Self-Help for Social Anxiety
In This Chapter
- Discovering the difference between social anxiety and just butterflies
- Understanding the complexity of social anxiety symptoms
- Learning how to recognize you’re not in the spotlight
- Identifying your self-help plan of attack
- How the internet can help—or hinder—social anxiety relief
Jack used to feel self-conscious walking down the street, dreading the possibility of running into someone he knew and being forced to say hello. Nancy hated to stand in line at the grocery store; although she knew it wasn’t actually true, she couldn’t shake the feeling that everyone was staring at her. Every time she had to deal with the grocery store checkout, she started sweating and her mouth felt like it was full of cotton. “I’m making a total fool of myself,” she thought.
Jennifer once agonized over returning a phone call from a new work acquaintance inviting her to an informal get-together. Maybe she’d call at the wrong time—the other person would be busy and wouldn’t want to talk to her. It was unbearable to feel rejected, even over the phone, even from someone she barely knew. After the call was made, Jennifer didn’t feel any better. She endlessly analyzed what she said, how she said it, and what the other person likely thought about it. And the party she was invited to? Forget it; as lonely as Jennifer felt, she couldn’t imagine walking into a room full of people.
Granted, meeting a crowd of new people, giving a speech, or going on a job interview can make many of us nervous. However, what Jack, Nancy, and Jennifer experience far surpasses the butterflies in the stomach or performance jitters that afflict most people now and then. Nancy, Jack, and Jennifer have social anxiety, a disorder in which the sufferer is plagued by such an excessive fear of embarrassment in social situations that it interferes with his or her life.
Here’s a list of just a few things we’ve seen people do—people who were once almost completely inhibited by their social anxiety: give a presentation, join a drama club, go out to a nightclub, make good friends, and be the center of attention at a birthday party. Some of these courageous individuals did it with the help of medication or formal psychotherapy; others did it without either of these. In this chapter, we take a look at the best self-help weapons against social anxiety—and how to use them.
Feeling Scrutinized
Ever walked up to a group of people who suddenly stopped talking? Or made a late entrance to a party and found yourself confronted by a roomful of strangers? All of us have been under the social microscope at some point, and it can be darned uncomfortable. We might have put on a brave face, but underneath, the alarm bells might’ve been ringing. Why did they stop talking? Were they talking about me? Who are all these people and why are they staring? What are they thinking about me?
Social anxiety sufferers feel this way much of the time when they’re around others. Some of us may be anxious in one or two situations, such as when we have to give a speech or when we ask someone out on a date. This is often referred to as a specific, or discrete, social phobia. Those who are afraid of and avoid many or even most social situations suffer from generalized social anxiety disorder.
Regardless of the number of situations that trigger it, the symptoms—racing heart, trembling voice, shaky hands, and rapid breathing—are similar. Many of them are shared by panic-attack sufferers; we discussed ways to handle these symptoms in Chapter 14.
As if these physical sensations weren’t bad enough, they are magnified by your fear that others will notice and judge your emotional distress. As a result, some social anxiety sufferers become so afraid that they actually feel paralyzed—as if they are unable to move. Not surprisingly, it doesn’t take too many negative experiences to try to find ways to avoid stressful situations and, when that’s not possible, to worry long before the event, suffer through it, and “obsess” about it afterward.
ON THE CUTTING EDGE
Research has shown that people suffering from generalized social phobia have more amygdala activity when confronted with threatening faces or frightening social situations. We may ultimately be able to use brain imaging methods to help assess the severity of a person’s social anxiety and evaluate the effectiveness of treatment.
Throughout this book, you’ve seen how anxiety can lead to vicious cycles. As a social anxiety sufferer, you can get stuck in your own fear of ridicule or humiliation, too. You worry about the possibility of doing something embarrassing, which makes you anxious. The more anxious you become, the more likely you are to tremble, blush, or make abrupt, clumsy movements. Your fear of disapproval, more than your fear of the actual situation, is what’s responsible for your anxiety.
But why are you afraid in social situations? Why does your anxiety center on fears of embarrassment or humiliation instead of snakes or spiders? Let’s take a look at the unique factors that can lead you down this particular path.
Risk Factors for Social Anxiety
In the movie The Perfect Storm, George Clooney and his supporting cast encounter a merging of weather conditions that collide to form a catastrophic storm. Had even one of them been missing, the result might have been vastly different. A similar conclusion might be drawn for the development of social anxiety disorder: an accumulation of risk factors adds up to tip the scale from shyness to social phobia.
