How to Overcome Social Anxiety
- Russell A. Hunter, PsyD
- Oct 7, 2019
- 13 min read
To Overcome Social Anxiety
1. Monitor your “If Then” Thinking
2. Lower Your Self-Preoccupation
3. Stop seeking approval
4. Master the art of small talk
5. Transform Your Beliefs
6. Learn Modeling and the “Act as If” technique
7. Learn how to use The Pratfall Effect
8. Build up your confidence
9. Learn How to Manage Anxiety and Panic Attacks
Social Anxiety (Social Phobia)
If you are dealing with social anxiety disorder then you could also be characterized as being modest, self-controlled, and caring about how you affect other people. You are just a very considerate person who does not want to offend anyone or disrupt them in anyway. Because if you did, then that would be very embarrassing.
So you see, socially anxious people can be good friends to have.
That being said, I’m very sorry that you have been dealing with this anxiety. It can be very uncomfortable and even scary to be in situations where you believe you could be judged, criticized, or made fun of. Not to mention the feeling of anxiety and fear can seem unbearable.
Social situations become very risky and you may be very self-conscious and worry about how others see you.
You would rather avoid certain social situations than deal with the discomfort that they bring.
There is hope. You will get better, feel less anxious, and be more confident!
To overcome and deal with your social anxiety you will learn to stop seeking approval, transform your beliefs, and learn how making mistakes can work to your advantage.
What is Social Anxiety?
Social anxiety disorder is common with an estimated 12.1% of U.S. adults and 9.1% of U.S. adolescents experiencing social anxiety disorder at some time in their lives (Harvard Medical School, 2007). Typical onset of social anxiety is between the ages of 8 and 15.
Social anxiety disorder used to be referred to as social phobia.
People with social anxiety disorder experience fear and anxiety about one or more social situations where they could be observed and judged by others.
Meeting new people, having conversations, being observed by others, eating or drinking around others, and performing or giving a speech are some of the situations that someone struggling with social anxiety would likely want to avoid. Even writing and signing your name in front of others could cause anxiety.
There is a fear that others will notice that you are anxious, that you will be evaluated negatively, and then you will feel embarrassed and possibly rejected.
These social situations always produce fear, are avoided or endured with intense anxiety, and the fear is totally out of proportion for the actual situation.
A person can be diagnosed with social anxiety disorder if they have been experiencing this fear and anxiety for at least 6 months.
Is it Shyness or Social Anxiety?
It is common for most people to feel shy on occasion. Everyone is capable of experiencing a certain amount of worry and tension in new social situations or when meeting new people.
Some people feel awkward and uncomfortable having attention placed on them or “Being the center of attention.”
I know it’s important for me to put my best foot forward and to be liked. This will cause me to be a bit shy or self-conscious, and possibly more reserved or cautious around people I meet for the first time.
Social anxiety, however, goes well beyond just feeling shy or awkward. Most shy people can warm up and feel more comfortable once the ice has been broken and they begin to socialize.
People with social anxiety disorder tend to become overwhelmed with anxiety and don’t usually warm up to social situations. They will feel extreme shyness even around people they know such as family events.
Someone who says they have severe shyness and avoids social situations, probably is experiencing social anxiety disorder.
What are the symptoms and signs of social anxiety?
People with social anxiety disorder may blush, sweat, tremble, have their mind go blank, and experience a rapid heart rate.
They may then fear that others will see them blush or sweat and then know that they are anxious.
Other symptoms include:
Difficulty speaking and word-finding
Having a stiff, rigid body posture and making poor eye contact
Feeling self-conscious around others and being fearful of being judged and criticized
Feeling embarrassed and awkward around others
Upset stomach or nausea
Trouble catching your breath
Dizziness or feeling light-headed
Muscle tension
Panic attack
What are Panic Attacks?
A Panic Attack is a sudden and uncontrollable feeling of fear and anxiety.
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5, APA 2003) defines a Panic Attack as an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four (or more) emotional and physical symptoms are experienced.
Note that the abrupt surge can occur from a calm state or an anxious state.
Panic attacks can happen during specific feared situations and they can happen randomly during periods of non-threatening, normal activities such as sitting and watching TV.
After experiencing a first panic attack, the fear becomes about experiencing another one.
