How should you respond when you receive a telephone call from a patient who seems anxious about the results of a test?

Phone anxiety is a common fear among those with social anxiety disorder (SAD). Many people may not like talking on the phone, or may even have a "phone fear." But when your hesitance to make and receive calls causes you to experience symptoms such as severe anxiety, shortness of breath, or a racing heart, you may actually have phone phobia.

Illustration by Jessica Olah, Verywell

Overview

Those who do not have SAD may be afraid to use the phone. They may be more comfortable in direct social interactions, perhaps due to the fact that face-to-face settings allow them to be able to read non-verbal cues, like facial expressions.

However, those with SAD obviously suffer from the opposite. If you are dealing with this condition, a phone fear may reflect issues you are dealing with regarding interaction with others in general.

Symptoms

If you feel extreme anxiety before or after interacting over the phone, you may indeed have a phobia. Some emotional symptoms of phone anxiety may include:

  • Avoid making calls or having others call you
  • Delay in making or answering phone calls
  • Obsess about what was said after calls
  • Stress about embarrassing yourself
  • Worry about bothering the other person
  • Worry about what you will say

Physical symptoms of phone anxiety may include:

  • Increased heart rate
  • Nausea
  • Shaking
  • Trouble concentrating

The fear of making and receiving phone calls can be disruptive to both your personal and professional lives. It is important to take phone anxiety seriously. Although answering the phone and making calls may seem like a simple task that everyone should be able to do, if you suffer from phone phobia, the anxiety can be terrifying and real.

Treatment

Treatment for phone phobia can include cognitive-behavioral therapy (CBT) techniques, such as cognitive restructuring and exposure training. In addition, there are many self-help strategies that you can use to cope with anxiety about using the phone.

Cognitive restructuring involves challenging beliefs and replacing negative thoughts with more constructive alternatives.

For example, if you constantly worry that you will bother the other person when making a phone call, cognitive restructuring might have you consider the evidence that this is actually true.

Why would the person answer the phone if he was too busy? Why would he have asked you to call if he didn't want to talk to you? Eventually, you would reach the conclusion that it is unlikely you are bothering the other person or that he doesn't want to speak with you.

Exposure training involves the gradual practice of progressively more difficult behaviors . In the case of phone anxiety, a hierarchy of fears might look something like the one below (listed from easiest to most difficult). Each behavior is practiced until you are comfortable and can move on to the next most difficult one.

Sample Hierarchy for Telephone Fear

Below is an example hierarchy for someone who gets nervous interacting over the phone:

  1. Calling a number that you know will only have a recorded message, like a customer service line
  2. Calling a family member or friend that you know well
  3. Calling a business and asking a straightforward question, such as when they close
  4. Calling someone that you don't know well with a simple question
  5. Calling someone that you don't know well about a complicated issue
  6. Making each of the previous types of calls in front of one person
  7. Making each of the previous types of calls in front of a group of people

Your hierarchy might be different depending on whether you find friends or strangers more difficult to talk to, and whether it is more difficult for you to talk on the phone in front of someone else.

It may be difficult to create a hierarchy to deal with the fear of answering calls. If you typically avoid answering the phone, one strategy would be to use a caller ID unit to identify who is calling. You could then start by answering calls from people that you are most comfortable with and letting other calls go to voicemail. Eventually, you would progress to answering more difficult calls.

Coping Strategies

Ideally, you should practice cognitive-behavioral techniques under the supervision of a trained therapist. If meeting with a CBT counselor isn't possible, or if you have already participated in CBT and are looking for additional ways to cope, the following strategies may come in handy.

  • Smile. Beforemaking and receiving calls, put a smile on your face. This may sound silly, but it helps you to relax and conveys a sense of pleasantness to the person you're speaking with.
  • Reward yourself. After making difficult calls, reward yourself by spending some time doing something that you enjoy.
  • Visualize success. Imagine a positive conversation and feeling good afterward.
  • Ascertain availability. If you are concerned about interrupting someone when you call, ask whether you are catching the person at a bad time. If the person is in the middle of something, this gives him the chance to offer to call you back.
  • Don't overthink it. If someone says "no" or turns down a request, realize that it could be for many reasons that have nothing to do with you. Try not to read too much into someone else's actions.
  • Prepare. Do a bit of preparation before making a call, but don't go overboard. Know generally what you are going to say, but try to anticipate that the conversation may not go exactly as you have planned. If there are important points that you need to bring up, make sure to write those down and keep them handy.
  • Let it go to voicemail. Realize that you don't always have to answer the phone. If someone is calling you at a bad time, or if you are too anxious to talk, it is acceptable to let calls go to voicemail from time to time.
  • Try another communication method. The phone may not always be the best method of communication. If you want to have a digital record of your conversation or if you want to give the other person time to reflect before responding, email may be the better choice. However, if you need to discuss something emotional or the topic is complex, a phone call or face-to-face meeting may be best.

A Word From Verywell

Phone anxiety is difficult but can be overcome. However, if you find that your fear of making and receiving phone calls extends into other areas of your life and that you have fears of social interaction in general, it might be helpful to consult a mental health professional. If you are diagnosed with SAD, treatments such as medication or therapy may be offered to you.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Gao Y, Li A, Zhu T, Liu X, Liu X. How smartphone usage correlates with social anxiety and loneliness. PeerJ. 2016;4:e2197. Published 2016 Jul 12. doi:10.7717/peerj.2197

  2. Verbeke W, Bagozzi RP. Sales Call Anxiety: Exploring What It Means When Fear Rules a Sales Encounter. J Marketing 2000;64:88-101. doi:10.1509%2Fjmkg.64.3.88.18032

  3. Ruggiero GM, Spada MM, Caselli G, Sassaroli S. A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes. J Ration Emot Cogn Behav Ther. 2018;36(4):378–403. doi:10.1007/s10942-018-0292-8

  4. Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. Maximizing exposure therapy: an inhibitory learning approach. Behav Res Ther. 2014;58:10–23. doi:10.1016/j.brat.2014.04.006

Additional Reading

How should you respond when you receive a telephone call from a patient who seems anxious about the results of a test?

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."

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