About Social Anxiety
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Social anxiety is one of the most common emotional problems people face, although many individuals are reluctant to seek help overcoming it. Most people, at some point, are nervous about humiliating or embarrassing themselves in situations that involve some kind of performance or the fear of being negatively evaluated by others.
Social phobia (or “social anxiety disorder”) is a severe form of normal interpersonal anxiety. Social phobia is not a fear of “socialising” but rather it is the fear of one or more interpersonal situations, e.g., asking people out on a date, talking to strangers, public speaking, or just being observed while eating, etc. Everyone, at certain times, becomes anxious in some interpersonal situations. Stage fright and anxiety during job interviews can be similar problems. Social phobia is usually accompanied by self-consciousness, i.e., a distressing feeling of being the “centre of attention.” Sometimes people with severe social phobia may also experience panic attacks in response to social situations. Around 12.1% of people have suffered from full-blown social phobia at some point (NCS-R), although many more people suffer from a milder version of the same problem, making social anxiety one of the most common emotional problems people face. Rates of diagnosable social phobia are about 50% higher among women than men (Roth & Fonagy, 2005, p. 152).
Research has shown that about 75% of people with social phobia are significantly improved following standard cognitive-behavioural therapy (CBT), making this the psychological treatment of choice for this problem (Clark & Beck, 2010, p. 381). `The recommended number of CBT sessions is about 14-18 for diagnosable social phobia but this may be more in particularly chronic, severe or complex cases or fewer for mild (subclinical) social anxiety. However, CBT also takes different forms and recent innovations in the field have led to somewhat briefer treatment approaches, which initial studies show may have a similar success rate in as few as 5-6 sessions.
Social anxiety, in the broadest sense, ranges from ordinary shyness or public speaking anxiety to a highly generalised and chronic condition that may overlap with Avoidant Personality Disorder (APD). However, there are two main diagnostic subtypes of social phobia:
i) Specific type, where the anxiety only relates to particular types of people or situation, and not others.
ii) Generalised type, where the anxiety relates to more or less any interpersonal situation.
Some researchers have also distinguished between four sub-types of social anxiety in terms of the type of situations that trigger the problem:
- Formal conversations, such as public speaking, which appears to be the most common social anxiety
- Informal conversations, such as chatting to strangers or asking people out for a date
- Assertive situations, where some conflict or confrontation occurs
- Being observed, without necessarily speaking, is the least common, albeit not unusual, form, in which simply eating in public or being watched by others causes anxiety
Many people are ashamed of their anxiety and worry that other people will see they are nervous and think badly of them. Anxiety about appearing anxious can be considered a kind of second-order anxiety, which helps to maintain the problem. However, signs of anxiety are usually not as obvious to observers as you think and they’re unlikely to see them as very important. Most people get anxious sometimes but you probably don’t realise how common it is because people tend to keep it secret. It’s really nothing to be ashamed about and even great actors, comedians, musicians, etc., are often happy to admit they sometimes feel nervous before an important performance.
Learning to accept anxiety as basically quite normal and harmless can help to prevent second-order anxiety (anxiety about anxiety) and it often leads to an overall reduction in anxious feelings and improvements in self-confidence and behavioural performance. Self-consciousness (self-focused attention) has been found by researchers to correlate closely with social anxiety and it is also known that focusing conscious attention on the external situation, other people, and task-at-hand, tends to counteract self-consciousness and reduce anxiety, when applied systematically over time, although this often requires the support of a therapist.
Recommended Self-Help Books
There are many self-help books available but often the advice they contain is unreliable. There are three main self-help books for social anxiety that we recommend, which describe evidence-based cognitive-behavioural approaches, similar to those used in individual CBT sessions,
by Gillian Butler
This is probably the book most commonly recommended by CBT practitioners to their clients with social anxiety. It’s quite inexpensive and easy to obtain. It’s easy to read and contains a good description of self-help based on David Clark and Adrian Wells’ model of social anxiety disorder, the most widely-used modern CBT approach. Gillian Butler is an expert on social anxiety.
by Debra A. Hope, Richard G. Heimberg, and Cynthia L. Turk
This is a more expensive book and slightly harder to obtain. However, it’s written by Richard Heimberg an American psychologist who is a leading researcher on psychological therapy for social anxiety and has been working in this area for many decades. It’s well-written, concise, and practical. It’s written more in the style of a set of instructions or manual than Gillian Butler’s book and intended primarily for use in conjunction with face-to-face therapy sessions, but it can also be used for “pure” self-help, without the support of a therapist.
by Martin M. Antony and Richard P. Swinson
This is another American workbook written by CBT researchers who are experienced in this area. It’s slightly more expensive but can be easily obtained. This book is quite similar to the one by Hope, Heimberg and Turk, but perhaps slightly more flowing, although the content is perhaps not as informative in places. It’s based on a more general CBT approach than Butler’s book, and lacks some of the specific CBT strategies that have been emphasised more recently for social anxiety, such as shifting focus of attention on to others more during social encounters.
Blog Articles About Social Anxiety
- Interview Anxiety: Some Basic Tips for Confidence-Building June 16, 2012Some self-help tips for overcoming social anxiety and building self-confidence in interview situations, based on a cognitive-behavioural approach.The post Interview Anxiety: Some Basic Tips for Confidence-Building appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Mindfulness & Social Resilience May 13, 2012Mindfulness & Social Resilience Gaining Appropriate Psychological Distance Copyright (c) Donald Robertson, 2012. All rights reserved. Distressing thoughts in social anxiety differ qualitatively from thoughts in most other forms of anxiety insofar as they are often attributed to other people, … Continue reading →The post Mindfulness & Social Resilien […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Detached Mindfulness in Social Anxiety October 20, 2011Some brief notes on applying Detached Mindfulness, from Metacognitive Therapy (MCT), to social anxiety situations.The post Detached Mindfulness in Social Anxiety appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Simple Experiments for Social Anxiety April 2, 2011This short article provides basic guidance on developing a list of potential behavioural experiments for social anxiety.The post Simple Experiments for Social Anxiety appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Cognitive Therapy of Social Anxiety: Re-appraisal Form April 2, 2011This detailed set of questions is designed to help you, with support from a therapist, evaluate your thinking about socially-anxious situations.The post Cognitive Therapy of Social Anxiety: Re-appraisal Form appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Video About Social Anxiety from NHS Choices March 26, 2011This is a short (5 minute) video clip from NHS Choices showing a patient describing the symptoms of social anxiety disorder, her experience of living with it, and how she benefitted from computer-based CBT.The post Video About Social Anxiety from NHS Choices appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Social Anxiety: Causes and Cures March 4, 2011This short article summarises some key features of social anxiety and discusses the conceptualisation and treatment employed in cognitive-behavioural therapy (CBT).The post Social Anxiety: Causes and Cures appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Cognitive Models of Social Anxiety: Part 2 January 28, 2011This is part 2 of a brief article outlining a basic cognitive model of social anxiety.The post Cognitive Models of Social Anxiety: Part 2 appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Cognitive Models of Social Anxiety: Part 1 January 28, 2011This short article outlines a cognitive-behavioural conceptualisation of social anxiety from a broad chronological perspective.The post Cognitive Models of Social Anxiety: Part 1 appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)
- Learn to Cope with Anxiety (Part 2) October 14, 2010This is the first part of an introductory handout about anxiety for cognitive-behavioural therapy (CBT) clients.The post Learn to Cope with Anxiety (Part 2) appeared first on Cognitive-Behavioural Therapy in London. […]Solutions: London Cognitive-Behavioural Therapy (CBT)