her clients and clients turn to her with such a request.
Olga notes that most often a social phobia is manifested in adolescence. Nonetheless, people turn to therapy for the next twenty to thirty-five years when they become aware of the problem: by this time, the usual strategies for avoiding the problem are becoming less effective. If at school it was not so difficult to refuse to speak at the blackboard (teachers may eventually give up on inactive students), the situation changes with the transition to the university and even more so with the beginning of the professional path.
Another problem that arises acutely in social phobia in adulthood is the difficulty in building romantic, friendly and other close relationships. At the same time, it is important to distinguish people with a social phobia from those who rarely need to communicate, but at the same time do not experience acute stress from the need to speak to someone. For a person with a social phobia, this situation becomes problematic - besides, he may strive for new acquaintances and communication, but rest against the mechanisms of the psyche that prevent him from doing so.
One of the causes of social phobia is the feeling that a person is different from others. For example, constant comparisons with the conditional “son of the mother’s friend” can lead to it - if they are not in favor of the child, this creates a feeling of otherness.
This is how Nina describes her experience: she faced social phobias in her childhood, but for a long time she took her symptoms for constraint. As a student, the girl decided that she had to overcome the "constraint", forced herself to come to parties in large companies - but this did not work. "I sat in the corner all evening and didn’t communicate with anyone - strong fear interfered. It made me even worse - guilt was added to fear: I reproached myself for not being able to cope with myself. Why can everyone else communicate normally am I not? I always felt like I was "wrong," "says Nina.
A large crowd of people for Nina is associated with a sense of danger. This is an irrational fear: the girl begins to think that the crowd can cause her physical harm, although this has never happened in her life. “My anxiety goes into a panic when I have to communicate with strangers,” she says. “This feeling is so strong that sometimes I just want to run away. When there is no such opportunity, I choose a place in the corner — I feel more comfortable. In the company of close people who know about my diagnosis (but there are few of them), I can crawl under the table or close with a chair. I don’t allow myself to know this with unfamiliar people. But if my absence is uncritical, I can apologize and leave. " Anxiety and fear in Nina usually develop into physical stress, the symptoms disappear only when Nina manages to get out of an uncomfortable situation.
When the girl realized the cause of her condition, she began to put herself less often in uncomfortable situations - the feeling of guilt began to calm down, but she didn’t completely disappear. "A friend told me to accept the fact that I would never feel good in companies. But this is exactly what I am not ready to put up with: because of this I lose a lot. I really want to interact with other people, just for now my "fear" is stronger than desire ", - says Nina. The girl began to work with a psychotherapist.
"Calm and quiet boy"
Sometimes a social phobia can have other symptoms besides the most obvious ones - the fear of public speaking or socializing in companies. For example, many phobic people are afraid to eat in public or go to public toilets. In addition, a phobia can be closely intertwined with other disorders - cause depressive episodes or lead to agoraphobia, that is, fear of public spaces.
All this survived Miroslav Rein. He showed the first signs of social phobia in kindergarten, he also finds the reasons for his condition in childhood. As a child, Miroslav faced physical violence in the family, which led to panic disorder. “When my father drank, my mother hid money and keys from the apartment and the car. I felt stuck in the frame: as if I tried to control my parents and, above all, my drunk father. Besides, I had to protect my younger brother from my father. So, the need for control and perfectionism, closely related to my disorders, began to develop in me, "he says.
In addition, parents constantly told Miroslav that he was obliged to be an excellent student - this increased the anxiety even more. At school, he began to control his feelings, emotions and behavior. “They began to call me a“ calm and quiet boy, ”although this did not correspond to my feelings. My outwardly restrained behavior was only the result of control, he says. At school, Miroslav encountered a cruel bulling. Classmates beat and humiliated a young man: they could spit or push into the women's dressing room. Many teachers turned a blind eye to the situation.
It was then that Miroslav exacerbated social phobia and new symptoms appeared: he stopped eating in the canteen and going to the toilets at school. As soon as he was going to have dinner with his classmates, there was a shiver in his hands, which only made the other students laugh. From this fear only grew, and there was a sense of a vicious circle. Over time, Miroslav began a panic attack: for the first time he survived one of them in ninth grade, when he went to the blackboard to tell a poem. “Then I began to avoid situations that disturb me: physical education lessons (there I often encountered masculine aggression) and public events. I left schools of television and theatrical skills. I completely stopped going to the blackboard, although I had studied well before. Of course, the grades immediately deteriorated: when I was called to the blackboard, I said that I didn’t know the answer, although I knew it well and taught the material, ”Miroslav tells of his experience.
Social phobia continued to define the lifestyle of Miroslav and after school. He chose the distance form of study at the university, and after, the remote format of work. In the office, he was very uncomfortable to communicate with clients. Having survived several serious panic attacks, Miroslav turned to psychotherapy.
Otherness and cognitive errors
“The deepest ideas of a person about themselves are laid back in childhood,” explains Olga Razmakhova, a psychotherapist. “In the case of social phobia, fear can be based on beliefs about their own inferiority or otherness. They also lead to the notion that the world is not safe, therefore, they also form protective mechanisms ". In psychotherapy, such schemes are called cognitive errors. From the point of view of the cognitive-behavioral approach that Olga practices, one should first pay attention to how we interpret reality: people err in the way they interpret social situations.
For example, during a public speech, a person decides that listeners are dissatisfied with him, even when he has no direct reason to think so. “It turns out that a person supposedly gives himself the right to read the thoughts of others and processes all incoming information purely in a negative way,” explains Olga. “So he draws any social situation to himself as dangerous from the very beginning.” Further, such a cognitive error, such as the effect of over-generalization, turns on: a person begins to think that the whole world is opposed to him hostilely, if once he has encountered a negative reaction.
