After the first intense months of pandemic, most countries have eased their lockdown restrictions. Which seems great, right? Well, for some people, jumping back to the daily, pre-lockdown routine means being confronted by daily social interactions, which can be demanding, frightening, and anxiety-inducing. These feelings are shared by people with social anxiety (not the disorder!), a topic which I think has been neglected when we discuss the negative effects of the lockdown. Therefore, this article will discuss social anxiety, its theories, and it will end with certain methods that may help overcome it.  

**Note that this article is not about social anxiety disorder,  as defined by the DSM-5 to exhibit a more intense, persistent level of social anxiety than described here.

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This article will cover:

1. A personal experience from the author
2. What is social anxiety? Avoidance of confrontation?
3. The Heimberg Model of SA/SAD
4. Information processing biases
5. Strategies to help overcome social anxiety

Personal experience

I want to start with a personal experience which I think can be insightful to many. I’ve experienced social anxiety, which manifested itself greatly after the lockdown restrictions eased last year. I finally had to attend classes in university four days a week, had to strike up conversations with people I didn’t know again, and I could see the effects it had on me; I was noticing my body language too much and I was anxious that how I moved my body, or what I said, would incite negative judgement from people. In turn, during conversations, I sometimes found myself not listening to what people were saying, but instead was preoccupied with monitoring my posture, my voice, and positioning my arms. I wanted to seem “normal”, while actually being worried with ideas of rejection and negative evaluation. There were very few people who were close to me, and I never experienced these anxieties with them, but at the same time, I was embarrassed to tell them about my struggles. Perceiving them so outgoing, while I was at home avoiding social interactions, further consolidated the belief that I was different and odd, and so I kept these to myself out of shame. This was my safe space; being at home and avoiding social “confrontations” to stay away from those negative feelings.

It's now been a while since I began confronting my anxieties in the presence of others. And one thing that made me more motivated to share my experiences was my gradual understanding that social anxiety is more common than I expected. To you and me, some people may just seem shy, but in reality it’s much more than that.

What is social anxiety?

Social anxiety can be defined as the fear of negative evaluation by others during interpersonal evaluation, in real or imagined social settings [2,3]. Therefore, people become socially anxious not only when they are currently being evaluated, but also when they have the idea that the possibility of interpersonal evaluation exists. In fact, prior to the social situation, people can worry as much or more about how others will evaluate them, as they do during the social situation itself (3).  

According to Leary and Kowalski(3), there are generally four distinct but interrelated experiences during social anxiety, that reflect cognitive, somatic, behavioural, and affective aspects:

1. Apprehensive thoughts or cognitions - when socially anxious, individuals tend to preoccupy themselves with negative thoughts about the current or future social interaction. For example, one might preoccupy themselves with thoughts about wanting to get out of the situation in response to a perceived negative evaluation from others (eg. “I bet they find my fidgeting so distracting”)
2. Somatic symptoms - these are physical symptoms such as sweaty palms or increased heart rate. When the sympathetic nervous system is activated due to feelings of anxiety or worry, the physical symptoms manifested are experienced as uncomfortable, strengthening the individual’s idea to escape from the social interaction [4,6].
3. Attempts to avoid/ escape the situation - due to the negative reactions induced by social interaction, individuals feel an urge to escape or participate less during social interactions. They can also express avoidant behaviours to avoid the negative experiences during social interactions(4).
4. Subjective, unpleasant feelings - individuals often report feeling nervous, fearful, or tense during the situation. Often, these are accompanied by other negative emotions such as hopelessness or anger.
   

Avoidance of confrontation?

Due to these negative experiences, individuals are likely to perform avoidant behaviours (avoiding feared social situations). However, avoidant behaviour prevents the individual from experiencing situations that disconfirms their negative expectations!! [7] Indeed, according to the conditioning theory, extinction learning (= understanding that interacting with others does not necessarily induce feared expectations) occurs only when individuals are repeatedly confronted by the fact that their feared expectation is wrong [8]. We can see how, in this case, avoiding the situation is a maladaptive coping mechanism [7].

The Heimberg et al. Model of SA/SAD

Rapee & Heimberg’s (1997) notorious cognitive-behavioural model of social anxiety/Social Anxiety Disorder helps us understand the process of social anxiety [6].  

The process begins with the perception of an audience. This elicits a mental representation of oneself as seen by the audience (“I think, they think I am this way”). Influenced and exaggerated by a history of (perceived) negative social experiences, external indicators of negative evaluation, and internal cues such as sweaty palms, lead the individual to conclude that the audience’s perception of them is very poor. Interestingly, they may believe that others hold very high and unattainable standards for their behaviour at the same time! Contradicting right? This creates a problem: socially anxious individuals attach significant importance to being positively evaluated by others, yet they assume that any evaluation will be inherently negative. The higher the discrepancy between the negative self-image and the perceived standard of audience’s expectation (that they must behave perfectly), the more likely the individual will anticipate negative social outcomes. This anticipation directly causes symptoms of social anxiety. Symptoms and external perceived negative stimuli from the audience result in the maintenance of social anxiety, and the cycle continues [5].

