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Getting over social anxiety


6 Ways to Overcome Social Anxiety – Cleveland Clinic

If you feel out of practice socializing after the last few years of social distancing, you’re not alone. If you feel more anxious than usual when leaving the house to socialize, that’s also totally normal, as is occasionally feeling overwhelmed or out of your element in large crowds.

However, when these nervous feelings persist — and cause you great anguish — you might have a social anxiety disorder.

“Social anxiety is one of those disorders where the name is pretty accurate in describing what it is,” says psychologist Dawn Potter, PsyD. “It’s anxiety that occurs in a social situation. If you have anxiety that routinely pops up in social situations that causes distress or inhibits you from doing things you want to do, then we might start to consider this a disorder. A person with social anxiety disorder would have frequent anxiety, panic or significant discomfort in a social situation. Then they would want to avoid that situation, or would enter that situation with a lot of distress. ”

Dr. Potter adds that there are different kinds of social anxiety. While one involves being uncomfortable with or avoiding social situations — either big or small groups of people you might not know well, whether in public or private — there’s also a specific type of social anxiety around public speaking.

“It’s performance-based only,” says Dr. Potter. “You would have anxiety about public speaking, but wouldn’t necessarily have anxiety about going to a party, ordering at a restaurant or speaking on the phone to an unknown person.”

Contrary to popular belief, being quiet in social situations, or preferring to socialize in small groups, doesn’t mean you have social anxiety — and this disorder isn’t synonymous with being an introvert. “Even if extroverts are generally outgoing and talkative, and like meeting new people, they can also feel nervous, anxious or on edge when meeting new people and performing in front of groups,” says Dr. Potter.

Dr. Potter stresses that it’s important to address your social anxiety, even if this feels difficult since it can have a major impact on your life. “It can have subtle negative effects on your career, friendships, dating life, or even family relationships,” she says. “It can affect you so broadly when you miss opportunities. When a person’s isolated, it can lead to depression because you miss opportunities to have a good time or enjoy yourself, and feel connected to other people.”

Luckily, Dr. Potter notes that social anxiety is very treatable, although strategies for overcoming social anxiety depend both on your individual personality and how much the disorder is affecting your life. For example, if you have panic attacks when going out in public because you are so overwhelmed, you might opt for medication, psychotherapy or a combination of both. Less severe anxiety might be better served by a different treatment option.

Here are a few other ways to approach getting over social anxiety.

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Practice public speaking

For those who have mild-to-moderate social anxiety disorder — for example, maybe it’s not causing you panic attacks — finding ways to practice public speaking is a good approach. Dr. Potter suggests joining a group such as Toastmasters, which is for specifically practicing public speaking and rehearsing.

Try cognitive behavioral therapy

Among the different kinds of psychotherapy available, cognitive behavioral therapy — which involves making changes to the way you think and feel about a situation, which, in turn, can help you modify your behavior — is a helpful way to approach social anxiety. “With social anxiety specifically, you want to identify patterns of thinking that cause you to avoid social situations — like if a person’s always expecting the worst outcome, or a person is fixated on the fact that someone might see them blushing, or sweating or stammering,” says Dr. Potter. “You want to help them learn to challenge those expectations and adopt more positive self-talk rather than negative self-talk.”

Gradually introduce yourself to anxiety-inducing situations

Dr. Potter recommends what she calls “situational exposure.” Identify certain social situations you’re afraid of, and work your way up from easier to more difficult scenarios while practicing relaxation techniques so you can tolerate anxiety. “For example, if you have a fear of large groups, and you’ve been mostly avoiding group activities, start by going out with a friend one on one,” she explains. “Then work your way up to going out with a small group of friends.” Repeat as needed until you feel more comfortable before attempting to go to a restaurant, a bar or a party where there would be more people. You can also work on situational exposure with the support of a therapist, Dr. Potter says. “Like cognitive behavioral therapy, exposure therapy is a type of treatment a trained psychologist can provide.”

