Social Anxiety Therapy
By Ilene S. Cohen, Ph.D., licensed marriage and family therapist, author.
What is Social Anxiety?
Social anxiety – also called social phobia or social anxiety disorder – is a paralyzing and debilitating condition. Those affected with social anxiety often feel uncomfortable in large social gatherings or small settings with unfamiliar people –any place out of their comfort zone creates anxiety for them. This, often manifested with a fear of embarrassment, becomes so intense that those afflicted with the condition often withdraw from situations that may cause them to be embarrassed. This has the person with social anxiety feeling isolated and alone. They are trapped in their comfort zone, not feeling like they can muster the strength to put themselves in situations that make them anxious.
More severe cases of social anxiety leave those suffering feeling as if they are being watched or scrutinized by others. Even a trip to the mall might become unbearable for fear of being watched, talked about, or judged by random people who are often oblivious to their existence. While most people with social anxiety realize this fear is irrational, they can’t help feeling anxious when confronted with uncomfortable situations. Most of the time, they surrender to their anxiety and start to avoid situations that make them uncomfortable. In the long run, instead of decreasing a person’s anxiety, it exacerbates it, allowing the anxiety to control their lives.
For some, this fear only exists in particular social and performance situations. This is known as generalized social anxiety disorder and is common among actors, musicians, and public speakers. For others, the anxiety is connected with everyday stimuli such as talking with strangers, eating at a restaurant, or shopping at a local grocery store. Leaving a person with social anxiety minimal places they feel comfortable and confident in.
Most adults experience some form of social anxiety, but the severity at which some experience the anxiety and the crippling effect it has, is what classifies it as a disorder.
Symptoms of Social Anxiety Disorder (SAD)
Some possible signs and symptoms of social anxiety disorder are:
- Fear of going places where people can judge you
- Constantly worrying that you will embarrass yourself
- Fear of speaking with strangers
- Nervous that others will notice that you are anxious
- Fear that you will blush, sweat, or stubble on your words in public
- Avoid people and situations in fear that you will be embarrassing
- Avoid being the center of attention
- Thinking about an activity in advance and being anxious about it
- Analyzing yourself and how you acted in social situations afterward
- Always thinking the worst after a social interaction
Possible Physical Symptoms:
Physical symptoms that can accompany social anxiety disorder, as shown on the mayo clinic, are:
- Blushing
- Fast heartbeat
- Trembling
- Sweating
- Upset stomach or nausea
- Trouble catching your breath
- Dizziness or lightheadedness
- Feeling that your mind has gone blank
- Muscle tension
Treatment for Social Anxiety Disorder
The most common treatment for social anxiety disorder includes psychotherapy or medications or both. Most therapists are well-equipped to deal with those who suffer from social anxiety. However, every person is different, and triggers that bring on stress and anxiety will vary from person to person. Seeing a therapist helps you to recognize these triggers while finding ways to desensitize yourself to them in the future. This will allow you to better deal with and manage your anxiety daily.
Your therapist will likely use one or more types of cognitive behavioral therapy (CBT) – or behavior modification – to decrease the mental strain brought on by anxiety.
In addition, they’re likely to recommend medications to reduce the physical effects of anxiety, such as cold sweats, shaking, nausea, or headaches.
Treatment Methods Used in Therapy for Social Anxiety Disorder
Psychotherapy – such as CBT (cognitive behavioral therapy) – or prescription medication is the most common treatment plan for those affected by severe social anxiety. In addition, creating healthy self-care routines as well as a good support system are an important part of maintaining on-going wellness.
Cognitive behavioral treatments such as exposure therapy, cognitive restructuring, and social skills training are often used by therapists to help overcome the severity of the condition. While these treatments effectively limit anxiety in those affected, there is no definitive cure. However, with proper therapy and a treatment plan catered to your specific anxiety triggers, most people that suffer from these social phobias go on to lead normal lives by learning coping mechanisms to deal with the symptoms of anxiety brought on by social situations.
Prescription drugs – such as Xanax – have been proven to be a powerful tool in reducing the stress brought on by this form of anxiety. The drug blocks certain neurotransmitters that normally trigger the “fight or flight” response in stressful situations. When used in conjunction with psychotherapy, these drugs have been proven effective in reducing social anxiety’s effects.
