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Social phobia - Help, my child is shy

Social phobia | ©: 2012 Fasphotographic - Fotolia

Most children are known to be sociable and open-minded. However, there are always exceptions. We are talking here about children, who are always on the sideline and find it hard to communicate with other children (often also with adults). Earlier this phenomenon was simply called shyness. Today it is known as an extreme expression – a social phobia.

But what is social phobia exactly?

Social phobia is one of the classic anxiety disorders and thus classified as an extreme fear of social situations, to stand in the centre of attention. Above all, the fear of an embarrassing or disturbing behaviour characterises this phobia. This anxiety expresses itself mainly in the avoidance of social gatherings because the child is afraid of rejection or has expectations that cannot be met by other people.

These fears appear in different symptoms. In those concrete situations the affected child responses with nervousness, absent-mindedness and a so-called depersonalization (loss of otherwise usual personality traits). Other accompanying symptoms could be blushing sweating, palpitations, cramps, but also by frequent slips of the tongue, stuttering, dizziness and also the feeling to be constricted.

To avoid such symptoms, the affected child will try hard to avoid those, for him difficult situations. They develop very creative strategies are to avoid meeting other people without their anxiety disorder being noticeable at first glance. The larger the number of participants in a social gathering, the greater is the avoidance behaviour of the person concerned. This reaction can lead to serious consequences such as total isolation. However, side effects such as depression, dependency on alcohol, sedatives, medications, etc. can be the result of this social phobia. The actual symptoms are partially covered or even repressed.

Causes and reasons for social phobias

Most social phobias start in childhood or adolescence. Experts distinguish between two different approaches, to identify the causes of social phobia. On one hand there are the behavioural theories, were the child's behaviour conditions the social anxiety. This avoidance conditioning is based on so-called observational learning. This refers to an observation of situations that trigger a phobic reaction in other people. Through this observation, a corresponding anxiety can be triggered within an observer.

If, after such observation, no corrective experiences can be acquired, the phobic disorder can become permanent with the prospective of deeper and deeper reaching consequences. As a result, the child may fall back of an avoidance behaviour, which is then called a failure behaviour. In conjunction with an enhanced self-awareness and other processing manoeuvres, which the child encounters before and after a social situation, three factors could be isolated, which are in the cognitive model, responsible for this social phobia.

The second field of attempts of explanation are the psychodynamic theories. In this case, it is assumed that the person subconsciously traumatic experiences and repressed emotional contents of the past in the form of a fear response reflect. Those traumatic experiences, for example, could be painful separations.

The so-called shame anxiety plays a particularly important role in this context. This can also result from traumatic experiences of the past the child was exposed to, humiliations or rejections. To protect itself from future traumatic experiences the child falls back on avoidance behaviour.

Finally, genetic causes may be responsible for a social phobia. Studies have shown that during the illness of a twin the other twin also, with an up to 50-percent probability, will develop a social phobia. However, experts do not believe that a social phobia is handed down from generation to generation.

Remedies for social phobias

If you presume that your child suffers from a social phobia, your first step would be to find an expert who, through various tests, can diagnose your child correctly. Subsequently, appropriate corrective action can be taken.

Children with social phobia respond well to an appropriate psychotherapy to remedy the situation. This therapy is called Cognitive Behavioural Therapy, (CBT). The objective is, through relevant behavioural experiments, to replace the avoidance behaviour with a more positive response to social situations. At the same time, the child or young person learns to take risks and how to handle the resulting consequences in therapy. For example, exposure or refusal. It is not uncommon that the own expectations of perfection are causing this social phobia. This perfectionism can be brought to a reasonable level by accepting appropriate reactions when taking risks.

Physical activity can complement the psychotherapy, and on the other hand through relaxation exercises such as autogenic training, yoga or progressive muscle relaxation. If the psychotherapeutic treatment alone is not enough, it may be accompanied by a drug treatment. The latter, however, is highly controversial among experts, since different antidepressants such as Moclobemide, Escitalopram, Paroxetine, Sertraline and Venlafaxine are to be used. Also, anxiolytic drugs such as Alprazolam or Lorazepam have proven to be effective in social phobias. However, you always run the risk of dependence.

What to do when you suspect a social phobia?

Specifically ask your child whether it feels uncomfortable in the presence of other people. If so, explain to him that such a fear is not all that bad and that he can get to grips with it. Avoid phrases like "Don’t be like that" or "Everyone has a bad run at times." Instead, motivate your child, talk to him and give him courage and let him know that he can come to you at any time if he needs to talk something over.

Youth work, social phobia and how to deal with it

As I just pointed out social phobias are often learned behaviour patterns resulting from (early) childhood experiences. The fear, to once again get into such an embarrassing situation is horrific. Therefore the child or young person will do everything possible to avoid those situations.

Hence, it is important to create a situation within the youth group, that conveys security for each child when things go wrong. Never embarrassed a child and in particular not in front of other children. Most importantly, create an atmosphere where the child is free of fear to participate, even if he at one or the other occasion doesn’t want to do a certain thing.

Everyone can contemplate for himself if he has a certain phobia (whatever that might be) and where that is coming from. This exercise can be quite eye opening, finding out to have fears, which, so far, I was not aware of.

The challenge for all youth groups is, to get to know the child with a social phobia, take it seriously and create group situations free of fear.