Ask your support system for a helping hand

It can be embarrassing or humbling to admit to people in your life that you’re anxious in social situations and might need help. However, letting a friend or loved one know you might need some extra support can be a major boost. “Many times, people are going to feel more comfortable if they’re in a social situation with somebody that they’re close to,” Dr. Potter says. “Especially if somebody has been fairly isolated in recent times, it can be helpful at first to have a buddy when you go back into a social situation.”

The key to this support is helping an anxious person become more independent over time. “Eventually, people with more generalized social anxiety will find it uncomfortable to go shopping or order food by themselves,” Dr. Potter explains. “You want to balance supporting a person and encouraging them to do it themselves.”

If you’re a friend or family member of somebody anxious in social situations, one way to offer support is to bring them into the conversation. “You might be like, ‘Oh, I think Sara has something she would probably like to say on that subject. She’s really interested in that,’” Dr. Potter says. “You can support them by bringing them out of their shells.” Before doing that, however, be sure to ask the person if that’s OK. “If you’re a person with social anxiety, you may not like being put on the spot to say something. Talk to that person in advance about how they want to handle certain things.”

Check in with yourself

When you’re out in public and start feeling anxious, it’s easy to spiral and become fixated on everything that appears to be going wrong, even if you’re the only one feeling that way. “In the moment, you need to focus outside of yourself and remind yourself, ‘This is probably anxiety. I can’t read their mind. I do not know what they’re actually thinking of me,’” Dr. Potter says.

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This is easier said than done, of course, so she suggests using a technique called “five senses” that can help you regain perspective and stay in the moment. “Do a check-in with yourself of all of your five senses to get yourself more externally focused. Distract yourself from unpleasant internal sensations and negative thoughts,” says Dr. Potter. “Then you can try to refocus on: ‘What are they actually saying to me? What else is going on right now? What can I see? What can I hear? What can I feel?’”

Look for silver linings — and be kind to yourself

If your social anxiety isn’t going away as fast as you’d like, that’s perfectly normal. “It might be that you moved too fast and need to spend more time practicing other social encounters before you’re up for the one you’re stuck on, or you need to work more on relaxation techniques and distraction techniques so you can tolerate that situation next time,” says Dr. Potter.

Analyzing after the fact what triggered a reaction, whether a panic attack or something else, can also help. “Try to break down, ‘How can I think about that differently?’ or ‘How can I change the situation next time?’” Dr. Potter suggests. “Let’s say you go to a concert and start to have a panic attack because you’re enclosed in by a lot of people. Maybe next time, you might sit in the back or on an aisle, or stay somewhere where you feel like there’s an exit route if you feel anxious or closed-in.”

Dr. Potter adds that other people are generally way more focused on themselves than they are on others. “They are most likely not scrutinizing your behavior in social situations, because they are busy thinking about what they are going to say or do next,” she says. “Your anxiety usually magnifies the negative and minimizes the positive — so the things you’re acutely aware of about yourself may not be particularly noticeable to others.”

When to worry about physical symptoms of anxiety

Social anxiety disorders can also lead to physical symptoms. “You might experience blushing, sweating, or a subjective sensation of feeling suddenly cold or warm,” says Dr. Potter. “You might also have physical tension, which could cause aches and pains, like a stomachache.”

You can also experience symptoms associated with panic, even if you don’t have a full-blown panic attack. “Panic symptoms are your heart beating fast, shortness of breath, a subjective feeling of losing control or a fear of sudden, impending doom,” says Dr. Potter. “People with social anxiety will typically experience some of these symptoms, including at a lower threshold, too.”

Determining whether these symptoms are from anxiety, or a more serious medical condition can be difficult. “If the pain goes away quickly after the anxiety-provoking situation has stopped, and if you have a subjective sense of knowing that you are currently afraid of something, then it’s more likely what you are feeling is probably anxiety,” says Dr. Potter. “But if you’re in doubt, you should definitely talk to a doctor about it and get advice on specific signs to look out for and what your risk factors are.”

If you have a known heart condition, this advice is even more important. “You want to be much more careful about seeking medical care for any of these types of symptoms,” she says. “And if you have cardiac conditions and you have anxiety, you should talk to your doctor about how to differentiate the two.”

