While social connection and engagement are generally viewed as something enhancing and enriching, associated with positive emotions, for many of us the experience of social situations is a profoundly anxiety provoking experience. For people who suffer from social anxiety entering into social situations generates feelings of apprehension and doubt as well as intensely unpleasant bodily responses such as a racing heart and sweaty palms (see Cognitive Behavioral Therapy). This is especially so for unfamiliar social situations or where a person feels scrutinized or evaluated by others. For social anxiety sufferers, social situations generate so much anxiety that even the anticipation of such events is associated with anxiety and they go to great lengths to avoid placing themselves in such situations. For instance it’s absolutely normal to feel nervous before an important meeting with a big client; however you may be suffering from social anxiety if you find yourself feeling anxious for weeks before, cancel the meeting or find yourself shaking so much in the meeting that you are unable to communicate. Avoiding events such as school parent meetings, presentations and end of year parties impact both on a person’s capacity to initiate and develop relationships as well as their ability to get ahead at work. Social anxiety of this scale impacts on day to day functioning.
So how can one overcome social anxiety? In my article Cognitive Behavioral Therapy: The therapy of choice for anxiety I provided an introduction to the key elements that need to be addressed in managing anxiety. These include addressing the thoughts, feelings and bodily/behavioral responses associated with anxiety as well as exposing yourself to the anxiety generating event; which are all relevant to overcoming social anxiety in particular. My previous article Feeling anxious: Managing the day to day experience of anxiety emphasized the need for developing awareness of your anxiety. I also provided some tips on tackling the thoughts and addressing the physical symptoms associated with feeling anxious which can be applied to overcoming social anxiety. However I did not address the key role of exposure in managing anxiety. This article will introduce you to exposure–based tools specifically in relation to overcoming social anxiety. Of course facing your fears using exposure would be used in conjunction with tools addressing your thoughts (e.g. thought stopping) and bodily response (e.g. breathing techniques, see Help your mental health: Strategy for fostering self-awareness).
Typically individuals with anxiety avoid anxiety provoking experiences or triggers. In the case of social anxiety this is especially problematic and so exposing oneself to the anxiety provoking social situation is a key aspect of overcoming social anxiety. Such techniques provide strategies for managing the anxiety that exposure usually triggers and they require the socially anxious individual to expose him/herself to the anxiety provoking experience thereby reducing the anxiety associated with the trigger. This is the real gist of overcoming social anxiety as anxiety generates avoidance which generates more anxiety which generates more avoidance. So avoidance of social situations plays a key role in generating and maintaining social anxiety. In contrast by confronting and staying in anxiety provoking situations gradually your anxiety will reduce. Hence a key aspect of overcoming social anxiety is breaking the cycle of avoidance, anxiety, avoidance through facing the social situations you fear in a measured and methodical manner.
The specific technique I will be introducing you to assist you in facing your fears involves creating an exposure hierarchy. This involves the graded exposure to anxiety provoking social situations. The first step in doing this is to create an exposure hierarchy. This involves listing anxiety provoking social situations from what is least anxiety provoking for you to what is most anxiety provoking. For instance if you find speaking in front of people anxiety provoking your least anxiety provoking event may be thinking of speaking in front of other people and your most anxiety provoking may be speaking in front of a large group. You would attempt to generate at least 10 events and thereafter rank these events from least to most anxiety provoking, giving them each a rating from 1 to 10 in terms of how much anxiety they evoke. Once you have this ranking you expose yourself to experiencing each event, starting with the least anxiety provoking event. You could use body and thought based techniques to make your anxiety more tolerable and stay in the event until your anxiety reduces. You would repeat exposing yourself to an event until your rating of the anxiety experienced dropped to zero. Only then would you move on to the next event, repeating the procedure until you get to your most anxiety provoking event.
Exposure-based techniques are essential to overcoming social anxiety and need to be approached with patience, gradually climbing up the anxiety hierarchy. The less generalized the social anxiety the more effective exposure techniques are. Also be aware of whether your anxiety may be caused at least in part by a skills deficit such as poor public speaking skills. Make sure that you address the aspect of any skills deficit in order to ensure maximum benefit from facing your fears. Overcoming social anxiety is a complex process involving the use of multiple skills and strategies which you can attempt to implement yourself. Remember that if you are not managing to improve your situation by yourself, there are qualified mental health professional available who are experts in the use of these techniques.