Counselling and therapy for anxiety about social situations

Social anxiety is characterized by marked apprehension and avoidance of social situations and interactions with other people for fear of scrutiny, criticism, embarrassment or rejection. This is commonly accompanied by and related to agoraphobia, a deep anxiety surrounding situations that the person perceives as being difficult to escape or get help.

People with social anxiety tend to experience intense emotional distress in the following situations—although the degree to which each is anxiety-provoking will of course vary from person to person:

  • Most social encounters – especially with strangers
  • Being introduced to new people
  • Being the centre of attention
  • Being watched whilst doing something
  • Meeting people in authority
  • Using public bathrooms
  • Eating or drinking in public
  • Making phone calls
  • Interpersonal relationships (platonic or romantic)

On some occasions, the anxiety becomes so intense that the person may experience a panic attack, which includes physical symptoms such as shortness of breath, dizziness and numbness, Interaction with others can cause intense distressalong with a convincing feeling of heart attack or impending death.

So, as you can see, where many of us feel a little anxious in social situations, this is certainly not the same as Social Anxiety, which can be deeply distressing and disabling. Without proper and prompt help, it can be tempting to avoid these horrible feelings by shying away from attention in social situations (not speaking up, not putting oneself forward for various opportunities), or even avoiding them altogether.

However, reclusive or submissive social behaviour will make anyone feel low and lonely, for as well as reducing the possibility of anxiety, this leads us to miss out on a wealth of potentially positive experiences with others. Also, far from alleviating your problems, this avoidance means that you can never disconfirm your underlying thoughts and fears about social situations i.e. it actually perpetuates the problem.

Locating the thoughts that lead to anxious feelings

Counselling can be a brilliant way to help break this cycle of anxiety and avoidance. During this process, the therapist works empathetically and collaboratively with you to locate and understand the thoughts that have led to these anxious feelings. They may include ideas such as “Everyone will laugh at me”, “I will say the wrong thing”, or “People will think I’m boring”.

Some of these negative thoughts may spring up automatically without you even realising or having time to recognise them before you jump to an anxious conclusion. Counselling helps us to slow down, and be really mindful of what is going on in our internal life, so that we can tease apart what elements of our experience are causing and maintaining our problems.

Therapists and counsellors at The House use their wealth of experience to help you to analyse the validity of these thoughts and challenge them accordingly. Through repeated challenging, you can eventually begin to deliberately, and then automatically replace them with more realistic and positive alternatives that stand up to this kind of therapeutic scrutiny much better.

Really paying attention to your surroundings

As well as helping you to challenge your unhelpful thoughts, counselling therapists can help to arm you with more productive and helpful ‘coping’ techniques including relaxation techniques, breath control, and adaptive displacement activities (e.g. really paying attention to your surroundings rather than monitoring yourself and your thoughts about situations).

By working up a ‘ladder’ of activities (from least to most anxiety provoking) in between sessions, you can have the chance to try out everything you have learned in the real world. In the following sessions, the therapist works with you to evaluate your experiences to see if you are ready to ‘move up a level’, or need more time to work on the current tasks.

The aim of these between-therapy activities is to empower you to essentially become your own therapist. Counselling Psychology aims to do away with the power differentials inherent in some previous forms of therapy such as psychoanalysis (wherein the therapist was seen as having insight and knowledge beyond that of the client, such that only they could help to provide answers and aid recovery).

Instead, the Counselling Psychologist’s approach is defined by collaboration, respect and empathy: our counsellors are here to help you to to work through your problems. They do not hold the ‘keys’ to positive change, rather they are very skilled at helping you to locate your own.

The House Partnership, 12th February 2012