3 Techniques for Overcoming Social Anxiety
What is Social Anxiety?
If you find yourself constantly worrying about other people’s opinions, or if you have been avoiding social situations for fear of embarrassment, it is possible that you could be dealing with social anxiety. Social anxiety is defined as the feeling of intense fear in anticipation of a social event. In small doses, fear is incredibly useful as it helps put our bodies into the ‘fight or flight’ response. In large doses, fear and anxiety can become quite debilitating.
In a ‘fight or flight’ response, our heart rates increase, our blood pressure rises, adrenaline is released, muscles tense and our breathing becomes faster. Each of these changes is optimised to help us either fight, or run away from danger. For example, faster breathing brings more oxygen into the bloodstream, a useful thing if you need to run away from an angry animal. The feeling of fear helps the body understand when it is time to protect ourselves. Conversely, when fear isn’t felt, the body knows it is safe to relax as there isn’t any danger present. The ‘fight or flight’ response, while usually helpful, can become problematic if triggered incorrectly.
Social anxiety, as a specific difficulty, is primarily focused towards situations in which someone is worried they will be scrutinised by their peers (Levinson et al., 2015). People experiencing social anxiety frequently anticipate that they will be evaluated negatively by others, that they they will embarrass themselves, that they will be rejected, humiliated, or cause offence to someone else. When experiencing social anxiety, social situations start to be seen as dangerous or threatening.
Unlike a standard fearful experience (e.g. a stranger yelling at you), anxiety is usually felt in anticipation of a threat, rather than as a reaction to an immediate danger (e.g. ‘What if a stranger yells at me when I go out?’). The anticipation of the ‘threatening’ social situation increases fear to levels sufficient to trigger a ‘fight or flight’ response.
Fearing the worst from social interactions, individuals experiencing social anxiety avoid social situations as a preventative measure. Avoiding social situations counterintuitively prolongs the anxiety experience as, without opportunities to experience a positive social interaction, the anticipation of the ‘threat’ continues unchallenged. This leaves those individuals experiencing social anxiety in a prolonged state of ‘fight or flight,’ with the body unable to relax in response to the anticipated threat.
Why is This a Problem?
It is important to note that everyone experiences bouts of anxiety in different situations. Presenting a talk to a group of people, meeting new people, or talking to someone in authority are all likely to increase someone’s anxiety levels. Anxiety and social anxiety only become a problem when the fear felt is disproportionate to the actual threat posed by the situation (Levinson et al., 2015). This disproportionate fear will start to impact day to day to day functioning, as situations and obligations are avoided in order to minimise fear levels.
The inability to reach a state of safety, even while performing day-to-day tasks, can have serious implications for physical health. Higher frequencies of ‘fight or flight’ responses, or extended periods spent in a ‘fight or flight’ response, are linked with negative long term health impacts, including an increased risk of heart attacks, coronary events, and strokes (Thayer, Friedman, & Borkovec,1996). In order to reduce this risk to physical health and improve day-to-day functioning, specific techniques have been developed to manage anxiety.
What Can I Do About It?
There are a number of helpful techniques to help individuals manage and overcome the symptoms and causes of social anxiety. From a cognitive behavioural standpoint, there are three areas to target when addressing social anxiety; physical reactions, unhelpful thoughts and avoidance behaviour. Below are three exercises that can help target these three problem areas:
- Limiting Physical Reactions: Controlled Breathing
When breathing, the body keeps a balance of the amount of oxygen and carbon dioxide in our blood, based on the level of activity currently being undertaking. When we are working hard (e.g. going for a jog), we use more oxygen throwing off the oxygen/CO2 balance. The body increases the rate of breathing when we are working, absorbing more oxygen to restore the internal balance.
When someone experiences Social Anxiety, the body (as a part of the ‘fight or flight’ response) increases our breathing rate significantly. This process, known as hyperventilation, results in the body taking in a lot more oxygen than it actually needs (since the person doesn’t burn up that oxygen running away, or fighting the anticipated threat). Too much oxygen can result in the physical anxiety symptoms of dizziness, confusion, a pounding heart, light-headedness and stiff or tingling muscles. Controlled breathing therefore is an excellent way to reduce the symptoms of anxiety, by helping to restore the body’s oxygen balance. Here is an example of a controlled breathing exercise you may like to try:
Using stomach breaths to utilise the entire lung capacity (holding a hand on your stomach to feel the rise and fall will help to identify stomach breathing), count to 4 as you breath in, hold your breath in for a count of 2 and then release over a count of 6. Wait for a count of 1 before repeating. Sometimes this is hard to achieve initially, so you may want to adjust the times slightly to compensate. Controlled breathing, even for just a few minutes, is an excellent way to restore the oxygen/CO2 balance and reduce physical anxiety symptoms.
