Social Anxiety Myths, Facts & Useful Tips for Teenagers and

Adults

What is Social Anxiety Disorder (SAD)? Characterizedbyapersistentfearofsocialorperformancesitua6onsinwhichembarrassmentorhumilia-onmightoccur.Exposuretosocialorperformancesitua6onsfrequentlyprovokesanimmediateanxietyresponsethatisexcessiveorunreasonable.Individualsusuallyhavepersonalinsightthattheirfearisunreasonableorexcessive.Thefear,anxiety,oravoidanceispersistent,typicallylastsformorethan6monthsandinterfereswiththeindividual’sfunc-oninginsocial,workorschoolcontexts

SAD Screener

10 Myths & Facts

MYTH

Social anxiety disorder is merely a pathological label for shyness.

FACT

Shyness is neither a pre-requisite for nor is synonymous with the disorder. Only a few shy children have their extreme shyness persist into adolescence and adulthood as social anxiety disorder. Also, 50% of adults with social anxiety disorder do not report excessive shyness in childhood.

MYTH

Social anxiety is normal, we all experience it.

FACT

Transient episodes of social anxiety is not uncommon, and part of normal development. For a small percentage of children and adolescents with SAD, social anxiety causes considerable distress and interference and does not diminish over Qme.

MYTH

Social anxiety is an adult thing.

FACT

The average age of onset for social phobia is typically mid-adolescence, which coincides with the onset of normal suscepQbility to social embarrassment. A number of researchers have reported diagnoses of the disorder in children as young as 8 years of age.

MYTH

Social anxiety boils down to bad parenQng.

FACT

Children with social anxiety disorder do not show high rates of childhood maltreatment or other specific forms of early-onset psychosocial adversity.

Research consistently shows that a heritable temperamental trait known as behavioural inhibiQon is commonly an antecedent to the development of social anxiety disorder.

MYTH

Socially anxious people should just stay away from others and avoid what makes them feel bad.

FACT

Avoiding the perceived threat of social interacQon is a strategy that may relieve anxiety in the short term, but perpetuates and aggravates the problem in the long term. Socially anxious people desire to have close relaQonships, just like anyone. They might crave social aWenQon, but are too terrified about negaQve scruQny to iniQate or engage in meaningful interacQon.

MYTH

People with social anxiety don’t know how to communicate and lack social skills.

FACT

Children with social anxiety disorder are able to communicate socially, though they can seem impaired when first interacQng with unfamiliar peers or adults.

In adulthood, socially anxious people actually underesQmate their ability to deal with socially threatening situaQons.

MYTH

Social anxiety is a feeling, and doesn’t really hurt or affect you.

FACT

Social anxiety disorder is a common reason for school refusal in young children, and it is the only anxiety disorder that has consistently been shown to be associated with dropping out of school early. Social anxiety affects how one thinks, feels and behaves. Some youth report that when confronted by an anxiety provokingsituaQon, they are flooded by so many thoughts that they are unable to think clearly and focus at all. Aside from affecQng work performance, pervasive anxiety in adults can cause physiological symptoms such as high heart rate and high blood pressure which can be dangerous in the long term.

MYTH

Social anxiety is something that can be overcome without professional help.

FACT

While individuals can implement self-help strategies to alleviate symptoms, people with social anxiety o]en have co-occurring problems such as depression or alcohol/ drug abuse, which makes it harder to overcome their difficulQes on their own.

MYTH

MedicaQon works beWer than psychotherapy to treat social Anxiety.

FACT

Many studies have shown the effecQveness of both cogniQve behavioural therapy and drug treatment in treaQng social anxiety.

Trials comparing drug treatment versus cogniQve behavioural therapy in social anxiety disorder suggested that drugs can have faster effects, but the effects of cogniQve behavioural therapy last longer.

MYTH

Psychotherapy for social anxiety is just talk therapy.