How to Get Over Social Anxiety: 9 Expert-Backed Tips

Living with social anxiety disorder can mean that even the most casual social interactions leave you trembling, dizzy, and afraid of criticism or rejection.

Severe social anxiety can affect your day-to-day life by making it difficult to engage in commonplace activities, such as:

  • talking with co-workers
  • buying groceries
  • eating in public
  • attending classes at school
  • going on dates

Managing social anxiety usually isn’t as simple as tossing yourself into a crowd, but it’s still an entirely achievable goal.

Looking for ways to feel more comfortable in social situations and interact with others more easily? These 9 strategies offer a place to begin.

Despite what some people might suggest, social anxiety goes beyond shyness, or feeling uneasy and nervous around new people. Social anxiety is a mental health condition, and it’s not always possible to work through symptoms yourself.

You can do a lot on your own to manage the anxiety and distress you experience, but getting professional support is always a good place to start.

A trained mental health professional can:

  • offer more insight on the difference between social anxiety and shyness
  • help you identify social anxiety triggers
  • teach helpful coping strategies, social skills, and relaxation techniques
  • offer guidance with challenging and replacing or reframing negative thoughts

Therapy also offers a safe environment to practice navigating anxiety-provoking situations through graduated exposure, one potential treatment for social anxiety.

Your therapist might recommend group therapy or support groups, which give you the chance to practice social skills and interact with other people also coping with social anxiety.

A therapist can also refer you to a psychiatrist, who can prescribe medication for social anxiety. Medication can provide some relief from severe symptoms, making it easier to start working through them in therapy.

Social anxiety doesn’t show up in the same way for everyone.

You might feel anxious about any situation where you worry about others judging you, from ordering food at a restaurant to leaving for the restroom during a class lecture. On the other hand, you could feel mostly fine simply being around others — as long as they don’t expect you to share your thoughts or speak up.

Pinpointing why and when you feel most anxious can help you take the first steps toward finding solutions to power through those feelings.

Tip: Start by listing situations that cause the most discomfort, the ones you feel utterly unable to face. These might include:

  • interviewing for a new job
  • meeting with a professor to ask for help
  • introducing yourself to someone you’re attracted to

Noting the symptoms you usually experience can also help you deal with them more effectively:

  • Feel lightheaded and dizzy? Try slowing your breathing
  • Worry everyone’s noticing your shaking hands or pounding heart? A grounding technique can help you refocus and stay in the present.

Chances are, you spend a lot of time thinking about the potential negative outcomes of those social situations you just listed.

You might worry about:

  • accidentally saying something rude or offensive
  • calling someone by the wrong name
  • tripping or spilling something on yourself
  • laughing, sneezing, or coughing at the wrong time
  • getting sick in front of other people

These things do happen on occasion, and they certainly can cause some short-term discomfort. It can feel frightening to imagine yourself in a similarly awkward situation, but try to keep things in perspective.

Even if you do make a small social blunder, that doesn’t mean other people will look down on you. In fact, they might remember a time when they found themselves in a similar position and offer empathy and compassion instead. Bonding over past awkward experiences could even help you make a new friend.

When you begin to feel overwhelmed by anxious thoughts, try challenging and replacing them with more helpful ones through a technique called realistic thinking. You can try this by asking yourself some basic questions about the scenario that’s worrying you and providing honest, balanced answers.

An exercise in realistic thinking

Say you’ve just started a new job, and your co-workers have invited you to their monthly happy hour. You’d like to get to know them better, but you feel terrified that you might say or do something that affects their opinion of you. Consider these questions and how you might answer them:

  • What makes me believe I’ll say something embarrassing? I did once before, and people laughed.
  • How many times have I spent time with other people and not said anything embarrassing? More than I can count.
  • What’s the worst that could happen? Why am I so afraid of this? I want them to like me, not think I’m weird or socially awkward.
  • Have you ever heard someone say something silly or awkward in public? How did you respond? I felt bad for them, but they laughed it off and no one seemed to care.
  • What if you responded in the same way? They’d probably think I’m a good sport.
  • What would you tell a friend worrying about the same thing? People will like you or they won’t. Making a mistake or joke that falls flat probably won’t affect their opinion overall.

