We’ve all heard the advice: if you fall off the horse, get right back on it or fear
sets in. In many cases, this makes good sense.
Facing your fears can be powerful, especially when you stay in the situation long enough to learn that you can cope with it and that a catastrophe isn't likely to occur. This process is called exposure or exposure therapy. Most clinical research studies have shown that to reduce fear and anxiety, the treatment process must include an exposure therapy component. You can't simply sit in a therapist’s office exploring how and why you developed your fears; you have to confront them head-on.
Exposure works exceedingly well for simple phobias, such as a fear of snakes or fear of heights, and it can prove effective for other anxiety disorders, as well. Unfortunately, it's not so clear-cut in the case of social fears.
Many people I've worked with tell me they force themselves into social situations every day, but it doesn't get any easier. Or they tell me they’ve already tried “exposure therapy” and it didn’t work. Why is this so? What’s going on?
1. A key aspect to successful exposure is to take a gradual approach. It’s important not to do too much too soon.
The trick is to break your fears into a series of steps, with the first few steps being only mildly challenging, with later steps increasing in difficulty. We sometimes call this a hierarchy – a list of situations that elicit anxiety, rank ordered by the amount of distress each would lead to if you entered the situation.
With social anxiety it's often difficult to break things down into gradual steps. For example, think of all the aspects involved in dating: you must read nonverbal cues, make pleasant conversation, listen and show interest to your dating partner, and perhaps go to restaurants or other social places. Simultaneously, you must manage any of your physical symptoms of anxiety, such as sweating or blushing. Also you must cope with negative thoughts and try not to let them affect your social skills. That's a lot to do at once. Add to the scenario that you have little control over the other person and how he or she will act and you can see why anyone (with or without social anxiety) might dislike dating!
2. Another key to successful exposure is to make it a habit. You must do the thing you’re afraid of repeatedly.
Repeated exposure isn't always feasible with social anxiety. Some things like dating, socializing with friends, and going to parties are just a few examples of social situations that don't follow a particular schedule. Opportunities for interviewing for a job, taking an oral exam, or public speaking are even less likely to occur on a regular basis. I know this has been a big problem for me in overcoming my fear of public speaking or doing media interviews. I simply don’t do it enough to realize that it’s not that bad.
3. Finally, for exposure to be effective, you should remain in the situation until your anxiety level drops. This is often difficult in the case of social anxiety. Think of all of the social situations that are brief by nature: a handshake, answering the phone, smiling at someone on the street, introducing yourself in a meeting…
There's no way to prolong these situations so that your anxiety level can come down naturally. In seconds or minutes, the event is over, but you're left with your heart racing and your hands trembling. You're also left with doubts in your mind about how the situation went. It happened so fast and while you were so acutely anxious, it's easy to misinterpret things. You don't get the positive shifts in your thoughts and beliefs that come from prolonged exposure.
So if you've tried exposure therapy before and it wasn't helpful, don't think that it's your fault or that you have failed. Despite the potential problems listed above, there are some ways around them, which I’ll talk about in a future post.
Photo credits: Bench by Lisa Runnels; others by Pink Sherbet Photography
Shyness is nice and
shyness can stop you
from doing all the things in life
you’d like to.
–Ask, by The Smiths (Read how we named our blog.)
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I am the co-author of Dying of Embarrassment, Painfully Shy, and Nurturing the Shy Child. Dying of Embarrassment: Help for Social Anxiety & Phobia was found to be one of the most useful and scientifically grounded self-help books in a research study published in Professional Psychology, Research and Practice. I’ve also been featured in the award-winning PBS documentary, Afraid of People.