How can CBT help with Social Anxiety?

February 26, 2021

Giving a speech.

Going to a party.

Speaking to someone you’re attracted to.

Stating your opinion in a meeting.

Making or maintaining eye contact.

Keeping up a conversation with an acquaintance.

Introducing yourself to a group.

Going on a date.

Talking on the phone or zoom.

Playing a sport in front of other people.

Silences in conversation.

Making requests to a boss/manager.

These are a few examples of situations that can be daunting for a person suffering from “social anxiety.” Social anxiety is one of the most common mental health problems in adults. To some degree, most of us feel uncomfortable in one or more of the above-listed situations from time-to-time, such as when asking someone out for a date or being called out at work for a missed deadline. But for the roughly 12% of the population who suffer from high and often unrelenting levels of “social anxiety,” social situations and being the focus of attention are almost always uncomfortable or anxiety-provoking.

Driving social anxiety is the fear of being judged negatively and/or of embarrassment that you believe you won’t recover from. These fears get so loud that people with social anxiety avoid or skip out of social situations (cancel plans, don’t speak in class/at meetings, leave events early, turn off the camera on a Zoom call), or they endure them with great discomfort and distress (may get sweaty or nauseous or blush, have heart palpitations, drink alcohol to get through). Often after social situations, people with social anxiety will go over the event like a Monday morning quarterback, critiquing themselves and their every move, often quite harshly. High levels of social anxiety can make life tough and cause problems for people across all areas of their lives, disrupting everything from the ability to relax with friends to having your opinions heard at work to getting all sorts of your needs met.

Thankfully, there is an effective treatment for social anxiety—cognitive behavior therapy or CBT. CBT helps people look at and change how they speak to themselves and to recognize patterns that are self-defeating in their thoughts. CBT also works on changing behavior. Do you remember the first time you drove a car? Likely, it was scary. Unfamiliar. You probably didn’t go on the highway that first time. Maybe you drove around the corner with a parent in the car. You may have slowly built your way up to driving on that highway- maybe even over the course of a couple years. After driving for a few years how do you feel now in a car? Even if you’re a nervous driver, the car probably feels less intimidating than that first time you drove. The reason is “exposure.” The more you do something, the more familiar you get, and the more confident you get. It’s like jumping in cold water. It feels freezing at first but after a few minutes your body adjusts, especially as you move around and settle in. In CBT for social anxiety, participants may be asked to gradually (with tons of support and coaching!) approach situations that make them uncomfortable or that they avoid. Of course, no one would be asked to give a presentation to a room of unfamiliar people on day 1- just like you wouldn’t drive on the highway your first time behind the wheel. It’s guided, gradual, and completely driven by the participant. CBT does not change your personality or make you into someone that you aren’t ….not everyone will want or need to give a presentation in front of a large audience. The goal isn’t to become a social butterfly but rather, for social anxiety to no longer be stopping you from doing things that matter to you. Participants in CBT may learn to approach feared situations gradually and eventually to go out in the world and do the things that have meaning for them. CBT for social anxiety can also include skills training or role-playing to help boost people’s confidence.

Groups for social anxiety can be particularly powerful. You might be thinking “What!?! A group where I have to talk about my most vulnerable feelings? Didn’t I just tell you I’m uncomfortable talking in front of people!?” Although it may sound backwards to put people together who are afraid of gatherings and social situations, group therapy for social anxiety is actually highly effective. In a room (in-person or virtual room) of people who share the same worries and similar experiences, working on social fears can feel safer. There are also many more opportunities to practice socializing with other people who also understand what it’s like to suffer from social anxiety. That’s why in January 2021, Modern Minds will be offering its first group CBT treatment for social anxiety. If you or someone you know may be suffering from social anxiety, please reach out to Modern Minds to learn more!

Naomi Ennis, Ph.D

Categories: REFLECT