HOW DO I KNOW IF I HAVE SOCIAL ANXIETY?

Do you feel self-conscious and worry about what others think?

Do you ever worry about blushing or shaking in front of other people?

Do you feel nervous before giving a speech, attending a meeting, or going to a party?

Do you worry that you will do something embarrassing or say something foolish in front of others?

If this sounds like you, you may be suffering from social anxiety (also known as social phobia). 

WHAT IS SOCIAL ANXIETY?

Social anxiety is a common problem affecting 8% of the population throughout their lifetime. Social anxiety typically develops during late childhood and adolescence, and if left untreated it often continues into late adulthood. Social anxiety is different from the normal shyness that many people experience. The main feature of social anxiety is a fear of social or performance situations where there are unfamiliar people or where people might judge them. Most people worry that they will act in a way that will be embarrassing, or that their anxiety will be noticeable to others. Social anxiety can be confined to particular situations (e.g., public speaking), or may have generalised to most social situations. For many people, entering a social situation almost always provokes anxiety, and can be accompanied by physical symptoms of anxiety (e.g., blushing, sweating), or a panic attack. People with social anxiety generally recognise that their fear is excessive or unreasonable, but they feel unable to stop it. Over time, many people begin to avoid social situations, or they endure them with great anxiety. Most importantly, social anxiety can really interfere with peoples lives. It can affect their work (or school), their relationships, their ability to socialise and it can also cause the sufferer to feel very upset and isolated.

Situations that are commonly feared and/or avoided by people with social anxiety include:

• Social situations where they fear that they might say something foolish

• Situations where they might become the focus of attention (e.g., having a birthday party)

• Eating or drinking in public

• Speaking in public (e.g., giving speeches, answering questions in classes/meetings)

• Writing in the presence of others

• Using public toilets

• Meeting new people, and making 'small-talk' with unfamiliar people

People with social anxiety may experience physical symptoms before or during a social situation, such as:

• blushing

• shaking

• nausea

• an urge to go to the toilet

• other more general symptoms of anxiety such as racing heart, shortness of breath and trembling hands

These symptoms are part of the fight/flight response.

After leaving a social situation, people with social anxiety often spend time criticising their performance - thinking about what they did or said and wondering what others thought of them.

HOW IS SOCIAL ANXIETY TREATED?

Social anxiety can cause people to avoid certain social situations or lead to social isolation, and can have a debilitating impact on a person's life. Clinical psychologists trained in Cognitive-Behavioural therapy (CBT) can provide expert advice about how to manage the symptoms of social anxiety and teach you how to cope in social situations.

Core aspects of cognitive-behavioural treatment for social anxiety include:  

1. Learn to manage anxiety

Clinical psychologists are well-trained in teaching anxiety-management techniques. These include:

• slow breathing
• progressive muscle relaxation
• meditation
• exercise
• selective focus of attention

2. Challenge your beliefs about the situation

People with social anxiety tend to think about social situations in a catastrophic way. Common unhelpful beliefs that can cause anxiety are: “Everyone is looking at me”, “Everyone will think I'm an idiot”, or “Everyone will notice that I'm anxious”. Cognitive therapy helps you to find new realistic and believable ways to think about such things. The human mind is very powerful and cognitive therapy helps you to harness that power against your social anxiety.

3. Face your feared situations

Avoiding social situations provides relief in the short term, but in the longer term it simply keeps the anxiety going. If you gradually start to face your feared situations, then two powerful things happen. Firstly, the more you expose yourself to feared situations, the less anxiety-provoking they become. Secondly, facing the situations you fear is also a useful way of testing out any unhelpful beliefs that you had about the situation.

4. Distraction and attention-training

Focus on the here and now. Direct your attention away from yourself and your anxiety and towards others. Simple distraction techniques include:

• Focus on one small piece of activity at a time (e.g., what someone else is saying).
• Counting features of your environment – cars, trees, colours, tiles.
• Focusing on your immediate sensory experience – what can you hear, see, feel?

5. Practice social skills

Learn basic conversational and social skills and practise these in situations where you feel comfortable.

6. Avoid using alcohol and sedatives to control anxiety  

Not only can such drugs be bad for your health, they also (a) stop you from practising and improving other coping strategies and (b) prevent you from testing out your fears and finding new genuine confidence.

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