Cure your Emetophobia and Thrive – Chapter 5 preview..
Cure your Emetophobia and Thrive – Chapter 5 preview… Chapter five: Social Anxiety
‘Social anxiety’ (sometimes called ‘Social Phobia’) is essentially a fear of being judged by other people. It can manifest as a fear of talking to other people, fear of intimacy in relationships, blushing, stuttering, many sexual problems, difficulty in maintaining eye contact, ‘shy bladder’ (not being able to urinate in public toilets), fear of public speaking or just a constant worry about what other people think about you. Wherever you are, whatever you are doing, you are worrying about what the other people around you are thinking about you. Do they think I’m clever? Do they think I’m stupid? Do they think I’m a good lover? Do they think I have a silly sense of humour? Do I look ridiculous in this? Does my bum look big in this? Most people care, to a greater or lesser extent, what others think of them. With severe social anxiety, this can become a constant obsession.
Most mental health professionals treat social phobia/social anxiety as just one of the spectrum of ‘anxiety disorders’ that exist (see DSM IV, The Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, 1994). They don’t seem to realise that every single one of us suffers from it to a greater or lesser extent, and that it affects EVERYTHING we do, think and say.
Let me explain why social anxiety affects all of us and where it comes from.
Love, to a child, is about being truly accepted, being valued, being loveable, being an equal member of the family unit and fitting in. The tenderness and care that a loved child receives helps them to develop their sense of self, their ego, their sense of belonging, their sense of deserving (they deserve love, they deserve to be treated well, they deserve to be heard), and, of course, their overall levels of self-esteem. All of these things in turn help the child to develop a mental robustness. It is this mental robustness that the child (and later as an adult) falls back upon when life becomes a bit challenging. We call this mental robustness ‘resilience’.
The growing and maturing child wants to please mum, dad, other family members, teachers and friends. They want to fit into this group, be a part of this group, share the same values and beliefs as this group; they want to be socially accepted. When you share the same values as a group of other people, they matter to you, their opinions of you matter to you, and you slowly start to judge yourself the way the rest of the group would do. It would be reasonable therefore, to view social anxiety as ‘the fear of not being accepted by your group’, whether you are talking about your family, your friends, your religious group, your community, or even your country.
The difficulty is, with the strict set of rules that families and societies tend to promote (e.g. don’t kill, don’t steal, don’t masturbate, don’t swear etc.) everyone, sooner or later, breaks one or more of these ‘rules’. Then you are in a bit of a quandary. What do you do?
- Do you ‘fess up’ and tell your families, friends and peers what you have done and risk their wrath, and possibly the loss of their love, affection and acceptance?
- Do you deny it, repress it, brush it under the carpet. This way, you can carry on as normal, stay comfortably within your family/societal group, and just pretend that your little transgression never occurred, until next time!
I’m sure you’ve realised, that 99.9% of people would choose number 2, either consciously or unconsciously, because choice 1 would be too uncomfortable to endure. So, we begin to develop mechanisms by which we can hide or conceal things we don’t like about ourselves, from our social groups, and from ourselves. These are normal psychological defence mechanisms.
As your perceived transgressions mount up, they start to affect the way you think about yourself. You begin to think of yourself as a ‘bad person’, not good enough or maybe even un-loveable. These are obviously difficult feelings and beliefs to hold, so our defence – the social anxiety – gets stronger, in order to protect us from having to face these feelings. You start to worry that other people might be judging you, because you are (consciously or unconsciously) judging yourself. You then tend to add many more bricks to your social anxiety wall, whenever you find yourself in a situation where you feel ashamed, guilty, embarrassed, judged, on the spot, etc., which builds and maintains this belief.
Again, you have the power to change this belief by managing your thinking but, as we have already discussed, this does not tend to happen spontaneously, as you are now wearing belief system-tinted glasses. You view all new experiences through ‘socially phobic eyes’! You start to judge yourself, you start to feel bad, irrespective of whether you are actually treated badly or not. You see yourself as unlovable, not good enough, not nice enough, or not deserving enough and worry that others must be viewing you in the same way.
There is plenty of research that points to social anxiety effectively being a belief or ‘unhelpful thinking style’ (more about them later) that the child learns from their parents… Lieb, Wittchen, Hofler, Fuetsch, Stein and Merikangas (2000), found that:
There was a strong association between parental social phobia and social phobia among offspring.
Whilst Cooper and Eke (1999) studied 867 four year-old children who lived and went to school near Reading, UK and concluded:
Compared with the mothers of the children in both comparison groups, the mothers of the children who were purely shy had a significantly raised lifetime rate of anxiety disorder in general, and social phobia in particular. The odds ratio of a social phobia in the mothers of the purely shy children was raised over the normal control group by a factor of more than seven. (My bolding)
If you are thinking ‘maybe the parents passed it on to their children via their genes’, Plomin and DeFries (as cited in Cooper and Eke, 1999) found that:
...an important role for familial environmental transmission has been suggested by the fact that the correlation for shyness between biological mothers and adopted-away children has been found to be low, whereas the correlation between adoptive parents and their adopted children has been found to be moderately high.