FACT

Treatment for social anxiety can include psychoeducaQon, progressive muscle relaxaQon, social skills training, imaginal and in-vivo exposure, video feedback, and cogniQve restructuring, among other things.

Some of the most common thinking distorQons and its anQdotes

Dichotomous thinking/All or nothing. You see things in black and white categories.

Make an effort to look for shades of gray in every situaQon.

OvergeneralizaQon. You see a single event as a never-ending paWern of defeat.

Make a conscious effort to look for excepQons.

DiscounQng. You reject posiQve experiences by insisQng they are not important, meaningful or don’t count.

Be aware of posiQve things that happen to you and accept them.

Consider other possible outcomes: PosiQve predicQons, neutral predicQons and less negaQve predicQons.

Catastrophizing. You exaggerate the importance and negaQve consequence of events.

EmoQonal reasoning. You assume your negaQve emoQons reflect the way reality is.

Ask yourself what is the thought, image or belief that may have caused your emoQon and reframe the situaQon.

Mental filter. You pick out a single negaQve detail and dwell on it exclusively so that your vision of all reality becomes darkened.

Figure out other ways you can perceive a situaQon by asking other’s perspecQve of the same reality.

Mind reading. You make assumpQons about other people’s thoughts and moQves.

When you noQce you are predicQng catastrophes try to develop alternaQve predicQons as well.

Fortune telling. You anQcipate that things will turn out badly.

Try to check your belief with the person you are mindreading when possible.

Some of the most common thinking distorQons and its anQdotes

Progressive Muscle RelaxaQon SystemaQcally tense and relax different muscle groups to

generate a sensaQon of release and relaxaQon in your body

Deep Breathing Count up to 3 while you are breathing in and count up to 6 when

breath out.

Self Soothing

Create a Fear Hierarchy

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10

1.  Generate a list of specific situaQons/ tasks related your source of anxiety.

2.  Rank them in order from least to most scary.

3.  Expose yourself (e.g. actual/ imaginaQon/ role-play) to each situaQon

gradually, starQng from the least threatening ones.

4.  Use the cogniQve anQdotes and self-soothing skills to help tolerate the

anxiety at each phase.

2

Example of a threatening situaQons hierarchy

Talking about myself

Diner with friends

Going to a party

Job interview

Giving a presentation to a group of colleagues

Asking my boss for a day off work

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10

9

8

7

4

Ask questions to a stranger

QuesQons or Comments?

REFERENCES Barlow, D.H., Farchione, T.J., Fairholme, C.P., Ellard, K.K., Boisseau, C.L., Allen, L.B., Ehrenreich-May, J.T. (2011). Unified Protocol for transdiagnos2c Treatment of emo2onal disorders. New York: Oxford University Press.

Burns, D.D. (2003). Feeling good: The new mood therapy. New York: HarperCollins.

Linehan, M.M. (2015). DBT Skills Training Manual. Second edi2on. New York: Guilford Press.

Ollendick, T. H. & Hirshfeld-Becker, D.R. (2002). The developmental psychopathology of social anxiety disorder, Biological Psychiatry (51) 44 – 58.

Rodebaugh, T.L., Holaway, R.M. & Heimberg, R.G. (2004). The treatment of social anxiety disorder, Clinical Psychology Review, (24) 883 – 908.

Stein, M.B. & Stein, D.J. (2008). Social anxiety disorder, The Lancet (371) 1115 – 1125.

Reinforcement is the most effecQve way to increase the frequency of behaviors

Reward yourself every Qme you engage in a social threatening situaQons

Some rules of the rewarding programs:

ü  Reward immediately followed the desired behaviour ü  Make sure the rewards are relevant for you. ü  Plan your reinforcement plan in advanced ü  Combine different types of rewards in your plan (food, goods, self speech)

Imagine the situaQon before you actually face it and and imagine yourself using the social skills

required to get your goal from the situaQon

Cope ahead using your imaginaQon