Social anxiety is a common problem and one that cognitive-behavioral therapy can treat effectively. People often become accustomed to living with social anxiety, not aware of how helpful therapy can be. Read on to learn more about social anxiety and about therapy options.
Last updated: November 1st, 2020
What is Social Anxiety?
Social anxiety disorder, also known as social phobia, is a psychological condition in which certain social situations become the cause of significant anxiety. These situations often have to do with performance. Typical examples include speaking with an authority figure, with a potential romantic partner, with strangers, or in front of an audience.
Some people with social anxiety think of themselves as being “just shy,” and surely for some people, that’s true. However, shyness, when it becomes more pronounced, can turn into a real problem. That’s when it turns into social anxiety disorder. The disorder is relatively common, affecting approximately 4% of the population at any given time. This makes it the third most common mental health disorder.
A fear of public speaking is a common problem for those with this disorder. Many people feel uncomfortable or anxious in certain social or interpersonal situations — this is normal. However, a person with social anxiety disorder will experience certain social situations to be so anxiety-provoking that they either avoid them or endure them with significant distress. This avoidance or distress becomes a significant issue in that person’s life.
Social Anxiety Symptoms
- Discomfort at the idea that others think poorly of you
- Fear of embarrassment or humiliation
- Fear that others will notice you’re anxious
- Feeling anxious while eating or drinking in front of others
- Anxiety when the focus of attention in a group
- Anxiety when anticipating any of the above situations happening
- Preoccupation with concerns about being negatively evaluated by others
- Racing heart or shortness of breath, sweating, blushing in any of the above situations
- A pattern of avoiding social situations that would make you anxious
- Discomfort with eye contact in feared social situations
Many people with social anxiety suffer from other types of anxiety. In fact, up to 90% of those with social anxiety have a related problem. It’s common for people with social anxiety to suffer from depression or from low self-esteem. Fortunately, therapy for social anxiety will typically address both of these other problems, often simultaneously. More on the therapy below.
Social Anxiety in Teens
For children and teenagers, social anxiety is largely similar to how it presents in adults. There are a few differences. For one, teens and kids will often have difficulty recognizing that their fears are not reasonable; adults typically do recognize this. Additionally, younger children will often have physical symptoms that can mimic illness such as stomachaches and headaches when they are feeling anxious. These are much less common in adults. Social anxiety is treatable in kids and teens, just as it is for adults, although the therapy is somewhat different.
Social Anxiety Treatment
The primary psychotherapy treatment for social anxiety is cognitive-behavioral therapy (CBT). CBT for social anxiety aims to accomplish two goals: 1) reducing the number of situations that are avoided and 2) changing the anxious thinking that typically occurs in these situations.
Reducing the number of situations avoided is a key part of what it takes to overcome social anxiety. How does CBT help people do that? In part, it accomplishes that by using a technique called situational exposure. Exposure typically involves working with your CBT therapist to find a social situation that is challenging for you, but not overwhelming. Using the skills you have learned in treatment, you then willingly enter this situation. These skills will help you manage the anxiety in a healthy way.
Over time, exposure lowers the anxiety you have in situations you used to avoid. The situations gradually become less and less daunting.
Changing Anxious Thinking
Social anxiety is largely driven by beliefs and thought patterns about how one will be perceived by others. As long as this thinking persists, the anxiety will continue to be a problem.
The most common thought pattern found in sufferers of social anxiety is when we make assumptions about how others are thinking and feeling. For example: let’s say you ask someone which way 39th street is. If you assume she thinks you’re an idiot for asking, you will likely experience some anxiety. Typically for those with social anxiety, that assumption is not a conscious choice. Rather, it’s an implicit part of how they think about other people. These assumptions are hard to change unless you learn to examine them and evaluate them. CBT strives to help people do just that. This is part of what makes CBT effective in this type of anxiety.
CBT is the treatment of choice for social anxiety disorder. Some medications can also be helpful, but CBT is the preferred first treatment for social anxiety because:
- research shows it to be highly effective for this disorder;
- it has no risk of side effects like SSRIs, the most commonly prescribed type of medication for social anxiety (common side effects of SSRIs include nausea, weight gain, and sexual difficulties);
- CBT teaches you skills that last beyond the end of the treatment. This represents an advantage over medications, which only help while you’re taking them;
- CBT is time-limited — typical treatment lasts 12 to 25 sessions.
Finding a Social Anxiety Therapist in NYC
Please contact us if we can help you in your efforts to find therapy for social anxiety here in New York. Our CBT therapists are doctoral-level psychologists. We also have student therapists who offer reduced-fee services. Our offices are in midtown Manhattan, but we offer teletherapy services to people elsewhere in New York State, New Jersey, and Florida. If you’re looking for therapy for social anxiety in another part of the country or world, please contact us — we are happy to help!