I’ll translate this statement from psychobabble into English for you: children tend to learn their social anxiety from the parents who bring them up on a day to day basis, whether or not these are their natural parents. There are two main reasons why parents who have social anxiety tend to pass it onto their children. Most importantly, socially anxious parents, because they fear being judged themselves and believe that they need to firmly stick to social ‘rules’ to be accepted, tend to be more judgmental towards their own children. They tend to convey a greater sense that making mistakes, behaving badly (especially in public!), and transgressing social and cultural ‘rules’ will have substantial negative consequences. Because they fear being thought of as bad parents, they are far more likely to want their children to be ‘perfect’, ‘model’ children – you can imagine the impact this could have on a child who wants to please mum and dad and fit in! This increases the likelihood that a child would want to hide any mistakes from their parents (and friends, teachers, etc.) and end up judging themselves harshly. Secondly, children may also notice their parent’s own anxiety in social situations and fear of being judged. This may reinforce to them that social situations are to be feared and that society is judgmental.
If you still don’t see how hugely important our sense or fear of being judged is, ask yourself this question. If I invited you into a big room with all your family, friends, co-workers and peers, and insisted that you share your deepest darkest secret with everyone present, what would it be? Something you really wouldn’t want to tell anybody else? I’ll bet you a bottle of Jack Daniels, that what you thought of was something incredibly personal, or linked to sexuality in some way, yes? Why? Because these are the areas that constitute our innermost feelings and desires, and therefore the experiences we have most capacity to feel guilt, shame and embarrassment about.
I’ve actually asked the ‘what’s the one thing you wouldn’t want to have to tell a friend or family member?‘ question at a number of seminars I have run over the last few years. I’ve asked delegates to write down their ‘guilty secret’ – the thing they wouldn’t want anyone to know – on a scrap of paper. I then collect up the scraps of paper, and count them up. I think I have collected up about 450 bits of paper now. The result? Almost every single one had written on it, something related to sexuality – sex, masturbation, having an affair, touching someone, termination of pregnancy, being abused, fantasising about someone – the innermost thoughts and feelings that we judge ourselves for. In other words, people are saying ‘I feel really guilty and ashamed about this, and I feel really bad about this, I don’t want others to know about this or they might judge me for it’.
Look at it another way. Of all the emotions we feel, guilt and shame are the only ones that are very hard to project outwards in order to lessen. You can LOVE your parents, you can HATE your sister, you can be JEALOUS of your brother, you can feel ANGER towards your teachers, you can feel SADNESS about your uncle – but you cannot feel GUILTY or ASHAMED FOR someone else – these feelings are all about you. YOU feel guilty or ashamed, it’s something that eats away at you, that is really, really hard to get rid of. There is an absolute plethora of research available that confirms ‘guilt and shame’ as the significant driving factor behind many common symptoms, including anxiety and depression. For those of you who would like to delve deeper into this area, some of the more interesting research includes: Hagley and Kelly, 2009; Gilbert, 2000; Averill et al., 2002; O’Connor et al., 2002; Ferguson et al., 1999; Lee et al., 2001; Tangney et al., 1992.
Essentially, the more prone you are to creating feelings of guilt and shame, the more you will worry what others think of you. The person who judges you most, is you. YOU are the one who has strong beliefs about how good and proper you need to be. YOU are the one who believes you’re a terrible person for doing that ‘terrible’ thing, and you project those fears onto other people and worry that they will think you are terrible too. Some people have so much social anxiety that they shy away from life completely and avoid relationships (of any kind) and all social situations, in order to minimise their exposure to their horrible feelings of being judged. Other people set very high standards for themselves in order to avoid perceived judgment. These people often describe themselves as ‘perfectionists’, but they are not really driven to be perfect, rather they are driven to avoid being judged for being a failure.
Throughout this book we are going to slowly break down your existing limiting belief systems and build them back up into ones that will enable you to live your life to the full!
Social Anxiety in Emetophobia
I have found that emetophobes have significant social anxiety, both in relation to their fear of being sick and in their lives generally, and this is supported by research. A number of studies have, for example, found that some emetophobic participants report social anxiety disorder as an additional problem to their phobia (Hout & Bouman, 2011; Lipsitz et al., 2001; Philips, 1985). One research study (Lipsitz et al., 2001) into emetophobia found that 62% of participants were more worried about vomiting in a public place than in private (although most were also fearful of vomiting in private as well)….
Want more? Get started here…