Social anxiety and what to do about it: CBT can help
A "social sofa" in Amsterdam

Loneliness can gnaw at us when we are home alone on a Saturday night, but also while walking down a crowded city street or at a party where we feel adrift in a sea of strangers. To break through the loneliness and connect to others, we do things like going to after-work drinks with colleagues, chatting with people at the gym or using dating apps. For some, this universal basic need to connect to others competes with an urge to avoid such connections because social situations trigger anxiety and fear. What makes some people so anxious around others that they choose to be alone despite wanting to be with others? And how can this anxiety be overcome?

What is social anxiety?

Anxiety of this kind is known as social anxiety. For some, social anxiety can be so broad and intense that even going to the grocery store or riding public transit can give rise to a sense of dread. For others, their social anxiety may be more narrowly focused on specific situations such as public speaking or dating. No matter what form the anxiety takes, what underlies it is a belief in a self that is flawed in some way that triggers shame and that must be hidden from others. These perceived flaws might relate to how well you interact with others (“I never have anything interesting to say so I can’t date”), to physical appearance (“My hair always looks awful and I know everybody is staring at it and thinks I’m weird”) and even to how obvious your anxiety is to others (“They can tell I’m breathing too fast and they must be wondering what is wrong with me”). Sometimes, especially in East Asian cultures, social anxiety is less about a fear of embarrassing oneself and more about a fear that some aspect of the self – the way you look or smell or behave — is offensive to or embarrassing for others.

This focus on the self can get in the way of having enjoyable social interactions and creating meaningful connections to others, connections that lead to friendships and romantic relationships. Instead of paying full attention to your conversation with someone you just met at a party, your mind is busy evaluating your performance and appearance, imagining how the other person sees you and trying to figure out if they are judging you. A pause in conversation can feel like a confirmation of your worst fears that you are dull and unfit for human interaction. An embarrassing social blunder that might, for most people, lead to a funny anecdote to share with others the next day, can trigger overwhelming feelings of shame in someone who is socially anxious. Sometimes, members of communities that are stigmatized in some way, such as the LGBT2Q+ community, can experience social anxiety that is connected to feelings of being stigmatized. So, in addition to worries about your social behaviour, how you look and whether people can tell you are anxious, you may have also grown up with the message that there is something wrong with you because of the community or group you identify with. It should not be surprising that someone would develop social anxiety if they hear the message over and over again that “You are not like the rest of us and that is bad.”

Overcoming social anxiety

The core of social anxiety, the belief in a flawed self that must be hidden from others, is also the key to overcoming it. Using the techniques of a form of psychotherapy called Cognitive Behavioural Therapy (CBT), a psychologist can work with you to first identify what you most fear about social situations and how these fears link to beliefs about yourself. Then, treatment can be tailored to challenge your specific fears and beliefs to help you learn that social situations aren’t scary and that you can cope even if a social situation doesn’t go the way you would have liked it to.

CBT has been shown to be the best way to treat social anxiety. If you cannot access private psychotherapy, some hospitals offer free treatment programs and there are also self-help books available that are based on the principles of CBT.

If you struggle with social anxiety, know that there is hope and seek help. Learn more about my services at drlarrybaer.com and counselling in general on this website.

Dr. Larry Baer

Dr. Larry Baer is a psychologist working in private practice and at a psychiatric hospital in Toronto, Canada. He is experienced in helping members of communities for whom stigma and social anxiety can be a dual struggle, including individuals who identify as LGBT2Q+ and individuals with a serious mental illness such as psychosis. Learn more at drlarrybaer.com.
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