How do you get better from social anxiety?

This page is intended to provide an overview of some of the ways how to in which you can make progress in decreasing your level of social anxiety.

If you are looking for therapist supported help please consider What the NHS Offers or Finding a private therapist.

The CBT approach

Cognitive Behavioural Therapy (see What is CBT) has the largest evidence base for treating social anxiety. It is an umbrella term for the type of therapy that is recommended for treatment of social anxiety amongst other mental health difficulties. CBT is based on the idea that your thoughts, feelings, physical sensations, and behaviour are all interconnected, and our thoughts and perceptions about situations strongly influence our emotional responses and actions. See the social anxiety maintenance cycle.

NHS CBT is delivered by the NHS Talking Therapy service and accessed via your GP or self-referral.

Self-Help and other psychological approaches

Please see our pages on Self-help, Courses and practical help, and psychological therapies for social anxiety.

Key steps to progress

• Learn about social anxiety
  Use this website and other resources to learn about social anxiety – see NHS webpages and guidance, self-help books, courses and practical help and other internet SA websites. Information and understanding can be the first step towards  improvement and it helps to know that many others face similar challenges and feelings. You are not alone, and there are ways to make progress.
• Consider therapist led support
  There are several routes to accessing therapy, as well as various types of therapy that may suit different people – see NHS treatment options, Finding a private therapist and the glossary of psychological therapies
• Medication
  Medication from your GP may be an option – it is sometimes used in combination with NHS talking therapies. We know talking to your doctor can be challenging when you have social anxiety – please see our page on medication and talking with your GP
• Take a structured but self-compassionate approach
  This involves understanding, patience, and determination in developing new skills and new ways of behaving
• Assess your own difficulties
  Get to know your social anxiety. People can be affected in different ways: some fear judgement or rejection, others dread their own physical symptoms or self-critical thoughts. Not everyone is consciously aware of exactly when and why they feel socially anxious, so a key skill will be to understand your own triggers. Try using the Social Anxiety Symptoms Overview to record what was going on in given situations. What were you feeling? What were you focusing on? How did this affect your thoughts and behaviour?
• Focus outward not inward
  For those who struggle with social anxiety, anxious thoughts and feelings are often exacerbated by “self-focus” where attention is directed inward on oneself rather than outward on the conversation or situation at hand. See our pages on mindfulness and focus of attention
• Learn to accept your anxiety
  Learning to accept your anxiety – by focusing on the practicalities of the situation rather than struggling against anxiety symptoms – can actually help you to feel better. Anxious thoughts, feelings and symptoms can begin to dissipate as you pay less attention to them. Choosing to accept the anxiety, just like you would with emotions you are more comfortable with (e.g. excitement), can help make these feelings less distressing and gradually reduce their power naturally in the background. See our page on fight or flight.
• Challenge negative thoughts and beliefs
  Learn to become more aware of how your thoughts and beliefs may affect your feelings before, during and after a given situation. It can be empowering to realise that you have some control over how you respond to your thinking. Some beliefs held by socially anxious people can be very self-limiting, such as ‘no-one ever listens to what I say’ or ‘I am unimportant’. See our page challenging negative thoughts and beliefs.
• Reduce avoidance and “safety behaviours”
  People with social anxiety often avoid some situations or use ‘safety behaviours’ to try and minimise the anxiety or danger they perceive. Safety behaviours might include avoiding eye contact, being quiet (or talking too much), rehearsing words before you speak, or staying with a ‘safe person.’  (see a fuller list here). Avoidance and safety behaviours may temporarily reduce anxiety but over time they reinforce the idea that social situations are dangerous and prevent you from engaging fully in them. In order to make progress you will need to face the situations that make you anxious, with new skills and ways of behaving, including dropping safety behaviours that may be holding you back. Please see our page on avoidance and safety behaviours.
• Work through behavioural exposures and hierarchies
  Behavioural challenges (or behavioural experiments) are activities used to test and challenge negative beliefs or assumptions. This is done gradually so it is not overwhelming, using a hierarchy of situations, from the least to the most anxiety-provoking. Worksheets are useful to make predictions about how you think you will feel/think/behave when doing the behavioural challenge. You then assess how correct (or not) the predictions were (you may be pleasantly surprised!). Please see our page on behavioural exposures and hierarchies.
• Practice – but with new strategies
  To make progress, you will likely need to incorporate new strategies. Repetition can be helpful but won’t lead to progress without new ways of thinking and behaving – see our pages on Avoidance and Safety Behaviours, Challenging Negative Thoughts and Beliefs, Exposure Therapy and Hierarchies, Grounding Techniques to help calm yourself, Worksheets and thought records.

Other things to consider

Communication and Social Skills
Generally, people with social anxiety don’t have anything wrong with their social skills, and come across better than they think – although sometimes anxiety can affect how effectively they display these skills. If you feel it would help, brushing up on your conversation skills and body language may make you feel more confident in interactions with others. Please see our page on conversation skills.

Assertiveness
Some people with social anxiety struggle to be assertive, or even know what they really want or need. Learning to know and express your needs, and to communicate them clearly can be extremely beneficial. Please see our page on assertiveness and social anxiety.

