Do you find enjoyment in meeting new people? Do you love to spark up random conversation? Do you enjoy large crowds? Do you love eating in front of others? Do you find that, if given the chance, you would jump on providing a speech in front of your peers? How about people that you have never met? Some readers may be answering yes to every question and some readers may be answering a mixture of yes and no. There are a few of you though that might be thinking, absolutely not, to all of the above. For the absolutely not crowd, you may not be saying this for lack of interest; rather, you may be saying this for fear of what could happen during those situations, specifically because they each involve putting you under a microscope in front of others. Every move you make is going to be watched, analyzed and potentially judged. Everything you do could go wrong and lead to potential embarrassment. You wonder if you are going to make a fool of yourself and if so, how will you ever recover? This is when you start to sweat, your mind starts racing and the only way to put an end to the madness is to avoid the situation in its entirety. In the most extreme cases, this could be better classified as social anxiety disorder, otherwise known as social phobia.
In the U.S., there are an estimated 7.1% of adults that have had social anxiety within the previous year, and an estimated 12.1% of adults have had social anxiety disorder at some point in their lives (National Institute of Mental Health, 2017). Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, social anxiety disorder is manifested as a marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, especially during social interactions, when being observed or when performing in front of others (American Psychiatric Association, 2013). While there are quite a few diagnostic criteria that must be satisfied, the general idea is that those with social anxiety disorder have an intense fear of social interactions. This intense fear can be accompanied by a high level of anxiety, negative physiological changes and ultimately, avoidance of the potential situation. Even worse, the simple thought of the situation can cause the same reactions. If you have ever found yourself in such a position, you may be asking yourself, why?
One potential explanation for having social anxiety relates to a theory known as the self-presentation theory (SPT). SPT was a framework based upon the idea that individuals attempt to manage or control the impression that others form of them; these impressions are important because they can dictate whether we receive a reward or punishment (Leary & Kowalski, 1995). The roots of social anxiety grow from this theory, specifically when we have a high self-presentational motivation, but low self-efficacy (Schneider, Gruman, & Coutts, 2012). If we have high self-presentational motivation, we are extremely concerned about what other people think of us; however, if we have low self-efficacy, then we are lacking in confidence of portraying a specific image to those same people (Schneider, Gruman, & Coutts, 2012). When those first two criteria are met, social anxiety then blossoms as a result of a third condition, negative outcome expectancies, or anticipated aversive repercussions that are a result of displaying an undesirable impression (Schneider, Gruman, & Coutts, 2012). The more straightforward version of the above is that social anxiety is created because we want to provide a really good impression, believe that we lack the ability to do so and thus, expect a negative outcome due to pessimistic thoughts. According to Schlenker and Leary (1982), “Socially anxious individuals do not perceive themselves capable of controlling, in the fashion they desire, the impression-relevant reactions of others.” Given that we now have an understanding of one potential root of social anxiety, the next natural question becomes, is there a way to eliminate or reduce it?
Three different studies have demonstrated a significant reduction in social anxiety through three different methods. Clark et al. (2006) demonstrated that cognitive therapy and exposure therapy with applied relaxation were both effective treatments for social anxiety. Additionally, they demonstrated that while both are indeed effective treatments, cognitive therapy was superior, in that twice as many patients were classified as responders to treatment – those that no longer fit the diagnosis for having social anxiety disorder – versus those in exposure therapy with applied relaxation (Clark et al., 2006). Masia-Warner et al. (2005) implemented a school-based intervention program aimed at improving overall functioning of teenagers with social anxiety disorder. The intervention program they implemented focused on social skills training, exposure and realistic thinking. 67% of those participants in the intervention condition no longer met the diagnostic criteria for social anxiety disorder when assessed at the completion of the program. Schmidt, Richey, Buckner, & Timpano (2009) demonstrated that attention training, specifically focused on the disengagement of negative social cues, effectively reduced the number of participants that met diagnostic criteria by 72%, approximately 25 of 36 participants. The key in this study was to break the focus of attention on negative stimuli by replacing this with positive stimuli, thus breaking the cycle of social anxiety.
In all, if you find yourself struggling with severe social anxiety, the above results should demonstrate that there is hope. Hope for those that struggle through life due to severe social anxiety. Hope that we can effectively retrain ourselves to escape the constant cycle of social fear. Hope that we can implement interventions which can prevent or eliminate social anxiety during our early years. Hope that we can once again engage with others, without having excessive anxiety or negative physiological responses. To be freed from the chains of social anxiety allows us the ability to live life to the fullest; a dream for those of you, like me, that suffer from social anxiety.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Clark, D. M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M., Grey, N., . . .Wild, J. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(3), 568-578. doi: 10.1037/0022-006X.74.3.568
Leary, M. R., & Kowalski, R. M. (1995). Social anxiety: Emotions and social behavior. New York: Guilford Press.
Masia-Warner, C., Klein, R. G., Dent, H. C., Fisher, P. H., Alvir, J., Albano, A. M., & Guardino, M. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of Abnormal Child Psychology, 33(6), 707-722. doi: 10.1007/s10802-005-7649-z
National Institute of Mental Health. (2017). Social Anxiety Disorder. Retrieved from https://www.nimh.nih.gov/health/statistics/social-anxiety-disorder.shtml
Schlenker, B. R., & Leary, M. R. (1982). Social anxiety and self-presentation: A conceptualization and model. Psychological Bulletin, 92(3), 641-669. doi: 10.1037/0033-2909.92.3.641
Schmidt, N. B., Richey, J. A., Buckner, J. D., & Timpano, K. R. (2009). Attention training for generalized social anxiety disorder. Journal of Abnormal Psychology, 118(1), 5-14. doi: 10.1037/a0013643
Schneider, F. W., Gruman, J. A., & Coutts, L. M. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (2nd ed.) Thousand Oaks, CA: SAGE Publications, Inc.