Guide
Social anxiety is the fear of being judged, of making a fool of yourself or of showing your anxiety in front of others. It affects many people and can limit studies, work and relationships.
What keeps it going
- Attention focused on yourself: we monitor whether we are blushing, our voice, our hands, and build a very negative image of ourselves, often much worse than what others see.
- Safety behaviours: preparing sentences, saying little, avoiding eye contact. They prevent you from checking that things go better than you fear and can even make you seem distant.
- Rumination before and after: we anticipate the worst and then replay the scene over and over.
A little theory · In Clark and Wells’ model, attention turns towards yourself: you see yourself “from the outside”, based on your sensations (“I’m red, so everyone can see it”). That image is usually much worse than what others see (Clark and Wells, 1995).
A little theory · In an experiment, people with social anxiety held a conversation using their safety behaviours and then without them. Without them, anxiety and belief in the catastrophe fell considerably more (Wells et al., 1995).
What helps
Shifting your attention to the conversation and to others, reducing safety behaviours and testing your predictions with small experiments. CBT for social anxiety is a very well-evaluated treatment.
A little theory · A network meta-analysis of more than 100 trials found that individual cognitive therapy was the most effective psychological treatment for social anxiety in adults (Mayo-Wilson et al., 2014).
Worksheets to practise
- 70 · Social anxiety: where does my attention go? · Self-focused attention and safety behaviours
- 10 · What I fear, what happened · Testing an anxious prediction (behavioural experiment)
- 08 · The map of my avoidances · Spotting avoidance and safety behaviours
- 09 · The ladder of small steps · Building a gradual exposure plan
- 74 · Saying what I need · Expressing yourself assertively, simply and respectfully
Sources
Clark, D. M. & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69-93). Guilford.
Clark, D. A. & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice. Guilford.
Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A. & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26(1), 153-161.
Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E. & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 1(5), 368-376.
These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).