Understanding the spotlight effect — the tendency to think others notice your mistakes more than they actually do — can also go a long way toward easing feelings of social anxiety.

You might believe everyone’s staring at you after an awkward faux pas, but most people probably didn’t even notice. Those who did? They’ll probably forget what happened pretty quickly.

When it comes to managing social anxiety, it’s just fine to start with little changes. You don’t have to volunteer to lead a meeting or strike up a conversation with everyone you meet.

A few ideas to try:

  • At the store, skip the self-checkout and challenge yourself to make small talk with the cashier instead.
  • Raise your hand in class to ask a question.
  • Compliment a classmate’s or co-worker’s outfit.
  • Host a small gathering for close friends and loved ones — socializing in your own space can help you feel more comfortable.

Some people also find it helpful to rename anxious feelings.

Instead of thinking “I feel so nervous about tonight,” try thinking “I’m so excited to see what people are like outside of work!” instead.

All those negative outcomes you worry about? Practicing ways to get through them ahead of time can help you feel more prepared to handle them if they come up during an interaction.

Ask a trusted friend or family member to role-play some everyday conversations with you.

A few scenarios:

  • You’re searching for an item at the drugstore and have to explain what you’re looking for to the clerk.
  • You pronounce the name of your friend’s date wrong and they correct you.
  • Your boss asks a question during a work meeting and you give the wrong answer.
  • You trip and fall in front of a large crowd of people.

Tip: To get more familiar with best- and worst-case outcomes, ask your conversation partner to offer different positive, negative, or neutral reactions.

Like general anxiety, social anxiety can involve overwhelming and uncomfortable physical symptoms, including:

  • sweating
  • a pounding heart
  • difficulty breathing
  • lightheadedness
  • an upset stomach

Relaxation exercises can help calm these physical reactions, making it easier to manage worry, fear, and the other emotional symptoms you experience.

Try these:

4-7-8 breathing:

  1. Inhale slowly through your nose for a count of 4 seconds.
  2. Hold the breath for 7 seconds.
  3. Exhale slowly for a count of 8 seconds.

Progressive muscle relaxation:

  1. Slowly tense each group of muscles in your body, beginning with your toes.
  2. Hold the tension for a count of 5 seconds.
  3. Slowly exhale as you release the tension. Focus on the new looseness in your muscles for a count of 10 seconds, breathing slowly.
  4. Move on to the next muscle group and repeat.

Regular physical activity can also help improve your mood by easing anxious feelings and promoting relaxation.

In a 2015 study of 115 college students living with social anxiety, performing small acts of kindness for 4 weeks helped reduce the desire to avoid social situations.

The link between kindness and social anxiety may not be immediately clear, but it makes sense, when you think about it.

Social anxiety generally involves some fear of rejection or disapproval. But if you’ve just done something kind and thoughtful, like bringing a sick co-worker their favorite soup or offering to pick up your neighbor’s grocery order, the person you help is far more likely to have positive feelings toward you than negative ones.

Earning this approval on a regular basis can help decrease your fears around social situations, so you might find that interacting with others gradually becomes easier.

A drink or two often seems like a great way to ease social anxiety and feel more comfortable in social settings. Certainly, a small amount of alcohol can help you feel more relaxed — but alcohol can also intensify feelings of anxiety and leave you feeling worse.

If you regularly use alcohol to manage social anxiety symptoms, you could eventually reach a point where you find it impossible to socialize without alcohol. You might also end up needing to drink more to see the same effects.

Consider trying out a mindful drinking approach, which involves cultivating awareness around when you drink, how much you drink, and how it makes you feel.

What about cannabis?

Some people swear by cannabis for social anxiety, and evidence from 2015 suggests CBD may offer some benefits.

Just keep in mind not everyone responds to cannabis in the same way. It may not have much of an effect, but it could also worsen your anxiety. Always start with small doses and pay close attention to unwanted side effects before trying more.

Learn more about using cannabis for anxiety.

