Social Anxiety

What is Social Anxiety

At any given time, about 13% of Americans suffer from Social Anxiety Disorder (also known as Social Phobia), making it the most common anxiety disorder. That’s a pretty big club. So you are not alone. The problem normally begins around the age of 16, although we see plenty of 8 year olds with crippling social anxiety. However, we also see people who first start feeling anxious when they are 40, 50, or 60.

People with social anxiety tend to evaluate themselves negatively, they focus a lot on negative aspects of themselves, and they tend to believe that others are paying close attention to their faults. This is not always the case, but it is almost always true that people with social anxiety do not feel good around people that they do not know and trust. They feel especially anxious before events, and they have a strong urge to avoid or escape interactions with others, particularly when the situation is unpredictable or uncontrollable, if they have reason to feel inferior to the people around them, or if they believe that they will be pressured to perform or to engage in uncomfortable small talk. This problem is made significantly worse when the anxious person does not have (or believes that they do do not have) strong social skills.

People with social anxiety tend to have negative expectations, such as “they will reject me… they will think that I’m weird… I had better not mess up again… people will notice that I’m anxious and think that something is wrong with me… they will think that I am incompetent…” These thoughts often balloon and become bigger and more awful – sometimes in a matter of seconds – a process that we call “catastrophising.” And that leads to a crippling sense of dread.

Some socially anxious people do not have these thoughts. They just feel terrible and want to avoid or escape.

Cognitive Behavioral Therapy (CBT) for Social Anxiety

Changing the way that you think
John Snyder is our social anxiety expert. He will help you learn to to notice thoughts that lead to anxious emotional spirals, and to come to more rational conclusions. You will learn to think more rationally about the social costs of making mistakes, about the amount of attention that people are actually paying to your mistakes, and whether you are actually making mistakes at all.

Changing what you do and how others treat you
If you really do have social skills deficits, he will help you identify and fix them. And he will help you learn how to more accurately evaluate whether your new skills are working so that you can modify them as need. If you are used to being mistreated by others, you will work on problem-solving techniques designed to help you assert your needs, stand up for yourself, and influence others’ behaviors in positive ways so that you can feel more comfortable in your environment.

Changing how you feel
The way we feel is influenced by our environment (see above), the way that we think (see above), our biology, and our behaviors.

If we get too little sleep, our biology is affected, and we feel worse. The same goes for drinking too much. But people who are anxious tend to sleep too little and drink too much because of their anxiety, or in order to avoid it. And this just feeds the monster, and makes it bigger and nastier. In therapy, you will learn skills that will help you sleep better and cope with anxiety without drinking (if that is a problem for you).

The one thing that tends to cut across people with all types of chronic anxiety is avoidance and escape behaviors. When we learn to face our anxiety (in very small, gradual doses), our brains become accustomed, and sometimes even bored with it – which is a very good thing, because it means that it is no longer painful. Very slow, gradual exposure to anxiety-provoking interactions and stimuli has been shown in countless studies to work. You can always tell your therapist that you do not want to do exposure exercises. And they can be put off for as long as you like. But they are effective. While we do encourage them, plenty of our clients say “no” and we respect that. In fact, one of our clinicians is deathly afraid of the woods at night and refuses to do exposure therapy for it. We won’t say who. But it’s not John or Kristen.