By Dr. Russ Morfitt
It is a common practice when seeing new patients suffering from anxiety to ask them if they’re getting any exercise. We know that exercise can help alleviate the symptoms of both anxiety and depression, though we’re not exactly sure why that is. Some research suggests that increased levels of endorphins play a role, while other research points to the individual’s attribution of a quickened heartbeat (often a sign of anxiety) to physical exercise rather than some external stimuli. But new research out of Queens University in Canada suggests that exercise or progressive muscle relaxation can actually change the way we view the world, in particular our perception of threats.
See also: The Spotlight Effect: or why Barry Manilow is still relevant
In a recent study, researchers asked student participants to walk, stand, or jog on a treadmill for ten minutes and then fill out a perception form, including identifying the direction of a walking stick figure. Those who stood for ten minutes were more likely to identify the figure as walking toward them (considered more threatening), while those who exercised – even just walking – were more likely to see the figure as walking away from them (considered less threatening). The results were similar for participants who engaged in some form of progressive muscle relaxation, as well. Something about the exercise and relaxation exercises had changed the way the participants perceived the world, from more threatening to less. This, it turns out, reduced their anxiety. So while we may not entirely understand how exercise and relaxation exercises help to improve our mood, there is abundant evidence that it is indeed the case.
See also: More Celebrities with Social Anxiety
By Dr. Russ Morfitt
One of the most important things to hear when we suffer from something painful like social anxiety is “me too.” Just knowing that someone else can relate to our feelings and our experience is immensely reassuring. So it’s sometimes helpful to point to others in the public eye who have experienced social anxiety as well. Our original list of celebrities suffering from social anxiety (including Donny Osmond and Jennifer Lawrence among others) was one of our most popular. So here’s a second short list of famous people who have known how tough social anxiety can really be, with some appearing to handle it more effectively than others:
Brian Wilson: the well-known scribe for the Beach Boys was famously depressed and highly anxious in the spotlight and in meeting others. He wrote a string of hit songs through the sixties and became the iconic image of the Beach Boys, one of the few American bands to rival the Beatles. Overcome by his misery in the midst of his success (and possibly suffering from some additional problems), he withdrew from the public eye into a world of psychotropic drugs and alcohol. But his career was reborn in the 90s when he was able to regain control of his life. A true tale of redemption.
Marilyn Monroe: The famous blond actress and model suffered from anxiety and depression over her long career. She was known to be reserved and insecure in private while she strived to be one of the best in her profession. In that quest, she also longed for a certain freedom from publicity that, of course, the media and public were not quick to provide. She turned to medication and alcohol to deal with her anxiety and died from an alleged overdose in 1962. Another example of the intense pressure on celebrities to live their private lives in the public eye.
See also: 5 Ways to Fight Inaccurate Thinking in Social Anxiety
Ricky Williams: the 1999 Heisman Trophy winner and 5th selection in the NFL draft, Ricky Williams was known during his career as an eccentric person, mostly because nobody had identified that he suffered from social anxiety. He was often camera shy and occasionally gave interviews in his helmet with its tinted visor. But after seeing a therapist and getting clarity on what he was suffering from, he claims he started to make his recovery; the diagnosis of social anxiety meant to him that he wasn’t crazy. With some cognitive behavioral therapy and medication he was able to regain control of his life again. William’s story is a reminder of the importance of giving a name to the things that cause us pain.
Johnny Depp: One of the most famous and talented actors in movies today is also someone who suffers from social anxiety. Johnny Depp has been able to manage his anxiety by employing a suite of relaxation techniques and a group of therapists who help him deal with his anxiety. Often times media outlets or the public refer to his introversion as a form of rudeness, but you can imagine how difficult it must be to excel at your craft when your profession is at odds with your emotional life. Depp is a testament to the power of the human will and to good therapy.
See also: Measuring Social Anxiety: Social Anxiety Tests, Scales, and Inventories
Daniel Tosh: Comedian and TV host Daniel Tosh gets asked a lot about how his social anxiety affects his acting. His answer is always the same: he creates a character in his mind that he adopts for his audience. His alter ego is whatever he chooses it to be, in his case loud, funny, and confident. Friends describe him as completely the opposite at home. For Tosh, creating a false persona in certain social situations may be what we sometimes call a safety behavior, which helps us to get by in the short term.