OK, so you know avoiding social situations entirely won’t do much to improve social anxiety. But you’ll also want to steer clear of tactics that keep your participation superficial. For example:

  • At parties, you keep busy in the kitchen, washing dishes and preparing food.
  • When you find yourself in a conversation, you encourage the other person to talk about themselves.
  • In a group, you stick to the edge, looking down at your phone so no one talks to you.

You might feel safer among the crowd when you show up without really engaging, but this doesn’t do you any favors when it comes to overcoming social anxiety. People may not reject you, but they can’t really get to know you unless you truly make an effort to interact.

Letting go of these not-so-helpful coping tactics may feel tough at first, but most people find the eventual payoff — improved relationships — well worth it.

Get more tips on making friends when living with social anxiety.

Feeling self-conscious around others and fearing the possibility of their disapproval can make it difficult to forge connections with potential friends or romantic partners.

It’s perfectly fine to stay single or have only a few friends. But when social anxiety holds you back from new relationships, a few changes can make a big difference.

True, some people you meet may simply not like you, but that’s OK. It happens. The more interactions you have, the more likely you’ll encounter people who really do get you — and welcome you with open arms.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.

Butler J. Overcoming social anxiety and shyness

  • pdf format
  • size 10.39 MB
  • added June 25, 2016

Constable & Robinson Ltd, 2007. - 413 p.

Gillian Butler - Clinical Psychologist, National Service Health Care UK" and "Oxford Center for Cognitive Therapy". In 2002, members of the "British Association for Cognitive and Behavioral Therapy" she has been recognized as one of the most influential women cognitive psychotherapists in the UK. Within 10 years she was part of a research team at Oxford, developing cognitive-behavioral methods for the treatment of anxiety disorders, including social anxiety. nine0011

This course:
Indispensable for those who suffer from shyness and social phobia.
Has already become a classic guide and helped thousands of people after first edition in 1999.
Recognized by psychotherapists and recommended by the national UK health service.
Contains numerous exercises and worksheets.

“Overcoming Social Anxiety and Shyness” is a book for working on this common problem on your own, explaining why it appears and offering practical methods for solving it. Don't let shyness ruin your a life. Everyone at times feels embarrassed, judged, criticized, but it becomes a problem when it destroys your confidence and prevents you from doing what you want to do. AT In the most extreme cases, shyness can significantly limit you, but it is not difficult to overcome with the help of cognitive behavioral therapy. Using real examples, Professor Gillian Butler offers a practical, easy-to- application of a course for self-study, which can become invaluable to those suffering from all forms of social anxiety. In addition, it is an excellent tool for psychologists and psychotherapists. The book contains a complete step-by-step course for self-help, providing all the necessary skills to overcome social phobia and shyness. nine0015 The course has earned the respect of both professionals and patients for its practicality and friendly approach.

The book explains what social anxiety is, the role of this fear, its origin, and what actually happens when shows social anxiety. The following is a complete a practical guide to overcoming these feelings, changing thinking patterns, reduced self-concentration of attention and increased confidence. Some additional topics are also covered. such as explaining the consequences of bullying in a team, training relaxation. nine0011

Course content:

What is social anxiety?
Symptoms and effects of social anxiety
Various types of social anxiety and its degree prevalence
About shyness
Is all social anxiety in our heads? Central role thinking in social anxiety
Where does social anxiety come from? What causes it?
Explaining social anxiety: understanding what is happening, when a person experiences social anxiety nine0011

Starting Points
Reducing Over-Focused on Ourselves and How We look in the eyes of others
Changing patterns of thinking
Changing the way we act

Increasing confidence
Basic beliefs and assumptions
Bringing everything together
Becoming assertive
Consequences of bullying in a team
Relaxation

"The cause of social anxiety is the fear of rejection"

InterviewMan among menKnow thyself

How to find your love if you literally cannot open your mouth to say a few words and get to know someone or someone you like? How to get a good job if you are afraid to go to an interview? And if you come, then sit, blushing to the ears, and you can’t really answer a single question.

People who suffer from this problem are fun to watch in movies. But in real life, there is no reason for fun here. Social anxiety, turning into a clinical disorder, breaks people's lives. Is it possible to help them and at what point should the alarm be sounded? nine0011

Psychologies: If you try to find out the signs of social anxiety from the Internet, it seems that almost all of us have it.

