“Just imagine them in their underwear!” is a common statement told to those who have a fear of speaking in front of large audiences. Although it can be useful to utilize your imagination in this way when faced with giving a presentation, it’s not always enough to overcome the anxiety that may arise in these types of situations.
Fear of public speaking is not necessarily indicative of Social Anxiety Disorder. However, if this fear interferes significantly with one’s life, a therapist might consider that a diagnosable problem.
Social anxiety can manifest itself in various other forms. For example, Judy, a very successful investment banker, begins sweating profusely whenever she needs to talk to her boss’ boss at a work event. She dreads these meetings and often feels a need to have a few drinks before starting a conversation. Scott, a graduate student, who is usually gregarious and engaging with his family, freezes up and rarely participates in class, for fear of saying the wrong thing. He often misses out on class discussions because of this fear. Lauren has found dating to be very difficult (and stressful) because she is afraid of not being able to maintain a lively dialogue on dates; she finds herself getting nervous, tense, and panicked beforehand. Consequently, she has decided to avoid dating altogether.
The role of avoidance
Social anxiety can lead to chronic avoidance of various social situations in order to escape intense feelings of anxiety or inadequacy. It may also create uncomfortable physiological sensations in the body or produce unhelpful thoughts that impede our social functioning. For people with social phobia, avoidance plays a significant role in maintaining anxiety surrounding social situations and can become a big problem. Indeed, 36% of people with social phobia report experiencing symptoms for 10+ years before seeking professional help.
One known treatment for social anxiety is exposure therapy, which is a form of cognitive-behavioral therapy. Exposure therapy for social anxiety typically involves the patient facing or imagining their fears, and then through guided and repeated exposure to the situation, realizing that the fear did not actually come true. Exposure works using two principles – desensitization and habituation. When a person becomes desensitized to their fears, the anxiety they experience begins to dissipate. Habituation then takes over. Thus, the same situation, when presented again, does not produce the same intense reaction as the first or second time. Exposure therapy can be either imaginal (using one’s imagination) or in vivo (in the actual feared situation). Exposure therapy, when done correctly and consistently, can be very effective in treating phobias and fears of any kind.
A common feature of social phobia involves thoughts that trigger and exacerbate our anxiety. These thoughts can lead us to overestimate how nervous we will become in a social situation and underestimate our own ability to interact and engage in social situations. Cognitive-behavioral therapy can help us to identify these distorted thought patterns and challenge the thoughts. This often proves helpful in overcoming social anxiety.
Lastly, there are also support groups for people suffering from social phobia that can be found in your local region. Gone are the days of envisioning people sans clothing; there are better options out there.