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By Dr. Russ Morfitt
Much of social anxiety rests on negative thought patterns: Everybody is staring at me. Nobody thinks I’m funny. My boss thinks I’m stupid. These negative thoughts are typically provoked by a trigger of some kind: a sideways glance, distracted friends, a boss having a bad day. One of the most helpful ways to overcome social anxiety is to challenge these inaccurate thoughts, but that requires some active planning and some (more) accurate thinking. Here’s a quick list of ways you can work on overcoming your own negative thought patterns.
1) Aim for some perspective.
When things go wrong, try to avoid the tendency to blame yourself. There’s a lot in life that has little to do with you. Someone’s bad mood, a missing invitation, someone’s averted gaze – they most likely have nothing to do with you. Do the friend test: would you say what you’re thinking to a friend, blaming them? If not, try to find a more realistic description of the situation.
2) Accept that you are less than perfect.
Many of us are perfectionists who like to hold ourselves to impossibly high standards and then beat ourselves up when we fail to meet a single one of them. We’re made up of thousands of thoughts and actions. A single flaw on any one of them does not determine our success or failure as a human being.
3) Fake it ’til you make it.
It’s important to keep a balanced view of yourself. What do other people value about you? What are your strengths? Have you ever noticed how more peaceful people deal with challenges, even minor ones? Think about how you would react in the same situation. It may seem strange, but it’s actually helpful to try to adopt their optimism and persistence in the face of difficulty.
4) Keep a journal of your negative thoughts.
It often helps to write down your negative thoughts (and their triggers) in a journal as they occur and then to revisit them later when you’re in a calmer mood. This allows for some perspective as you consider the merit of the negative thought. Does the thought seem justified? Does the same thought come to mind or do you now see the experience differently? Your boss not looking at you may have nothing to do with you and everything to do with her having a bad day. If there’s a chance that the thought has merit, can you identify some ways that you could cope?
5) Avoid exaggeration.
We often exaggerate in using words like “always” and “never” to describe our perspective of a situation. They rarely describe a situation accurately. Instead, try to use words like often, normally, many, etc. Even that small distinction can cause a huge shift in our thinking. And try not to exaggerate the importance of a single event. How important will your gaffe (if indeed it is one) be in a month, in a year, in five years?
Most of us stand out in our own minds. Whether in the midst of a personal triumph or an embarrassing mishap, we are usually quite focused on what is happening to us, its significance to our lives, and how it appears to others. Each of us is the center of our own universe.
Because we are so focused on our own behavior, it can be difficult to arrive at an accurate assessment of how much–or how little–our behavior is noticed by others. Indeed, close inspection reveals frequent disparities between the way we view our performance (and think others will view it) and the way it is actually seen by others.
- assign a number to the feeling of public awareness around you and then cut it in half,
- remember that the few who do briefly pay attention to you also probably quickly forget you, or they may like something about you (and then shift to thinking of their own spotlights)
- if an awkwardly worn Barry Manilow t-shirt is noticed by only about 20% of people in a situation designed to draw attention to it, your worst gaffe can hardly do more.
May is National Mental Health Month. If you’re on a college campus you may have seen signs promoting social anxiety and depression awareness. Or if you’ve been reading the news you may have seen some recent coverage of the same. We’re always excited to see these issues getting more national attention because realizing you’re not alone is such an important step in overcoming these issues.
At Learn to Live we’re dedicated to providing encouragement, resources, and strategies to help people overcome their social anxiety. Our main focus is our program allowing members to access internet-based Cognitive Behavioral Therapy. We’d like to do something special to celebrate National Mental Health Month. I’ll let my colleague and co-founder, Dale Cook, provide you with the details.
My name is Dale Cook and I am the co-founder and CEO of Learn to Live. I’d like to tell you about a special discount that we are offering in celebration of Mental Health Month. In an effort to make help for social anxiety available to as many people as we can, we’re cutting the price of our online Social Anxiety Program in half through the end of this month.
