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CBT therapy specialising in anxiety disorders

Social Anxiety Disorder

 

If you have social anxiety disorder (or social phobia), you fear situations in which other people can get a good look at you, such as eating at a restaurant, giving a presentation to a group, introducing yourself at a meeting, entering a party, even introducing two friends who haven't met before. Some people experience a generalised kind of social phobia and fear a variety of social interactions. Others have a more specialised fear, maybe focused on public speaking, eating in public, writing in front of others, nervous sweating, or using a public bathroom. People often think of shyness as being related to social phobia. They are similar, but shyness is more of a general inhibition in front of others, and doesn't always include the physical symptoms of panic that are part of social phobia. There are usually two surprising contradictory features of social anxiety.

 

Contradiction 1

The first contradiction is that most people with social anxiety disorder approach social situations with a feeling of unworthiness. They think that they don't belong in the social setting because they don't 'fit in' or because they lack some sort of quality - they're not smart enough, not interesting enough, not pretty or handsome enough, and so on. They also tend to believe that everyone there will be especially interested in them - in looking at them, thinking about them, and judging them. So here we have people who simultaneously believe that 'I am unworthy!' and also that 'everybody wants to find out about me!' If you experience social anxiety, you probably feel self conscious, and then these thoughts arise as additional symptoms of anxiety.

 

Contradiction 2

The second surprising feature has to do with the kinds of physical symptoms people experience as part of social anxiety, social phobia is very similar to panic disorder. In each case, people experience panic attacks, which consist of powerful physical symptoms of fear. But the panic attacks people experience with social anxiety disorder are different from the panic attacks which people experience as part of panic disorder, in one very important way. People with social phobia have lots more visible, or observable symptoms. They experience blushing, sweating, trembling, and voice cracking, which aren't usually part of panic disorder. Why do they have all these symptoms that others can observe? Because that's what they're afraid of. They hope so strongly to not show any anxiety that they end up showing it. People with panic disorder don't usually get such visible symptoms, because they're not worried about displaying their anxiety. They're worried about dying, fainting, and going crazy. And so those are the kind of feelings that they get. With anxiety disorders, you get what you oppose, and social anxiety disorder is no exception.

 

You do it to yourself

It's actually your reaction to shame and embarrassment that produce these unwanted symptoms. Shame and embarrassment are uncomfortable feelings which fuel the idea that you have something to hide, some aspects of yourself which are so negative that you figure you should prevent others from noticing. This leads to secrecy, a powerful force behind social phobia. The urge to keep your flaws secret leads you to oppose the symptoms. This is why someone concerned with blushing will find themselves thinking 'I hope I don't blush!', and apply some extra makeup in the hope of hiding it. This is why someone concerned with sweating will think 'Please, let me get through this party without sweating!', and pack some napkins in his pocket so he can dry his hands without observation. And on and on it goes, the same for symptoms of trembling, voice cracking, and so on.

 

The way out..

Just like panic disorder, the first step is learning how to cope with panic. The second step is not to get carried away by the negative thoughts of guilt and shame. Lastly, one needs to learn not to try so hard to hide their feelings and symptoms. Learn these and you will be well on your way to recovery. With social anxiety disorder, it's the very efforts people make to hide their 'shameful' secrets that produce the visible symptoms they had hoped to avoid. The path out of social anxiety disorder is so much easier when you come to see that secrecy is not your friend; that others will generally be as accepting of your flaws as you are of theirs; and that when you give up your efforts to hide and oppose your visible anxiety symptoms, that's when they become less frequent and disturbing.

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