Virginia Ironside's Dilemmas

I suffer from a social phobia. I am afraid to drink and eat in public, because I am afraid that my hands will shake. I worry it will be noticed and I will feel humiliated and people will not consider me a serious person and, worse, not a real man. This problem basically excludes me from one of the largest and best part of social life. I've consulted many therapists and a CBT counsellor, but it still persists. What would you advise me to do, apart from not staying home (because I already know that but I can't overcome it)? Yours sincerely, Guy

Virginia says... You seem to have so many fears, so let's look at them one by one. Firstly, you fear that your hands will shake. Do you have any evidence that they will shake? If they do, indeed, shake, then no amount of therapy will help, as your fears are founded in reality. But a doctor might be able to help you overcome what sounds like a kind of tremor – not uncommon.

If this is just an irrational fear and your hands have never, in fact, shaken, then ask yourself why you think they might. Your next fear is that if they do shake, you will feel humiliated. Why? There is nothing especially wrong with hands that shake. It doesn't mean you are less of a person. Look at someone like Stephen Hawking. He doesn't think that because he uses a wheelchair and finds speaking hard that everyone thinks he's an idiot. Far from it.

You then say that people will think you're not a serious person. Why, again? There's nothing to link hand-shaking with lack of seriousness. As for people thinking you less of a man, that's simply not true. It is cowardly behaviour or excessive greasiness or rudeness that might make people think you were less of a man. Not shaky hands.

But of course you know all this because the cognitive behavioural therapist has, I hope, pointed it out. But if all the rational arguments fail (and they usually do, in face of a full-blown phobia) why not draw attention to your problem before anyone else does? You could say: "I've got a phobia about eating or drinking in public, so forgive me if I don't have anything." Or you could simply lie and say: "I've inherited a tremor from my father, which is really irritating when I'm eating. I do hope you understand."

If the worst comes to the worst, go out but don't eat or drink. You can make an excuse, saying you've just had a meal, or you're not thirsty.

It seems to me you've not got the help, yet, that you need. A good therapist would come with you to a pub and see if it would be possible for you to order a drink and bring it to the table on one day, and then perhaps, the next day, to lift the drink to your lips without drinking, and so on.

I feel sure you're curable, with enough determination. Return to your doctor and ask for referral to a different CBT therapist. I've no doubt that with the right help, you might not be cured completely, but certainly your problem could be lessened considerably. And then you could lead a normal social life.

Readers say...

Face your fears

The only real answer is to be as honest as you can: admit your nervousness and your shaking, don't fear it. It is in attempting to portray a different persona that you are afraid of being found out. Start with those closer to you. I don't mean force your fears on others, but don't be afraid to say, this is who I am. As for your "real man" concerns, why not go on a week's outdoor pursuits course where you can address the physical fear of climbing, abseiling etc; to the novice intensely scary but, as you would find, very uplifting and emotionally rewarding.

Phil Brown By email

Get medical help

I have lived with essential tremor all my life. The friends I go out with pretend not to notice unless I ask for help with something. Beta-blockers help to reduce tremor (Guy should see his GP) and alcohol does the same. In fact, a consultant neurologist advised me to have a glass of wine before going out. Guy, don't give up on your social life; go out and learn to live with it. It can be done.

Andrew Kett By email

Next week's dilemma

Dear Virginia, My partner committed suicide a month ago, by poisoning himself in our car. I have no idea why he did it. He seemed his normal self that morning and had no worries. My son and I are finding it very difficult to come to terms with, as you can imagine. But to make it worse, we live in a small village and people are starting to talk, spreading rumours that it was my fault, somehow. Some of my son's friends' parents have stopped speaking to him as well. I don't know how I can cope. Life simply seems too difficult to continue. Yours sincerely, Clare

What would you advise Clare to do?

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