You can save 50% on the Learn to Live Social Anxiety Program by clicking here and using code MHMONTH at checkout. The entire 8-course program is only $74.50 with this special offer. Offer ends May 31 at midnight CST. Continue reading to learn more about the program and the positive results that our 1,500+ members are already experiencing.
The Learn to Live Online Social Anxiety Program
The Learn to Live Social Anxiety Program is an online Cognitive Behavioral Therapy (CBT) Program that is confidential, accessible at home and as effective as the most potent in-office psychotherapy.
The 8-course Program challenges sufferers to engage with their social anxiety through multi-media and CBT-based exercises and activities. It also allows sufferers to enlist friends, family, or others as Teammates, who can support them throughout the process. The Program was developed by our own Dr. Russ Morfitt, who has over 16 years of experience successfully treating patients with Cognitive Behavioral Therapy and manages the CBT Center, a specialty anxiety clinic he founded in Eden Prairie, Minnesota.
How Effective is the Social Anxiety Program?
Studies have shown that online CBT is at least as effective as face-to-face Cognitive Behavioral Therapy. Members of our Program have experienced a significant reduction in their level of social anxiety as demonstrated by an average reduction of 21 points on the Leibowitz Social Anxiety Scale (LSAS). The LSAS is the main social anxiety test that we use at Learn to Live. Learn more about the Leibowitz Social Anxiety Scale or take this free social anxiety test now.
A 21 point LSAS reduction means that our members on average experience a change from “severe” social anxiety to “moderate, or from “marked” social anxiety to “mild.” For many sufferers, these results mean they are able to live their life more fully and finally participate in the events and relationships that they have so often watched from the sidelines.
What Members of our Social Anxiety Program are Saying
You don’t need to take our word for it. Here are some emails from members describing what it’s like to live their life more fully:
“My progress is incredible. Things are really changing for me, and I feel so much better and more able to live.”
“I am extremely happy with my progress. I feel confident going out and eating with others with little to no concern as to what people are thinking of me. This is leaps and bounds ahead of when I first started the Program!”
“The biggest progress I’ve made is actually thinking about whether my thoughts are correct. The Program has given me more confidence that possibly my first “flight” reaction, and my first thought about what others may think about me, may not be right!”
“Lesson 6 was probably my favorite. It was interactive, fun, educational, and helpful. I felt like the Lesson really emphasized me taking control of my life.”
“Doing the assessment at the beginning, and reading the goals I initially set and how much progress I’ve made towards those goals, was really effective in helping me understand just how much I’ve grown, and all the ways in which social anxiety affects my life.”
Want to hear more? Find the full list of Learn to Live member reviews and testimonials here.
We hope you’ll take the time to consider the Learn to Live Social Anxiety Program, and we are thrilled that you are taking the first steps towards overcoming your social anxiety. It wont be easy, but it will be worth it. To take full advantage of the resources we offer, please connect with us on Facebook, Twitter, and YouTube. We frequently share videos, information, and even the occasional meme to brighten your day.
See you in the Program,
1) Listening to our social anxiety
We are trained to listen to our bodies and our emotions, but social anxiety is a poor guide. When we listen to the demands made by our social anxiety — escape, avoid, leave! — we may experience temporary relief, but those actions ultimately keep us stuck. Cognitive Behavioral Therapy is one helpful way to inspect the thought process to make sure we’re listening to the right kind of advice.
2) Failure to do a reality check
Many of our fears could be overcome through a simple reality check, a simple verification of whether what we believe to be true really is true. For example, we believe that everyone is staring at us but we don’t check to see if indeed they are. We assume they are bored with us or gossiping about us, but we don’t look as closely as we could. People who are anxious assume there is danger unless there is compelling evidence of safety. People who are not anxious assume safety unless there is compelling evidence of risk. Overcoming anxiety involves requiring evidence of risk rather than safety. Making this shift causes a subtle but profound change in the way we feel.
3) Blindly facing our fears
We often err in the belief that by simply doing the thing we’re afraid of doing we’ll cause ourselves to overcome the fear of it. The spirit of this idea is wonderful, and the very foundation of the fear-facing element of CBT, but often there is something missing. Thoughtful fear facing requires that we do an honest assessment of our thoughts and feelings. To do otherwise is to set ourselves up for failure. If we don’t become less afraid after repeatedly doing a scary thing, it can be very discouraging. This problem is so closely tied to problem #4 that by solving the one, we’re well on the way to solving the other.