- Gradual Exposure to Reduce Avoidance Behaviours
Those experiencing Social Anxiety frequently avoid anxiety provoking situations. While this is facilitative in reducing the level of fear felt in response to an immediate threat, the underlying fear caused by anticipation of the perceived threat will not disappear. Infact, avoiding anxiety provoking situations frequently tends to strengthen overall levels of Social Anxiety, as no chance is given for an individual to disprove their fears, or develop evidence that opposes their negative beliefs about social scrutiny.
A key part in any cognitive behavioural program to overcome Social Anxiety will include a form of gradual or graded exposure. Gradual exposure is a way of establishing confidence through exposure to progressively more anxiety provoking situations. This is conducted over an extended period of time through multiple exposures, progressing once situational anxiety has been effectively reduced. A psychologist can guide you through the goal setting process, ensuring that goals are achievable, specific and measurable. An example goal for an individual experiencing Social Anxiety could be spending a Saturday night out at a restaurant with a group of friends. A gradual exposure plan might then look something like this:
- Pick up takeaway from a restaurant by yourself
- Pick up takeaway from a restaurant with a close friend during a weekday
- Have lunch in a restaurant with a close friend on a weekday, staying at the restaurant for 30mins
- Have dinner in a restaurant with a close friend on a weekday, staying at the restaurant for 30mins
- Have dinner in a restaurant with 2 friends on a weekday, staying at the restaurant for 60mins
- Have dinner in a restaurant with 2 friends on a Saturday night, staying at the restaurant for 60mins
- Have dinner in a restaurant with 4 friends on a Saturday night
Additionally, a psychologist is also able to assist in providing situation based strategies for coping with anxiety throughout the gradual exposure process. Anxiety responses tend to peak quickly but also fade away reasonably quickly if no perceived threat emerges from the environment. This process, known as habituation, is the critical mechanism that assists people to overcome anxiety, social or otherwise.
- Addressing Unhelpful Thoughts and Thinking Styles
Anxiety and anxiety responses are largely automatic, meaning they function neurologically outside of our logical thinking process. For example, most individuals are able to logically talk through why a presentation to a group at work isn’t really a life or death situation. However, when they go to give the presentation, their ‘fight or flight’ response still becomes activated in response to their fears of being scrutinised.
Learning to recognise unhelpful thoughts, or unhelpful styles of thinking is a core part of psychological therapy. In instances of Social Anxiety, a cognitive behavioural approach helps you become a ‘scientist’ of your own thoughts and thinking styles, recognising unhelpfully anxious thoughts, and treating them as a sort of automatic prediction about what may happen (e.g. Out at a dinner the thought may be: ‘I’ll embarrass myself if I am around my friends for too long’). To be a good scientist, individuals gather evidence to see if there is or isn’t support for the predicted outcome. This is where gradual exposure activities described above come in handy, as experiments to test the automatic predictions. Individuals can set up gradually larger experiments to test whether an unhelpful thought or ‘hypothesis’ holds up against the evidence. Working with a psychologist will also provide you with someone to discuss the results of these experiments, and create strategies on how to use the new information to address any future anxious thoughts and emotions.
There are a number of approaches, including cognitive behavioural therapy, which have been used successfully to help individuals overcome social anxiety. A number of pharmaceutical options have also proven very effective in managing the symptoms of anxiety when combined with cognitive behavioural therapies. If you are interested in learning more about specific medications you should contact your GP or a psychiatrist to discuss possible treatment options.
If you feel that social anxiety is impacting negatively on your life, call 07 3067 9129 today to book a consultation at the Wishart or Loganholme offices. For those outside of Brisbane, Skype or phone consultations are available.
Author: Vision Psychology.
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- Thayer, J. F., Friedman, B. H. & Borkovec, T. D. (1996). Autonomic Characteristics of Generalised Anxiety Disorder and Worry. Biological Psychiatry, 39(4), 255-266. Doi: https://doi.org/10.1016/0006-3223(95)00136-0
- Levinson, C. A., Rodebaugh, T. L., Shumaker, E. A., Menatti, A. R., Weeks, J. W., White, E. K., Heimberg, R. G., Warren, C. S., Blanco, C., Schneier, F., Liebowitz, M. R. (2015). Perception matters for clinical perfectionism and social anxiety. Journal of Anxiety Disorders, 29, 61-71. Doi: http://dx.doi.org/10.1016/j.janxdis.2014.11.002
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).