The case under review is that of Ted, a 19-year-old college student, with a self-reported history of intense anxiety at the prospect of speaking in class. He deals with the fear by taking only crowded lecture courses and seating himself at the rear of the room where he hides himself as completely as possible. On occasions when teachers began to call on students at random Ted experienced intense anxiety accompanied by sweating and trembling after which he would quickly exit the room and return to his residence. Away from the situation it would take Ted as long as a few hours to calm himself again.
A primary diagnosis of social phobia is warranted. Social phobia consists of a chronic condition, often manifested in adolescence, in which the individual has a baseless, very intense fear that, in a specific setting, some aspect of his/her behavior will attract unfavorable attention resulting in ridicule or criticism. The behavior he/she is afraid of committing will be inappropriate, incorrect, and even involuntary and will invoke contempt in those watching him/her. Although social phobics may understand that their fears are irrational they continue to agonize over the possibilities of incorrect behavior in the specific situation. In most cases they engage in extreme efforts to avoid the particular situation that evokes the fear, but when such circumstances are unavoidable and any possibility exists that they will be forced to perform they immediately begin to experience great anxiety.
Ted's symptoms are those associated with social phobia. He experiences irrational worry and intense fear that he will behave in a manner that will induce criticism. His reaction is specific to a particular situation (i. e., classroom speaking) rather than general. He feels that his performance will be ruthlessly scrutinized by others. He exerts great effort to avoid the situation. He becomes highly anxious on being exposed even to the possi...