Holiday Cheer or Holiday Fear?

Social Anxiety Disorder: What is it? What are the symptoms and causes?

The holidays bring the opportunity to join with friends, family, and co-workers to celebrate. However, for individuals with social anxiety, this can be accompanied by a sense of dread as they receive invitations for company parties, family engagements, and neighborhood parties. This leads to the dilemma about whether to skip these engagements and feel lonely or whether to attend and struggle with the anxiety of meeting new people, eating in front of others, starting conversations, and making small talk with coworkers or distant relatives.

What is Social Anxiety Disorder?

Social anxiety disorder is a common anxiety disorder characterized by persistent fear in social situations where the individual faces possibly scrutiny or judgment by others. Individuals with social anxiety disorder fear that they will act in a way that will show that they are experiencing anxiety or that they will be negatively evaluated by others. This anxiety is usually present for at least 6 months and leads afflicted individuals to avoid social situations or endure them while experiencing intense anxiety and distress.

Social anxiety is the most common anxiety disorder and the third most common psychological disorder. About 13% of the population experience the disorder, which often begins during adolescence. Unfortunately, the social nature of anxiety often leads individuals to avoid pursuing treatment. In fact, more than 2/3 of individuals with social anxiety do not receive treatment for it and most individuals with social anxiety disorder do not seek treatment until after they have suffered the symptoms of it for over a decade.

Negative Thinking

Those with social anxiety often perceive their performance in social situations to be lacking and they are plagued with thoughts such as “No one will want to talk to me,” “They will think that I am boring,” and “I won’t have anything to say.” Despite these thoughts, many people with social anxiety disorder do not demonstrate deficits in social skills – they simply perceive themselves as lacking in social skills or being awkward. This perception can lead to avoidance of social skills and the assumption that the individual already knows what the outcome of social outings will be— negative evaluation by others and going home feeling more lonely than they were before they went to the engagement.

In addition, individuals with social anxiety tend to notice any negative feedback from others, ignore positive feedback, and interpret neutral information as being negative. For example, a socially anxious person is likely to notice any moment where their conversation partner seems disengaged, not recognize moments when the conversation partner is clearly enjoying the conversation, and interpret the conversation partner’s neutral facial expressions as indicating that the conversation is going poorly. This is an automatic bias, meaning that it occurs without an individual with social anxiety even recognizing it, and it all but ensures that an individual with social anxiety will walk away from social interactions with a negative perception of the interaction.

What To Do?

So if you have social anxiety, this holiday season gives yourself a holiday gift and choose to face your fears, by going to some of these parties. But go into the situation actively searching for positive feedback from others. You have to retrain your brain to recognize the positive incoming information—people smiling at you, individuals seeking you out to say hello, someone saying that they are glad that you came. You may be surprised that there truly is positive feedback. Notice your negative thoughts about the social situation and treat them as hypotheses to be tested. Then gather information to try to support and refute your hypothesis. For example, if I think that no one at the party will talk to me, treat this as a testable hypothesis–go to it and see if anyone speaks to you. Or if you leave the party thinking “That was an absolute disaster,” identify evidence that supports the notion that it went poorly, but also actively search for evidence that it may not have gone poorly. This will be challenging at first, but you truly can retrain your brain to notice the positive information as well as the negative information.

So take off your coat and stay awhile at the party and wait for your anxiety to reduce. With repeated exposure to anxiety-provoking situations, the peak of your anxiety will be lower and it will take less time for it to pass. Eventually, after facing your fear many times, you may experience little anxiety in social situations. It is facing your fear repeatedly that breaks the connection between social situations and anxiety. So pick a few social engagements to attend and see them as opportunities for you to start overcoming your social anxiety.

Credit: College of Cognitive Behavioural Therapies

therapistAvy Joseph is Director and Co-founder of CCBT and City Minds. He lectures on a number of the courses. He is registered and accredited CBT therapist with the British Association for Behavioural and Cognitive Psychotherapies (BABCP). He has an MSc in REBT from Goldsmiths College and is a board accredited member of Association of Rational Emotive Behavioural Therapy (AREBT). He is accredited by the National Counselling Society (NCS) and is a Fellow of the National Hypnotherapy Society (HS). Avy has authored several books on CBT and REBT. He has a private practice in Central London.

He has recently published Confidence and Success with CBT and Visual CBT with Maggie Chapman, Co-Founder of the College. Other published works include Cognitive Behavioural Therapy – your route out of perfectionism, self-sabotage, and other everyday habits.