Stefan Hofmann: It is. Social anxiety is built into us by evolution. We are social animals, we need to be part of a group. But one must distinguish between ordinary anxiety and social anxiety disorder as a clinical diagnosis. At the heart of social anxiety is the fear of being rejected, ridiculed. nine0011

For those who suffer from this disorder, fear takes precedence over all other emotions. They have difficulty - or not given at all - the simplest social interactions. As a result, they shut themselves off from society and doom themselves to constant, everyday suffering.

They lead a lonely life - not because they like it, but because they are unable to build relationships. They choose a job they don't like just because it doesn't involve socializing. They cannot start a family. In short, the problem seriously reduces the quality of their lives. nine0011

How to determine the line that separates "normal" anxiety from pathology? Let's say I need to make a speech. I am terribly worried, I blush when I get up to the podium, I stumble…

And this is absolutely normal! There would be more cause for concern if you did not experience any excitement at all in this situation.

Why?

Because if a person does not worry at all about how he is treated and how others see him, this indicates his problems. So, for example, psychopathy can manifest itself. Psychopaths do things without wanting or being able to understand how they will affect other people. nine0011

Let's say I can't get up to the podium at all? And instead I run away and hide under the table?

But this, I'm afraid, is already a disorder. Especially if, for example, your career depends on the speech you need to deliver. In fact, the line you're asking about is often quite obvious. For our patients and their environment.

If a person does not worry at all about how they are treated and how others see him, this indicates problems. nine0011

When anxiety starts to cause real problems rather than discomfort, action must be taken. In any case, specialists have in-depth interview techniques that allow us to determine whether we are dealing with social anxiety or social anxiety disorder.

And if it's a disorder, should it be treated? Are there any medications?

In principle, yes, in therapy, for example, selective serotonin reuptake inhibitors can be used - drugs of the antidepressant group, which are also prescribed for many other types of disorders. These drugs help to suppress anxiety, but they cannot eliminate the fear of rejection - the root cause of the disorder. But psychotherapy in this situation gives good and stable results. nine0011

That's good to hear. Because the number of mental disorders is increasing so rapidly that there is a suspicion that they are “invented” specifically to sell us all new pills.

Yes, some disorders do suggest that they were invented under the formulas of pharmacists. And some others disappear suddenly when companies take a drug off the market. But social anxiety disorder is not one of those “inventions.” It is a disease that brings suffering to many people. According to available data, 13% of the population experience social anxiety disorder during their lifetime - at least in Western countries. nine0011

Do exercises and meditation help to cope with anxiety?

Meditations are useful, but for other problems. And in the case of social anxiety disorder, I consider the exposure technique to be the most effective: immersing the patient in those situations that create the greatest difficulties for him. But I would advise you to contact specialists, because the exposure can be quite a painful experience that you need to prepare for.

Independent reading of books or articles is not always enough for this. Exposure is the experience of consciously entering situations that the patient is avoiding. The experience of being able to stay in them without fleeing. The experience of their constant repetition. nine0011

Can such an experience be traumatic in itself?

That is why I recommend contacting specialists. Our therapy is not those swimming lessons where a person is simply thrown into the river from a bridge. There is no risk of drowning, because at first we still teach the patient to enter the water, breathe in it, swim in shallow water. We usually form small groups of 4-6 people with similar problems.

In the case of social anxiety disorder, I think the most effective technique is exposure: immersion in situations that create the most difficulties

This group with two therapists is the most effective. It already creates a kind of social environment and thus provides the initial skills to overcome social anxiety.

We invite participants to give speeches to the group, very short and simple at first. For example, participants can talk about their work, hobbies, some hobbies.

This is not an easy task for many of our patients. But we teach them to focus their attention not on their own fear and anxiety, but on those to whom they turn, for example. nine0011

On the other hand, staying face to face with your anxiety without trying to escape or suppress it is also very important. And sometimes the task is to stand in front of the group and not say anything at all, but just stand there, feeling anxious and letting yourself know that nothing terrible is happening.

