Shyness And Social Anxiety System

Treating Social Phobias and Social Anxiety

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Phobias are usually defined as irrational fears of objects or situations. Simple phobias involve fear of, for example, snakes or spiders combined with an ability to see that there is no reason to be afraid. Agoraphobia is somewhat different and is characterised by fear of leaving the home or safe environment. Agoraphobia is highly co-morbid with panic problems and we have touched upon it briefly in the section on panic. Finally, social phobia involves anxiety about social situations and a fear of embarrassment.

We argued at the beginning of this chapter that phobic problems, particularly specific phobias, are extremely common and that in our view it is a mistake to assume that, just because indivduals meet the majority of criteria for a clinical diagnosis of phobia, it means that they are pathological, abnormal, or disordered in any way. This issue of distinguishing normal fears from phobias is a factor in epidemiological studies which, nevertheless, reveal an average of about 6 per 100 in community surveys for mild phobias with approximately 2 per 1000 being viewed as disabling (Myers et al., 1984). Phobias tend to have their origins in childhood in the case of specific phobias (e.g., Rutter, 1984), although as we noted earlier a large number of childhood fears disappear as the individual matures. Social phobia and agoraphobia have a later onset (Antony & Barlow, 2002). Phobias are more usually reported by women, with estimates as high as 95% for simple phobias (Rachman, 2004).

Fear-derived simple phobias are characterised by extreme fear and anxiety in the presence of the phobic stimulus, an uncontrollable desire to leave the feared situation, and, outside the feared situation, an ability to see that the fear is unfounded.

Theoretical work suggests that there are three main routes to the acquistion of such phobias (Rachman, 1990, 2004). The first is through a two-process conditioning sequence in which the phobic stimulus becomes classically conditioned to elicit fear, and it is then instrumentally reinforced by the person avoiding the feared stimulus (Mowrer, 1960). The second route is through vicarious conditioning or modelling in which the individual witnesses another person's fear reaction. Finally, phobias may become acquired through the dissemination of information about the phobic object (see Field, 2006, for a discussion). Support for these three putative routes has been through simple self-report surveys (e.g., Hekmat, 1987). However, as we shall argue in Chapter 9, it is by no means clear that the initial emotional reactions, particularly in the vicarious route, were ones of fear. A final point, and one that we made earlier, is that some phobias are more common than others and this seems to reflect some form of evolutionary preparedness (Ohman & Mineka, 2001; Seligman, 1971) where we have a propensity to develop fear reactions quickly to objects and situations that were genuinely threatening to our forebears. Unfortunately, there have been few experiments on prehistoric humans to test this hypothesis!

Within SPAARS, the proposal of two routes to emotion generation seems to offer a ready account for the phenomenology of specific phobic states. The SPAARS analysis would propose that the phobic object was initially appraised at the schematic model level as threatening. This appraisal would not have to involve an actual encounter with the object; fear-related appraisals could result from a vicarious experience of the phobic stimulus or from some form of instruction. The next stage in the development of the phobia would be the laying down of associative routes to this fear response. In the case of prepared stimuli, we have suggested that such links can become established after one distressing encounter; other non-prepared stimuli would come to elicit fear automatically as a result of repeated fear-related appraisals at the schematic model level. As the individual develops, the schematic model appraisals of the phobic object will not be fear-related and the individual will be able to see no reason to be afraid. However, we propose that the generation of fear within SPAARS via the associative level will persist each time the person encounters the phobic stimulus. This automatic generation will activate the fear module which will reconfigure the SPAARS system in order to deal with threat. The associated action potential to flee the situation is, therefore, likely to be extremely strong and difficult to resist.

In sum, in this section we have presented a brief review of fear-derived phobias and indicated how they can be explained using the two routes to emotion within the SPAARS framework. However, not all phobias are characterised by a fear reaction; for many, the spider is more disgusting than fearful and the role of disgust in these cases is considered in more detail in Chapter 9.

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