Fear of experiencing a panic attack in social situations may actually bring on a panic attack and strengthen social anxiety.
Symptoms of Panic:
Palpitations, pounding heart, or accelerated heart rate.
Sweating.
Trembling or shaking.
Sensations of shortness of breath or smothering.
Feelings of choking.
Chest pain or discomfort.
Nausea or abdominal distress.
Feeling dizzy, unsteady, light-headed, or faint.
Chills or heat sensations.
Numbness or tingling sensations.
Derealization (feelings of unreality) or depersonalization (being detached from oneself).
Fear of losing control or “going crazy.”
Fear of dying.
Common, social situations that may be avoided or where anxiety is endured include:
Interacting with new people
Going parties or social gatherings
Going to work or school
Eating in front of others
Writing in front of others
Using public restrooms
Entering into a situation where people are already seated
Starting conversations
Giving presentations and public speaking
Making eye contact
Dating
What causes social anxiety?
Social anxiety disorder may be inherited. First-degree relatives have a 2 to 6 times higher chance of inheriting social anxiety disorder. The National Institute of Mental Health (NIMH) has also identified a gene in mice that appears responsible for learning to be fearful.
Other possible causes or risk factors for social anxiety disorder include hormonal imbalances, underdeveloped social skills, and traumatic experiences in childhood such as being bullied.
Excessive Self-Preoccupation
Socially anxious people tend to be more preoccupied with their worries, their personal limitations, and how other people will react to them.
Social anxiety involves a lot of self-focused energy on one’s own thoughts, feelings, and behavior. Their thoughts are centered on themselves rather than on their surroundings or on other people.
Highly self-focused, socially anxious people’s thoughts are usually negative and involve thoughts of other people’s disapproval of them.
As human animals, we have a strong need to belong and to be accepted by others. So we naturally care about how are behavior may affect others. But caring too much about one’s own behavior can lead to excessive self-preoccupation and social anxiety.
How is social anxiety treated?
If you believe you could have social anxiety disorder it will be helpful and important to seek consultation with a mental health professional to first verify the diagnosis and then receive appropriate treatment.
Social anxiety can be successfully treated with psychotherapy, support groups, and in some cases, a combination of psychotherapy and medication.
Psychotherapy
Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving. You learn ways of improving your communication skills and different ways of responding to social situations and to your feelings of anxiety.
CBT helps challenge and change your unhelpful beliefs that cause the anxiety.
After you learn to master the anxiety, you will be encouraged to approach more social situations that trigger the anxiety. This is where you apply your new CBT skills within a feared situation and have the experience of feeling less anxious and more confident.
This is when your beliefs really begin to change and the social anxiety becomes non-existent.
Support Groups
Support Groups help you feel……well, supported. You will feel validated and empathized with because the other group members understand exactly how you feel.
Support groups are great places to learn coping and communication skills because you can practice them in a safe social environment before exposing yourself to the really scaring situations.
Medication
Please consult with your primary care physician or a psychiatrist regarding the use of medication.
Medication can help reduce anxiety in social situations that you have been avoiding such as school, work, and family functions.
Commonly prescribe medications include benzodiazepines, anti-depressants, and beta blockers.
Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use. However, the long term use of benzodiazepines is associated with the risk of developing tolerance, dependence, and possible other adverse effects.
Commonly prescribed benzodiazepines are:
Alprazolam (Xanax)
Lorazepam (Ativan)
Diazepam (Valium)
Clonazepam (Klonopin)
Anti-depressant medications are also effective at reducing symptoms of anxiety on a daily basis. This helps dampen the physical and emotional effects of anxiety and increases a person’s capacity to cope with stressful situations.
Commonly prescribed anti-depressants are:
Citalopram (Celexa)
Escitalopram (Lexapro)
Sertraline (Zoloft)
Paroxetine (Paxil)
Fluoxetine (Prozac)
Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety.
Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to anxiety.
Commonly prescribed Beta Blockers:
Propranolol (Inderal)
Atenolol (Tenormin)
Acebutolol (Sectral)
Bisoprolol (Zebeta)
Metoprolol (Lopressor, Toprol-XL)
Nadolol (Corgard)
Nebivolol (Bystolic)
How to Overcome Social Anxiety
1. Monitor your “If Then” Thinking
The first step in dealing with social anxiety is to monitor your if then thinking.
