Susan is planning on getting married and tells me that she is extremely anxious about the wedding. At first I think that this is how almost everyone feels, facing their wedding with mixed feelings about how well it’s going to go. But then she says, “No, I’m afraid that I will be sweating as I walk down the aisle and that my voice will hesitate and break and that I will just look like a fool.” She goes on to describe a number of situations where she feels anxious: “I feel that when I am at a party that people can see how anxious I am, that my hand will tremble while I hold a glass of wine. I just think that I come across like nervous wreck." Susan tells me that she has avoided a number of situations where she fears that her anxiety will be exposed—going to parties; meeting her partner’s friends; speaking up in meetings; or even asking a store clerk to show her an item. Susan tells me that she often drinks several glasses of wine before going out to a party to get her nerve to face people.
Susan is like a lot of people—she suffers from social anxiety disorder.
The typical symptoms of social anxiety disorder are the fear of being evaluated by others in social situations; the fear that one's anxiety will be obvious to others and that one will be humiliated; and the tendency to avoid these situations or to tolerate them with extreme discomfort. During any given year about 7% of adults suffer from social anxiety, and for many, these problems persist for years, often accompanied by depression and alcohol abuse. People with social anxiety often do not achieve what one would expect of them, because of their difficulty facing people and dealing with the discomfort of social situations. Interestingly, although women are more likely than men to suffer from social anxiety (1.5: 1 ratio), men are more likely than women to seek treatment, possibly because men in our culture are expected to be more assertive and confident socially.
And people who are socially anxious often engage in “safety behaviors”—essentially, superstitious behaviors that they think make them more secure and less likely to unravel in public. Typical beliefs about safety behaviors include:
When socially anxious people enter a situation they anticipate how they will unravel and worry about how they could make a fool of themselves. When interacting with people, they think that others are noticing every sign of their anxiety and judging them, and when they are finished, they engage in a “post-mortem” where they review their performance from the perspective of their most critical voice. If you have social anxiety you can probably see yourself in the following examples of typical social anxiety worries when meeting or speaking to people:
Does any of this fit you? Do you worry about interacting with people? Are you afraid of being evaluated? Do you avoid situations that might involve interacting with people—especially new people? Are you anxious about speaking in front of people? Are you afraid to take a leadership role because you will need to speak more? Do you drink more before you socialize? And do you ruminate and criticize yourself after you interact with people?
In my next post, I will describe some powerful techniques to reverse social anxiety so that you can get more out of life.