After that the real expositions follow?

No, no, don't get ahead of things. In the next step, we move on to more complex speeches. For example, participants must speak on a topic that they know little about. Or express your views, knowing for sure that the group will not share them. nine0011

The complication occurs gradually, the work goes on one two-hour session per week. And only around the seventh session do we move on to “field” expositions, when our participants perform some actions no longer within the group, but in the outside world.

What kind?

Those that can be regarded by themselves as wrong, violating their ideas about norms and decency. Things they would never do. For example, imperceptibly, but on purpose, drop a plate of food on the floor in a restaurant. And then ask the waiter to clean everything and bring a new dish. Or sing loudly in the subway at rush hour. Or walk into a store, select a few items, ask them to pack them, and then announce, “Sorry, I changed my mind and won’t buy anything.” nine0011

When anxiety starts to cause real problems rather than discomfort, action needs to be taken

It is important to understand that our participants are certainly not doing anything illegal or harming anyone. The maximum that threatens them is to be mistaken for people unpleasant and rude. Very well! There are a lot of really rude and unpleasant people in the world, and they live quite normally.

And it is important for our participants to go beyond the limits that they have set for themselves, and to understand that no catastrophe will occur in this case. They do not become criminals, do not fall through the ground, and the whole world does not immediately come running to pillory them. This awareness gives freedom - the understanding that you have the power to change your own rules of relationships with society. nine0011

How effective is this therapy?

Maximum efficiency. In addition, the effect is very long-lasting. Imagine: 12 sessions is enough for people to go years, and often decades, without experiencing serious problems with social anxiety. These 12 sessions are simply life changing.

Are all the inhabitants of the world equally affected by social anxiety? Is there a difference between representatives of, for example, Eastern and Western cultures?

Yes, but I myself would like to know what causes it. I did a lot of research on this issue, but did not find the answer. In Japan and China, for example, people report much less social anxiety. nine0011

In the West, social norms are more flexible and uncertain than in the East. We have to decide how to behave ourselves

And perhaps the fact is that social norms in these countries are very strict. They do not give much room for interpretation, and in almost any situation you know how you can behave and how not.

In the Western world, these norms are much more fluid and vague. We often have to guess, to decide for ourselves how to behave. That can not but provoke social anxiety. But on the other hand, perhaps the rigid framework of Eastern culture simply does not allow complaining about problems: in Japan and China, not only social anxiety disorders, but many other types of disorders are much less. nine0011

Social anxiety by definition depends on external factors. Does she have internal causes? Education, predisposition?

Of course there is. For example, it is very likely that a timid and shy child, as an adult, will have difficulty entering into social interactions. As early as two and a half months, certain types of reactions and behaviors of the child may indicate future problems.

First of all, it is high reactivity - for example, overreacting to loud sounds, new toys, new situations and new people. If in these cases the child cries loudly, tries to hide, seeks salvation from the parents, the likelihood of developing social anxiety disorder is markedly higher. nine0011

Can parents help children avoid this?

Yes, and the sooner they do it, the better. Parents should encourage their children to contact other people, the outside world. In this case, everything can be changed, no matter whether it is a simple habit, character trait or temperament. To be honest, I am generally sure that if you make the necessary efforts, you can change everything.

The exposure technique involves immersion under the guidance of a psychotherapist in those situations that the patient fears. nine0057

Here are some tasks that are given during therapy:

Stand in front of the entrance to the Park of Culture and ask ten people: "Do you know where the entrance to the Park of Culture is?"

Order a donut at a café, "accidentally" drop it on the floor, and say, "I accidentally dropped my donut... Can I have another one?" (The goal is to get another one without paying for it.)

Stand on a street corner and sing "God Save the King" loudly for 10 minutes.

(For male patients) Ask the pharmacist to sell you condoms. When she brings them, ask: "Is this the smallest size you have?" nine0011

Stefan Hofmann - clinical psychologist, professor at Boston University (USA), head of the Laboratory for Psychotherapy and Emotion Studies, president of the International CBT Association. Author and editor of books on cognitive behavioral therapy and anxiety disorders.

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