What is social anxiety?
Social anxiety disorder (also called social phobia) is a common type of anxiety disorder affecting 7.5% of people worldwide. It is a mental health condition that typically features an intense fear of being watched or judged by others. Those with the disorder feel uncomfortable in everyday situations – such as speaking with friends, meeting new people, or eating in front of others. Social anxiety can affect a person’s school, work, or daily activities. It can make it hard to make and keep friends and can lead to complete avoidance of social interactions. (1)
What are the signs and symptoms of social anxiety?
Social anxiety disorder may show a range of symptoms such as:
• Feeling self-conscious and afraid others will judge you
• Staying away from places where there are people
• Avoiding eye contact and speaking with a soft voice
• Difficulty sleeping
• Dizziness
• Chest pain
• Restlessness
• Nausea (2, 3)
Social anxiety and panic attacks
The fear of social situations due to social anxiety may escalate into a panic attack. Panic attacks may last several minutes, even hours (though rarely) and cause physical symptoms, including:
• Nausea
• Trembling
• Sweating
• Heart palpitations
Although distressing, these symptoms are generally transient and do not cause any physical harm. (4)
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How is social anxiety disorder diagnosed?
Like other mental health conditions, social anxiety disorder is diagnosed based on criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) or International Classification of Diseases-10th edition (ICD-10). For social anxiety disorder, these include:
• A persistent fear of social situations.
• Fear of being exposed to unfamiliar people or scrutiny by others.
• Fear of acting in a humiliating or embarrassing way.
• The fear impacts upon a person’s normal routine, functioning and relationships.
• The fear is not due to an existing mental disorder or substance (e.g. drugs). (5)
Social anxiety may stop people getting social contact
People with social anxiety often feel conflicted about interacting with others. Instinctively they often know they need social contact, but fear of embarrassment or humiliation may lead them to avoid others. They may shy away from normal behaviours such as:
• Shopping
• Starting conversations
• Speaking on the telephone
• Working
• Meeting strangers
• Eating with other people (6, 7, 8)
Complications of social anxiety
Social anxiety may sometimes cause people to experience low self-worth and feel insecure, which can lead people to lose or quit their job, experience a marriage breakdown, or stop socialising with friends. Further repercussions may include an incapacity to relax that may lead to misuse of drugs, alcohol, or reliance upon other negative coping behaviours. (9, 10)
What causes social anxiety disorder?
The exact cause of social anxiety is not known. However, as with many mental health conditions, a combination of genetic predispositions and environmental factors is thought to be involved. Several factors thought to increase the risk of social anxiety include:
• Family history of social anxiety
• Misreading other people’s behaviours as threatening
• Overprotective and highly critical parents
• Underdeveloped social skills and lack of confidence (11, 12)
What other anxiety disorders are there?
Social anxiety disorder is one of six anxieties disorders listed in the (DSM-5). The other disorders are:
• Generalized anxiety disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Phobias
• Obsessive-compulsive disorder (13)
How does hypnosis work?
Hypnosis is a highly focused, deeply absorbed state of attention. The hypnotherapist will help you become relaxed and focused, thereby reducing distracting thoughts and feelings while encouraging you to become more receptive to new ideas or perspectives. Hypnosis can allow you to learn new social skills and relaxation strategies that can help you integrate these tools for you to use more effortlessly, a process called automaticity.
Hypnotherapy for social anxiety
In social anxiety disorder, social situations act as a trigger for emotional responses of fear. Hypnotherapy can allow the feeling of fear to subside to easily managed levels. A common method called systematic desensitization involves slowly exposing subjects to fearful situations. The goal is to make the scenarios feel normal in real life.
This process is divided into three stages:
1. Hypnosis and relaxation training: the therapist teaches the subject to enter a deep state of relaxation.
2. Building a hierarchy: the therapist builds a hierarchy of suggestions based on the subject’s individual’s social fears. Easy situations may include talking to a close family member, and more difficult scenarios might involve as talking to a stranger.
3. Gradual exposure to feared situations: the therapist guides the subject to imagine the less frightening social situations, then slowly introduces more challenging scenarios. (16, 17, 18)
What does the science say?
There are many studies published that have described the merits of hypnosis as an effective treatment for treating social anxiety in combination with other approaches. Hypnotherapy has also been shown to be helpful for a range of anxiety disorders and phobias such as:
• Generalized anxiety disorder (19)
• Test anxiety (20)
• Airplane phobia (21)
• School phobia (22)
• Public speaking anxiety (23)
• Panic disorder (24)
• Sexual performance anxiety (25)
• Post-traumatic stress disorder (26)
Hypnotherapy has also been shown to improve the effectiveness of cognitive-behavioural therapy (CBT). (27)
Accessing hypnotherapy
Hypnotherapy clinics are located around the world and many specialize in social anxiety. A more affordable option is hypnotherapy available from smartphone applications such as Mindset. These apps allow direct access to professional hypnotherapy recordings.
Another option is self-hypnosis, in which the subject learns to enters a deep state of relaxation, then gives him or herself detailed suggestions for more effectively managing social anxiety. (28)
Are there risks with hypnotherapy?
Hypnotherapy is a highly safe and pleasant experience in the majority of people. Realistically, any technique that has the potential to help can also harm if it is misapplied. The hypnotherapy sessions offered in Mindset have been developed by leading experts who consistently encourage a focus on the positive and what you can learn that will be beneficial to you. If you have any concerns, however, you may wish to consult a mental health professional before engaging in hypnotherapy for social anxiety. (29)
A Word from Mindset Health
Social anxiety disorder is a common mental problem that can have a severe impact on life. The disorder may be socially crippling and prevent people from participating in everyday activities. Fortunately, hypnotherapy is a promising treatment that has been used successfully to reduce anxiety and promote easier social interaction.
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