W ho are the people most likely to suffer from social anxiety? Parents recognize that some children are easily frightened from birth on and cry a great deal, while others seem more resilient by temperament (they seldom cry, hardly ever get upset, and are less easily frightened). Some children love to explore the world around them. Others are cautious and don’t tolerate change well. Children who are inhibited are more likely to have a parent with social anxiety disorder. An anxious person is more likely to have a parent or sibling who suffers from depression. Many people with social anxiety disorder report having one or both parents who have a substance abuse problem such as drinking or come from a family in which:

1. there is substantial conflict between the adults,
2. parents are overly critical of the children (where things are never good enough), and
3. there is excessive concern about what other people think.

National surveys find that about five percent of children and adolescents suffer from a social anxiety disorder. Children with an anxiety problem seldom report that they are feeling anxious. Instead, they report the presence of physical symptoms, which include headaches, stomach aches, nausea, rapid heartbeat, dry mouth, blushing, dizziness, and shortness of breath. They try to avoid the following situations – speaking in class, taking tests, reading aloud, writing on the board, inviting friends over to play, eating in front of others, going to parties, and playing sports. Children and adolescents with social anxiety disorder may go on to develop other related problems, such as loneliness, depression, and low self-esteem. Although some children will overcome their shyness in time, as interactions with others cause their fears to dissipate, others will experience a worsening of symptoms. If a child shows symptoms by the age of six that have not improved by the age of ten, it is probably time to seek a professional intervention.

  Defeating Social Anxiety  
There are three stages that people experience in overcoming problems with social anxiety –

1. Identify the patterns of anxiety
2. Change the thinking that accompanies anxiety-provoking situations
3. Change the anxious behavior

  Identifying the Patterns of Anxiety –  
People often see the distressful symptoms of social anxiety as their enemy, so they try to avoid thinking about it. In order to overcome social anxiety, however, it is necessary to “embrace” the anxiety. That is, sufferers need to identify the features of their anxiety and acknowledge these characteristics as their own. When people fully understand a problem, they are better able to cope with it. Shutting out the problem, on the other hand, keeps it in the dark where it is difficult to work with.

People often become aware of anxiety by identifying their physical reactions, which include a racing heartbeat, flushing, upset stomach, excessive perspiration, dizziness, poor concentration, and shaky hands. It is important to understand whether these physical reactions take place before (anticipatory anxiety), during, or after the anxiety-provoking situation.

Some people cope with anxiety by engaging in avoidance behavior. This happens when the person tries to stay away from situations that arouse anxiety. This is helpful in some circumstances, such as avoiding driving during rush hour. However, when the person starts to avoid business meetings, taking classes, and socializing with friends because of anxiety, the impact on one’s lifestyle can be constricting. A related symptom of anxiety is escape behavior, which involves leaving a situation that arouses anxiety. This can include running out of a class when the time to speak is near, leaving a party shortly after arriving, or exiting the airplane before it departs.

A helpful exercise, after examining one’s physical reactions and other behaviors associated with anxiety, is to set goals which would be achievable if the anxiety were not present. These goals should be specific. For example, 1.) Enroll in a music class next month, 2.) Make a date with Bonnie for lunch next Thursday, 3.) Make a presentation at the next business meeting. Establishing these goals increases one’s awareness of what life could be like if the anxiety were conquered – and it serves as a motivator for coming to terms with anxiety. If the goals are actually achieved, the stage is set for practicing some behaviors that directly address symptoms of anxiety.

The anxiety sufferer is acutely aware of physical symptoms, much more so than other people are. There are a number of tactics one can use to influence these symptoms –

  Accepting the symptoms –   when a person fights against the symptoms, anxiety actually increases. A better strategy is simply to accept the symptoms. Don’t fight them. Just let them happen. Then let them pass.

  Changing one’s focus –   Shift your attention to the external environment rather than focusing on the symptoms.

  Masking the symptoms –   This provides a temporary way of getting through an anxiety-provoking situation until the symptoms come under better control. For example, wear a sweater to hide underarm perspiration.

  Learning relaxation techniques –   A therapist can provide a number of ways to get one’s body to relax, including deep muscle relaxation and deep breathing. Practicing these techniques everyday, and not just prior to an anxiety situation, is a powerful way to regulate symptoms that now seem out of control.

  Changing the Thoughts Which Accompany Anxiety –  
Those who suffer from social anxiety engage in excessive self-focus. Their thoughts focus internally on themselves rather than on the external world around them – and this only serves to increase anxiety levels. Furthermore, excessive focus on the internal symptoms means that one loses important information about what is going on externally, and it may give others the impression that the anxiety sufferer is trying to be distant from them.

The following process provides a way to modify excessive self-focus and replace it with a healthier, other-directed approach –

When feeling anxious, remind yourself to focus on others.
Think about the other person, what this person is trying to say, how the other person feels, etc.
If your attention moves back to your anxiety, try not to feel that you are failing. Just let it pass and refocus on the other person.
Try to avoid planning your responses to the other person. Allow yourself to have some spontaneous reactions to others.
Try not to engage in mind-reading – that is, trying to figure out what other people are thinking about you. They are probably much more interested in themselves.

Socially anxious people also engage in negative thinking, especially about themselves. They emphasize their weaknesses and minimize their strengths. Virtually any negative thought can be changed into a positive. For example, “I am a failure because of my anxiety” can be changed into “I am facing a life challenge to show how strong I can be as I overcome my anxiety.”

The first step in overcoming negative thoughts is to be aware of them. It helps to have a trusted friend or therapist give you feedback about negative thinking patterns. Then ask yourself how realistic the negative thought might be. For example, “If my hands shake during my presentation, everybody is going to laugh at me.” Have you ever been in an audience where everybody laughed at a person whose hands were shaking? Not likely. In fact, people tend to support a person having a hard time – and they may be drawn to your vulnerable and very human nature. Now ask yourself, what evidence do you have for your negative thought? Can the situation be looked at in a different way?

  Change the Anxious Behavior –  
The single most important strategy for overcoming social anxiety is to face your fear. Get back on the horse again. Take the car out for a drive once more. Go swimming again. Get back on an airplane. Give another speech before an audience. Go to another dinner party. Ask somebody else to go out on a date. Managing your physical symptoms and changing your thinking do little good unless you come to terms with your fears by getting back into anxiety-provoking situations. Doing this takes courage. Avoiding it perpetuates the problem.

When you put yourself back into the anxious situation, realize that there are coping mechanisms that you may not have used before. You know that you can change your negative thinking and you can manage your physical symptoms. And facing the anxious situations can be done gently, one step at a time.

First, develop some practice assignments that directly challenge your fears. Make sure they are relevant to the anxiety. Make the assignments increasingly more difficult. And make sure that you can repeat them for practice. For example, if you fear public speaking, start out with making conversation with one person. Then move on to talking to a group of two or three people. Then talk to five people in an informal group. Move on to asking a question in a formal business meeting. Then talk at more length in the business meeting. And finally, after you have repeated all of these steps several times, find a way to speak in public to a large group.

As you practice going into anxiety-provoking situations, remember to relax your body. Deep breathing techniques are especially effective. Practice deep breathing until you can put your body into a relaxed state on purpose. Then go into the anxiety-provoking situations in a relaxed state. You’ll be ready to face your anxiety. It takes courage, each step of the way, but you can be successful.