Social anxiety disorder

How to be socially confident

For many people social events and gatherings can be stressful and they will do anything they can to avoid them or need someone or something to give them confidence. People who experience social anxiety may employ avoidance behaviours that go beyond cancelling the occasional social invite and may get to the point where they isolate themselves and as a result feel increasing anxiety and low mood.

Learning to be socially confidence can be challenging and difficult, especially if you have let it influence your life choices to a great extent. At Schoen Clinic we will help you build your self-esteem, reduce your self-consciousness and increase your ability to socialise with others.

Shy = socially anxious?

Shyness is perceived as a characteristic that describes some people who may be more introverted than others, or soft spoken, a little less conversational. It isn’t an illness and it is not an indicator necessary that someone has social anxiety. It is perhaps someone being more cautious about speaking until they get to know someone or others or that they prefer to listen first before speaking. Many people who have social anxiety may have these characteristics but their complete avoidance of situations and isolation are indicators of the condition.

Social anxiety disorder defines an overwhelming, long-lasting fear triggered by social situations. It is also sometimes known as social phobia. Many people worry about social situations but having social anxiety disorder results in you feeling exceedingly worried before, during and after the event, disproportionate to the level of worry necessary for the situation. Social anxiety often occurs at a very early stage – mostly as early as puberty. Symptoms of social anxiety disorder are grouped into two types: physical and psychological.

Signs of Social anxiety: Physical symptoms

  • Upset stomach or nausea
  • Sweating
  • Trembling or shaking
  • Heart palpitations
  • Blushing
  • Sweating
  • Shortness of breath
  • Dizziness or faintness
  • Tense or achy muscles
  • Panic Attacks

Signs of Social anxiety: Behavioural / Psychological symptoms

  • A feeling of dread in relation to everyday activities (e.g. meeting strangers or speaking on the phone)
  • Avoidance of social activities or interactions
  • Fear of embarrassment
  • Fear of criticism or judgement
  • Finding it difficult to do activities if others are watching
  • Lack of clarity in thoughts
  • Often feeling like you are being watched and judged
  • Avoidance of eye contact
  • Low self-esteem
  • Emotional hypersensitivity, particularly to judgement or criticism
  • Alcohol consumption prior to social interaction
  • Stammer
  • Highly critical of self

Causes & Risk factors of Social anxiety disorder

As with other mental health conditions, social anxiety disorder is likely to be caused by several biological, psychological and environmental factors and an interaction between these. Risk factors for development of social anxiety disorder include:
  • Genetic vulnerability: sometimes illustrated in family history of social anxiety, or other mental health disorders
  • Structural abnormalities in the brain associated with the fear response. Over-activation may lead to a heightened fear response, causing increased anxiety in social situations
  • Issues in brain processes involved in reading others’ behaviour
  • Experience of parents who are either anxious themselves in social situations or are controlling or overprotective
  • Underdeveloped social skills
  • Shy, timid or withdrawn temperament
  • Experience of an unpleasant or embarrassing social situation, including rejection
  • Experience of trauma, including abuse and bullying
  • New social or occupational demands
  • An appearance or condition that is likely to draw attention (e.g. facial disfigurement or tremors)
  • Experience of bullying
  • Experience of conflict

Diagnosis: How Social anxiety is diagnosed

Firstly, we will get to know you as a person and consider your past experiences and current fears. We will explore with you the situations you fnd difficult and those you find less difficult.

Secondly, we will conduct a clinical examination for you, backed up by structured interviews and questionnaires. We also carry out differential diagnostic examinations, such as the exclusion of agoraphobia (claustrophobia) or panic disorder with agoraphobia.

Diagnostic criteria:

  • The pronounced fear of attention and performance situations, in which you could embarrass yourself, exists for more than six months.
  • Being confronted with a situation in which you are in the public eye or in which a performance is demanded triggers an anxiety reaction or panic attack in you.
  • You recognise that your behaviour is excessive.
  • You avoid certain situations or only withstand them under great pressure and anxiety.
  • Clear impact on your quality of life, restricting you.

Coping with your anxiety in the presence of others

At Schoen Clinic, we rely on multimodal therapy, which includes both individual and group therapy. The aim of the treatment is for you to learn how to deal better with your social anxiety. We will work with you to set the pace of change and the goals for increasing your coping skills. We will help you gradually develop skills for reducing your social anxiety. In the best case, you will no longer feel socially anxious and completely at ease.

Depending on the severity of your social anxiety and your ability to manage group work and individual therapy, we will agree a programme of treatment and therapy. For some people working in groups may be the first step to learning new skills. The groups are supportive and understand social anxiety with others in the group able to relate to these experiences.
For those who would benefit for an intensive day programme we will ensure you have a full weekly review to make sure you are getting the most out of the programme and work to reducing your days with us as soon as is possible.

Individual therapy

Cognitive Behavioural Therapy (CBT) is often the treatment of choice for someone with social anxiety although it is not always the case. Our therapists have a broad knowledge of therapies and we can offer psychodynamic and psychological therapies including CBT. Individual therapy is encouraged on a brief intervention model to optimise the time you spend with your therapist and increase efficacy.

Specialised group therapy

At Schoen Clinic we offer group therapy especially for people experiencing incapacitating anxiety and low mood, including social anxiety. You will learn methods and strategies for coping with or reducing your anxieties. In addition, you will share experiences and helpful strategies with each other, which decrease your feelings of loneliness and increase your self-awareness. The programmes provide an eclectic mix of psychodynamic, cognitive behavioural and mindfulness/relaxation groups so that participants get a full and rounded treatment experience to promote rapid recovery.

Skills development groups

We offer a wide range of skills development groups for the many difficulties associated with social anxiety. These include:

  • ‘Social skills’ group training
  • Relaxation training
  • Mindfulness training
  • Creative therapy
  • Coping with depression groups

Exposure as a central element

Attending the day programme can be daunting and it encourages you not to avoid but to take control. Gradual exposure to a stimulus or environment that triggers anxiety is a methodology that helps to reduce anxiety as are incrementally supported to build coping strategies to deal with the anxiety provoking situation. We therefore understand that gradually building up to attending groups can be helpful to some. Others may want to take advantage of our small groups and full programme, this exposure may be difficult to begin with but can quickly reduce as you experience positivity and acceptance among your peers at the clinic.

Meet the team

Our team of experts consultant psychiatrist, clinical psychologists, therapists, and specialist nurses work together as a multidisciplinary team for the benefit of every patient in the treatment of social anxiety disorder.

Our specialised clinic

Discover here our specialised clinic for social anxiety disorder. Let our experienced team advise you now.