Have you ever experienced social anxiety? Do you reject invitations to social events because you might feel uncomfortable if you went? Does being anxious around others keep you from doing things you want to do in life?
Social anxiety is feeling anxious and nervous in situations involving other people such as public speaking, engaging in conversation, or attending a gathering. Most people have felt slightly anxious before an important work event or meeting someone new, but for individuals with social anxiety, this feeling can be extremely overwhelming and interferes with their daily life. Often, an individual with social anxiety fears that they will display visible symptoms of anxiety or act in a way that is embarrassing and uncomfortable (APA, 2013). People with social anxiety strongly fear being negatively evaluated or criticised in the presence of others (Beyond Blue, n.d). Nonetheless, social anxiety is fairly common, with research indicating that 11 per cent of the Australian population will experience social anxiety at a point in their life, usually with an onset in childhood or adolescence (Beyond Blue, n.d).
The psychological treatment with the largest evidence-base for social anxiety is Cognitive Behavioural Therapy (CBT), which assists individuals in responding differently to anxious thoughts and challenging maladaptive emotional responses (Kaczkurkin, 2015). CBT targets what psychologists refer to as the three core components of anxiety – the cognitive, physiological, and behavioural symptoms. Essentially, treatment addresses the thoughts individuals have regarding social situations, how they feel in their body, and how they behave in response to the anxiety. Here are some evidence-based tips to manage these symptoms of social anxiety:
Cognitive Component
Imagine you receive an invite to a friend’s birthday, and as you scroll through the invite list on Facebook you notice you only know one other person attending. The following thoughts run through your mind: “It’s going to be so awkward”, “I won’t be able to get a word out”, and “I wont be able to cope” leading you to feel anxious and worried. Now imagine again the same situation, but this thought go through your mind: “It’ll be a good opportunity to meet someone new” and you feel excitement instead of anxiety. As shown by this example, our thoughts play a large role in how we feel emotionally.
It’s important to remember that just because we have a thought does not mean it’s true – sometimes thoughts are accurate, sometimes partly accurate, and something not true at all. We can challenge the accuracy of our thoughts by searching for evidence indicating the original thought may not be 100% true and considering alternative perspectives. For instance, for the thought “I won’t be able to get a word out”, we could ask Have I had any experience that suggests this thought is not completely true? Do I know that for certain? and for the thought “It’s going to be so awkward” we could ask Am I jumping to any conclusions? Are there other ways of viewing this situation? What is the worst thing that could happen and would I find a way to cope? After asking a series of thought challenging questions, try to compose a short and rational response to your negative prediction, for instance “I don’t have a crystal ball. I can go to the party and try to enjoy myself. Normally I am able to get a word out and I’ll make it a challenge to introduce myself to someone new”. By being realistic about our fears and challenging negative thoughts and predictions, with practice we can change how we feel about social situations.
Physiological Component
The physiological aspects of social anxiety such as increased heart rate, trembling fingers, tense muscles, and blushing are controlled by the body’s sympathetic nervous system. When the brain perceives danger, the fight or flight system is activated which increases anxiety. In contrast, the parasympathetic nervous system decreases arousal. The best way to manage the physical symptoms of anxiety is to use strategies that activate the parasympathetic nervous system.
Paced breathing:
Often when we are anxious, we breathe from the chest rather than deeply from our abdomen.
Before entering into a social situation, slow down your pace of breathing way down (to about 5-7 in and out breathe per minute). Breathe deeply from the abdomen. Breathe out more slowly that you breathe in (e.g., 4 seconds in and 6 seconds out). Do this for 1-2 minutes to bring down your arousal.
Progressive Muscle Relaxation (PMR)
In PMR, each muscle group is tensed in turn, and the tension is then released. This relaxes the muscles and allows you to notice the contrast between tension and relaxation. You can practice progressive muscle relaxation by listening to a voice recording (such as this https://www.youtube.com/watch?v=ClqPtWzozXs) or following the instructions below.
Focus your attention on different parts of your body in the sequence below. Go through the sequence three times.
- Tense and release: Tense that body part, hold it for a few moments, then relax
- Lightly tense and release: Tense that body part with just enough tension to notice, then relax
- Release only: Just pay attention to each muscle group and decide to relax it
Behavioural Component
Often, social anxiety is maintained by avoiding something we fear such as declining to give a toast at a friend’s wedding or not attending a party we’ve been invited to. More subtle examples of avoidance include going to a social event but staying on the phone most of the time to avoid conversation. When we avoid something, we never get to learn that what we fear might not be as scary as we think it is.
If you’ve had a fear in the past, how did you overcome it? Research shows that exposure is one of the most important techniques for the treatment of social anxiety (Kaczkurkin, 2015). Exposure therapy is based on the idea that lengthy and repeated exposure to feared or avoided situations leads to a reduction in anxiety. An example could be asking multiple strangers for directions to a café nearby until asking becomes comfortable, or even boring!
To overcome avoidance, construct a ladder or hierarchy of places or situations that you avoid, with those that make you feel slightly anxious at the bottom and the most anxiety-provoking ones at the top. Some examples might include giving a three-minute speech in front of a large group, talking on the phone with a friend instead of texting, making small talk with a stranger at a party, offering your opinion at a meeting, being assertive with others, or asking someone to have a coffee with you. Set a small and measurable goal for the exposure, such as “I will go to the party and talk to three people, two of whom I haven’t met before”. Start at the bottom of the ladder and gradually work your way up to the top. Research has found that by remaining in an anxiety-provoking situation for 30 to 45 minutes, the distress of anxiety naturally comes down on its own. So hang in there despite your anxiety, be your own cheerleader, and use your thought challenging skills!
If social anxiety is interfering with your daily life, feels overwhelming, or is preventing you from doing things you enjoy, a psychologist can help you deal with your fears and anxieties. Through therapy, a psychologist can assist you in living a healthier and more fulfilling life. The psychologists at The ProActive Psychology Practice have experience working with clients who experience social anxiety, so feel free to reach out to us.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Beyond Blue. (n.d.). Social phobia. Retrieved 4 April, 2021, from https://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/social-phobia
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioural therapy for anxiety disorders: an update on the empirical evidence. Dialogues of Clinical Neuroscience, 17(3), 337-346.