4) Seeking comfort
Trying to feel comfortable is a poor strategy. Huh? It seems reasonable, doesn’t it — what’s wrong with trying to feel comfortable? And yet we have found that the very things we do to try to feel less anxious often keep us from getting past our fears. We continue to stay afraid because we keep trying to play it safe, taking precautions. As long as we continue to play it safe we can’t discover that those things we view as dangerous may not really be so dangerous after all.
5) Mind reading
Mind reading is the mistaken belief that we can read the thoughts, feelings, and motivations of others. We assume we know what others are feeling, what they think about us, and why they said what they said. We are most likely mistaken in that belief, and yet it is so deeply ingrained in us that we find it impossible to believe otherwise. That voice of self-criticism comes from a place deep inside us and is a formidable opponent. But recognizing that voice and learning to turn it off is one of the most important things we can do when facing social anxiety.
Almost everyone feels at least a bit of anxiety before speaking in front of a crowd or has some degree of nerves in unfamiliar social settings. The socially anxious person, however, has a debilitating level of anxiety, which interferes with their everyday functioning and causes them to modify their daily routine so as to avoid the stress of even small social interactions. Their experience of the stress of social anxiety is often characterized by its intensity, duration and effects. For the socially anxious, butterflies turn into nausea, sweating, diarrhea, and shortness of breath. The healthy fear that makes us prepare well for a talk becomes a debilitating anxiety about how others will perceive us. This leads to coping mechanisms like constantly avoiding social situations, always bringing friends to shield themselves, and drinking before an engagement in order to soothe their nerves.
The symptoms that define social anxiety are many, but they boil down to three essential categories: cognitive/emotional symptoms, behavioral symptoms, and physical symptoms. The cognitive/emotional category covers our thoughts and feelings during or leading up to a social interaction. The behavioral deals with how we behave as a result of that fear. And the physical enumerates the long list of physical manifestations that our excessive fear might take. We made a handy chart of these symptoms below for our readers. While average readers may recognize some of these in their own lives, the socially anxious person will know them for their outsized influence in their life.
Cognitive/Emotional symptoms of social anxiety
- excessively negative thoughts about oneself
- thoughts of inadequacy
- excessive self-consciousness and anxiety in routine social situations
- mind games
- low self-esteem
- unrealistic demands on oneself
- anxiety that disrupts your daily routine, work, school or other activities
- excessively high standards
- expectation of being judged
- fear of embarrassment or humiliation
- intense anxiety before an upcoming social engagement
- belief that others will notice you’re anxious
- fear of social interaction with strangers
Physical symptoms of social anxiety
- shortness of breath
- racing heart or tightness in chest
- feeling dizzy or faint, unsteadiness
- trembling or shaking
- shaky voice
- muscle tension
- cold, clammy hands
- upset stomach, nausea (i.e. butterflies)
- disorientation or confusion
- dry mouth
- difficulty talking
Behavioral symptoms of social anxiety
- avoiding social interactions out of fear of embarrassment
- avoiding social situations to a degree that limits your activities or disrupts your life
- staying quiet or hiding in the background in order to escape notice and embarrassment
- always bringing a buddy along with you for security
- avoiding situations where you might be the center of attention
- drinking before social situations in order to soothe your nerves
- avoiding eye contact
The Liebowitz Social Anxiety Scale (LSAS) is a short questionnaire used to measure how social anxiety plays a role in different life situations. This social anxiety test was developed in 1987 by Dr. Michael R. Liebowitz, a psychiatrist and researcher at Columbia University. Studies have shown the LSAS to be a cost-effective and efficient way to identify those with social anxiety. The scale features 24 items, 13 relating to performance anxiety and 11 dealing with social situations. Originally designed to be administered by a clinician, it has since become a popular self-report scale (technically, the LSAS-SR) because of its ease of use. We have a version of the Liebowitz Social Anxiety Scale on our homepage because it provides meaningful results.