Let go of perfectionism
People with social anxiety often hold themselves to very high standards. They may believe that if they could only be liked by everyone, or be the most interesting, attractive, witty person in the room their problems will be over. However, this is unrealistic and puts way too much pressure on yourself. Relaxing your standards a little and reducing the amount you compare yourself to others can help you to become more comfortable with who you are and less critical of yourself.

Reduce over-thinking
Excessive worry and over-thinking past or future events tends to maintain social anxiety and is often counter-productive.
– It can help to get the thoughts written down rather than just going round and round in your head (see thought record examples, thought record blank template, challenging negative thoughts
– It’s not always simple but try not to “sweat the small stuff”, many of the things that happen will be forgotten in day or two, including by others who are often much more forgiving than we imagine.
– Be self-compassionate and try to find a positive distraction (music, exercise, TV, crafting, puzzles, walks, movie etc). Learning that you don’t have to obsess and over-think – that there can be positive alternatives – can help you get on with the practicalities of the rest of the day.

Grounding techniques to help calm yourself (In Situ)
The best way to “ground yourself” when facing a socially anxious situation is often to “focus outward not inward”. However, some other grounding techniques may work for some people – see Grounding techniques to help calm yourself (In Situ).

Journalling and Goal Setting

Journalling – writing down thoughts and feelings – can give us a way to reflect and learn from experiences. Sometimes just writing things down brings a sense of relief from difficult feelings and can help you to think about future ways forward. Create a list of the ways you want to move forward in your life. Having a list of future goals helps foster a sense of purpose. See Step Ladder Worksheet and Exposure Therapy and Hierarchies.

Celebrate Small Achievements
Celebrate even the smallest achievement. The habit of being able to pat yourself on the back can go a long way. It’s about progress for you, NOT comparing yourself to others. Each small step is a step forward, whether it is saying hi to a stranger or talking to the cashier. Write each one down so you can physically see the achievements and progress.

To tell or not to tell?
Coping with social anxiety on your own is a big strain on emotional health. Even though it can be daunting or difficult, telling another person is often a helpful first step. Please see our page on talking to friends or family (it includes some other contact points if you have very limited family or friends) and our page to tell or not tell.

Support Groups and forums
Sometimes it can help to talk with others that understand how you feel. See our pages on support groups and forums.

Meeting new people
There are various strategies you can use to expand your social circle and feel more connected to others. Please see our page How to make friends when you have social anxiety.

Lifestyle factors
Don’t overlook the basics! In addition to the ideas below, it is also a good idea to make sure that your lifestyle supports the changes you want to make, as physical and mental health are linked. Exercising, using relaxation techniques, eating healthily and avoiding too much caffeine and alcohol may help to keep your baseline level of anxiety lower. This in turn will make your efforts to overcome social anxiety easier.

Coping with rejection
People who are shy or socially anxious are often very sensitive to feelings of rejection. Learning about rejection and the fact that any rejection may include factors which are nothing to do with you, may help you feel more comfortable taking social risks and doing the things you want to do. Please see our page on fear of rejection.

Coping with setbacks
Being able to cope with setbacks is an important part of overcoming social anxiety. Even as you begin to make progress there will be times when things are difficult. Getting better is usually a journey and there tend not to be quick fixes.

Even a well-planned behavioural experiment may be scuppered by unexpected circumstance e.g. you suddenly feel more anxious than expected, you find the person you are dealing with is difficult or in a bad mood, or an unexpected or challenging individual joins your well planned interaction. Even when you have been making good progress, setbacks and even recurrences of intense social anxiety may still occur. Coping with setbacks, allowing time to pass and trying again are all parts of the journey to getting better.

Conclusion

Challenging your social anxiety will be… challenging! You will have good days and bad days; times when things go well and times when you feel stuck or even like you are going backwards. This is a normal part of the process.

You will have to face the situations you fear – but not by repeating what you have always done – but my tackling similar situations with new skills, new perspectives, new ways of thinking and behaving.

Remember, some social anxiety is normal. In fact, it might not be helpful to eradicate all social anxiety. For example, anxiety can help us perform well in interviews if it is within a manageable range. For most people with social anxiety, with support they will decrease the amount of anxiety they experience in social situations, which helps improve relationships, self-esteem and quality of life.

Please also see the resources listed directly below.

An NHS Self-Help guide
Click below to access the NHS Self-help guide produced by Cumbria, Northumberland, Tyne And Wear NHS Foundation Trust
NHS Cumbria, Northumberland, Tyne And Wear Social Anxiety PDF – An NHS self-help guide

Self-Help via the Australian Centre for Clinical Interventions (CCI) Self-help resources
Please also see this free series of PDFs that give an overview of social anxiety and various CBT style techniques: www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Social-Anxiety

Please also see these links to other websites:

www.verywellmind.com – Things to Start Doing If You Have Social Anxiety

www.verywellmind.com – Living with Social Anxiety

www.verywellmind.com – Day to Day strategies for coping with Social Anxiety