06/08/2012 04:39 pm ET Updated Aug 08, 2012

Treatment for Social Anxiety

If you feel emotional discomfort about social situations, interactions with others, or being evaluated or judged by others, you may have "social anxiety" -- a problem shared by almost 20 million others in the United States.

According to Wikipedia, "The essence of social anxiety has been said to be an irrational or unreasonable expectation of negative evaluation by others."

The American Psychiatric Association estimates that social anxiety is the number one most common anxiety disorder and is also the third most common mental disorder in the U.S.

Treatment for social anxiety

One of the most common forms of treatment consists of cognitive-behavioral therapy CBT), which attempts to help patients change their thinking process so as to eliminate the negative thoughts that cause social anxiety. When your thinking process changes, you react with less anxiety to situations.

Another approach, which I've successfully used with literally thousands of clients, is to help them eliminate the beliefs that cause the social anxiety. Here is a list of the beliefs that I've found underlie this common fear for most people.

  1. "Mistakes and failure are bad."
  2. "I'm not good enough."
  3. "Change is difficult."
  4. "I'm not important."
  5. "What makes me good enough or important is having people think well of me."
  6. "Nothing I do is good enough."
  7. "I'm not capable."
  8. "I'm not competent."
  9. "I'm inadequate."
  10. "If I make a mistake or fail I'll be rejected."
  11. "I'm a failure."
  12. "I'm stupid."
  13. "I'm not worthy."
  14. "I'll never get what I want."
  15. "I'm powerless."
  16. "People aren't interested in what I have to say."
  17. "What I have to say isn't important."
  18. "It's dangerous to have people put their attention on me (something bad will happen)."
  19. "What makes me good enough or important is doing things perfectly."

If you had these beliefs about yourself, can you see why you would have social anxiety -- "an irrational or unreasonable expectation of negative evaluation by others"?

Specifically, if you had the belief, "What makes me good enough or important is having people think well of me," is it clear that your sense of self-worth would be based on what others thought of you?

And is it real that if you believed, "It's dangerous to have people put their attention on me (something bad will happen)," you would fear social interaction?

Conditioning also plays an important role

Although my experience with clients has led me to conclude that the primary source of social anxiety is our beliefs, I've discovered that conditioning also plays an important role.
The classic example of how conditioning works was an experiment a physiologist named Pavlov conducted with dogs. When presented with food, the dogs salivated. Then a bell was rung just prior to presenting the dogs with food. After numerous presentations of the food with the bell, the bell was rung and no food was delivered. The dogs salivated anyway, because they had associated the bell with the food. In other words, a neutral stimulus that normally would not produce a response does so because it gets associated with a stimulus that does produce a response. In other words, the neutral stimulus gets conditioned.

Here's an example I use with my clients that will make the process of conditioning very clear. Imagine that I handed you an ice cream cone with one hand and made a fist with my other hand and drew it back as if to hit you. What would you probably feel? Some level of anxiety if you thought you might get hit. Now imagine that the next few times someone handed you an ice cream cone, the same thing happened and you felt anxious each time.

What do you think you would feel the next time you were handed an ice cream cone, even if there was no menacing fist? Probably anxious. And yet it's clear that ice cream cones are not inherently scary. If this next time there was no fist, only ice cream, why would you feel anxious? Because ice cream cones got conditioned to produce fear. The ice cream cones just happened to be there every time you got scared by the fist.

The principle is that anything that occurs repeatedly (or even once if the incident is traumatic enough) at the same time that something else is causing an emotion will itself get conditioned to produce the same emotion.

There are four important conditionings involved in social anxiety.

  • Conditioning: Fear associated with criticism and judgment.
  • Conditioning: Fear associated with not meeting expectations.
  • Conditioning: Fear associated with people putting their attention on me.
  • Conditioning: Fear associated with rejection.

Can you see how being conditioned to experience fear in these four situations would lead to anxiety in social situations?

When the relevant beliefs and conditionings are eliminated, the social anxiety is also.

Get help

If you or someone you know has this problem, don't continue to suffer needlessly. Social anxiety can be treated successfully. There are thousands of CBT therapists and people who can eliminate beliefs and conditionings. In fact, it is possible in some cases to totally eliminate the problem.

Please leave your comments and questions here about today's post. I read all posts and answer as many as I can.

Morty Lefkoe is the creator of The Lefkoe Method, a system for permanently eliminating limiting beliefs and de-conditioning the stimuli that cause negative feelings and behaviors.

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