Risk factors for social anxiety disorder include the following:
- Gender. Men are about two thirds as likely as women to have social anxiety disorder.
- Family history. Some research indicates that you’re more likely to develop social anxiety disorder if your biological parents or siblings have the condition.
- Environment. Your environment may influence the development of social anxiety disorder in a number of ways. Some experts theorize, for instance, that social anxiety disorder is a learned behavior. That is, you may develop the condition after witnessing others with symptoms. In essence, you may be learning social anxiety disorder by example. In addition, there may be an association between controlling or protective parenting and social anxiety disorder in children.
- Negative experience. Children who experience high levels of teasing, bullying, rejection, ridicule, or humiliation may go on to develop social anxiety disorder. In addition, other negative events in life, such as family conflict or sexual abuse, may be associated with social anxiety disorder.
- Temperament. Children who are shy, timid, withdrawn, or restrained when facing new situations or people may be at greater risk of social anxiety disorder.
- New social or work demands. Meeting new people, giving a speech in public, or making an important work presentation may trigger the signs and symptoms of social anxiety disorder. These signs and symptoms usually have their roots in adolescence, however.
As you can see, a number of things can contribute to the development of social anxiety. And, like a perfect storm, it’s often a matter of certain risk factors converging: biology (anxiety in general has a genetic component); temperament (some people are just more inhibited in social situations than others—this is also influenced by genetics); and life experiences (a humiliating event, the parenting style you grew up with, and other situational experiences). For instance, a shy third grader “freezes” when called on in class and, as a result, is reprimanded by her teacher and teased by her peers.
When you begin to feel socially anxious—often as a result of a stressful event or period in your life—the fear usually doesn’t go away on its own. The good news, though, is that social anxiety, like other forms of anxiety, is treatable.
ANXIETY ATTACK
Many people think that having a drink before an experience that makes them nervous is a good way to calm down. However, there’s a strong link between social anxiety and alcohol use disorders; self-medicating with alcohol or drugs (recreational or prescription) can easily become a “crutch” and may lead to substance problems.
Social Fears
Social anxiety is complex; not everyone is afraid of the same situations. I may be petrified about speaking in public. You may be nervous about eating in a restaurant. Underlying each situation are fears of scrutiny (criticism or ridicule arising from attention or evaluation from others), humiliation (being rejected), or embarrassment (from making a mistake or appearing foolish). Here are some common anxiety-provoking situations; check the ones that consistently make you nervous:
Acting, performing, or giving a talk in front of an audience
Talking to people in authority
Expressing your opinion
Interviewing for a job
Voicing disagreement
Speaking at a meeting
Responding to criticism
Giving and receiving compliments
Eating out in public
Asking someone out on a date
Drinking in public places
Answering personal questions
Using a public restroom
Meeting strangers
Being the center of attention
Getting onto a crowded elevator
Calling someone unfamiliar
Entering a room when others are already seated
Returning items to a store
Going to a party
Making eye contact
Giving a party
Resisting a high-pressure salesperson
Joining a conversation already in progress
Making mistakes in front of others
Participating in small groups
Taking a test
Bumping into someone you know
Writing while being observed
Talking with people you do not know very well
Working while being observed
Initiating conversation with someone you’re attracted to
Many of these activities are things a lot of us do regularly. Many of them are also vital to your career success and personal relationships. As such, untreated social anxiety can wreak havoc on virtually every aspect of your life. On the positive side, when you decide to face your fears, you have a lot of opportunities to practice. And practice you must if you’re going to overcome your social fears. This practice involves changing your mental behaviors as well as your outward ones.
ON THE CUTTING EDGE
New research indicates that one of the most stressful situations for those of us with social anxiety is meeting people we consider “authority figures,” whether that’s a boss at work or our future in-laws.
Fear of Negative Evaluation
Most people consider the term performance to mean some type of formal presentation or event. Those of us with social anxiety can feel performance pressure in the simplest social interaction; shaking someone’s hand or greeting a stranger can feel like a test. In fact, one of the hallmarks of social anxiety is the tendency to misinterpret neutral social cues as evidence that others are negatively evaluating you. People who suffer from shyness or social anxiety often believe other people will think badly of them or people will judge them. Because of their vulnerability to rejection and disapproval, they also tend to be overly concerned with making a positive impression on people.