For a person with social phobia, social assessments are especially significant, and he is afraid of them. "Describing the symptoms: trembling in hands before performances, acute anxiety or fear of being in public transport - people may not be aware of the social factor behind them. Already during the course of therapy, it is usually found out that anxiety attacks are associated with those social situations where a person waiting for an assessment of his behavior, "- says Olga.
Another reason for a social phobia is the feeling that a person is different from others. For example, constant comparisons with the conditional “son of a mother’s friend” can lead to it - if they are not in favor of the child, this creates a feeling of otherness. Olga notes that it also becomes the cause of bullying in school: children who go beyond the limits of standards are usually subject to bullying - according to external data or behavior.
The way to work with a phobia is to try to distance yourself from your thoughts. We all can think about our thinking: when an alarm occurs, the technique suggests taking the position of an “impartial observer”
Representatives of vulnerable groups are in a special risk zone for social phobia. According to studies, LGBT people are especially vulnerable to mental disorders and anxiety. “Some psychiatrists appeal to this fact, trying to prove that homosexuality is a deviation from the norm, and not its variation. However, as soon as LGBT people get equal rights, the number of mental disorders in this group decreases significantly. We can judge This is from the experience of countries that legalized same-sex marriages - so, I see a direct correlation between government policy and the psychological state of my clients and clients, ”said Olga.
Nina is bisexual. She had a long and sincere relationship with a man, but still she liked girls more often - though the girl always tried to reject this part of herself. "A month ago, I sometimes decided to wear rainbow earrings. It would seem that this is such an insignificant detail, besides not everyone understands the meaning of this symbol - but because of them I am always nervous. I am afraid that they will condemn me or even cause physical harm. Of - for the profession - I work with children - I have to constantly hide my orientation, I can’t tell about her and her parents. So, despite the fear, I try to be myself for a little bit. But sometimes, wearing these earrings, at the last second I come back and change them to more neutral ones. Any moment in which I differ from others only increases fear, "says Nina.
A similar story can occur with gender identity, as was the case with Miroslav - he is an gender person (Miroslav uses the pronoun "he" in relation to himself. - Approx. Ed.). At school, he avoided lessons that implied gender division: labor and physical education, because he felt particularly uncomfortable. "I do not recognize the presence of male and female, for me these concepts are nothing more than stereotypes. Since childhood, I did not understand why we, boys and girls, have different hairstyles, toys or colors in clothes. I was hurt because I could not wearing dresses, although I loved them very much. It seems that I was born with a certain awareness that gender is a construct that only prevents us from living. I could not freely express myself and felt ashamed that I always did not look like others As a result, I was constantly condemned. Of course, the stigma worked "for the benefit of" my social noy phobia "- says Miroslav.
"Do I live my life or does my life live me?"
Some tools for working on social phobia can be used outside of psychotherapy sessions. The most effective way to fight, according to Olga Razmakhova, is to begin to live through the situations that a person had previously tried to avoid. "A new social experience helps to remove cognitive errors - to stop thinking for others or let them think about me, whatever. In a situation of social phobia, a person cannot feel whole and comfortable, relying only on what he thinks of himself, - the evaluation of others is important for him. It is necessary to come to a certain emancipation: to build relationships with oneself and not to depend on the opinion of society, "said Olga.
Another way to work with a phobia is to try to distance yourself from your thoughts. We all can think about our thinking: when anxiety arises, the technique suggests taking the position of an “impartial observer” in relation to our thoughts - that is, try to look at them “from above” or “from the side”. The task here is not to correct disturbing thoughts, but to change the attitude towards them. It helps to separate rational ideas from disturbing symptoms and not allow the latter to control us.
All this does not mean that a person will immediately stop experiencing anxiety and discomfort. First you need to perceive your feelings differently and start working with them. “I allow myself to feel anxious and talk about it in public - it helps a lot. Speaking at a scientific conference, I can start a speech like this:“ As I speak about anxiety and panic attacks, I’ll become a good example of what I’m talking about. ” This reduces the level of shame and allows you not to waste efforts on concealing anxiety, ”Olga Razmakhova shares her experience. Helps and talk about their own experiences with a loved one.
According to the stories of Olga, many clients turn to specialists with a request to clear the alarm. "Often therapists go on this initial request. It turns out that we completely want to exclude this emotion from our lives. But this is impossible and non-constructive. The history of conditional recovery here is not to wipe out any emotion, but to learn to live with it certain episodes. Besides, you can always look at an alarm from a different angle. So, I can experience it before meeting with a loved one or protecting an important project - then it stops being a problem for me and becomes a significant marker . The Events For people with social phobia it is important to experience a similar experience when I accept a certain emotion it ceases to have power over me It's a question of whether I live my life or my life I live, "- says psihoterapevtka..
To deal with the problem of social phobia is really possible. Olga suggests moving on the “why” question: first of all, it’s worth finding out what changes a person wants to bring into his life, and not what to remove from it. If he or she seeks to build partnerships and romance with others, to realize their values and gain a new communication experience is quite realistic.
Social culture is no less important in this sense, says Nick Vodwood: “Although millions of people have mental disorders, and a large proportion of the population have Internet, they don’t talk about it. They keep it secret. They are afraid. dehumanization both from the outside - dismissal, bullying, ostracism, and from the inside, when a person cannot accept or seek help. To support any initiatives aimed at helping people with mental disorders, to inform and overcome stigma is very important and a huge step forward, the results of which will affect absolutely each of us, directly or indirectly. "
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