Making Progress

Disclaimer :
The content in this resource is provided for general information only. It is not intended to, and should not be, treated as a substitute for the medical advice of your own doctor or any other health care professional.

How do you get better from social anxiety?

There are a lot of ways to decrease your level of social anxiety. This page is intended to provide an overview of how to make progress if you want to use self-help techniques, or supplement work with a therapist. Working with a qualified CBT therapist (see NHS NICE guidance and What the NHS offers) is the recommended therapy. Another option is try private therapy (including CBT based online therapy) – see our pages on Finding a private therapist. However if you are struggling, it is possible to make some progress on your own.

On this page we provide an overview of various techniques that are used to treat social anxiety. Our focus is mainly on CBT because this is the treatment with the most scientific support for its effectiveness.

There are other forms of psychological therapy although there is less clincial evidence to support them as treatments for social anxiety. Please see our page on other psychological social anxiety therapies

Alternative treatments to promote general relaxation include dietary supplements, aromatherapy, hypnotherapy, meditation, mindfulness, eflexology, reiki, Tai chi, yoga. It is ultimately up to you how you develop any relaxation techniques and what you think helps you.

There are a number of self-help books that will provide you with more detailed account of the issues and techniques that are outlined below.

Lifestyle factors

Don’t overlook the basics! In addition to the techniques 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 will help to keep your baseline level of anxiety lower. This in turn will make your efforts to overcome social anxiety using CBT easier.

The CBT approach

In order to get better, you will need to tackle the thoughts and behaviours that maintain your social anxiety using the skills outline below. As you get better at doing this, your feelings will start to follow and you will feel your levels of anxiety decreasing. It is important to break the hold of social anxiety through facing your fears gradually, decreasing avoidance and safety behaviours and combating your negative automatic thoughts and beliefs.

Overcoming social anxiety can be challenging, as you will have to face the situations you fear. You will also need to be relatively consistent in carrying out the exercises: regular practice is key to making progress.

Writing things down is used for all aspects of CBT. Getting your thoughts and predictions about particular situations out on paper helps you to view them more objectively when you are trying to consider alternative ways of looking at things. Having a written record will also allow you later to see how far you’ve come and how much progress you have made.

There are a large number of types of CBT worksheet for social anxiety, which vary depending on which technique you are using. We are aiming to provide downloadable worksheets but for now please see this example thought record based on the book the shyness and social anxiety workbook. Most books on social anxiety will contain worksheets – ways to clarify the situations, thoughts, beliefs and behaviours you need to work on – see our page on self help books.

Five key skills

Here we outline five key skills that will help you overcome social anxiety using a CBT approach. It is generally a good idea to take one technique at a time, such as challenging negative thoughts or focusing on overcoming safety behaviours. You will need to learn a bit about social anxiety and about your own social anxiety before you can move on to the others, but you can decide what order you want to try skills 3-5.

  • 1. Learn about social anxiety
    Use this website and other sources (see our pages of self help books and youtube content) to learn about social anxiety so that you have a better understanding of it. Information is a powerful tool and you may feel better as you recognise you are not alone. Other people have similar difficulties and most importantly there are ways you can overcome them.
  • 2. Assessing your own difficulties and using CBT worksheets
    It is a good idea to gain as much insight as possible into your own individual social anxiety. People can be affected in different ways: some may worry about talking too little and others that they talk too much, or some may worry about giving presentations while others struggle most with being observed writing or eating. Not everyone is consciously aware of why they feel anxious in certain situations, so a key skill to observe yourself. Notice when you become socially anxious, and use CBT worksheets to record what was going through your mind at the time. What were you focusing on? How did this affect your thoughts and behaviour?
  • 3. Challenge negative thinking
    Once you have begun to identify your negative thoughts and the situations you struggle with, you can gradually become more aware of how you automatically respond and make a deliberate effort to change this. It can be empowering to realise that you have some control over your thinking and what you believe about yourself and others. Generally this technique involves using worksheets to try and find positive or more helpful alternatives to unhelpful ways of thinking.
  • 4. Changing behaviours
    People with social anxiety often behave in ways that maintain their fears. This can mean they completely avoid situations that provoke anxiety. It can also include ‘safety behaviours’ they use when they are in situations that make them anxious such as avoiding eye contact, censoring what they have to say or staying with a ‘safe person.’ Avoidance and safety behaviours may temporarily reduce anxiety but over time they reinforce the idea that social situations are dangerous and that you cannot cope with them.In order to decrease social anxiety you will need to face the situations that make you anxious, and learn to drop safety behaviours. You can complete worksheets making predictions about how you think you will feel/think/behave when doing them, and then assess how much your predictions are supported (you may be pleasantly surprised!) This is done gradually so it is not overwhelming, using a hierarchy of situations, from the least to the most anxiety-provoking.
  • 5. Changing beliefs
    Beliefs are overall assumptions about ourselves, other people and the world that give rise to our thoughts and behaviours. Some beliefs held by socially anxious people can be very self-limiting, such as ‘people are usually critical and hostile’ or ‘no one ever likes me’ or ‘I am unimportant’. If you have such beliefs, it is not surprising if you try and avoid people! Your thoughts and behaviors stem from these beliefs.Changing beliefs is done in a similar way to changing thoughts, using CBT worksheets to become more aware of your beliefs and how they affect you, and replace old, unhelpful beliefs with new, more helpful ones.

