Many people acknowledge some amount of discomfort when it comes to socializing. Often concerns about how we are perceived, what others think of us, or our ability to perform the way we believe we “should” in our interactions can feel daunting. This can be relatively normal, and despite these concerns most people are still able to push through towards having quality interactions and relationships. For others, however, this discomfort can seem impossible to overcome and be debilitating—eliciting a sense of fear that can cause disruption in their ability to function. It is within this deterioration of functioning that some people can reach diagnostic criteria for social anxiety disorder (SAD), also known as social phobia.
Social anxiety disorder can feel overwhelming: a phone call or work meeting can bring on intense over-thinking days in advance, running simulations in the mind over and over again about what to say and how to say it, just to get on the call and forget what was practiced or have the conversation go a direction that could not have been predicted. Social gatherings can bring on intense physical discomforts such as physical tension and an inability to relax, intrusive concerns about how they are perceived, what people “really” think about them, while imagining all the ways they could “mess up” or embarrass themselves. The simple act of walking towards a social interaction can bring on feelings of fear, panic, and a sense of heaviness that pushes us back towards isolation to get that sense of safety.
Interestingly, social anxiety can affect different people in different ways, as what triggers each individual is relative. For some, daily tasks such as going to the restroom, walking down a hallway, or eating in public can bring on intense distress, while others will note only feeling these difficult feelings in slightly more specific instances, such as work or school, or in their personal or dating life.
In some cases, those suffering from social anxiety will begin retreating from their social obligations, connections, and relationships. Sometimes engaging in a self-fulfilling prophecy of anxiety that starts with the thought that “people don’t really like me,” and then after repeated no-shows to gatherings, repeatedly not answering texts and phone calls, people do begin to give up. To the social anxiety suffer, this can feel like confirmation; “I knew they didn’t really like me.” Some will even rationalize to themselves that they “don’t need people,” as they seek some rational confirmation of their desire to avoid people for the sake of reducing their anxiety.
These types of rationales are disputed by most medical sciences: research has suggested an evolutionary need for connection that created real safety and teamwork that has allowed our species to survive for some 300,000 years, as well as studies that show increased health and longer life spans amongst those that engage socially. Other studies that have attempted to isolate variables related to happiness and contentment with life often highlight the need for social connection.
This is a subject dear to hearts of many therapist, for while it should be accepted that life will undoubtedly bring on discomfort, our relationships, interactions, and the ability to connect with our fellow humans can bring a balance to these discomforts by manifesting some of the greatest joys this life has to offer. Acceptance of this life means acknowledging and accepting that to be alive means that some suffering, some distress, will occur. It is a natural byproduct of being alive, not a bug to be fixed. But other people, with all of their varying personalities, quirks, habits, and insights are truly amazing and offer an endless array of possibilities, connections, and adventures! Some notable philosophers throughout history have even suggested that the way towards a meaningful and purposeful life is through our relationships and social connections.
Working with a therapist that utilizes cognitive behavioral therapy modalities, such as Acceptance and Commitment Therapy (ACT), mindfulness, Dialectical Behavior Therapy (DBT), as well as others, can be extremely helpful. These therapies can help the person suffering
from social anxiety identify their goals and values, see how their current behaviors are limiting their ability to move towards those goals and values, while also helping disrupt some of the cognitive distortions about socializing that are so common: “Your friends likely really do like
you, but your anxiety is causing you to think the worst and seek out small signs that them not liking you could be true.”
In the end, however, the absolute best approach for overcoming social anxiety is with exposure therapy. Cognitive work alone will not allow the social anxiety sufferer to overcome their fears and build connections. While cognitive challenging and restructuring may be utilized in the beginning and throughout the therapeutic journey, exposure must be part of the work. This is the only way to build up a tolerance to the distressing feelings while practicing social skills and moving towards your values and goals in real time.
But don’t worry! You do not have to do it all at once. When you work with a therapist who specializes in cognitive-behavioral therapy (CBT) and exposure therapy, they will help you build a hierarchy of exposure where you begin with social tasks that feel doable and move your way up the hierarchy progressively as you experience success. For some, they may start by purchasing something at a local gas station or convenience store, working to reduce their fear response in the presence of the cashier. For others, it could begin as a walk through their neighborhood, or down the hallway of their work or school, as they resist avoiding eye-contact and small talk with those they pass. Wherever you are in your journey with social anxiety, a therapist that specializes in these modalities can work to find a starting point that will allow you to begin the process of finding some of the greatest joys and connections this life has to offer.
