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Ethan Husbands, NCC
• June 14, 2024

Do you experience shyness or nervousness when meeting new people? Do you find yourself thinking about how others may perceive you or overpreparing for a presentation? That’s normal! So how can you tell if you are experiencing some pre-happy hour jitters or social anxiety?

Research tells us that we all possess a built-in threat detection system called a fight or flight response. When our brain identifies a situation as dangerous, that internal threat detection system gets activated. So a situation like a presentation at work or being on a first date, would naturally set off that threat detection system. Both of those situations open us up to being evaluated by people we want to impress and there are potential serious consequences! We are in danger of making a mistake that could cost us a job or future partner! Both situations pose a potential threat to our career or future happiness! With social anxiety, that threat detection system can rev up almost everywhere.

Social anxiety is defined as intense fear/anxiety of situations in which you may be scrutinized or potentially negatively evaluated. What may come to mind is the aforementioned examples like presenting a project at work or going on a date. With social anxiety, people often fear and/or believe they will be judged as anxious, weak, unintelligent, crazy, boring, or unlikable. What that looks like is in most/all situations where we could be negatively evaluated or harshly judged, the internal alarm system goes off and that fight or flight response is activated. The unfortunate truth is that there are few situations where we are free from any potential judgement or scrutiny. You may be starting to get a sense as to how pervasive social anxiety can be. The impacts are often far reaching.

When someone who experiences social anxiety is in a situation where they could be judged, it often comes with some physiological symptoms. Some are more noticeable like excessive sweating, especially in the palms, forehead, and underarms; or uncontrollable trembling or shaking, particularly in the hands or voice, as well as blushing. Some symptoms are harder or even impossible to tell from the outside. Symptoms such as stomach discomfort, nausea, or gastrointestinal issues can be a response to social stressors. Some other reported symptoms include dizziness, disassociation, racing thoughts, and an increased heart rate. Additionally, the impact of social anxiety is not just physical

Social anxiety also can affect our cognitions, or our thoughts and thinking. These cognitions are often around things like performance or how others may view them. When making small talk with acquaintances, folks may have thoughts like “I don’t have anything to add” or “they’ll think I am boring”. When making a request, someone with social anxiety may think they are being a burden or “I should be able to do this myself”. These thoughts are not only intrusive and intense but can have a serious impact on someone’s self-esteem and identity. Situations that trigger social anxiety can be so overwhelming it often feels easier to just avoid these situations all together. That’s where the behavioral component comes in.

Social anxiety can make so many situations distressing, so it is only natural to want to avoid them. This can look more overt and obvious, like skipping a party despite being invited, or not speaking up in a meeting despite having something to share. It can also show up more covertly. Individuals with social anxiety may do things or enter situations that bring on anxiety, but in a way that limits the most threatening aspects. For example, a person may still go the party, but make sure to drink to feel more comfortable or only sticking around people they know and feel comfortable with. All of these symptoms can have a profound impact on people’s lives and can even make things like keeping a job, or maintaining relationships feel impossible.

So, what can be done? Research shows Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are two highly effective therapeutic approaches for treating social anxiety. In CBT, individuals learn to identify and challenge maladaptive thought patterns and beliefs that contribute to their social anxiety. You can also learn to train your attention and shift your mind from how others may perceive you, to being more open and curious. Additionally, CBT incorporates behavioral interventions, such as social skills training and relaxation techniques, to address avoidance behaviors and build coping skills. These skills will help to assist in engaging in social situations differently and more frequently. After successful treatment, individuals find themselves enjoying and engaging more with what matters, getting lost in conversation, and can connect with those around them. Ultimately, they are able to live a more value and goal centered life.

Ethan Husbands, NCC

Staff Therapist

Ethan Husbands, NCC (he/him) specializes in working with Anxiety disorders, including OCD, social anxiety, panic and agoraphobia, phobias, depressive disorders and PTSD. He utilizes evidence-based approaches including Cognitive behavioral therapy (CBT), Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and Cognitive processing therapy (CPT).

References & Citations

Albano A. M, DiBartolo P. Therapist Guide. New York: Oxford University Press; 2007. CBT for Social Phobia in Adolescents. 

Heimburg R. G. Cognitive behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry. 2002;151(1):101–8. 

Hoffman S. G, Smit J. A. Cognitive behavior therapy for adult anxiety disorders; A Meta analysis of randomized placebo- controlled trails. Journal Clinical Psychiatry. 2008;69(4):621–32. 

Hope, Debra A., Richard G. Heimberg, and Cynthia L. Turk, Managing Social Anxiety, Workbook: A Cognitive-Behavioral Therapy Approach, 2 edn, Treatments That Work (New York, 2010; online edn, Oxford Academic, 1 Jan. 2015), https://doi.org/10.1093/med:psych/9780195336696.001.0001

Ponniah K, Hollon S. D. Empirically supported psychological interventions for social phobia in adults: a qualitative review of randomized controlled trials. Psychological Medicine. 2008;38(1):3.