A Case of Social Phobia

There are times in most peoples lives where, due to circumstances, they dont cope well. Sometimes, if the right help isnt available, poor coping strategies, such as drugs, drinking alcohol, beating oneself up, avoidance of certain situations, etc, can amplify the whole problem making things go from bad to worse. Nowadays, although more and more drugs such as Prozac and anti-depressants are being described, depression is on the increase, so in many cases drugs are not the answer One of the aspects of poor coping strategies is that it can manifest itself in Social Phobia. This is where people will do almost anything to avoid being around other people for fear of being laughed at, humiliated or even the fear of being ill in public. I am seeing more and more of this type of condition and its a shame that people resort to drugs or leaving their jobs because they dont know what else is available to them. One person I know even dropped out of university, despite being a brilliant student, because he had become a social phobic. I thought Id share with you a case, which is not dissimilar to other cases Ive worked on, where the person had a social phobia. Meet Jack This person, lets call him Jack, was a 25 year old man. He had a good job that he liked and on the whole appeared like a normal young man. However, he hadnt led a normal life for about 8 years. He hated being around people, especially crowds, unless he absolutely had to. This had seriously affected his life. He could go to work but he couldnt go out, or if he did, it was for a very short time and then he made excuses to leave early, and hed never been to a cinema since he was a teenager. As you can imagine this limited his social life dramatically. He couldnt even go to supermarkets. Supermarkets are horrendous places for someone with a social phobia as they often feel they may become ill (e.g. vomit or faint) whilst shopping and they also fear that people there are looking at them which increases their anxiety massively. Session 1 During our first session after the case history I discovered that his goal was to be able to go to places like supermarkets, pubs and generally feel relaxed in public places, and to stop the excessive sweating that often accompanies this condition. The next thing we did was to use Solution Focused questions to help him get focused on what he wanted. Its interesting that most people are so absorbed in how things are now and why they dont like it, that they have put themselves in a Symptom Trance. Next, we wo rked together to come to a small goal that he could do in the week to get out of his comfort zone. Its very important that comfort zones are challenged in small ways. The goal was to deliberately go into the work canteen and eat something (something he never did).

This may not sound like much to someone who hasnt a problem being around people, but for a person with social phobia, it is really difficult. He agreed the goal. Session 2 The next session he reported back to me that he had in fact gone into the canteen, albeit shaking, and managed to buy a coffee and stay nearly 10 minutes. So he did well. I then used Cognitive Behavioural Therapy (CBT). I love working with CBT because its so simple and it helps people from awfulising or making global statements to themselves which keeps them stuck in disempowering behaviour. An example of that would be someone who fails their driving test and then tells themselves because I failed my driving test Im a failure. Then, quite often they will remember other times in the past when they failed at something. This then reinforces their view that they are indeed a failure or worthless, etc. This faulty thinking is because they havent been shown how to discriminate in their thinking patterns in different contexts of their lives, so they just take the general view that they are x and that people dont like/approve of them or will laugh at them. In fact, often, a social phobic will be terrified of being embarrassed or humiliated! Even being asked a simple question in a lecture can make them experience extreme terror. During the session we actually show up the unhelpful thinking patterns that they are in and the beliefs they have drawn from then. When Jack could actually see how his thinking was affecting his behaviour, he had a shift. The next step, once he realised that people in public places were not actually looking at him, or waiting for him to embarrass himself, was to set a goal. I used hypnosis for him to visualise this goal, how he would like to be, feel and what he would do in a particular situation. His goal was to go to the supermarket and just walk around it, if he felt confident enough he could buy something too. I put this into a hypnotic visualisation. I always offer to accompany the person on this particular goal if they want. Jack did want this so we set off to a supermarket not too far from my office. I gave him a Confidence Anchor for him to use. I also asked him to watch the people in the supermarket as he walked around and he would notice that they themselves were in trance. If you watch people in shops they are so engrossed in looking at things on shelves and reading labels they often dont notice anyone. I wanted Jack to do this for 2 reasons, one so he shifted his focus off himself and how he was feeling, and for him to notice people were not actually interested at all in him. We walked around the supermarket and he chose not to buy anything and then we left. Once outside he said: I felt really shaky but a bit excited too. This was good, he has already begun to change his perception of something, that before, was fearful. Once he realised that people were indeed deeply interested in what they were buying and not paying him a scrap of attention, he experienced some relief.

Session 3 We did a further session and he reported back to me that he had gone to the supermarket near where he lives, but in the end couldnt go in. This is normal the first time they go on their own. However, he did report back to me that he went to a party and stayed until after midnight and enjoyed himself and asked a girl out! I think it would be fair to comment he was progressing! I did more CBT on things that needed cleaning up, such as what would happen if he became ill in the theatre, this was where he was going with his date. We worked on that until he felt okay, then I re-inforced full confidence and ego boosting in hypnosis to help him. We also used Emotional Freedom Technique (EFT). His goal was to go shopping that week, go to the theatre and practicing visualising how he wanted to feel in different situations. He was to call me and tell me how he got on. He did, one week later and he was absolutely delighted to report that he did all of the above things plus more and only felt slightly nervous. He didnt need any more sessions. Jacks story has a happy ending however many people suffering from social phobia have their lives very negatively affected or resort to drugs, which is so unnecessary when there are so many therapies and strategies that can help them. Social phobia can range from the mild (e.g. not liking crowds, therefore avoiding parties, etc) to full blown out, such as not being able to go to work anymore. They then become even more anxious too. In fact, often its the anxiety that can trigger social phobia in the first place. So if you or anyone you know suffers from some form of social phobia then stop suffering and seek help, you can have your life back.