Health: Fighting social phobias

JANUARY SALES can be a real problem for Vivian Birch. On a bad day her social phobia is so severe she can't answer the phone, and even the prospect of talking to shop assistants or of travelling on public transport terrifies her.

"Sometime I'm so frightened of even the phone that I can't bear the noise it makes, and I have nightmares where the phone is walking up the stairs to strangle me in bed. Now I have an answer-phone which I use on a bad day so there is no chance of me having to talk to a stranger," says 29- year-old Vivian.

She is one of an increasing number of people suffering with social phobia, or extreme shyness. It's a problem that peaks at this time with the pressures of New Year parties, office dos, eating out, and other social occasions.

For millions of people shyness like this is a chronic problem that can wreck lives, ruin any chance of a relationship and even lead to suicide. Some psychologists believe that the problem is increasing as people lose their social skills in an age of telephone-banking, automatic checkouts and tele-working.

"These days you exchange information and not emotions. There is no sentiment, no face-to-face contact, no small talk, and some kids would rather play computer games than play with real live friends,'' says Professor Philip Zimbardo of Stanford University in the US, a leading authority on shyness.

Social phobia is described by the American Psychiatric Association as a pronounced and persistent fear of social or performance situations in which embarrassment may occur, and it estimated there are around two million social phobics in Britain alone. Sufferers experience a range of symptoms that can include mutism and other speech problems, low self-esteem, social anxiety, loneliness, uncontrollable blushing, physical shak- ing, and extreme difficulties in forming relationships.

Nature and nurture, genes as well as social conditioning, are thought to play a part, and one research team working with twins reared apart, found around one in six of the population are born with a predisposition to shyness, although most shyness is thought to be acquired in early childhood.

"Over the past 10 years shyness has been increasing at the rate of around one per cent a year until now it is about 50 per cent which suggests there is something significant happening in our society which is increasing the level of shyness,'' says Zimbardo.

Vivian Birch, whose responses to socially phobic situations include mutism, dizziness and nausea, has tried a number of different therapies to ease her problems. She is currently taking Seroxat for the depression that is an integral part of social phobia for one in three sufferers. The same type of formulation has been described as an anti-shyness pill, and increasing numbers of similar drugs are on the market or in development.

"Since January I have been taking Seroxat. I am finding it very helpful and it has made quite a difference to me. I don't see anything wrong with a drug for social phobia if it gets people to a stage where they can tackle the problem," she says.

Another new treatment for social phobia, computer-based psychological therapy, is being pioneered by The Maudsley Hospital and the Institute of Psychiatry in London.

The computer programme, FearFighter, that Professor Isaac Marks and his team have produced, involves half-a-dozen one-hour sessions which show the patient how to use exposure therapy to confront his or her fear.

"The essence of our programme is about self-treatment. The types of homework that could be set for social phobia might be for them to ask someone the time at a bus stop, or to engage a stranger in conversation for one minute," says Professor Marks.

The Maudsley programme has been used by 90 patients, a third of them social phobics. The results are expected to conclude that it is as successful as face-to-face therapy.

The Maudsley self-care clinic is on 0171 919 3365, and the Phobics Society runs a self-help network, telephone 0161 881 1937.