Self-Help for Social Phobia

[Daniel E.]

Self-Help for Social Phobia
About.com, Social Anxiety Disorder Blog
October 31, 2007

Part of the problem with social anxiety is that sufferers haven’t had enough positive experiences of being in the right frame of mind socially –- a place where the body is relaxed, breathing is slow and natural, and the mind is free of negative thoughts. The social phobic can’t be anxiety-free in feared situations without first training the mind and body to behave this way. Although these behaviors may seem awkward and unnatural at first, over time they will become automatic.

The Clinical Research Unit for Anxiety and Depression at the University of New South Wales in Sydney, Australia has assembled some basic self-help strategies to aid those with Social Anxiety Disorder (SAD) to reduce anxiety in social situations. The group notes that although treatment is available and effective for SAD, only 25% of people with the disorder ever receive treatment.

While not a substitute for professional treatment, for those that may otherwise receive no help, self-help is a good starting point. Below are three areas that can be worked on through self-help strategies.

Slow Breathing
People with Social Anxiety Disorder may breathe too quickly in anxiety-provoking situations, which in turn exacerbates other anxiety symptoms. This is part of the “fight or flight response.” Below are some steps to get control of your breathing.

1. Count the number of breaths that you take in one minute (count an inhale and exhale as one). Make a note of this number. The average person will take 10 to 12 breaths per minute.
2. Focus on your breathing. Inhale and exhale through your nose. Take deep breaths from your diaphragm instead of shallow breaths in your chest. Inhale for 3 seconds and exhale for 3 seconds (use a watch or clock with a second hand). As you exhale think “relax” and release tension in your muscles. Continue breathing this way for 5 minutes.
3. Count your breaths per minute again and see if the number has reduced.
4. Practice this breathing technique 4 times per day when already relaxed.

When in social situations, make sure that you are breathing the way that you practiced. In time, this way of breathing will become automatic.

Conquering Negative Automatic Thoughts
As a person with Social Anxiety Disorder, you are likely to misinterpret comments or facial expressions made by other people. In particular there are two common thought patterns that contribute to your anxiety.

• Mindreading. You assume that you know what other people are thinking about you (such as "Everyone can see how anxious I am").
• Personalizing. You assume that the behaviors of others are related to you (such as "He looks bored, I shouldn’t have invited him to this movie").

The thoughts that you have are so automatic that you probably don’t even realize you are thinking them. Below are some steps to getting control of your negative thoughts.

1. Think back to a recent social situation in which you felt anxious. Write down what your negative thoughts were before, during and after the situation.
2. Ask yourself questions to challenge your negative thoughts. For example, if your negative automatic thought is "People are yawning, they must think that I am boring," ask yourself "Is there an alternative explanation?" In this case your alternative thought may be "It probably has nothing to do with me, they are just tired."
3. Try to notice the automatic negative thoughts that you have before, during, and after feared social situations, and challenge them with alternatives.

Facing Your Fears
Although in the short term, avoiding feared situations may reduce anxiety, in the long term it severely limits your life. In addition, the number of situations that you fear grows as your fear becomes generalized. People with Social Anxiety Disorder need gradual exposure to social situations as part of reducing the anxiety associated with them.
Below are some steps to overcoming avoidance.

• Identify the top 10 situations that you avoid.
• For each situation on the list, break the goal down into a series of steps, increasing in difficulty. For example, if you are afraid of being the center of attention, your steps might look like this:
  1. Tell a funny story about yourself to a group people that you know well.
  2. Tell a funny story about yourself to a group of people that you don’t know well.
  3. Voice your true opinion to a group of friends.
  4. Voice your true opinion to a group of strangers.
  5. Make a toast at dinner with people that you know well.
  6. Make a toast at dinner with people that you don't know well.
• Practice each step as much as necessary before moving on to the next. If you notice anxiety, challenge negative thinking and use the slow breathing technique to relax.

Over time, as you practice relaxation, challenge negative thoughts, and face feared situations, you will find it easier to stay anxiety-free in stressful situations.

Source: Andrews, G. (Ed.). (2007). Clinical Research Unit for Anxiety and Depression, UNSW. Self Help for Social Phobia. 28 July 2007.