Psychotherapy, Self Esteem

What is Social Anxiety?

Social anxiety is more than just shyness. Social anxiety interferes with a person’s ability to fully function in society and have the life that they want.

I have been encountering more people suffering from this fear than any other. The sad thing is that most people think they are alone and that they are the only one who is worried about what others will think of them (or say about them), or how others will treat them.

Many people fear that they will be bullied or socially rejected and as a result they either act harsh to defend themselves against perceived attacks before they happen, or they just stay home all together…even though they are bored and want to go out and enjoy life.

The symptoms of social anxiety are divided in three groups:

  1. physical symptoms,
  2. cognitive symptoms, 
  3. personality traits.
Physical symptoms: 
A tendency to blush

  • Shaky voice and trembling of hands and feet

  • Sweaty or cold hands

  • Intense sweating

  • Panic attacks 
  • Muscular tension

  • Shortness of breath or breathing difficulties

  • Pain or pressure on the thorax

  • Diarrhea

  • Confusion

  • Difficulty making eye contact
Cognitive symptoms:

  • Fear of being judged or criticized

  • Anxiety or fear of being in the spotlight

  • Fear of showing symptoms of distress

  • The belief that others see you as anxious, weak, crazy or stupid

  • Fear of meeting strangers

  • Fear of authority figures

  • Anxiety that is so strong it disrupts routine daily activities
Personality traits:

  • Low self-confidence and self-esteem

  • Difficulty being assertive

  • Negative thought patterns – “I’ll appear stupid”
  • Undeveloped social skills

  • Excessive sensitivity to criticism

The good news is that psychotherapy is effective at treating social anxiety. There are also medications which are very good at reducing anxiety. 

There are three main approaches therapists currently use in treatment:

  1. Dynamic,
  2. Behavioral, 
  3. Cognitive. 

The Dynamic approach explores underlying issues, childhood experiences, and attempts to make the unconscious conscious. Perhaps someone picked on you or teased you as a small child. As a result you may feel that world is not a safe place although you cannot put your finger on why it isn’t safe.

The Behavioral approach looks at how we learn and develop behaviors over time. Such as, if someone teases us or bullies us, we learn to associate people with shame and then we do everything that we can to avoid being teased, bullied, or shamed. We allow ourselves to develop a fear of other people and expect that because one person teased us, everyone will tease us.

The Cognitive approach focuses on what we think about our situation, sometimes before we even realize that we have had a thought. So when I think I have to go to work or I would like to go to the mall, the first thing I think is, “ugh, the people” and I immediately have a sense of fear or foreboding. Even if it is an activity that I want to do (gym, yoga, shopping, movies, etc) I will not allow myself to go because I think other people are not safe.

Treatment for Social Anxiety is often behavioral in nature, with the therapist guiding the client through exercises more closely resembling the feared object or situation. I start someplace (online or in the person’s home) that the person feels safe. Then, through behavioral, and sometimes cognitive exercises, we help people face their fears and behaviorally learn new associations in a safe and fun way. Exploring underlying issues can also be beneficial, if the client wants to understand the root of their problem, but it is not necessary for successful treatment.

Prognosis for Social Anxiety is very good if treated effectively.

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