In Chapters 8 and 9, we examined the link between negative automatic thoughts, irrational beliefs, and feelings of anxiety. For instance, we discussed how negative thinking (“What if I lose it?”) in response to an uncomfortable feeling (fear) or unpleasant physical sensation (dizziness, rapid heartbeat) can worsen your anxiety. With social anxiety, your automatic thoughts and irrational beliefs center on social situations, the opinions of others, and your sense of your own competence/lovability as influenced by interpersonal interactions. In other words, your fear about what others are thinking is often a reflection of what you believe about yourself. It’s these thoughts and beliefs that you have to change.
ANXIETY ATTACK
If your social anxiety causes severe physical symptoms, use the panic-attack survival strategies discussed in Chapter 14.
You can start by catching your negative automatic thoughts and slowly beginning to replace them with realistic, rational ones. You can easily get so caught up in the anxiety and dread around stressful situations you don’t pay attention to the negative conversation you’re having with yourself. To get used to this process, think back over three or four actual occasions you found difficult over the past month and try to recreate your thoughts before, during, and after these occasions. Create something like this:
Situation: Giving a presentation.
Thoughts beforehand: Man, I dread that talk next week. I don’t know what I’ll have to say. Maybe I’ll go blank; I’m going to make a total fool of myself.
Thoughts during: Oh, man. I’m sweating. I know the boss can see how nervous I am. She must think there’s something wrong with me.
Thoughts afterward: Well, I blew it again. How could I have missed that statistic?! John does these kinds of things like they’re a piece of cake.
Conclusions: I can’t handle things the way other people can. Some people have it and some people don’t; I don’t.
Now, keep a social anxiety diary over the next two weeks. Write down what situations you felt anxious in as well as the thoughts, feelings, and physical sensations you experience before, during, and after. As you journal, begin using the strategies we discussed in Chapters 8 and 9 to counter your social-anxiety-specific thoughts and beliefs. Remember, the trick is to recognize the thinking errors that are common in social anxiety—catastrophizing that a minor faux pas is a major disaster, personalizing reactions from others without any concrete evidence, focusing only on what you did wrong and ignoring situations you handled well—and begin to make them more rational and neutral. The more you consciously practice and repeat this process, the more automatic it will become.
In addition, as people become well acquainted with the negative thoughts that plague them, they often discover dysfunctional beliefs that form the core of their social anxiety. “I just can’t handle rejection. If someone criticizes me, it means I am a bad person. I just can’t fit in with other people. No one likes people who are weak or make mistakes. If others don’t think I’m worthy, I must not be.” These kinds of beliefs have often been around for a while and take time to correct. By paying attention to and correcting the conclusions you draw about your social anxiety, you can begin to chip away at these core beliefs. “I can’t tolerate rejection” gradually turns into “I don’t like to be rejected, but I can handle it. And it doesn’t say anything about my value as a person.”
ANXIETY ATTACK
Volunteer work naturally focuses on helping others and, as such, can be a great way to practice letting go of the “spotlight” effect.
The Spotlight Effect
One of the cognitive distortions social anxiety sufferers tend to share is sometimes referred to as the “spotlight effect,” the excruciating sensation that all eyes are on you and that you are being judged. You tend to consistently overestimate the degree to which other people’s attention is focused on you, how much they remember about what you said or did, and how much importance they attached to it. It’s not that you’re self-centered; it’s just that you’re so self-conscious in social situations that you can’t help but think others see—and judge—what you’re doing. In fact, research suggests that at the root of the “spotlight effect” is your excessive self-processing in anxiety-inducing social situations. This means that you do the following:
- Zoom in on what is happening inside your body, especially anxiety symptoms like shaking, sweating, redness of the face, and difficulty speaking
- Focus on the negative images and thoughts that are swirling around in your head
- Are less able to pay attention to, and evaluate, the reactions of others
- Easily interpret ambiguous responses (body language, unclear comments) as confirmation that you are being rejected or ridiculed
In other words, you are likely to see what you already believe. However, understanding the reason for the spotlight effect doesn’t make it go away. What can help, though, is to plan out ways to shift the focus from yourself to others. In fact, this is an excellent strategy.
