Social anxiety typically involves avoidance of things we find uncomfortable. Learn more about why this a problem, and what therapy involves.
“Just imagine them in their underwear!” is a common statement told to those who have a fear of speaking in front of large audiences. Although it can be useful (and entertaining) to use your imagination in this way when giving a presentation, it’s typically not enough to overcome the anxiety that comes up in these situations.
Fear of public speaking is a symptom of social anxiety disorder. However, not everyone uncomfortable with public speaking has social anxiety. Social anxiety can involve any situation between you and someone else. It could be a boss, a stranger, or someone you’re interested in. It doesn’t have to revolve around one person though; usually it involves types of situations.
Typical examples look like these:
Judy, a very successful investment banker, begins sweating profusely whenever she needs to talk to her boss’ boss at a work event. She dreads these meetings and often feels a need to have a few drinks before starting a conversation.
Scott, a graduate student, who is usually gregarious and engaging with his family, freezes up and rarely participates in class, for fear of saying the wrong thing. He often misses out on class discussions because of this fear.
Lauren has found dating to be very difficult (and stressful) because she is afraid of not being able to maintain a lively dialogue on dates; she finds herself getting nervous, tense, and panicked beforehand. Consequently, she has decided to avoid dating altogether.
The role of avoidance in social anxiety
Social anxiety can lead to chronic avoidance of various social situations in order to escape intense feelings of anxiety or inadequacy. It may also create uncomfortable physiological sensations in the body or produce unhelpful thoughts that impede our social functioning.
For people with social anxiety disorder, avoidance often maintains anxiety around social situations and can become a big problem. Indeed, 36% of people with social phobia report experiencing symptoms for 10+ years before seeking professional help.
Think of it this way, every time you avoid a social situation that makes you uncomfortable, you make your anxiety a little bit stronger. This happens via a principle called negative reinforcement. Negative reinforcement in this case is the notion that when we do something that removes an unpleasant feeling, we’re more likely to do that thing again. This is the principle that alarm clocks use on us to get us out of bed; they annoy us until we turn off the alarm, and hopefully waking up in the process. It’s also the principle that explains why nagging your partner and avoidance in social anxiety succeed in changing behavior.
But what is the behavior that avoidance helps to change? Unfortunately in social anxiety, avoidance has the effect of making us more likely to avoid going to a social situation next time. Avoidance basically ends up leading to more avoidance! Eventually this becomes a problem. Fortunately, CBT has a solution.
Exposure therapy
One known treatment for social anxiety is exposure therapy, which is a form of cognitive-behavioral therapy (CBT). Exposure therapy for social anxiety typically involves the patient facing or imagining their fears, and then through guided and repeated exposure to the situation, realizing that the fear did not actually come true.
Exposure works using two principles – desensitization and habituation. When a person becomes desensitized to their fears, the anxiety they experience begins to dissipate. Habituation then takes over. Thus, the same situation, when presented again, does not produce the same intense reaction as the first or second time. Exposure therapy can be either imaginal (using one’s imagination) or in vivo (in the actual feared situation). Exposure therapy, when done correctly and consistently, can be very effective in treating phobias and fears of any kind.
Problematic thinking
A common feature of social phobia involves thoughts that trigger and exacerbate our anxiety. These thoughts can lead us to overestimate how nervous we will become in a social situation and underestimate our own ability to interact and engage in social situations. Cognitive-behavioral therapy can help us to identify these distorted thought patterns and challenge the thoughts. This often proves helpful in overcoming social anxiety.
Lastly, there are also support groups for people suffering from social phobia that can be found in your local region. Gone are the days of envisioning people sans clothing; there are better options out there.
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