Length: approx 2000 words. Printing or emailing this to yourself recommended.

Overcoming Social Anxiety with CBT

Studies about social anxiety have shown that people who are socially anxious tend to have patterns of thinking biases that contribute to why they feel anxious. Part of overcoming social anxiety is learning to understand these and what to do about them.

The first part of this article is about thinking and behaviour patterns that are common in people with social anxiety. The second part is about what to do, once you understand your own patterns, to feel more comfortable in social settings.

Common Cognitive Biases Addressed in Social Anxiety CBT (Not everyone with social anxiety has all of these, but everyone who is socially anxious is likely to have some of them).

1. Interpreting ambiguous events in negative way (For example, “if someone yawns when I’m speaking it must be because I’m boring rather than because the listener is tired”).

2. Interpreting mildly negative events in a catastrophic way. (For example, “If my friend said she was annoyed by something I did, it must mean she’s not going to want to be friends anymore.” Or, “If someone says something insulting, it must be because I suck rather than that the insulter has a tendency to be patronizing”).

3. On some level, assuming other people are going to judge you negatively. Two variations on this are:

a) Assuming nothing you do will make people like you
b) Assuming that people will only like you if you’re perfect or act a certain way.

4. Looking out for signs of being negatively evaluated, and paying too much attention to these. For example, on a date, looking for cues the person you’re out with isn’t connecting with you rather than cues they are.

5. Focusing so much attention on yourself (how you’re being perceived by others and/or your performance), that you don’t have enough mental processing capacity to pay adequate attention to cues others are giving about their needs.

In social interactions, people regularly adjust their own behaviour based on cues from the people they’re interacting with, which makes the interaction more successful and more enjoyable for both conversation partners. For example, people give cues about which conversation topics they’re more vs. less interested in, or that they’re sick of one topic of conversation and are ready to move on to another.

During conversations, anxious people often use so much of their mental processing capacity thinking about their own feelings/thoughts/behaviour, they don’t have enough processing capacity left to attend to the normal signals their conversation partners are offering them.

6. Reasoning based on

a) feeling anxious, or
b) experiencing the physical sensations of anxiety.

For example, “If I feel anxious, there must be something to be anxious about”.

7. “If I feel nervous, other people must see me as a nervous person and judge me negatively.” Again, reasoning based on internal cues.

8. Doing a biased postmortem of social events. Thinking back over social interactions and over focusing on the negative or perceiving negatives where none existed. This leads to feeling more nervous about similar social interactions in the future.

Other issues addressed in Social Anxiety CBT.

1. Avoidance.

Avoiding of situations that trigger anxiety. People’s natural response to anxiety tends to be avoid being in situations that trigger their anxiety. The trap is that avoidance increases anxiety. When people avoid particular situations because those situations are anxiety provoking it tends to strengthen their beliefs that they wouldn’t have been able to handle the situation or wouldn’t have been liked by the other people present. This beliefs are often erroneous.

Avoidance of thoughts that trigger anxiety: People sometimes also avoid thinking constructively about how they could make good social impressions because even thinking about social interactions is anxiety provoking. This type of avoidance (avoidance of thoughts that trigger anxiety) also tends to increase anxiety.

2. “Safety behaviours”

“Safety behaviours” in this context are things social anxious people do with goal of reducing their anxiety which

a) actually impair their performance or the impressions they make on others, or
b) stop the person from realizing that they could’ve handled the situation without needing the safety behaviour.

For example, drinking alcohol or taking anti-anxiety medication like Valium or Xanax to cope with attending a party. These drugs have side effects of interfering with cognitive processing (thinking) and they’re dis-inhibiting, so they may make the person behave in a less likable way than if they’d used other strategies to manage their anxiety.

Self-sabotage (in the form of things like not preparing or not working hard at being friendly) can be a type of safety behaviour because it reduces your psychological investment in the event/interaction.

3. People who are socially anxious as teens or adults often report having been shy or “a bit nervous about socializing” for their whole lives. One of the most important ways people learn social skills is through practicing social skills with same age peers during the growing up process. Kids who are shy tend to get less exposure to doing this, so sometimes shy or socially awkward kids/teens miss out on finetuning their social skills and end up with social skills that are less well developed than other adults. Its never too late to finetune your social skills if you’d like to gain confidence in this area. It’s also nothing to be ashamed of. If social skills aren’t a strength for you, I’m sure you have other strengths.

4. Sensory Sensitivities

Some people dislike certain social interactions because of sensitivities to things like noise (e.g., groups of people talking, background noise in a cafe) or the sensory overload of parties.