If your “If Then” thinking is focused on anxiety, then you will experience anxiety. If your “If Then” thinking is focused on a desired outcome or what you want, then you will feel less anxious.
Example: “If I stumble on my words and blush, then people will think I’m stupid and I will be embarrassed” vs. “If I blush, then people will see that as an endearing sign of honesty.”
If you constantly focus on the possibility of danger, then your brain and body will prepare you for that danger. That means experiencing anxiety.
Begin identifying the positive outcome and experiences you want to have and deserve to have.
2. Lower Your Self-Preoccupation
If you are socially anxious, then you may also be highly self-focused on how you are appearing and presenting to other people. This self-focused worry only serves to increase anxiety and fear.
To lower your self-consciousness:
Direct your focus outward.
Focus on other people.
Observe other people’s behavior and interactions.
Find out as much as you can about other people around you.
Develop and practice a series of questions designed to learn about the other person. This takes the focus off of you and most non-socially anxious people like to talk about themselves.
3. Stop seeking approval
To overcome social anxiety stop defining yourself based on other people’s impressions of you. Different people will have different impressions of you. It will be very difficult to constantly manage all of those impressions and to meet everyone’s expectations.
It’s like walking into a room with a bunch of fun house mirrors.
Each mirror changes the way you look, but that doesn’t mean you have to believe that you actually look that way.
You know what your true appearance looks like so you will not be fooled into believing the distorted image from a fun house mirror.
The more you know yourself, the less you will be affected by other people’s distortions of you or what they project onto you. Just be yourself. Be comfortable with being quiet or with being very talkative.
4. Master the art of small talk
Introduce yourself. Ask a lot of conversation sustaining “What” questions. “What brings you here today?” “What did you think about…?” “What’s your thought on….?” “What’s your favorite….?”
5. Transforming Your Beliefs
Profound and lasting changes happen when there is a shift in your beliefs.
The first step in self-transformation is to understand your beliefs about social situations, beliefs about yourself, and beliefs about your ability to be social.
You have developed beliefs about yourself, other people, and the world. Your current beliefs influence how you think, how you behave, and how you feel. If you believe that the world is basically a dangerous place, then your thoughts, behavior, and feelings will follow. If you believe that you are defective and not a capable person, then your thoughts, behavior, and feelings will reflect those beliefs.
Early experiences such as being bullied in school for example, and any other stressful experiences could have instilled a sense of uncertainty and helplessness. These experiences contribute to the development of your beliefs and attitudes about yourself and about the world.
Just because you believe something, it doesn’t make it true.
Think about beliefs that people have that are not true such as “All men are good drivers and all women are bad drivers.” These beliefs are not accurate or true. These inaccurate beliefs are called stereotypes. Think about the stereotypes that you have about yourself and other people.
Your unhelpful beliefs and attitudes need to be identified and the truthfulness or accuracy of these beliefs need to be disputed or proven false.
After disputing these beliefs, you can replace them with more sensible ones.
Albert Ellis, Ph.D., the founder of Rational Emotive Behavior Therapy (a form of CBT), identified an irrational belief that applies to social anxiety:
“I absolutely must under all conditions do important tasks well and be approved by significant others or else I am an inadequate and unlovable person!”
Identify your own beliefs about yourself and other people
1. “At my core I am a person.”
2. “I absolutely must always or I am an inadequate
and unlovable person.”
3. “Other people are/will always and that is cause for me to be very anxious all the time.”
Dispute your irrational beliefs by answering these questions
1. What is the evidence for this belief? What facts suggest this belief
is 100% true all the time?
2. What evidence does not support this Belief? What facts
or experiences suggest that this belief is not true all the time? Are
there contradictory experiences?
3. How does this belief help me?
4. What would I tell a friend who had this belief?
Develop more accurate and helpful beliefs
Your new belief will be more accurate and realistic. It will not just be a positive or wishful belief.
For example: “It’s not fair to expect myself to be a perfect person for everyone all the time and it’s not fair to expect everyone to respond to me perfectly all the time.”
“Even though I sometimes make mistakes, there are people who still care about me.”
Your more helpful beliefs will be solidified when you test them out in social situations and actually have a positive experience while holding onto those beliefs.
