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. Working with a qualified CBT therapist (see NICE Social Anxiety Guidelines and What the NHS offers) is the recommended therapy. Another option is finding a private therapist or medication. It is also possible to make progress through self-help.

On this page, we provide an overview of various help, ideas and 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 therapy sometimes used – but with less clinical evidence – see our page glossary of psychological therapies.

There are a number of self-help books and courses and practical help that will augment many of the ideas 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 outlined below. As you get better at doing this, you should start to feel your levels of anxiety decreasing. By facing your fears gradually, decreasing avoidance and safety behaviours and challenging your negative thoughts and beliefs, you will start to break the vicious cycle of social anxiety.

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, alongside new ways of thinking and behaving, is key to making progress.

Worksheets and journalling are used for many aspects of CBT. Getting your thoughts and predictions about particular situations down 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 several types of CBT worksheets for social anxiety and similar ideas and worksheets are used in many of the self-help books.

Read about CBT in more detail on our webpages What is CBT?, What the NHS Offers, Finding a Private Therapist.

It is also possible to make progress with self-help CBT.

Key skills

Here we outline key skills that will help you overcome social anxiety using a CBT approach. You will probably need to work through skills 1-2 before you can move on to the others, but you can decide what order you want to try the rest.

• Learn about social anxiety
  Use this website and other resources to learn about social anxiety – see what the NHS offers, NHS webpages and guidance, private therapy, self-help books, support groups and forums, courses and practical help and other internet SA websites. Information is a powerful tool, and it may also help to know that so many others face similar challenges and feelings. Most importantly, you are not alone, and there are ways to make progress.
• 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 how they are perceived, aspects of conversation, some fear judgement or rejection, some dread their own physical symptoms or self-critical thoughts. Not everyone is consciously aware of exactly when and why they feel anxious, so a key skill will be to understand your own triggers. Notice when you become socially anxious, use these CBT worksheets to record what was going through your mind during the situation. What were you focusing on? How did this affect your thoughts and behaviour?
• Accept your anxiety
  This may sound contradictory but learning to accept your anxiety, rather than struggling against it, can actually help you to feel better. Fighting your anxiety just makes it worse. See fight or flight response. Also see our page on grounding techniques to calm yourself socially
• Challenging negative thinking
  Once you have begun to identify the situations you struggle with, you can gradually become more aware of how your thinking 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 and what you believe about yourself and others. Generally, this technique involves using worksheets to try and find more helpful alternatives to unhelpful ways of thinking. See challenging negative thoughts and beliefs.
• Challenging 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 core beliefs, often develop in childhood and can form the basis of social anxiety. Challenging long held beliefs may be difficult but self-help, therapy and CBT worksheets can help you become more aware of these beliefs and how they affect you. See challenging negative thoughts and beliefs.
• Changing safety behaviours and avoidance
  People with social anxiety often behave in ways that result in maintaining their fears. This may mean they completely 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, talking too much, rehearsing words before you speak, 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 gradually drop safety behaviours and to think and focus on more helpful ways of approaching challenging situations. Please see our page on avoidance and safety behaviours.
• Work through behavioural exposures and hierarchies
  Most of us have a variety of situations that we find challenging. The idea of behavioural exposures and hierarchies is to complete worksheets that build our own personal hierarchy of difficulty. This could mean a list of safety behaviours to drop, or particular situations you want to take on. This is done gradually so it is not overwhelming, using the 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 challenges, and 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 continue progress, you will likely need to incorporate new strategies. Repetition is 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

The skills listed above form the core of most CBT for social anxiety. However, there are issues you may wish to consider:

Assertiveness
Some people with social anxiety struggle to be assertive. Learning to communicate clearly and assertively (the middle path between passivity and aggression) can be extremely beneficial.
Please see our page on assertiveness and social anxiety and https://www.cci.health.wa.gov.au/resources/looking-after-yourself/assertiveness

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.

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 to become more comfortable with who you are and less critical of yourself.

Reduce worry and over-thinking
Excessively worry and over-thinking past or future events tends to maintain social anxiety and is often counter-productive. Sometimes it helps to find a positive distraction (music, exercise, TV, crafting, puzzles, walks, movie etc) rather than “over-think” – but it can also help to write down and challenge your worry and over-thinking. See our page on techniques for challenging negative thoughts and Australia CCI – Overcoming Negative Thinking.pdf.

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 our page on of CBT worksheets for social anxiety.

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.

Medication
Medication from your GP may be an option – it is sometimes used in combination with 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.

Tell someone you trust
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.

Meeting new people
People who have high levels of anxiety in social situations may find it difficult to make new connections, friends or start new relationships. 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

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. Please 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.

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