The Complete Guide to Social Anxiety Treatment

A complete and updated guide to social anxiety treatment with the 3 key components to overcoming social anxiety and become more confident.
Medically Reviewed by
Dr Hamilton

Experiencing some amount of social anxiety is normal. However, when it's not just a matter of wanting to be accepted, and it’s so intense it prevents you from enjoying your social life, it’s a serious issue.

If social anxiety is left untreated or is treated incorrectly, it can be debilitating, and that stops you from carrying out your daily routine.

In this complete and updated guide, you'll learn everything you need to know about treating social anxiety through three key components to overcoming it and becoming more confident.

Social anxiety is a condition in which a person has an excessive fear of being closely watched, judged, and criticized in social situations1.

Social Anxiety Disorder often goes undetected for years before people seek treatment. Only 30% get adequate treatment, and it can take up to ten years to find professional help2.

Here are some reasons3 why people don't seek help:

- Not trust mental health care professionals, such as psychiatrists and psychologists.
- Worry about money.
- Feel that asking for treatment is a sign of weakness.
- Think you will get better if enough time passes.
- Worry that if people find out, it could cause them to think less.
- Lack of information. Don't know where to start.
- Think the symptoms are not severe enough.
- Believe that there is not cure for social anxiety.

One quick Google search for social anxiety treatment will give you a long list of results, and they are messy.

It's easy to see that the two most common types of social anxiety treatments are medications and psychotherapy. However, those are simplifications and don't help you understand how to overcome the issue.

The best social anxiety treatment is more integrative than that and includes an essential factor: you.

An integrative approach deals with the components of social anxiety as interconnected parts and takes the whole person into account through the process, rather than just treat one issue.

Below is a comprehensive guide to overcoming social anxiety, organized into three key components4.

Social anxiety treatment, key component #1: Change your thoughts

Individuals experiencing social anxiety have automatic thoughts and beliefs that contribute to their anxiety, like:

“People will think I’m ridiculous.”

“I won’t have anything to say.”

"I'll blush."

These thoughts are like traps. When you fall into them, you become anxious.

The first step is to recognize the automatic thoughts that are the foundation of your fear. For example, if you're worried about giving a presentation, the underlying thought might be: “I’m going to blow it. Everyone will notice that I'm nervous.”

It can be scary to think about why you feel and think the way you do about social situations, but understanding your thoughts is an essential component to getting over social anxiety.

The next step is to analyze the thought. It helps to ask yourself questions about the automatic thoughts: “Even if I’m nervous, will people necessarily notice it?” or “Do I know for sure that I’m going to blow the presentation?”.

This analysis of your automatic thoughts can help you identify some unhelpful thinking patterns or Thinking Traps, like:

1. Mind Reading

Mind Reading is jumping to conclusions about another person's thoughts, feelings, or intentions without checking them out. Specifically, believing that others are thinking bad things about yo

Examples:

People find me boring.

My boss will think I'm an idiot if he sees my hands shaking.

When people look at me, they are thinking I am strange or weird.

2. Catastrophic Thinking

Assuming that if a negative event were to occur, it would be terrible. Telling yourself that you won't be able to handle the situation, or viewing tough situations as if they will never end.

Examples:

It would be terrible if my anxiety showed during my presentation.

I would not be able to handle making a fool of myself.

It would be a disaster if I blushed while answering a question in class.

3. Negative Glasses

Paying more attention to the negatives and ignoring the positives in a situation. Dismissing positive qualities, achievements, or behaviors by telling yourself that they don’t count.

Examples:

Ignoring positive feedback from a teacher or boss.

Focusing on audience members who seem bored during your presentation and ignoring those in the crowd who appear to be enjoying what you have to say.

4. Fortune Telling

Making negative predictions about the future, such as how people will behave or how events will play out. Predicting that what a person believes is likely to come true, even though the likelihood is low.

Examples:

My presentation will be a disaster.

I will never be in an intimate relationship again.

I will have nothing to say if I phone my cousin.

I will lose my job if I make a mistake.

The final step is to replace the automatic thoughts with more realistic and helpful ways of looking at social situations and yourself.

Social anxiety treatment key component #2: Learn to relax

Several changes happen in your body when you become anxious. But, there are techniques to teach you how to relax and reduce physical responses to anxiety.

One of the first body response from anxiety is beginning to breathe faster than normal. Rapid, shallow breathing leads to physical symptoms of anxiety, such as a feeling of suffocation, increased heart rate, muscle tension, and dizziness.

Learning to slow your breathing down can help you bring your physical sensations of anxiety under control.

Here is a breathing exercise to help you keep your calm yourself down in situations that trigger your anxiety.

Keep calm and breathe!

Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach. Inhale slowly and deeply through your nose for four seconds. The hand on your stomach should rise while the hand on your chest should move very little. Hold the breath for two seconds.

Exhale slowly through your mouth for six seconds, pushing out as much air as you can. The hand on your stomach should move in as you exhale, but your other hand should move very little.

Continue to breathe in through your nose and out through your mouth. Focus on keeping a slow and steady pattern of breathing in for 4 seconds, holding for 2, and breathing out for 6.

Additionally, to deepen the breathing exercise, regular practice of relaxation techniques, like progressive muscle relaxation, meditation, and yoga will also help you get more self-control and feel more relaxed.

Social anxiety treatment key component #3: Face your fears

One of the most important things you can do to overcome social anxiety is to face the social situations you fear.

While avoiding uncomfortable situations may help you feel better in the short term, it prevents you from learning how to cope in the long term. In fact, the more you avoid a feared social situation, the more frightening it becomes.

So, the more you avoid feeling anxiety, the more power it has over you. Anxiety and confidence are inversely related, so for you to decrease anxiety, you have to gain confidence.

Avoidance may also prevent you from reaching your goals. For example, a fear of speaking up may prevent you from standing out in the classroom or sharing your ideas at work.

While it may seem difficult to face a feared social situation, you can do it by taking it one small step at a time.

In other words, it's important to face your fears gradually.

The key is to begin with a situation that you can handle and gradually work your way up to more challenging situations. It's like climbing a mountain. You'll build your confidence and social skills as you move up.

For example, if socializing makes you anxious, you might begin by accompanying a friend to a party. When you become comfortable with that step, you might try introducing yourself to someone new.

To reach the mountain peak, or be successful on overcoming social anxiety, it’s important to be patient and not to try to face your biggest fears right away. It’s never a good idea to move too fast, take on too much, or force things. This strategy will backfire and strengthen your anxiety.
Overcoming social anxiety on your own is a challenge. Luckily, there are resources and tools to help you overcome it successfully.

References

1. Social anxiety disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org (accessed June 02, 2016).

2. Delays in initial treatment contact after first onset of a mental disorder. Wang PS, et al. Health Serv Res. 2004.

3. Barriers to Psychological Care-Topic Overview - WebMD, http://www.webmd.com/mental-health/tc/barriers-to-psychological-care-topic-overv (accessed June 02, 2016).

4. A model of the development and maintenance of generalized social phobia. Kimbrel NA. Clin Psychol Rev.2008.

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