For example, at a small gathering, you might make a goal of helping another person feel more comfortable. You might decide to find out three things about another person in the room and prepare questions that another person would enjoy answering. You can practice being a good listener, making a point of reflecting back what you are hearing to ensure that the other person feels heard.
You can look around the room and see if anyone else seems nervous. Social anxiety disorder affects 13 percent of the U.S. population; the odds are good that someone else in the room has some degree of it. Can you spot who it might be? If you can’t, the odds are that no one can spot you, either. But what if you do spy someone who seems unsure or anxious? How would you feel toward that person? Would you instantly dislike him or her and direct the rest of your time and attention to negatively critiquing him or her? No? Then why would anyone do that to you?
STRESS RELIEF
As part of an experiment, students wearing what they believed to be embarrassing T-shirts were sent into a room of their peers. Although the students were convinced (and mortified) that almost everyone would notice the T-shirts, fewer than 50 percent of their peers actually remembered them.
When you shift your focus in social situations, you begin to see that you are not, in reality, the center of anyone else’s attention. In social situations where you’re feeling especially vulnerable, you can be skeptical of what your thoughts are telling you.
Changing Behavior
It’s possible, though, that you’re putting the cart before the horse; maybe you don’t go into social situations at all. Many people who have suffered from social anxiety for years have become exceptional escape artists, learning to either avoid a threatening situation altogether or to use enough “tricks” while in one that they never truly engage. Unfortunately, learning to think new thoughts isn’t going to get you very far if you don’t engage others.
Changing your behavior is just as important in conquering social anxiety as changing your thoughts. In fact, in the long run, changing what you do is probably the most helpful way to overcome social anxiety. Many of the strategies we discussed in the preceding chapter are extremely relevant to social anxiety; you need to develop an anxiety hierarchy where you list your feared social situations, ranking them from most frightening to least. Then start at the bottom of the hierarchy and work your way to the top.
ON THE CUTTING EDGE
Although social anxiety disorder is highly treatable, most people who have it never seek professional help.
Because social anxiety is so complex, it may be useful to develop different hierarchies for different situations. For example, a fear of speaking in front of a group can be broken down into various steps, starting with an easy one and moving up to a challenging one. The same can be done for going to a party or interviewing for a job. A social anxiety hierarchy for fear of talking in front of a group of people might look something like this:
Most Stressful
Giving a formal presentation
Leading a team discussion in front of a boss
Asking a question or giving input during a staff meeting
Joining a group of co-workers already sitting at the lunch table
Engaging in casual conversation with strangers in the elevator
Going with a friend to a party where I don’t know many people
Bumping into a couple I don’t know very well
Least Stressful
As we discussed in the preceding chapter, the goal is to gradually tackle each item on the anxiety hierarchy. However, unlike some simple phobia situations that you can avoid altogether, you may find that you actually have to do a few of the items on this list on a regular basis. As such, you need to also take an honest look at ways you escape mentally while you are in an uncomfortable situation and gradually eliminate these, too.
For instance, you may go to a party but sit in the corner, say little or let someone else do the talking, or stay close to a safe person. These “safe” behaviors allowed you to stay in a stressful situation, but now you need to move beyond merely surviving your social anxiety. You want to overcome it!
In between practice sessions when you focus specifically on the items in your hierarchy and on restructuring your negative automatic thoughts, countless opportunities exist for you to boost your social self-confidence. Some of these need last only a few seconds or a few minutes at most. For example:
- Return a greeting from a neighbor or co-worker.
- Say hello to a neighbor or co-worker without waiting to be greeted first.
- Ask a clerk where to find something in a store.
- Ask a stranger for directions.
- Accept an invitation to lunch with a small group where other people will do most of the talking.
- Accept a compliment with a simple thank you.
- Give someone else a compliment.
- Respond to a simple question with a brief answer if you have one.
- Respond to a question you honestly can’t answer with a simple admission that you don’t know.
You will gradually learn that you can cope and feel comfortable in social situations. It is worth remembering that many other people feel anxious in social situations, too; it just doesn’t show. You are not the only one.
ANXIETY ATTACK
Medication by itself may not be effective in alleviating social anxiety altogether, although it can help make taking social chances easier. Across studies, half or more of social anxiety sufferers report significant improvement from cognitive-behavioral psychotherapy.