Self-care routines – Engaging in self-care and preventive practices can help you build the all-important psychological resources needed to better manage anxiety when it strikes. Good routines that include regular exercise, sleep, and meditation can improve both physical and psychological functioning and are a key component of any treatment plan.
Support groups – Many people with social anxiety find support groups helpful. A group of people with similar challenges can feel like a safe space to learn about how others with social anxiety disorder approach and overcome the fear of social situations. Check out AnxietyTribe, online support group as one option for group support.
What to Look for When Finding a Therapist
Know that you are not alone, and it is perfectly normal to get anxious in certain social situations; however, if your anxiety is so severe that it harms your quality of life, it’s time to get help.
Nearly any general therapist is equipped to handle most instances of social anxiety disorder, but with the most severe cases, you should seek a specialist who has experience in dealing with advanced cases of social phobia. It’s not uncommon for this disorder to be linked to other mental health conditions (in its most severe cases especially) so finding a therapist who specializes in social anxiety disorder is often the best course of action.
Search TherapyTribe for a therapist that specializes in treating social anxiety disorder; there is no need to live with anxiety and the challenges it creates in your life.
Social Anxiety therapists in Top Cities
- Toronto
- Los Angeles
- Manhattan
- New York City
- London
- San Francisco
- Calgary
- Denver
- Vancouver
- Mississauga
- Brooklyn
- San Diego
- Ottawa
- Atlanta
- Chicago
- Hamilton
- Queens
- Boston
- Philadelphia
- North York
- Washington
- Vaughan
- Nashville
- London
- Sydney
- Seattle
- Raleigh
- Guelph
- Victoria
- Melbourne
- Rochester
- Miami
- Boca Raton
- Tampa
- Arlington
- Phoenix
- Beverly Hills
- Colorado Springs
- Brampton
- Oakville
- Richmond Hill
- Markham
- Windsor
- Brantford
- Yonkers
- Syracuse
- Frisco
- Houston
- Dallas
- Saint Paul
CASE STUDY
Post-Pandemic Impact on Social Isolation and Anxiety
When the COVID-19 pandemic began, staying at home and socially distancing from others became necessary to slow virus transmission. Social isolation kept our loved ones and us safe. Some individuals love socializing, especially after being locked down for so long, while others may face anxiety in these now-new social interactions. Individuals who have never experienced social anxiety before COVID-19 may feel surprised that they are feeling it now.
Individuals already dealing with social anxiety before the pandemic are familiar with the worry and discomfort social situations bring up for them. However, many people with prior social anxiety experienced the pandemic differently than others who were not socially anxious. They felt that the pandemic was ideal for their social anxiety. People suffering from social anxiety preferred remote learning, work, and socialization. It allowed them to avoid settings and situations that created stress and discomfort. However, as we come back out in society, those who experience social anxiety are likely to feel that familiar distress come up again.
Their social anxiety did not go away but was temporarily on pause, as they were not made to manage situations that caused them anxiety. Prolonged avoidance means that people with social anxiety have had fewer opportunities to practice their social skills and realize that their worst fears usually don’t come to pass when they go into a social situation. Missing out on corrective experiences can create individuals to have more anxiety going into new situations again. Just know that this is entirely natural if you’re experiencing anxiety in social situations. If anxiety about socializing becomes so intense that you’re actively avoiding outgoings you want to participate in, that’s a sign that you need help. People who choose to go out but have extreme anxiety may also benefit from seeing a professional.
References
- National Institute of Mental Health (NIMH). (2022) Social Anxiety Disorder: More Than Just Shyness. Retrieved Feb 15, 2024 from: https://www.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness
- Why You May Experience Social Anxiety as You Emerge from the Pandemic. Retrieved December 4, 2022 from: https://www.healthline.com/health-news/why-you-may-experience-social-anxiety-as-you-emerge-from-the-pandemic
- Timothy J. Legg, PhD, CRNP (2018, Feb). What’s to know about social anxiety disorder? Retrieved April 17, 2019 from: https://www.medicalnewstoday.com/articles/176891.php
- Noone, R.J. and Papero, D.V. (2015). The Family Emotional System: An Integrative Concept for Theory, Science, and Practice. Lexington Books, Maryland.
- Social anxiety disorder (social phobia). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org
- AskMayoExpert (2017). Social Anxiety Disorder. Retrieved May 3, 2019 from: https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561