CBT for Social Anxiety
It’s normal to feel nervous in some social situations, perhaps going on a date or giving a presentation causes butterflies in your stomach? But in social anxiety disorder, also known as social phobia, everyday interactions cause significant anxiety, self-consciousness and embarrassment because of a fear of being scrutinised or judged negatively by others. At its worst it causes isolation and prevents sufferers from forming close relationships, but with key understandings from CBT, you can fight back!
Social anxiety arises from the perception that there is something embarrassing and deficient about us. We can probably all relate to the idea of looking in the mirror and focusing on something we perceive to be problematic, for example a spot, and trying to hide it. Social anxiety is the same, except with the flaw we perceive is related to our internal self, our personality and our social skills.
Everyday social interactions, such as a conversation, meeting unfamiliar people or being observed eating or drinking become triggers for heart palpitations, shaking, sweating, a shaky voice, blushing, and even panic attacks. Giving a speech or presentation can also provoke these strong physical sensations, and they can become a source of added concern as the person worries that what they’re experiencing will get unwanted attention from others.
Sufferers report experiencing anxiety not only in advance of social contact, but again afterwards, when you are likely to spend hours ruminating on how the situation went, painfully analysing every gory detail and feeling hugely uncomfortable.
Sadly one common coping strategy is avoidance, and many sufferers are compelled to cut themselves off from people, even avoiding social situations altogether if they can. But this avoidance leads to feelings of isolation, loneliness and possibly depression. Every client I’ve met with social anxiety has, deep-down, wanted to get closer to others, to stop hiding and feel comfortable, but thought that this was not how their life was to be.
CBT asks the question, what if there isn’t a flaw? Or if it’s there, it’s something so barely perceptible that no one really cares about it?
How CBT Can Help
CBT asks the question, what if there isn’t a flaw? Or if it’s there, it’s something so barely perceptible that no one really cares about it? If this were true, you could take the risk of being you, of being authentic, allowing yourself to relax and enjoy social situations. Sounds amazing, I know, and using CBT I’ve seen many life-long, socially anxious clients turn their lives around.
This is because CBT focuses on changing the key maintaining factors that keep social anxiety going:
- As social anxiety is associated with acute self-focus and self-consciousness, it’s likely that in social situations you are so focused on yourself that you miss all or some of what others are saying and doing? This inward focus and the self-evaluative commentary (“how am I coming across, am I being interesting enough, are they bored?” – you get the idea) takes your attention away from what’s happening outside of you. This is a key target for CBT, so shift your attention outward to what’s happening around you! In the moment, this means consciously placing your attention on the group, the person you’re talking to or simply your immediate surroundings. Look outside yourself. Turn your attention from inside to out and you will be able to make the most of your natural social skills. This takes some practice but clients (and my own experience) know it to be a game-changer!
- Challenging the ‘safety behaviours’ people use to reduce anxiety in the moment, such as standing on the edge of a group, scrolling on their phone, even rehearsing what they’re going to say. Trouble is these behaviours often send the wrong message socially, we can come across as stand-offish or disinterested. They take up a lot of thinking space and mean we’re focusing on how we’re coming across, rather than relaxing and engaging with others. In CBT I support and encourage clients to drop these so-called helpful behaviours and engage differently.
- We often set ourselves unrealistic standards socially, so daring to be just be normal; accepting the silences (yes, they’re normal!), allowing an um and an ah here and there can help you feel more comfortable, and relax into the social skills you have.
I’m with you every step of the way, encouraging, advising and reminding you that we have to put action before feeling confident, because when we see ourselves doing challenging things, we start to believe we can! Avoiding experiences means we don’t get the evidence to see our own capabilities in their true light, so we will plan gradual exposure exercises to test your predictions in real-life situations.
Social anxiety is changeable and in my experience, the vast majority of clients make marked progress. Get in touch to see if you could benefit from CBT for social anxiety disorder.
