Many of us have experienced the awful dread that accompanies those occasions when we are exposed to the scrutiny of others. Whether it is delivering a speech or presentation, trying out for a part in a play, or showing our artwork to peers, the fear of being criticized, or worse, publicly humiliated, can be overwhelming.
Very few people enjoy being in the spotlight and no one likes being judged, but these types of social situations are part of life. When social anxiety becomes so potent that it causes us to retreat to the safety of our bedroom rather than expose ourselves to potential criticism, it has become life impairing. Social anxiety has the power to derail our careers and sabotage our relationships, so knowing how to get help for severe social anxiety is essential.
About Social Anxiety Disorder
Social anxiety, also referred to as social phobia, involves the irrational fear of being judged negatively by others or a fear of social humiliation. It is not just a matter of being shy in a social setting, but rather intense feelings of anxiety that are so strong it can result in the same symptoms as a panic attack. According to the Anxiety and Depression Association of America, about 15 million adults in the U.S. suffer from social anxiety disorder.
We can all vividly recall an incident from our past when we were absolutely mortified with embarrassment. We can remember every little detail of the profoundly embarrassing act—something we said or did that you would pay any amount of money to erase from your life story.
The reality is that as awful as that etched-in-stone memory is in our own minds, those who were present have long forgotten it. Sadly, a few public zingers like that can permanently change a person’s ability to function in social situations forevermore because we remember how we felt. Multiple humiliating public moments can lead to profound social anxiety for someone who is already prone to shyness and social avoidance.
In fact, people actually remember socially painful moments with much greater clarity than they do physical pain, according to a study published by the Association for Psychological Science. Study participants reported experiencing higher levels of pain after recalling a past socially painful event than recalling a past physically painful event. The weight of the social humiliation is so intense that we tend to replay the tape over and over in our heads, etching it into our memory as an incident never to be experienced again.
Social anxiety has the effect of limiting one’s potential in achieving personal goals. Due to the intense fear associated with public appearances, social anxiety causes the individual to avoid situations that are performance or competition-related, or may limit exposure to social settings that would benefit them professionally, such as networking, attending conferences, or even the annual office holiday party.
Symptoms of Social Anxiety
Once someone is struggling with social anxiety in their day-to-day life, they tend to make certain adaptations, usually avoidance behaviors, in order to avoid public embarrassment again. One of these compensations involves avoiding asking questions or seeking clarity about an upcoming social event. Nothing is more important than blending in to someone with social anxiety, so asking for further clarification about the upcoming social event, such as inquiring about the rules, details, or expectations regarding the particular event, is avoided.
People who suffer from social anxiety disorder may experience a great deal of emotional distress throughout their days, versus the typical response of the occasional jitters or clammy palms when in a stressful social situation. The symptoms of social anxiety disorder may include:
- Intense worry well in advance of an upcoming social event
- Irrational fear of being humiliated in public
- Excessive fear of being judged by others
- Shortness of breath
- Blushing easily
- Stomach upset and nausea
- Racing heart
- Feeling faint
Overcoming Social Anxiety
The following actionable steps can help an individual manage social anxiety when it emerges. These actions do not supplant getting professional help for severe social anxiety, but offer coping skills to practice while in treatment.
- Anticipate feeling anxious in a social setting and make a plan in advance to respond to it. This might involve some practicing in the mirror, but can help you be proactive in an uncomfortable social setting. Practice aloud introducing yourself to someone. Practice making eye contact, smiling, extending your hand, or offering a compliment. Anticipate these interactions and prepare in advance.
- Check your body language while at the social gathering. Make a mental note of off-putting postures and check that you are not assuming these. For example, are you standing off in a remote corner of the event? Are your arms crossed in front of you? Are your eyes cast downward? Correct these and look more approachable and engaged.
- Small talk. Most people with social anxiety avoid small talk at all costs. But when at a work event, small talk is going to happen. Why enlist the help of a colleague who can buddy up with you, making the small talk interactions less intense. Having that additional voice in the mix helps deflect all the attention from being directed at you alone. Again, practice in advance with a few easy conversation openers and topics to use and practice looking engaged.
- Practice using guided imagery prior to an event. Picture yourself successfully navigating the event in your mind’s eye. See yourself successfully moving from one person to another, smiling and extending a hand. Imagine yourself being genuinely interested in meeting new people and learning new things at the event. If required to deliver a presentation, practice, practice, practice in advance to help fend off the nerves.
- Don’t look for outs. You are likely quite adept at making excuses to get out of social events. You may believe you truly cannot squeeze the event in to your schedule. In reality, however, this may be a reflexive default you employ to avoid any social situation that might cause anxiety. Stop and ask yourself if you really are all that busy or if you are practicing avoidance.
- Think about the source of the anxiety. For many people, intense shyness and avoidance of social gatherings is a product of childhood experiences. People who had overly critical parents who withheld praise, even when perfectly warranted, can grow up to be socially insecure. Recognizing this connection can be freeing for people with social anxiety, helping them take control of their own lives in a positive way.
How to Get Help for Severe Social Anxiety
When the above actions simply do not cut it, and you find yourself becoming more isolated as the result of the disorder, it is important to know how to get help for severe social anxiety. Outpatient services through a private practice psychiatrist can offer psychotherapy, group support, and medication for mild to moderate social anxiety, but for severe social anxiety, a more intensive approach through a residential program is appropriate.
A residential wellness program can assist someone suffering from excessive social anxiety through the following treatment elements:
- Cognitive Behavioral Therapy (CBT). A highly effective therapeutic method for treating social anxiety disorder is CBT. A licensed therapist will help you identify how fear of rejection or of being evaluated in specific situations leads to an automatic coping response of avoidance. The irrational thoughts about being harshly judged lead to the safety behaviors. The CBT therapist will guide you toward confronting the coping behaviors and eventually replacing them with assertive behaviors to be accessed in each anxiety-provoking situation. The client practices these new responses and eventually they become habit.
- Prolonged Exposure Therapy (PE). When the individual being treated for severe social anxiety has a history of trauma that is contributing to the mental health disorder, it is necessary to address the trauma as part of the overall treatment plan. PE offers the individual an opportunity to become desensitized to the traumatic memory through consistent and prolonged exposure to discussing the disturbing experience in therapy.
- Eye Movement Desensitization Reprocessing (EMDR). EMDR is also helpful when trauma might be a contributing factor to the social anxiety. EMDR involves an 8 step plan toward desensitizing the individual to the traumatic experience. The doctor uses his or her finger or other object and has the individual follow the back and forth motion while discussing the traumatic memory.
- Psychodrama Role Playing. One group therapy technique involves role-playing through psychodrama, where stressful social situations can be constructed and played out in a safe, supportive space. By dramatizing various social experiences that provoke anxiety, individuals can acquire new confidence, as well as learn tools for managing stress in a social setting by acting them out.
Treating social anxiety disorder is absolutely possible, but requires a skilled therapist who employs CBT as the basis of treatment. The techniques taught by the CBT therapist will need to be practiced consistently until they eventually become habit. Combined with medication, and relaxation techniques, such as deep breathing exercises and mindfulness, severe social anxiety can be treated and overcome.
Medical Concierge Provides Help for Individuals Struggling with Social Anxiety
Medical Concierge offers compassionate care for individuals suffering the effects of severe social anxiety. Allow our mental health experts to guide you back to wellness and functioning through an integrated program featuring both evidence-based therapies and complementary activities. Medical Concierge provides both outpatient and residential programming in South Orange County, California. For more information about our program please contact us today at (844) 290-8535.