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Social anxiety refers to extreme levels of shyness and anxiety that rise in social situations and environments to the point that it has debilitating impact on people’s lives as it stops them from doing things that they wish they could do. The anxiety can also be raised in anticipation of the social situation. Examples of situations that people often experience social anxiety in can be public speaking, eating in public place, crowded places, talking to a group of colleagues at an office meetings, talking to strangers etc. Being in these social situations is often accompanied by uncomfortable physical reactions, intense emotions, intrusive thoughts and certain behavioural patterns. The uncomfortable physical symptoms of anxiety often include sweating, trembling, feeling like the stomach turns, blushing, a rapid heartbeat, feeling light headed,muscle tension, the voice tends to change or shake etc. The worry that other people will notice these physical symptoms, stare and criticize the individual often leads to increase the focus of attention on these physical symptoms, which causes the intensification of the sensations, the discovery of more symptoms and diverts attention away from the actual interaction. Thus, for example, if a person concentrates more on the visibility of his blushed cheeks and sweaty hands than on the topic of the conversation, the conversation will not go well, which in turn will strengthen the person’s belief that his social skills are lacking. As a result the levels of anxiety, discomfort, embarrassment, vulnerability and self-consciousness will rise.

Socially anxious people often think that everyone looks at them and that they are constantly being negatively judged and scrutinized. They often believe that they are socially inadequate or out of place, boring, stupid, not good enough and that they have nothing interesting to contribute to the conversations. There is a prediction of poor performance in the subjectively perceived ‘nerve wracking’ social situations. Out of fear of doing something that will embarrass them, like saying something that is not funny or stupid, appearing awkward or making a mistake; they will try to stay quiet, disappear in the crowd, quickly leave the room, or just avoid going to the social event/environment in the first place. Over time the socially anxious will feel more alone, disconnected, less confident and the ability to function well at work and in private life will diminish.

Social anxiety is maintained by various dysfunctional behavioural patterns and irrational and unhelpful thoughts. By avoiding social situations, socially anxious individuals inhibit themselves from experiencing positive social interactions and refuting existing negative thoughts. The longer social situations are avoided, the idea of attending and participating in social activities becomes more daunting, is perceived as impossible and the anxiety becomes more intense and frequent.  Using safety behaviours, such as standing in the background of a party, not talking to people, helping in the kitchen or organizing things so you will not have time to interact, avoiding eye contact etc, may help in the short-term to manage anxiety and feel safer but safety behaviours have long term negative consequences. By depending on safety behaviour the socially anxious can not prove to themselves that they are able to cope well in social situations and thus the level of confidence and efficacy decreases.

The negative thoughts about the self and others that are present before and during a social situations damage the ability to function in the social situation as well as to overcome social anxiety. Socially anxious thoughts often originate from similar cognitive errors. The socially anxious usually label themselves negatively and these beliefs are held as true and reflective of the self. Putting a label of the self such as boring, stupid, unlovable, incompetent etc reduces self-confidence, self- worth, chances of successful coping with social anxiety and increases self-criticism and negative emotions in general. Before the social interactions they often worry excessively and are preoccupied with what if statement. What if I say something stupid, what if my hand will shake and I will drop the glass… These thoughts increase the anxiety felt and focus all energy and attention on possible negative distressing aspects that might not even occur. In fact, most catastrophic thoughts that we have about the future often don’t occur. The tendency to focus on the negative parts of the event reduces the ability to enjoy it and recognize the positive parts or successes that occurred. Socially anxious individuals also have the tendency to think that they can mind- read what the other person is thinking about them. There is an assumption that others think poorly of them or judge them without having any actually proof that others do it. They might think that others think that they are boring but unless the other person actually said it to their face, they really don’t have any real evidence to support it. It is just an assumption that causes more anxiousness, lowers self- esteem and increases the risk of developing depression.

What can you do about social anxiety? CBT has a few successful strategies. Calming and relaxation techniques will help reduce the intensity of the anxiety and the physical symptoms that are experienced. Finding, analyzing, challenging and reconstructing the negative thoughts that promote and maintain social anxiety is essential and crucial for dealing with social anxiety. Overcoming avoidance of social situation and confronting them by gradual exposure is also needed in order to complete an effective treatment. This also included stopping safety behaviors and in some cases the improvement of social skills and assertiveness. In extreme cases and even sometimes due personal preferences, some people rather go to a psychiatrist and get a prescription for medication to help reduce anxiety.

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