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Social Anxiety Disorder

How would you feel if you had to give a presentation?  Might you start sweating?  Feel your body temperature rising?  Ohoh Feel very conscious that you are the centre of attention?  Become increasingly aware of other physical symptoms such as shaky hands, a quivering voice and difficulties speaking properly?  Sound familiar?  If so, you may have social phobia, more commonly referred to these days as social anxiety disorder (SAD).  But don’t worry – you are far from alone here.  At least 12% of the population are likely to suffer from SAD, making this disorder more common than other anxiety issues such as generalised anxiety disorder and OCD.
People with SAD have ongoing, high levels of anxiety about social or performance-driven conditions.  In these situations they feel like they are being scrutinised by others and can really feel quite embarrassed.  Fear of public speaking is one of the most common fears, but people with SAD can feel anxious interacting with other people or even just being around them.  SAD patients typically recognise that their condition is unreasonable and problematic. They can worry for weeks or even months about forthcoming social events.  The good news is that this disorder is very treatable.

Psychologists have evidenced how individuals experiencing SAD tend to latch onto a multitude of negative beliefs that work against them, e.g.:

– They hold unrealistically high standards of themselves, believing that they must perform perfectly in all social situations.

– They consider themselves as either unattractive, inferior or even weird.

– They believe they are in danger of doing something very embarrassing while in the company of others

– They have a deep fear that their expected inept social behaviour will inevitably lead to terrible consequences.

– They believe that they have no control over their anxious feelings and often, to their added embarrassment, suspect that the physical symptoms of their anxiety are very noticeable to others.

Psychologists have suggested that these issues can often develop in childhood, and may be connected with overprotective parents for example.  Or they can emerge from growing up with socially anxious parents.  Or from the child’s own experiences outside of the family.  An earlier experience of being bullied is so very common in the patients I have seen in my own clinic.  Other factors have also been suggested, such as genetic predispositions, trait tendencies, and biological abnormalities.  Often a child may be unaware that something is wrong until they reach their teenage or early adult years.

People with SAD typically anticipate that social disasters will occur, and they repeatedly do things to avoid or escape situations in some way to help prevent or reduce the chances of such disasters.  While this may feel helpful in the short term, longer term the consequences are dire.  It has been sad to see the extent that my patients have literally shrunk the extent to which they live their lives.  Yes SAD can be quite a life limiting disorder.  Its been so rewarding to enable my clients to live fuller, happier and more rewarding lives by treating their SAD!

While avoidance/escape tactics are common, nonetheless SAD can still be triggered by different everyday spontaneous experiences.  Common triggers include meeting new people, being watched while doing something, initiating/maintaining conversations, public speaking, performing on stage, eating in front of others, being teased or criticised, talking with people perceived as “important”, being called on in class, asking someone for a date, going on a date, going to parties or other social gatherings, dealing with conflict, asking for refunds, attending interviews, etc.

Unless it is treated, SAD is one of those problems that tends not to go away by itself.  The strategies relied upon by most people with SAD to help them cope tend to be the very things that keep the problem going.  Thankfully there are a number of effective treatments for SAD.  Psychotherapy has been proven to be highly effective in reducing social anxiety.  Cognitive behavioural therapy (CBT) in particular has been scientifically evidenced to be highly beneficial in treating the disorder. See my other article to learn about how CBT works in practice to treat SAD.  If you think you may have SAD, you don’t need to keep suffering.    Find a BABCP accredited therapist, get the help you need, and get your life back!


Vickie Norris

MSc, PG Dip CBT, PG Cert CBT, BA Hons
BABCP accredited CBT psychotherapist

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