6. Modeling and the “Act as If” technique
Does it seem like other people are much more confident and have an easier time socializing? With this technique you will “act as if” you have no fear.
For this technique you will identify someone that you believe is socially proficient. This will be someone you admire. This can be a close friend, family member, celebrity, or a character in a movie. Identify the person you want to model.
Imagine how this person might think and feel in social situations. Observe their body posture and facial expressions. Observe their tone of voice.
Imagine yourself behaving the same as the person you have chosen to model in a social situation.
The next time you are in a social situation act “As If” you were that person. You are not trying to become this person, you are only acting as if.
Practice this technique and even role play with someone.
7. Mistakes can be part of the show: The Pratfall Effect
The Pratfall Effect was first studied by social psychologist Elliot Aronson in 1966. Aronson found that people who others considered “superior” would become more likeable after they committed some type of pratfall.
When people make clumsy mistakes, they appear more human, and more genuine.
Deliberately create and make a clumsy mistake that you are in control of such as a fumble or a trip. Then smile and laugh it off.
This will actually endear people to you and make you more likeable as a real person who is not perfect and can laugh at themselves.
8. Build up your confidence
To build your confidence approaching people and talking to them do this: Walk up to 10 random people and ask them for the time. This is quick and simple and helps you begin to expose yourself to the anxiety and fear.
You can then make the encounter longer by asking random people for directions to someplace. This is a good experiment to do to get used to rejection since a lot of people may not actually know the directions to the place you are asking about. This helps you learn how to respond to a “No I can’t help you.”
9. Managing Anxiety
Feeling confident in your ability to manage the symptoms of anxiety will help with your fear of embarrassment and fear of panic attacks in public places.
Turn on Your Parasympathetic Nervous System
The parasympathetic nervous system is also called the “Rest and Digest” system. It produces a calm and relaxed feeling by:
Decreasing the heart rate
Dilating the blood vessels
Increasing salivation
Stimulating tear production
Stimulating the digestive system
Increasing a feeling of calm
Improves sexual arousal
The parasympathetic nervous system is activated by stimulating something called the vagus nerve. This nerve is very long and it runs from the hypothalamus in the brain to the chest, diaphragm, and intestines.
The vagus nerve can therefore be stimulated through diaphragmatic breathing, humming, and singing.
You can also turn on your parasympathetic nervous system with progressive muscle relaxation and by exposing yourself to cold temperatures.
Diaphragmatic Breathing Exercise
1. Inhale through your nose slowly by expanding from your belly first
then fill your upper lungs for a count of 5.
2. Hold your breath for a count of 2.
3. Exhale slowly and forcefully through pursed lips for a count of 10.
4. Repeat this 5 to 10 times or do it for at least 1 minute.
Progressive Muscle Relaxation
1. From a seated position begin by tensing your legs and buttocks
for a count of 5, then relax.
2. Tense your abdomen for a count of 5, then relax for a count of 5.
3. Tense your arms for a count of 5, then relax for a count of 5.
4. Shrug your shoulders to your ears and tense for a count of 5, then
relax for a count of 5.
5. Press your tongue to the roof of your mount for a count of 5, then
relax for a count of 5.
Tips: Let all of the tension release and flow out or your muscles. Exhale as you release the tension and relax. You should feel the muscles become loose and limp.
Focus on the difference between the tension and relaxation as this is the most important part of the exercise.
Exposure to Cold
Research indicates that your sympathetic (fight or flight) system slows down and your parasympathetic system increases when your body adjusts to cold temperatures (Makinen et. al. 2008).
It appears that any kind of cold exposure works such as drinking cold water, running hands under cold water, and splashing cold water on your face.
Take care of your physical health
Get regular exercise or physical activity to flush the stress hormones out of your body.
Get adequate sleep.
Eat a healthy diet and be mindful of your caffeine and alcohol intake.
For more information:
Please purchase my book “Attacking Panic: The Power to Be Calm” for more in depth information on how to stop panic attacks quickly and how to treat the root cause (Amygdala/Sympathetic Nervous System).
The book shows you how to go beyond just giving up control and allowing yourself to experience a panic attack.
The book has more powerful strategies that will short-circuit your fight or flight system, stop a panic attack very quickly, and even prevent a panic attack from occurring.
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