If you’re one of these people, it might help to know that this difference between you and what might seem like the rest of the world is actually a reasonably common difference in people’s neurological wiring. Sensations (like music playing in the background in a cafe) that are pleasant to say 80% of people, might be things you find extremely unpleasant.

What you can do. (These strategies are best used with a psychology PhD to help you. You may like to try them on your own, but if you find it too hard then please consider working together with a psychology PhD)

The best approach to take for applying this advice is to self experiment. Instead of pre-judging (i.e. guessing) what you think will work for, self experiment with trying out the advice, and do a reality-based assessment of how well it worked.

Another thing to keep in mind is that nothing you do is likely to reduce your anxiety to zero. The goal is to reduce your anxiety enough that your can show off your best self. Over time, this will have a cumulative effect of reducing your anxiety tendencies.

CBT Social Anxiety Practical Tips

1. Print this article. Go through the list above and next to each point write as many examples you can think of of ways you do the thing mention. Skip those that don’t apply to you, but your own examples might be more subtle than the ones given so you’ll need to take an open-minded approach.

2. Whenever you notice yourself thinking about a social interaction (either doing a postmortem or anticipating a situation that’s coming up), try to identify the thoughts going through your mind. Try to classify the thoughts you’re having according to which type of cognitive bias or avoidance pattern they represent.

3. Cultivate the following habit.

When you think someone doesn’t like you or has judged you negatively, rather than judging yourself as unlikeable or not good enough, think about alternative possibilities.

First, think about whether you have enough evidence to conclude that whoever you think has judged you negatively really has. If you’re convinced they did, consider the following:

a) If they judged you, does it say more about them than about you? Were they having a bad day that predisposed them to being critical? Are they an open-minded, accepting, thoughtful person who sees the best in people and is interested in new ideas and other people’s perspectives, or not?

d) Did something get in the way of you showing your best self? How might you have handled the situation if you could do it over?

4. When you’re feeling nervous about a future social interaction/event, instead of worrying do something useful. In as much vivid detail as you can muster, visualize how you want the event/interaction to go. Imagine how your best self would act in the situation. The real event might not go exactly as you imagined, but if you’ve done detailed visualization of how you want it to go then you’ll be better prepared to get the situation back on track, and you’ll have more confidence that it’s not that you don’t know how to act to have the situation be successful, it’s just a matter of putting that knowledge into practice.

5. Reduce self focused attention by focusing on goals for interactions/events that are incompatible with self focused attention. For example, goals like finding out something that is a source of self pride for your interaction partners, or giving a compliment to each person you talk to.

6. Role Play. Easily one of the BEST ways of reducing anxiety. You’ll obviously need to rope in a friend or your partner to help you. When you role play, you’ll experience anxiety you would’ve felt during the real situation in the role play instead. You’ll experience less anxiety during the real thing. You’ll also perform better because you’ve done a high-realism practice. You might even end up giggling through the role play which will help you relax for the real situation.

7. Self experiment with reducing avoidance. All of the techniques mentioned so far should be combined with practicing in real situations (e.g., after you’ve practiced visualizing, you should try out what you practiced). It’s usually much easier to self experiment with reducing avoidance if you tell yourself that self experimenting doesn’t commit you to long term self change. Figure out for yourself which situations have enough rewards to make it worthwhile for you to endure some anxiety to access the rewards. The more you self experiment with reducing avoidance, the less anxiety you’ll experience.

8. Don’t criticize yourself for having social anxiety. The thinking and behaviour patterns seen in socially anxious people (like self focused attention) are useful qualities in small amounts. For example, in small amounts, it’s good for people to be concerned about how other people view them because it helps motivate us all to behave in prosocial ways. The way human evolution works is that the adaptive traits people have are distributed on a curve so that most people have some of the trait (the useful amount), but a few people have a lot of the trait (too much).

9. There are tons of amazing, creative strategies people can learn for overcoming anxiety by having some sessions with a psychology PhD. If you’ve had social anxiety for a long time, your social anxiety bothers you, or it interferes with aspects of your life, then having some psychology PhD appointments is probably going to be a wise investment of your time and money. You’ll get someone that can identify thinking and behaviour patterns associated with your social anxiety that you’re not be able to see yourself (we all have blindspots in understanding our own thinking and behaviour). You’ll also get someone who can help you come up with strategies for overcoming your anxiety that are helpful but don’t feel overwhelming.

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admin (at) aliceboyes (dot) com.