Breaking Down Social Anxiety

I don’t know about you but since the changes with physically distancing due to COVID restrictions, I am finding socializing a bit different, a bit more stressful. I am noticing more social anxiety within myself and wonder if practicing socializing is an important part of keeping my skills sharp.

Last month I was invited to dinner (post-COVID hopes) by an acquaintance and their partner and I noticed myself worrying about how I would present myself at this dinner and was feeling anxious about being evaluated by this couple. I caught myself thinking:

“I better start reading the newspaper so I can present myself as informed and avoid looking stupid.”

“At least, I am a therapist so I can guide them to talking about themselves the entire dinner.”

“I think I’ll just stay home and my partner can go alone.”

I only share this example to let you know, therapists struggle too. I am a person too who also experiences struggles and wants to belong and be accepted just like you do. Let’s talk a little more in-depth about social anxiety.

What’s the difference between social anxiety and social anxiety disorder?  


Social Anxiety

Social anxiety is the excessive worry about being in social settings that may bring unwanted attention or scrutiny.  People who experience social anxiety are often afraid of being humiliated, criticized, embarrassed, uncomfortable, judged, or showing signs that they are nervous.  

“Anxiety is the internal alarm or concern that arises when an external threat is not physically present.  Anxiety is also the anticipation of a treat that never materializes.”  

Heid, M. ( 2020, July). Rising to the Challenge. Time Magazine, The Science of Stress Special Edition, 13.


It is typical to be nervous before a performance or a speech but people suffering from social anxiety experience this nervousness relentlessly.  The impacts can be detrimental, not only to ones’ relationships but also to a person’s overall health and wellbeing.  

People who experience social anxiety believe that negative social experiences are highly probable and too costly to endure.  Folks may experience endless commentary in their heads about how they are interacting, if what they are saying is “stupid,” if how they are acting is “weird,”  if the people they are with can tell if they are nervous, making engaging socially a brutal experience, so “Why even bother?!”  


Some common areas of stress for people experiencing social anxiety are public speaking, meeting up in class/social group, talking to a person of authority, meeting new people, going to a party, engaging with strangers, and taking an exam or test.  

Here are the signifiers identified in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition) for:

Social Anxiety Disorder (Social Phobia)

  • Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. 

  • The person is worried that they may act in a way that would expose their discomfort or be evaluated by others negatively. 

  • Social situations almost always provoke fear and anxiety. 

  • Social situations are avoided or endured with intense fear or anxiety. 

  • Fear and anxiety are out of proportion to the threat posed by the social setting. 

  • The fear and anxiety are persistent, lasting more than 6 months. 

  • The distress causing significant impairments in the person’s life. 


Common Experiences of People with SAD (Social Anxiety Disorder)

Fear of Negative Evaluation: 

Often people who experience Social Anxiety Disorder want to come off in a favorable light but deeply believe in their inability to do so.  

Fear of Positive Evaluation:

Yes! People who experience SAD can also fear positive evaluation! Bringing undue attention and more pressure to succeed.  


Presence of Safety Behaviors:  

To combat the fear of acting weird in social settings people who experience SAD often spend a lot of time and energy rehearsing conversations they may have, deflecting attention, or preoccupying themselves with something distracting from the social setting, incorporating behaviors to try to bring more feeling of safety into a distress social situation.

Emotion Suppression 

Socially anxious people tend to suppress both positive and negative emotions.  By suppressing even positive emotions in public, a person is able to protect themselves against the possibility of a negative evaluation from another.


Oh Shoot, this is sounding a bit familiar… What now? 


Cognitive Behavioral Therapy can be helpful in addressing the thought patterns associated with Social Anxiety and Social Anxiety Disorder.  According to the Cognitive Behavioral Therapy model: thoughts influence feelings influence behavior.  We can begin to tease out some of the thought patterns reinforcing social anxiety and explore the self-talk that reinforces ways of being in the world that are not fulfilling and challenge them!  We can not stop our automatic first thoughts but we CAN purposefully introduce new thoughts and be intentional about creating new neural pathways in the brain to create and live the life we want to live!  

Eye Movement Desensitization and Reprocessing (EMDR) can also be helpful in treating social anxiety by targeting underlying beliefs (both conscious and less conscious) contributing to high levels of social anxiety and replacing these beliefs with ones that a more supportive to engaging socially.