The Social Phobia Inventory (SPIN) is a questionnaire developed by Dr. Jonathan Davidson at Duke University for screening and measuring generalized social anxiety disorder. The assessment scale consists of 17 items covering the spectrum of social phobia such as fear, avoidance, and physiological factors. Each item is ranked by the test taker on a scale of intensity, from “Not at All” to “Extremely” and assigned a corresponding number value. A score higher than 19 indicates likelihood of a social anxiety disorder.
3. Mini-Social Phobia Inventory (Mini-SPIN)
The Mini-Social Phobia Inventory (Mini-SPIN) is an abbreviated instrument based on the SPIN (above) developed by Dr. Jonathan Davidson at Duke University. Here also, each item is ranked by the test taker on a scale of intensity, from “Not at All” to “Extremely.” Despite its brevity (only 3 items), the Mini-SPIN has been found to accurately differentiate between people with and without generalized social anxiety disorder.
In the study of social anxiety, it is common to differentiate between social interaction and performance anxiety. Mattick and Clarke (1998) designed the Social Interaction Anxiety Scale (SIAS) to assess social interaction anxiety and the Social Phobia Scale (SPS) to assess fear of scrutiny by others during routine activities (eating, drinking, writing, etc.). These scales are often administered together. Both scales consist of 20 items, which are rated 0 to 4; total scores range from 0 to 80. The two tests possess good convergent and discriminant validity, having been shown to discriminate between clinical conditions, people with social phobia, and those without. Together they have become some of the most popular tests administered by psychologists.
The SPAI assesses specific somatic symptoms, cognitions, and behaviors across a wide range of potentially fear-producing situations to measure social anxiety and fear. SPAI results are particularly useful for discriminating between panic disorder, agoraphobia, and social phobia. This 45-item test is an ideal screening instrument for schools, outpatient clinics, hospitals, residential treatment facilities, prisons and other correctional environments, and employment settings. For example, the SPAI can help monitor treatment change and detect those who may suffer from maladaptive social anxiety. In corporate settings, the SPAI helps distinguish those who may have difficulty in positions requiring high levels of social interaction (sales) and social performance (speeches). With a sixth grade reading level, the SPAI is appropriate for individuals who are 14 years of age or older.
5. Fear of Negative Evaluation Scale (FNE)
Fear of Negative Evaluation, developed by Watson and Friend, assesses the degree to which people worry about how they are perceived and evaluated by others. The authors describe FNE as “apprehension about other’s evaluations, distress over their negative evaluations, and the expectation that others would evaluate oneself negatively.” (1969) Their Fear of Negative Evaluation Scale (FNE) is a 30-item self-report measure of social anxiety running from high fear of negative evaluation by others to no apprehension about other’s evaluations. The FNE has been shown to correlate with measures of anxiety, depression and general distress. The FNE has not been shown to correlate strongly with other measures of social apprehension.
6. Social Avoidance and Distress Scale (SADS)
The Social Avoidance and Distress Scale (SADS) contains 28 items, 14 of which assess social avoidance and 14 of which measure social anxiety. The SADS was developed by David Watson and Ronald Friend and is closely related to their FNE.
By Dr. Russ Morfitt
Offering online, or web-based, Cognitive Behavioral Therapy as a tool to treat social anxiety seems a bit oxymoronic. Isn’t it counterproductive to use a tool that allows a person to avoid social interaction to battle anxiety about social interaction?!
On the face of it, yes, it seems crazy. But the research shows again and again that web-based Cognitive Behavioral Therapy is just as effective as face-to-face CBT. Online CBT has the added benefit of being able to reach that group of sufferers who either a) do not have access to a therapist trained in CBT, or b) suffer from anxiety so severe that meeting with someone face-to-face is simply too terrifying, a non-starter.
CBT itself is a highly structured therapeutic approach that involves a good deal of self-reflexion about a person’s thoughts and behaviors. The internet, it turns out, is a great place to start walking someone through the difficult process and to host the resources to help someone overcome their anxiety. Those first successful steps online provide the inspiration and motivation to continue the pursuit of wellness with real people in real situations, the very core of our social existence.
