Once the fear has been triggered the physical reaction can lead to a cycle of distress. The body responds to any naturally stressful situation by tensing up. This helps the person perform better. However if the reaction is misinterpreted and excessive this can lead to unnecessarily high levels of tension.

Although a sufferer may realise that the muscular pain and breathing difficulties they are experiencing are merely a response to stress; if the bodily reaction is extreme enough it may give rise to a fear of the symptoms of phobia: a fear of the fear. Anticipation of this discomfort, the fear of chest pain or hyperventilation can produce the stress that triggers these symptoms.

Some of the physical symptoms of phobia include:

shaking/trembling
sweating excessively
nausea
dizziness
hyperventilation
chest pain
freezing

As fear levels increase, the mental processes intensify and distort. A phobic person will overestimate the danger they are in and underestimate their ability to cope. For example someone with a fear of driving will overestimate the dangers of road travel while underestimating their own driving ability. In this way they may lose all sense of perspective. They expect disaster to be the only outcome. This is called catastrophising.

Some of the common mental processes associated with phobia include:

catastrophising
ignoring the positive
exaggerating
over generalizing
looking for disaster
thinking in all or nothing terms.

As for psychological treatment, among the most effective are CBT (Cognitive Behavioural Therapy) and CGBT (Cognitive Group Behavioural Therapy). In supportive environments, social phobics can learn to address their fears and can steadily overcome them.

With the help of a therapist, they can develop strategies for coping and find a more constructive way of viewing their fears. The advantage of group therapy is that they can meet and interact with fellow sufferers, which will help them to realise that they are not facing their problems alone.