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Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions
Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions

Section 11
Fear and Anxiety in Social Setting

CEU Question 11 | CEU Test | Table of Contents | Phobias
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs, Nurse CEUs

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On the last track we began a discussion regarding social phobias.  We discussed the DSM Identification of social phobias, the fear of being evaluated, and features of social phobias. 

On this track we will continue to discuss social phobias.  Let’s examine two causes of social phobia.  The two causes of social phobia that we will discuss on this track are shame and social image and fear of loss of love or abandonment.

Two Causes of Social Phobia

#1  Shame and "Social Image"
First, let’s discuss shame and social image.  The experience of shame is important in discussions of social phobia because the socially phobic client is fearful of being shamed in many situations.  As you know, shame is an affect related to a client’s conception of his public image at the time that he is being observed or believes he is being observed.  

The client’s notion of his social image may be accurate or inaccurate; but if he believes that his image has been tainted, and he cares about the observer’s opinion of him, then he is likely to feel shame.  Sal stated, "The possibility of being thought of as weak, inferior, or inept is just as bad as actually being talked about in these terms."  In other words, what others think of Sal is the crucial ingredient of shame induction— irrespective of whether they communicate this opinion.

The key factor in the activation of shame is exposure to observation by one or more persons.  This affect was triggered when Sal realized that he had been observed violating specific social norms, expectations, or demands, especially in relationship to appropriate appearance and behavior. 

Sal’s perceived  "deviant" appearance or behavior were judged (he assumed) to be reflections of his weakness, inferiority, ineptness, character flaw, or immaturity.  The public sanctions for lack of conformity, by and large, made Sal feel inferior, depreciated, and immature.  The actual social consequences may consist of covert depreciation or open expressions of disapproval, ranging from mild mimicking to overt ridicule.It should be noted that if a client like Sal manages to conceal his "substandard" behavior or engages in a shameful activity in private, then he does not feel shame.

A client who feels shame sees himself as relatively helpless in attempting to counteract his depreciated public image.  Sal believed he was subject to painful group reprisals, such as public humiliation and ridicule, and is powerless to ward off these attacks.  The social opinion is absolute, finalistic, irrevocable.  

It was futile for him to try to modify or appeal the group verdict.  Sal stated, "Any protestations only increases their enjoyment of my embarrassment."  Sal acknowledged his "inept" behavior by statements such as "I made a public display of myself," and hung his head or attempted to hide to avoid their gaze.  In his mind, the antidote for shame was to vanish from the shameful situation.  Sal often made statements such as, "I should like to fade away," or, "I felt like merging into the woodwork.

#2  Fear of Loss of Love or Abandonment
Next, let’s discuss the fear of loss of love or abandonment.
As you already know, in intimate relationships, the demands are more "personal" than in "public relationships" and have to do with satisfying the specific needs and expectations of a particular person rather than with preserving an image.  Fears of loss of love or abandonment may at times become entangled with the same concerns about performance as do other evaluation phobias.

 In these cases, the individual fears that he will not live up to the expectations or demands of a loved one. He may then slide into the same rut as the socially anxious person:
(1) a sense of vulnerability because the other person has the power to terminate the relationship. He may come to fear that nothing he can do is good enough;
(2) a sense of being continually judged and possibly disapproved of;
(3) a defensive inhibition, so that his actual behavior becomes stilted and artificial;
(4) "catastrophizing" about the consequences of rejection.  

For example, a woman was in a continuous state of "high anxiety" over the possibility of being rejected by her lover.  She believed that he was judging "everything" about her—how she dressed, spoke, prepared meals, arranged their social life.  She worried that a single misstep would induce him to break the relationship. She sought continual reassurance that he was not displeased with her. Ultimately, he did leave her—not because of any deficiencies in her performance but because he could not tolerate her incessant requests for reassurance. 

Think of your socially phobic client.  Is a fear of shame or a fear of abandonment lurking behind the social phobia?

On this track we have discussed two causes of social phobia.  The two causes of social phobia that we discussed on this track are shame and social image and fear of loss of love or abandonment.

On the next track we will discuss public speaking phobias.  Four aspects of public speaking phobias that we will discuss are being able to function, the role of anxiety, performance feedback, and the phobic client’s cognitive set during speech.

Peer-Reviewed Journal Article References:
Baumann, C., Schiele, M. A., Herrmann, M. J., Lonsdorf, T. B., Zwanzger, P., Domschke, K., Reif, A., Deckert, J., & Pauli, P. (2017). Effects of an anxiety-specific psychometric factor on fear conditioning and fear generalization. Zeitschrift für Psychologie, 225(3), 200–213.

Castelloe, M. S. (2016). Review of Traumatic ruptures: Abandonment and betrayal in the analytic relation [Review of the book Traumatic ruptures: Abandonment and betrayal in the analytic relation, by R. A. Deutsch, Eds.]. Psychoanalytic Psychology, 33(4), 664–671.

Eterović, M. (2020). Recognizing the role of defensive processes in empirical assessment of shame. Psychoanalytic Psychology. Advance online publication.

McCabe, R. E. (2015). Review of The mindfulness and acceptance workbook for social anxiety and shyness: Using acceptance and commitment therapy to free yourself from fear and reclaim your life [Review of the book The mindfulness and acceptance workbook for social anxiety and shyness: Using acceptance and commitment therapy to free yourself from fear and reclaim your life, by J. E. Fleming & N. L. Kocovski]. Canadian Psychology/Psychologie canadienne, 56(1), 152–153.

McCraw, K. S., & Valentiner, D. P. (2015). The Circumscribed Fear Measure: Development and initial validation of a trans-stimulus phobia measure. Psychological Assessment, 27(2), 403–414.

Owuamalam, C. K., Tarrant, M., Farrow, C. V., & Zagefka, H. (2013). The effect of metastereotyping on judgements of higher-status outgroups when reciprocity and social image improvement motives collide. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 45(1), 12–23.

Platt, M. G., & Freyd, J. J. (2015). Betray my trust, shame on me: Shame, dissociation, fear, and betrayal trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 7(4), 398–404.

Ranđelović, K., Smederevac, S., Čolović, P., & Corr, P. J. (2018). Fear and anxiety in social setting: An experimental study. Journal of Individual Differences, 39(2), 61–75.

Online Continuing Education QUESTION 11
What are two possible causes of social phobias? To select and enter your answer go to CEU Test.

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