Social Anxiety

Social anxiety and social phobia can take many forms.

Some people experience anxiety only in very specific situations: eating or writing in front of others, using public restrooms, or (the most common fear of them all) public speaking.

Others experience fears in many or most social settings: public speaking, meeting new people, attending social events, romantic situations, and so on.

Some people struggle to maintain social contact despite their intense discomfort.

More often, the anxiety leads to avoidance. The avoidance makes these situations unfamiliar. The lack of familiarity further reduces the comfort. The problem becomes self-perpetuating.

Some people with social anxiety may become virtually housebound. Unlike agoraphobia, where the fear is of specific physical symptoms, in social anxiety the fear is of the disapproval or judgment of others.

Treatment

Cognitive behavioural treatment of social anxiety involves several components.

Cognitive work investigates the pattern of thinking in the feared social situations. Often the feared outcomes are viewed as more likely than they really are, or as more intense if they do occur. Specific exercises can help overcome these patterns of thinking.

Skills training addresses the lack of familiarity with certain situations - such as making small talk, ways of introducing oneself, or how to express oneself assertively.

Exposure therapy involves gradually confronting feared situations at mild levels, gaining confidence, then gradually tackling more difficult situations. Therapist and client work together to plan activities to carry out.

Social phobia is extremely treatable. Like all anxiety treatments, it requires dedication and a willingness to tolerate at least a small amount of anxiety. It does NOT involve bringing on severe anxiety, however, as this is not helpful.