This article was published on: 03/8/19 3:01 PM
When you go to a social event, does it feel as though all eyes are on you? Do you worry that people might be judging you or talking negatively about you in some way? Are you afraid to be called on in class or in a business meeting? You might try to be inconspicuous by sitting in the back row and/or by avoiding eye contact. You may dread social activities, avoid them altogether and/or force yourself to attend, all the while white-knuckling your way through until it’s finally over.
Does any of this sound familiar? If so, you may be suffering from Social Anxiety Disorder. Social Anxiety Disorder is diagnosed when you have an intense fear of being judged negatively in social situations. Often this fear is associated with significant distress and may affect multiple areas of your life, from work to hanging out with friends at the mall. Often those who experience symptoms of this disorder may have begun feeling this way in childhood or early adolescence. Social Anxiety Disorder is a difficult disorder as, without the right kind of treatment, it may ebb and flow throughout your life.
So how does this happen? When someone with social anxiety enters a social situation, they may suddenly become bombarded with distressing thoughts about how others may be perceiving them. This shifts the focus away from the external world to the internal self, leading to unfair and often critical self-evaluation. This is often exacerbated by a hypersensitivity toward the reactions of others, which in turn fuels the anxious loop, triggering even more fear (Nordahl & Wells, 2017; Fox, Fernandez, Rodgebaugh, Menatti & Weeks, 2016).
You may find that you try to make yourself feel better by avoiding eye contact or you may rehearse a conversation before you have it. Do you ever check your phone or grab a drink just so you are doing something or have something to hold? Maybe you get a friend to go with you just so you don’t have to be by yourself and you always have someone to talk to. You may worry a lot before you go to any event, or you think about the event a lot before it happens and then again after, mentally reviewing everything that may happen or did happen. Maybe you just avoid the event altogether. Whatever technique you use, it may work briefly but, as you probably have found, it doesn’t work that long and you often feel even worse afterwards.
If you have said yes to any of the above, you are probably wondering what you do now. It may feel pretty hopeless, but research has found that the best treatment for Social Anxiety Disorder is individual Cognitive Behavioral Therapy (CBT) over any other psychological treatment method (Nordahl & Wells, 2017).
When using CBT, you are asked to perform gradual exposures in order to learn that you can manage your fear and even live with it, thereby teaching yourself that you do not need to use avoidance or safety strategies. Additionally, this therapy focuses on challenging your unfair beliefs about yourself and helps you learn some other types of helpful thinking strategies. The goal of CBT is not to eliminate anxiety, but rather to reduce your symptoms by collaboratively helping you learn that the fear you previously had about social situations may not really be as scary as you thought, and you can actually handle it!
References
Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Association, 2013.
Fox, J. M., Fernandez, K. C., Rodebaugh, T. L., Menatti, A. R., & Weeks, J. W. (2016). Investigating stereotypes of social anxiety. Anxiety, Stress & Coping, 29(2), 173–186. Retrieved from http://proxy-tu.researchport.umd.edu/login?ins=tu&url=http://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=112232858&site=eds-live&scope=site
Nordahl, H., & Wells, A. (2017). Testing the metacognitive model against the benchmark CBT model of social anxiety disorder: Is it time to move beyond cognition? PLoS ONE, 12(5), 1–11. https://doi.org/10.1371/journal.pone.0177109
Written by Rachel A. DiComo, Graduate Intern and edited by Andrea G. Batton, LCPC
The Maryland Anxiety Center was founded by Andrea G. Batton, LCPC with a vision of creating a practice where clinicians and staff work cohesively and collaboratively with patients to provide optimal psychological care. The Maryland Anxiety Center specializes in the treatment of anxiety and related disorders from a cognitive behavioral perspective, the gold-standard and most effective treatment for such conditions.