shy society

Most people feel some degree of trepidation before a public performance, ranging from mild anticipatory tension to shuddering dismay. But imagine if you felt the same debilitating anxiety about day-to-day social encounters; if a proposed visit to the pub filled you with terror, or the prospect of meeting people at a party was enough to banish you to self-imposed hermitdom.

Between one in fifty and one in twenty people suffer from social phobia. For them, the fear of being consumed by stricken silence in a wave of shyness, or the potential horror of making a gaffe in public, is enough to make them avoid almost all social contact. A vicious circle ensues - since they've starved themselves of human contact, they naturally become more gauche and tongue tied. In addition, their obsessive and paranoid ruminations about their perceived social inadequacies make them intense and self-centred, and to strangers, this can come across as morose introversion.

Unfortunately, these traits aren't immediately endearing in the average social situation. Light-hearted banter may seem trite to social phobics, but it builds bridges, enabling more meaningful contact to develop. Social phobia should be distinguished from mere shyness. A social phobic's avoidance of social situations is so extreme that it interferes with their life and their relationships.

The condition also has features in common with agarophobia, depression and panic disorder. Like them, it is now so widely recognised that it merits a definition of its own in psychiatric classification systems. The onset of social phobia is usually at a young age. Pre-school children may show tendencies, especially those who have exhibited separation anxiety - clinging to mum or dad's knees at play school and inspiring extreme guilt and distress in the departing parent. Of course, only a small percentage of all children who are shy will go on to become social phobics; for most, it's just a phase that's quickly surpassed. The condition can also develop in early adolescence, especially if the gawky teenager feels like he/she doesn't belong. We might think it's incredibly superficial when petulant pubescents insist on having the right trainers, but the angst of wearing drab chain store clothes

or sporting a geeky haircut is very real when being cool is all.

Social phobics often feel like shy outsiders. In a way, social phobia is an extension of the normal uncertainty that many people feel when plunged into intimidating situations as adolescents, berating their lack of self-confidence. However, most people realise that there's more to social skills than brash self-adoration - the overbearing, crashing bore who traps victims in a corner and drones on about himself non-stop is not the most popular person present.

The social phobic never quite feels being him/herself is good enough. People with social phobia are at risk of developing other psychological problems as a result. Anxiety, depression, and reliance on alcohol or drugs can result. It's important that these are dealt with in addition to the primary problem. As with most psychological problems, the treatment of social phobia involves both psychotherapy and drugs.

The most popular form of therapy is cognitive-behavioural therapy. This involves working through the problem, from explaining the basis, through tackling the negative feelings aroused by social situations, to, finally, dealing with those situations. The key is changing the way the person thinks about themselves and their interaction with others. They're helped to understand that social situations don't rely on performance; that it's OK to be in a social setting and not be the life and soul, and that listening is as important as speaking. Group therapy seems to be especially helpful.

The drug treatment of social phobia has spanned several groups of drugs in the past few years, but the most effective seem to be the variety of antidepressants that increase levels of serotonin in the brain. Other antidepressants have also been used with more modest success.