Social anxiety as we know it today has come a long way since it’s first recognition. With our incremental acquisition of knowledge, particularly with developments in modern medicine over the last 100 years, this is to be expected. But what was once known as shyness, as an undesirable trait dictated by “society”, it is now given the credence it deserves as a complex mental health condition. Read on to appreciate just how this took place.
Early records show, and experts believe, the first reference to social anxiety was first described by Hippocrates as “shyness” in early 400 B.C., referring to people who “love darkness as life” and "thinks every man observes him". Next, Charles Darwin wrote about the physiology and social context of blushing and shyness. Thenn, during the eighteenth century, European psychiatrists, psychologists, and authors started examining the topic. However, the idea of providing recognition to the study of social anxiety as a discipline did not arise until the 20th century. It was around this time when psychiatrists used terms such as social phobia to refer to extremely shy patients.
The term “social neurosis” was used to describe the condition in 1938 by Schilder, a psychiatrist. Then, Joseph Wolpe, a South African psychiatrist, determined a path for the improvement of behavioral therapy for treatment of phobias in 1950 by developing a technique called systematic desensitization. This led to increased involvement of researchers in behavioral therapy of phobias. This was the beginning of cognitive behavioural therapy.
In 1960, a British psychiatrist named Isaac Marks put forward the idea of classifying social phobias as a separate category from other phobias. Later in that decade, the American Psychiatric Association (APA) defined social anxiety, namely, as “a specific phobia of social situations or an excessive fear of being observed or scrutinized by others.” This is largely how it is discussed today. One very public event occurred in 1967, when Barbra Streisand was performing in Central Park and she forgot lyrics to a song mid-performance. She attributed this to anxiety and was very open about her treatments which she received. The public's awareness of anxiety was increasing, albeit without society’s perception changing.
Since the existing definition was a narrow one, social anxiety continued to be given broader classification throughout the 1980s. APA officially added social phobia as a psychiatric diagnosis, describing it as “a fear of performance situations and did not include fears of less formal situations such as casual conversations.” However, in 1994 the term social phobia was replaced by “social anxiety disorder (SAD).” SAD described the depth of disorder as “marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others.” This led to changes in the diagnosis criteria.
Since the turn of the millennium, there has been a distinct increase in the use of Cognitive Behavioural Therapy to support individuals with anxiety. This approach underpins the most common treatments in many countries, with group sessions being utilised for those under 18 years of age with very positive results. And, in true 21st century fashion, the team at oVRcome have developed a programme which uses exposure therapy through virtual reality experiences to support those with social anxiety. Modern technology for a condition which demands more support services. We have also developed a free Social Anxiety Test which delivers a personalised report to see where you are at. It’s an excellent tool to start with, so take a look today!
Like many things in life, understanding the evolution of social anxiety disorder, its diagnosis and treatment options is helpful in learning more about our own relationship with the condition. Such developments and the efforts from a Government level to improve provisions and awareness means that we are, hopefully, moving towards a future where those with social anxiety can feel seen and supported. It’s just like Murray B. Stein said in 1996 - “Might there be a brand of “shyness” serious enough to warrant medical attention? There is. It is “social phobia.””
If you’d like to read more about social anxiety, in particular how it is thriving in a modern, online society, why not have a read of one of our previous posts? Social media - like / love / anxiety takes a look at how online culture is creating a more anxious society through unrealistic expectations of what life is truly like.