Portrayal of Social Phobia in Popular Culture
PSYC1024: Clinical Perspectives on Anxiety, Mood and Stress
Monday, January 15, 2018
Portrayal of social phobia in popular culture
Multifarious mental health issues have been an increasingly prevalent topic in recent years. Social phobia also known as a social anxiety disorder (SAD), is a common mental health disorder nowadays. By definition outlined in DSM-IV, social phobia refers to the persistent fear or anxiety experienced in interactions and performance situations (American Psychiatric Association, 2013, p.203). The protagonist Tanmeng in book Solitary Patients (Chendong, 2009) who is an extremely introverted high school student and could not fit in the social circle due to the impact of a tough childhood, will be discussed as a SAD patient in the following essay. Furthermore, after showing what cause and maintain SAD through the cognitive model, the treatment that the character received and the best evidence-based treatment will be evaluated.
Symptoms of social phobia
The concept of SAD has elastic boundaries and there are dozens of symptoms associated with social anxiety. Blanco, Nissenson, and Liebowitz (2001) state that based on occasions that symptoms occur, scientists typically label symptoms into two broad categories. The one is social interactions such as communicating with one or more people, and the other is social performance such as being a focus of the attention. Tanmeng is diagnosed with social phobia because he has phobic symptoms, for example, he operates outside the class and never starts a conversation with others, which indicates he has trouble with social interactions. Although the book does not provide details about how he reacts to a gala event because he chooses not to participate with, it still indicates symptoms of SAD in social performance.
A cognitive model of social phobia
Social phobia is a disabling mental condition in both adults and adolescences. People having specific phobias for instance flying, height and spider phobia could avoid most of the encounters with specific phobia object. On the contrary, avoidance is not a cure for social phobia patient and actually, it is the main reason why social phobia persists. Over the last few years, it has been corroborated that considering the particularity of SAD, the cognitive model of social phobia (Clark &Wells, 1995) is one of the most influential contemporary models. Roth and Heimberg (2001) suggest that the Clark and Wells’ model as a formulation conceptualization of SAD presents a theoretical framework regarding the development as well as maintenance of the disorder. The cognitive model provides a systematic review of analyzing etiology and maintenance of SAD.
Causes of social phobia
Given the overview of symptoms of social phobia, understanding the etiology of social anxiety is beneficial since it provides significant information about what could enhance the risk for the development of social phobia. As Rapee and Spence (2004) described, social phobia is evoked through a combination of genetic predispositions, temperament, childrearing and negative life experiences. Based on the record about Tanmeng in the book, his parents splitting haunted him, he did not receive too much love from this broken home, and things got worse since his grandmother who is the only person caring about him passed away. It is conspicuous to notice that his rough childhood experiences cause social phobia of Tanmeng. As he is aloof from communication to get help, his symptoms are intensified with time going, which leads the topic to the reason for the maintenance of SAD.
Maintenance of social phobia
Recent studies have identified a couple of factors that could maintain the disorder from a variety of aspects including biology, psychology, and society. As per Clark (2001), the model details several key mechanisms to maintain SAD involving negative social cognitions, safety-seeking behaviors, self-focused attention, pre-event processing and post-event processing. By the observation of Solitary Patients, there is a correlation between the cognitive model and case of Tanmeng of social phobia. Marom, Aderka, Hermesh, and Schechtman (2009) believe that people with social phobia often act safety seeking behaviors during stressful occasions to avoid negative evaluation by others. In the case of Tanmeng, out of contact with peers and social event maintains his social phobia because he takes credits for choosing this method and safety seeking behavior will become his priority. This results in enhancing socially awkward and maintaining his SAD.
Treatments for social phobia
Individuals with social phobias can be treated with evidence-based treatments effectively. Marom, Aderka, Hermesh, and Schechtman (2009) argue that both cognitive behavior therapy (CBT) and pharmacotherapy have validity on treatment for social phobia.
CBT refers to a time-limited treatment for SAD involving between 12 to 18 weekly sessions by intervening some components, for instance, cognitive restructuring, social skills, and psychological education. However, several studies comparing the efficacy of CBT and drug therapy shows that effects of CBT are more enduring than medication. Besides, the rates of relapse are higher for pharmacotherapy than CBT. According to Gould, Otto, Pollack, and Yap (1997), among dozens of available randomized trials for treatments of SAD, CBT has been demonstrated as the most effective treatment for social phobia.
The first half of Solitary Patients narrates that Tanmeng has hovered around the social circle for years. Whereas, the plot reverses at the moment that Melinda, an extroverted girl becomes his new desk mate. She talks to him and helps him even though no student would do that. At the end of the story, he beams with pleasure on the opening ceremony of the university. Tanmeng has recovered from social phobia. Although not receiving any professional treatment, the help from Melinda renders him face his inside fear and rebuild social skills.
Social phobia, a recurrent and intense anxious reaction to a social occasion, is generated by the combination of gene, childrearing or negative life experiences, and moreover maintains through negative social cognitions, safety behaviors, and event processing. Finally, based on a large body of empirical experiments, cognitive behavior therapy has validity in treating social phobia by rebuilding cognition. The case of Tanmeng could be considered as a typical case of SAD. This is because except that the treatment case is not the optimal one, the rest correspond with concepts of SAD.