Other things to consider

The skills listed above form the core of CBT for social anxiety. However there are other ones you may wish to practice:

Assertiveness
Some people with social anxiety struggle to behave assertively: they may either be too passive and unable to stand up for themselves or become excessively angry. Learning to communicate clearly and assertively (the middle path between passivity and aggression) can be extremely beneficial.

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. But if you feel it would help, brushing up on your conversation skills and things like body language may make you feel more confident in interactions with others.

Let go of perfectionism
People with social anxiety often hold themselves to very high standards: perhaps so high that they cannot be met. They may believe that if they could only be liked by everyone, or be the most brilliant, interesting, attractive and witty person in the room their problems will be over. But it is good to remain flexible: relaxing your standards a little and reducing the amount you compare yourself to others can help you live a more fulfilling life.

Reduce worry and rumination
Excessively worrying and ruminating over past or future events tends to maintain social anxiety. These are attempts at problem-solving, but are very often counter-productive. See our page on techniques for overcoming them.

Accept your emotions
This may sound contradictory to the CBT approach, which tries to reduce anxiety, but learning to accept how you are feeling rather than struggling against it can actually help you to feel better. This is a key component of ACT therapy.
Also see our page on grounding techniques to calm yourself socially.

Medication
Medication, from your GP, may be an option – it is sometimes used in conjuction with talking therapies. We know talking to your doctor can be challenging when you have social anxiety – please see our page on talking with your GP.

Tell someone
Coping with social anxiety on your own is a big strain on emotional health. Even though its difficult, telling another person is often a helpful first step. We know it can be daunting and difficult, but please our page on talking to friends or family (it includes some contact points if you have very limited family or friends).

Where you can – and if/where appropriate – tell the people you are with
Coping with intense social anxiety thoughts, feelings, symptoms is really hard. It is even harder if you have to hide your feelings and pretend everything is ok when it really is not. Where you can – and where appropriate – tell the people you are with. Even just telling one person may take the pressure off. None of us should have to hide how we feel – if someone with other health issues were suffering disabling thoughts and feelings they would probably let others know. Social anxiety is really common. 12% lifetime prevalence equates to 8 million people in the UK and even using the “3% stricter clinical criteria” (referred to in NICE guidance) there will be over 2 million people with social anxiety in the UK this year. It is no shame to say you feel nervous with people sometimes.

Meeting new people
People who have high levels of anxiety in social situations may find it difficult to make new friends or start new relationships. There are various strategies you can use to expand your social circle and feel more connected to others. Please this link on making new friends when you have social anxiety

Coping with rejection
People who are shy or socially anxious are often very sensitive to rejection. Learning about rejection, and understanding that there are many reasons you may be rejected, many of which are nothing to do with you will help you to deal with it. Learning to cope with rejection will in turn lead to you being more comfortable taking social risks and doing the things you want to do.

Coping with setbacks
Even as you begin to make progress it is likely that setbacks – and recurrences of intense social anxiety – may happen at times. Even a well planned “behavioural experiment” may be scuppered by unexpected circumstance. 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.

One thing to remember is that it’s not possible or even desirable to be completely free from social anxiety. But it is possible to massively decrease the amount you experience in many situations, which will improve your relationships, self-esteem and overall quality of life.

Further reading :
www.verywellmind.com – Things to Start Doing If You Have Social Anxiety
www.verywellmind.com – Living with Social Anxiety
www.aboutsocialanxiety.com – How to stop zoning out when people talk
www.verywellmind.com – Day to Day strategies for coping with Social Anxiety