What is Social Anxiety Disorder and How Can Therapy Help?

Wrongly viewed by many as just ‘shyness’, social anxiety disorder is a long-term and overwhelming fear of social situations.

It manifests as an intense fear of being watched, judged or of feeling humiliated. These fears become so extreme that it interferes with our daily life. 

What may seem like an ‘everyday’ activity to one, will fill someone struggling with social anxiety with extreme fear. Activities such as answering the phone, going to the supermarket or bumping into an acquaintance are terrifying.

If you feel trapped by these kinds of fears, it is important to know that you are not alone. Social anxiety disorder, or social phobia, is one of the most common forms of anxiety disorder and up to 13% of the general population experience social anxiety at some point in their life.

People who experience social anxiety are often more likely to experience other mental health concerns, such as low mood, depression and panic disorder.

Symptoms of social anxiety:

Cognitive symptoms:

  • Worrying a lot about making a fool of yourself in front of others
  • Feeling very anxious before going into a social situation
  • Thinking others will notice your anxiety
  • Fearing situations where you don’t know people 
  • Dreading upcoming events
  • Worrying that you will be judged by others
  • Obsessing over the embarrassing things that could happen to you
  • Unable to say, or do, the things you want to
  • Dissecting how you acted in a social situation, after the fact

Physical symptoms 

– A very dry mouth

  • Sweating
  • Blushing 
  • Heart pounding and palpitations 
  • Wanting to urinate or open your bowels
  • Feelings of numbness or pins and needles in the fingers and toes, which can happen when you breathe too fast
  • Shaking
  • Muscle tension
  • Stammering 

Behavioural symptoms

  • Avoiding social situations
  • Escaping 
  • Needing a friend, parent or partner to be with you at all times
  • Using safety behaviours
    • Drinking alcohol or other substances
    • Avoiding eye contact
    • Not saying anything personal 
    • Asking too many questions

Social anxiety disorder has two main distinctions. The two main manifestations of social anxiety disorder are general social phobia and specific social phobia:

General Social Phobia

If you struggle with general social phobia, you may experience distress in a wide range of situations. This may present itself in many ways, including:

  • Worry that other people are looking at you and scrutinising what you are doing
  • Dislike being introduced to other people
  • Fear going into shops or restaurants
  • Worry about eating or drinking in public
  • Struggle to be assertive

Specific Social Phobia

If you struggle with specific social phobia, your anxiety may only present itself in a specific situation.

Examples of this could include fear of public speaking, stage fright more generally, or dealing with authority figures. It may be, that outside of these specific situations, you are not ruled by your anxiety. But when put in the situation, it can be debilitating. 

Here are four unhelpful thinking styles that will fuel social anxiety:

Mind reading 

This is when you assume that you know what other people are thinking. In order to protect ourselves from what we fear is the worst, the anxious mind anticipates what others may be thinking of us – and it is most often negative. 

Fortune telling 

This is where your anxiety believes it can predict the future. At what this actually means is that you assume the worst will happen. 

Fortune telling exacerbates your anxious thought processes before you’re even in the situation.

Catastrophising 

This is where our anxiety makes us blow things out of proportion. For example, if people notice that you’re nervous, or we forget what to say, the world will end. 

Personalising 

This is when our anxiety assumes that people are negatively focusing on you or that people’s private conversations are about you.

Ways to combat social anxiety

Self-help

The first step to making a change is by accepting that things need to change. By acknowledging your own anxiety, you are in a stronger position to challenge it. 

Try to observe what is going on in your mind, what situations trigger you the most and how you behave when you are triggered. Writing this down can be helpful. Try keeping a daily journal. By doing this you are able to track your progress and also recognise your triggers and when you could be falling back into negative thinking patterns.

Self-help techniques can often incorporate aspects of relaxation, thought reprogramming, and exposure to feared situations.

Examples of relaxation techniques could include deep breathing, guided imagery, breath control and mindfulness techniques.

Therapy

CBT works on the idea that the way you think affects how you feel, and in turn, your feelings affect your behaviour. By challenging the way you think about social situations that feed your anxiety, you’ll be able to establish new thought processes that combat the anxiety.

Through CBT, one of our therapists will work with you to discover any unhelpful rules, assumptions or predictions that feed your anxiety. They will also ask you to describe the physical symptoms you experience and any safety behaviours you use to avoid or cope with the anxiety.

Through CBT for social anxiety, you will learn how to challenge the unhelpful thoughts that trigger the anxiety. By being able to capture the thought and the fear, you are able to rationalise it, and in time replace it with more balanced thought processes. 

CBT will also help you to face the social situations that feel overwhelming, gradually and safely. They will also teach you tools and skills to manage the physical symptoms to be able to feel more in control in a social situation.

Talking therapies are also an option, for a gentle guide and safe space to talk about how social anxiety is affecting your life. Finding a judgement-free zone, where you are able to open up about your anxieties can be a lifeline when you begin to face your fears. Our therapists are guided by, and what steps you feel comfortable taking.

How can Hope Therapy help?

When you are struggling, it can feel like you are the only person in the world feeling the way you do, which can make social situations even more overwhelming. 

You are not alone. 

Here at Hope Therapy, we have a fully qualified and experienced team of Counsellors and Cognitive Behavioural Therapists who are there to support you. 

They are trained and able to help you develop positive skills, interventions and insights to support your anxiety, along with exploring underlying issues that can either contribute to your anxiety or result from it. 

Our main priority is supporting you on your journey to understanding your psychological needs, and how to overcome your triggers.

Compassion and understanding are at the core of all we do. We want you to hold on to the fact that that social anxiety is a highly treatable mental health condition, and finding the right therapist is a great start in your recovery journey. Please don’t hesitate to get in touch with us.


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Ian Stockbridge
Owner and lead counsellor of Hope Therapy & Counselling Services. Ian draws upon various approaches including CBT, Person-Centred Counselling and Mindfulness.

To book a session with Ian or one of the Hope Team, just get in touch.

www.hopefulminds.co.uk

Email: contact@hopefulminds.co.uk
Mobile: 07379538411

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