What Is Social Anxiety?

You're supposed to attend a charity gala this weekend, and your stomach is in knots. What if your close friend bails? What if you have no one to talk to? What if you can't think of anything interesting to say? What if everyone can tell you're anxious? You consider canceling your RSVP.

It's possible you struggle with social anxiety.

The DSM-5 defines social anxiety as:

"A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating."

Also, according to the DSM-5, in order to meet criteria for Social Anxiety Disorder, you must typically experience anxiety in these social/performance situations, recognize the fear is excessive, and either uncomfortably tolerate this distress when in these situations, or avoid them entirely. The fear and/or avoidance of such situations generally lasts six months or more and tends to interfere with overall functioning.

Perhaps you fear social/performance situations in general, or you might have specific situational triggers, such as public speaking, appearing in front of crowds, meeting new people, socializing at parties, interacting with higher-ups at work, asking for help or favors, etc. Underlying most of this is a fear of being judged or negatively evaluated and a concern that your anxiety will be obvious to others.

Social Anxiety Disorder Therapy:

Treatment of Social Anxiety Disorder typically involves cognitive-behavioral therapy (CBT), the goal being to challenge some of the thoughts that lead to the experience of anxiety (e.g., "I have to be interesting at all times" or "If they see I'm anxious, they'll think less of me") and engaging in exposure exercises.

Exposures exercises encourage us to engage in exactly what we fear. So, if you fear public speaking, you might sign up for Toastmasters, where you can practice just this. With exposure, we see acclimation and reduced anxiety over time. If you fear unstructured social situation, we might set up a series of graded, exposure exercises, perhaps starting with spending some time at a coffee shop, then saying hello to someone at the coffee shop, then striking up a conversation with a stranger, and then proceeding to more challenging exposures, such as attending parties and school dances.

You tackle your fears one step at a time.

Another effective counseling modality for Social Anxiety Disorder is group therapy.  Group therapy encourages social interactions (with strangers), and allows you to practice relating to others in a safe, therapeutic space.  Because of the exposure built into the treatment, you might see quicker, more sustainable gains with group. That's our experience. The more you interact with others, the easier it becomes.