Some people have said, “Well, isn’t it kind of a paradox that if a person has social anxiety that they would turn to an online program to get help with this problem with real-life flesh-and-blood people?” And that’s a great question. But what we’ve found is that if we offer CBT online it suddenly becomes accessible. One of the really sad stories is how few people with social anxiety really go out there and ask for help, but with online CBT I can take my first steps right at home – I don’t have to tell anybody, I don’t have to go through the fear of talking to a receptionist, making the schedule, being involved in that ambiguous scheduling situation, and I can just launch into learning the tools right at home.
But of course it doesn’t stop there, and this is the thing that I like to explain – once somebody is learning the tools online then they learn how to take the vitally important steps of applying them in interactions with flesh-and-blood people, facing their fears with flesh-and-blood people out there in the wild. And there the CBT really has its power. So they learn it online and they apply it out there in the real world. And that’s where their skills are really strengthened, and that’s where they really experience the benefit.
For more Social Anxiety related videos, please subscribe to the Learn to Live YouTube Channel.
By Dr. Russ Morfitt
I’ve informally tracked some of the feelings that accompany social anxiety, as shared with me by people who have experienced them. It is so much more than apprehension and nervousness, which I did not put on the list because they are so obvious. For many people, social anxiety is the fear AND the regret of imperfections AND the shame of being on the outside. If you suffer from social anxiety, you’ve likely experienced many, if not all, of these emotions.
1. Fear (naturally)
The fear of being in the spotlight is perhaps the most common feeling associated with social anxiety. That fear is crippling and manifests itself in a number of way: sweaty palms, racing heart, dry mouth, blushing, and shaking hands. It could be any number of things that provoke the fears: the thought of giving a speech, performing in front of others, speaking out in class, meeting someone new, or simply walking into a room. Any one of them is sufficient to provoke this feeling.
Dread is the anticipation of something unpleasant. Our over-thinking of an upcoming event, such as a family gathering, holiday, or birthday celebration, can turn the days leading up to that event into long hours of nervousness and discouragement. We don’t know that the prediction we are making will really come true (e.g. that others will stare or judge, or that I won’t know what to say), but dread involves bracing ourselves for misery anyway.
Embarrassment is associated with our tendency toward self-criticism and judgment. We are overly concerned with the judgment of others and project our own self-criticism onto them. “(Gasp) They heard me say something incorrectly, or they saw me do that awkward thing, or they are all just about to focus on me.” We think our smallest mistakes are insurmountable gaffes, obstacles that cause others to judge and reject us. We discuss this topic more in our post about dating with social anxiety.
Sadness stems from the thought that the world is passing us by and we can only sit by helplessly and watch. Social anxiety brings with it the urge to avoid people – even though we long for relationship – so our worlds get smaller, and then we feel lonely and think we’re really missing out.
Disappointment is born of the many missed opportunities for engaging with friends and family. Every holiday, every birthday, every night out for others is another disappointing reminder of what I don’t have. I see how much everyone else enjoys each other’s company and long for the same.
Beyond the pain of not enjoying the company of others, we can be emotionally hurt by the lack of understanding that others have for our problems with social anxiety. Sometimes they don’t know how their behavior affects us, but it would be too awkward to ever discuss how it hurts to be uninvited, excluded from conversations, or teased.
We are angry at ourselves and at others. Why can’t I go out in public? Why can’t I speak to others? Why was I made this way? Why doesn’t anyone understand?
The loneliness is that disconnect that we feel as we watch others get together, go out, and enjoy each other’s company. We want desperately to join in but feel helpless to do so. We may have turned down a few offers for social contact in the past, but we still long to be included and connected.
I am the only one in my family who can’t go to the family reunions. It feels like there is something wrong with me and that it would be humiliating if others knew I was socially anxious. So I do what I can to conceal it.
Some people had never heard of panic attacks before basketball player Royce White reported them publicly. But those of us who have experienced them rarely forget that feeling of panic, sometimes enveloping us when the spotlight hits us and we freeze. It’s as if the entire body and mind lock up in suspended animation. It feels like we must struggle to even breathe as if detached from our own bodies. The animal response is “fight or flight” but there is no physical threat. One of the main goals of Cognitive Behavioral Therapy (CBT) is often to overcome that conditioned response.
So how closely do these track with your own experience? Whatever the case, just remember: don’t give up.