Facing Social Anxiety - And Winning

Increased heart rate. Profuse sweating. Difficulty breathing! Symptoms suitable for the emergency room. But what may not be apparent to many is that these are all physical manifestations of social anxiety, or the “. . . persistent fear of social situations where the individual fears that he will act in a way that will be embarrassing and humiliating”, as defined by one of ICC’s therapists who served a client exhibiting this condition.

Fred came to Intercommunity Counseling Center as a young adult with an extreme fear of interacting with people. The strong emotion led him to avoid what many consider the highlights of life, including meeting new people, interpersonal communication and any kind of attention. This behavior interfered with his job, social activities and relationships, leading to a profound sense of isolation.

Like numerous others who face social anxiety, Fred experienced the scary symptoms listed above, plus other physical indicators like dry mouth, tensing of muscles and the tendency to blush, in social situations. His ICC counselor notes “The recognition of these symptoms leads to a vicious cycle, where their presence exacerbates the individual’s embarrassment and thus worsens their anxiety and fear. Experiencing this intense reaction is uncomfortable and distressing; thus, in an attempt to prevent the discomfort, many individuals begin avoiding social interactions and isolate themselves.”

Considering that social anxiety is impelled by negative thoughts, our therapist chose to use the cognitive behavioral model, created by Aaron Beck back in the 1960s. “I work from a cognitive behavioral model, meaning I address both maladaptive thoughts and maladaptive behaviors that contribute to the persistence of anxiety symptoms.”

The cognitive component of this approach focuses on how the client perceives troubling situations. Together, therapist and individual specify problems, then identify thoughts and behaviors that accompany these challenges. “These thoughts may revolve around believing that everyone is paying attention to the individual, catastrophizing future events, or the belief that the individual knows what others are thinking of him. I helped Fred find evidence that supported and contradicted each of his fears and negative thoughts, something that is new to individuals as we usually tend to find only evidence that supports our beliefs.”

The behavioral component centers on changing responses to emotional triggers. Unfortunately for the client, the most effective progress is achieved through confronting fears. For Fred, “some sessions were extremely difficult for him to get through, causing him intense emotional reactions and fear responses. These sessions usually involved role-playing through various social situations, imaginative simulation of distressing events such as job interviews, and homework assignments that involved social tasks such as simply saying ‘hello’ to a stranger.”

Long-term coping strategies provided to Fred by our therapist included:

• Diaphragmatic breathing: slow breathing technique promoting relaxation
• Progessive muscle relaxation: diversion practice focusing on muscle groups and away from current threat
• Thought stopping: interruption method banishing negative beliefs 

In as few as twenty sessions, Fred’s life dramatically improved as he reconnected with old friends, started attending social events, made new friends and even landed a job. “Throughout the entire process, Fred was able to enthusiastically share how he was able to utilize several of the techniques he learned in session during all of these social situations . . . when faced with a crowd of people, Fred said he was able to refocus his attention on something other than his anxiety and search for evidence that contradicted his negative thoughts. Overall, Fred was more than happy with the different skills he learned in therapy that helped him manage and control his anxiety.”

The online Social Anxiety Fact Sheet declares the disorder to be the third largest mental health care problem in the world. At some point in their lives, thirteen percent of the population stand the chance to develop social anxiety. But cognitive behavioral therapy is reported to be widely successful. President of the Social Anxiety Association, Thomas A. Richards, Ph.D, notes “Twenty years of experience points to the fact that people who have lived with this condition and overcome it, make the best group leaders.”

Because cognitive behavioral therapy is shown to be effective for so many psychological ailments, Intercommunity Counseling Center promotes and supports its practice by its numerous, talented therapists.