Practice
To manage your recovery from social anxiety, you need to consistently and repeatedly practice your newfound skills. There are several issues to keep in mind as you do this:
- Divide and conquer. It can be daunting to think of all the skills you need to work on to conquer social anxiety—dealing with the uncomfortable physical sensations that occur, challenging negative thought patterns, and socializing with other people at the same time. Instead, look at your recovery as a three-pronged approach and, in the beginning, work on them individually.
- Schedule practice sessions. Don’t wait for situations on your hierarchy to appear before you start working on them. If nothing’s coming up on your schedule, create situations that will force you to practice: go to the grocery store, ask a friend to look over your shoulder while you’re writing, or go out to eat in a restaurant.
- Expand your social skills. You can learn how to join in, listen, make memorable presentations, and communicate effectively. Build your social confidence by acquiring knowledge in which you feel lacking; this could include reading columns like “Miss Manners” or books like How to Win Friends and Influence People.
- Consider seeking professional help. Studies suggest that as many as 70 percent of social anxiety sufferers also suffer from other challenges such as agoraphobia, panic disorder, or depression. And approximately 20 percent of those with social anxiety use alcohol to ease their fears. If you are experiencing other difficulties in addition to social anxiety, consider seeking professional help.
STRESS RELIEF
The first few minutes of a presentation are usually the most anxiety provoking. You can plan ahead for this by memorizing the first few minutes of your talk, getting to the room early and meeting everyone there, and asking the audience several questions to shift your mental focus from yourself to others.
Virtual Help or Avoidance
Virtual reality can be used to help people overcome debilitating fear; for example, people who are too terrified of flying to make the leap between visiting an airport and actually taking a flight can benefit tremendously from therapy that includes a simulated airplane ride. Could the internet provide a “virtual” social setting, a safe place where a severe social anxiety sufferer could jump-start his or her recovery?
The answer appears to be a qualified “yes.” There are wonderful online support groups for all anxiety disorders, including social anxiety. Some of these are filled with good tips, warm support and encouragement, and touching personal experiences. Chat rooms or discussion boards can be a great way to “put one’s toe in the water” and try out social contacts with which you’re less comfortable in the “real” world.
For example, research in 2013 showed that the more one felt connected to others on Facebook, the fewer symptoms of anxiety and depression they reported. A 2014 study showed that among people with high social anxiety, feeling connected to others on Facebook was related to higher well-being regardless of how connected they felt to people in the offline world. Findings were the opposite for people low in social anxiety—it was the offline connections that mattered more, with Facebook connectedness adding little.
On the downside, you can’t allow online relationships to substitute for “real-world” ones. Posting and commenting on Facebook is no substitute for face-to-face interaction. Allowing the internet to become one’s entire social network is not a therapeutic use of virtual reality. When it comes to social anxiety, the internet best serves as a stepping stone; you try out your new skills with your online contacts and then take them out into the real world.
ANXIETY ATTACK
Not sure if your internet use is too much? Ask yourself whether your relationships have improved or deteriorated since you went online and whether you spend more or less time interacting with others in real life.
In the last three chapters, we’ve looked at what self-help has to offer to help you overcome your anxiety. In these chapters, we’ve reviewed strategies for recognizing, and slowly tackling, the distressing thoughts, feelings, and physical symptoms that plague anxiety sufferers. We’ve also reviewed systematic desensitization, a way you can gradually train yourself to face situations you’ve been avoiding.
These self-help techniques work as long as your psyche is ready and able to use them. The reality is that many of us anxiety sufferers have struggled for years with our fears and have developed fairly ingrained habits of “survival.” Or we find ourselves battling more than one problem; perhaps an additional anxiety disorder, a secondary depression, or excessive drinking.
Overcoming an anxiety disorder should not be thought of as something one has to do on one’s own. In the next chapter, we explore state-of-the-art anxiety disorder treatments and how “self-help” can include finding the right assistance.
- People suffering from social anxiety disorder fear ridicule, rejection, or embarrassment to such an extent that they avoid social activities that are essential to professional success and personal satisfaction.
- Social anxiety is often a result of a biological vulnerability (shy temperament, family history of anxiety) interacting with certain life experiences (critical parenting, humiliating social experiences).
- Social anxiety is a complex phobia. The fear of public humiliation and scrutiny can generalize to many different situations.
- The most effective self-help for social anxiety incorporates strategies for managing physical symptoms, restructuring dysfunctional thoughts and beliefs, and gradually introducing social situations. Boning up on your social skills can also increase your interpersonal self-confidence.