Social Anxiety CASE STUDY

Social anxiety is one of the largest psychological problems in the world today.
Social anxiety/phobia is
thought to affect 1 in 10 at some time in their lives. Approximately 3% of the people are suffering from
social anxiety at any given point of time. This kind of anxiety disorder tends to begin in childhood or
adolescence. According World Psychiatric Association, roughly 40% of social anxieties begin before the
age of 10 and 95% start before 20 years. 43% of children with social anxiety have anxiety driven school
refusal. And at least 30% of school refusals are thought to have social phobia.
Unlike some other psychological problems, social anxiety is not well understood by the general public.
DEFINITION
Social anxiety is the fear of social situations that involve interaction with other people. You
could say social anxiety is the fear and anxiety of being negatively judged and evaluated by
other people. It is a pervasive disorder and causes anxiety and fear in most all areas of a
person's life. It is chronic because it does not go away on its own although its effect may
attenuate.
PERCEPTION
People with social anxiety are many times seen by others as being shy, quiet, backward,
withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested.
Paradoxically, people with social anxiety want to make friends, be included in groups, and
be involved and engaged in social interactions. But having social anxiety prevents people
from being able to do the things they want to do. Although people with social anxiety want
to be friendly, open, and sociable, it is fear (anxiety) that holds them back.
TRIGGERING SYMPTOMS
People with social anxiety usually experience significant distress in the following situations:
 Being introduced to other people

 Being teased or criticized
 Being the center of attention
 Being watched or observed while doing something
 Having to say something in a formal, public situation
 Meeting people in authority ("important people/authority figures")
 Feeling insecure and out of place in social situations ("I don’t know what to say.")
 Embarrassing easily (e.g., blushing, shaking)
 Meeting other peoples’ eyes
 Swallowing, writing, talking, making phone calls if in public
EMOTIONAL SYMPTOMS
The feelings that accompany social anxiety include anxiety, high levels of fear, nervousness,
automatic negative emotional cycles, racing heart, blushing, excessive sweating, dry throat
and mouth, trembling, and muscle twitches. In severe situations, people can develop a
dysmorphia concerning part of their body (usually the face) in which they perceive
themselves irrationally and negatively.
Constant, intense anxiety (fear) is the most common symptom.
MISCONCEPTION
Social anxiety is many times confused with panic disorder. People with social anxiety do not
experience panic attacks (they may experience "anxiety attacks"), in which the principal
fear is of having a medical problem (e.g., heart attack). People with social anxiety realize
that it is anxiety and fear that they are experiencing. They may say things like "It was
awful and I panicked!", but, when questioned, they are talking about feeling highly
anxious. They are not talking about the fear of having a medical problem. People with
social anxiety do not go to hospital emergency rooms after an anxiety situation. People
with panic disorder many times go to hospital emergency rooms, or doctor's offices, at first
because they feel there is something physically wrong with them.
High rates of alcoholism and other substance abuse, family difficulties and problems, lack of
personal relationships, and difficulty in obtaining and continuing with employment are
among the everyday problems experienced by many people with social anxiety disorder.
Social anxiety disorder treatment #1: Challenge negative thoughts
Social anxiety sufferers have negative thoughts and beliefs that contribute to their anxiety.
If you have social anxiety disorder, or social phobia, you may find yourself overwhelmed by
thoughts like:
 “I know I’ll end up looking like a  “People will think I’m stupid.”
fool.”  “I won’t have anything to say. I'll
 “My voice will start shaking and I’ll seem boring.”
humiliate myself.”
Challenging these negative thoughts, either through therapy or on your own, is one
effective way to reduce the symptoms of social anxiety disorder.
The first step is to identify the automatic negative thoughts that underlie your fear of social
situations. For example, if you‘re worried about an upcoming work presentation, the
underlying negative thought might be: “I’m going to blow it. Everyone will think I’m
completely incompetent.”
The next step is to analyze and challenge them. It helps to ask yourself questions about the
negative thoughts: “Do I know for sure that I’m going to blow the presentation?” or “Even if
I’m nervous, will people necessarily think I’m incompetent?” Through this logical evaluation
of your negative thoughts, you can gradually replace them with more realistic and positive
ways of looking at social situations that trigger your anxiety.
Social anxiety disorder treatment #2: Learn to control your breath
Many changes happen in your body when you become anxious. One of the first changes is
that you begin to breathe quickly. Overbreathing throws off the balance of oxygen and
carbon dioxide in your body—leading to more physical symptoms of anxiety, such as
dizziness, a feeling of suffocation, increased heart rate, and muscle tension.
Learning to slow your breathing down can help you bring your physical symptoms of anxiety
back under control. Practicing the following breathing exercise will help you stay calm when
you’re the center of attention.
Social anxiety disorder treatment #3: Face your fears
One of the most helpful things you can do to overcome social anxiety disorder, or social
phobia, is to face the social situations you fear rather than avoid them. Avoidance keeps
social anxiety disorder going.
Avoidance leads to more problems
While avoiding nerve-wracking situations may help you feel better in the short term, it
prevents you from becoming more comfortable in social situations and learning how to
cope. In fact, the more you avoid a feared social situation, the more frightening it becomes.
Avoidance may also prevent you from doing things you’d like to do or reaching certain
goals. For example, a fear of speaking up may prevent you from sharing your ideas at work,
standing out in the classroom, or making new friends.
Challenging social anxiety one step at a time
While it may seem impossible to overcome a feared social situation, you can do it by taking
it one small step at a time. The key is to start with a situation that you can handle and
gradually work your way up to more challenging situations, building your confidence and
coping skills as you move up the “anxiety ladder.”
For example, if socializing with strangers makes you anxious, you might start by
accompanying an outgoing friend to a party. Once you’re comfortable with that step, you
might try introducing yourself to one new person, and so on.
Social anxiety disorder treatment #4: Build better relationships
Actively seeking out and joining supportive social environments is another effective way of
tackling and overcoming social anxiety disorder or social phobia. The following suggestions
are good ways to start interacting with others in positive ways:
 Take a social skills class or an assertiveness training class. These classes are
often offered at local adult education centers or community colleges.
 Volunteer doing something you enjoy, such as walking dogs in a shelter, or
stuffing envelopes for a campaign—anything that will give you an activity to focus on
while you are also engaging with a small number of like-minded people.
 Work on your communication skills. Good relationships depend on clear,
emotionally-intelligent communication. If you find that you have trouble connecting
to others, learning the basic skills of emotional intelligence can help.
When self-help for social anxiety / social phobia isn’t enough
The best treatment approach for social anxiety disorder varies from person to person. You
may find that self-help strategies are enough to ease your social anxiety symptoms. But if
you’ve tried the techniques above and you’re still struggling with disabling anxiety, you may
need professional help as well.

Social Anxiety CASE STUDY

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Social Anxiety CASE STUDY

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Social anxiety is one of the largest psychological problems in the world today.

 Being introduced to other people

Social anxiety disorder treatment #1: Challenge negative thoughts

Social anxiety disorder treatment #2: Learn to control your breath

Social anxiety disorder treatment #3: Face your fears

Avoidance leads to more problems

Challenging social anxiety one step at a time

Social anxiety disorder treatment #4: Build better relationships

When self-help for social anxiety / social phobia isn’t enough

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