Information-processing biases

Here, we discuss some biases of socially anxious people that support their social anxiety.

1. Attention bias to threat - Individuals with social anxiety focus more on internal and external threats in social situations [5]. For example, their relatively high heart rate, or people’s (perceived) “bored” faces. This attention bias makes them more likely to exhibit symptoms. Attention training can help individuals focus away from the threat stimuli, resulting in a decrease of symptoms [2,5].  
   

2. Attention bias away from positive stimuli - attention bias toward social threat may go hand in hand with bias away from positive stimuli [5]. The tendency to allocate attention away from positive stimuli can increase the state of anxiety in response to a stressor [1,2, 8]. Some research expressed that training individuals to attend to positive stimuli may heighten positive emotional reactivity.
   

3. Interpretation bias - this is defined as the tendency of individuals to interpret neutral or ambiguous stimuli as threatening [5]. For example, research found that when under time pressure to judge faces, socially anxious individuals tend to misinterpret disgust faces as exhibiting contempt, while non-anxious participants tend to misinterpret disgust faces as happy [5]. This, however, was not shown when participants were given a longer time, suggesting that the lack of positive bias among anxious participants was evident only when they were required to make interpretations quickly, much as in real life.

Strategies to help overcome social anxiety

Now we shall discuss some psychological strategies that have been shown to reduce social anxiety:

1. Exposure-based strategies - as mentioned previously, socially anxious individuals tend to exhibit avoidance behaviour that does not expose them to the possibility of falsifying their feared expectations [7]. This means the individual’s perceived connection between social situations and negative expectations will remain intact! Exposure-based strategies force individuals to confront feared social situations, and when repeatedly done, research has shown that social anxiety symptoms decrease [8]. This is because the individual is repeatedly confronted with disconfirming evidence of their feared expectations, and this would defeat the initial connection between the social situation(s) and feared expectations [7,8].
   

2. Cognitive strategies - these strategies help individuals identify anxiety-provoking thoughts and feelings and replace them with more realistic views [2]. Initially, this may be difficult to point out because socially anxious people tend to attempt to “bury” these negative thoughts and feelings to not act anxious [6,7]. An example of this strategy is recognizing thoughts of anxiety and embarrassment when thinking about speaking in front of the classroom. The goal is to replace these cognitive distortions with more realistic views, such as thinking “if I were in the audience, I would be more interested in the information presented rather than the person’s body language”.
   

3. Mindfulness and acceptance-based strategies - These strategies help us accept unwanted thoughts, emotions, sensations, and other experiences rather than trying to control them [1]. A neutral thought – for example, “I’m nervous about attending this party”, can quickly become a negative thought; “there’s something wrong with me”. By teaching socially anxious individuals to approach thoughts with acceptance and curiosity rather than judgement, meditation can help to improve self-image [1,8].

In conclusion…

Social anxiety is an uncomfortable experience, and avoidant behaviours that help the individual decrease tension and anxiety can be considered an ineffective coping mechanism as it does not permit them to be confronted with falsified feared expectations. Furthermore, certain biases and negative experiences during social interactions can further feed this cycle. Psychological strategies can help overcome social anxiety; the most important step is to face discomfort by recognizing negative feelings and thoughts!

Have you ever experienced social anxiety? If so, how did you experience it? Furthermore, what do you think are good ways to gradually overcome social anxiety?

Reference list

1. Dibdin, E. (2021, July 2). How Meditation Can Help You Manage Social Anxiety. Psych Central. https://psychcentral.com/anxiety/how-meditation-can-help-you-manage-social-anxiety

In-text citation

2. How Cognitive Behavioral Therapy Can Treat Social Anxiety Disorder. (2021). Verywell Mind. https://www.verywellmind.com/how-is-cbt-used-to-treat-sad-3024945
3. Leary, M. R., & Kowalski, R. M. (1997). Social Anxiety. Guilford Publications.
4. Morrison, A. S., & Heimberg, R. G. (2013). Social Anxiety and Social Anxiety Disorder. Annual Review of Clinical Psychology, 9(1), 249–274. https://doi.org/10.1146/annurev-clinpsy-050212-185631
5. Penney, E. S., & Abbott, M. J. (2014). Anticipatory and Post-Event Rumination in Social Anxiety Disorder: A Review of the Theoretical and Empirical Literature. Behaviour Change, 31(2), 79–101. https://doi.org/10.1017/bec.2014.3
6. Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35(8), 741–756. https://doi.org/10.1016/s0005-7967(97)00022-3
7. Rudaz, M., Ledermann, T., Margraf, J., Becker, E. S., & Craske, M. G. (2017). The moderating role of avoidance behavior on anxiety over time: Is there a difference between social anxiety disorder and specific phobia? PLOS ONE, 12(7), e0180298. https://doi.org/10.1371/journal.pone.0180298
8. Swinson, R. A. A. M. M. P. (2019). Shyness and Social Anxiety Workbook: Proven, Step-by-Step Techniques for Overcoming Your Fear. ReadHowYouWant.