Opening Up

The mirror in which a self-image takes shape is distorted for people with social anxiety disorder (SAD). Lynn Alden, a psychologist at the University of British Columbia, says her patients describe themselves as "awkward" and "unskilled," and this kind of negative self-perception may feed a debilitating aversion to social situations. New research raises some potential ways to address this anxiety more effectively.

Focus on the Positive

Although they represent different approaches, cognitive behavioral group therapy and mindfulness-based stress reduction were both found to lessen negative self-perceptions in SAD patients and to boost positive ones, according to a recent paper in the Journal of Anxiety Disorders. Researchers found that an increase in one's favorable self-views predicted a reduction of SAD symptoms, which include fear or avoidance of eating in a public place and of meeting strangers.

Revise the Self-Image

Compared to others, socially anxious people may be less kind to themselves as they process and recall social feedback. Cognitive neuroscientist Leonie Koban and colleagues had both SAD individuals and control groups give speeches and receive ratings from judges, which allowed the researchers to examine affective updating—how people adjust their feelings about themselves. "Healthy people are much more receptive to the positive feedback than socially anxious people, and their feelings about themselves change more in a positive direction," Koban says. "The socially anxious tend to react more strongly to negative events." She is looking into using self-compassion, which was associated with more positive updating, as an intervention—for example, by having people write to themselves about negative experiences as they would to a friend.

Leave the Safe Zone

When patients with SAD enter social situations, they cope by using "safety behaviors" like staying on the edge of groups, not talking, and avoiding eye contact. "They hold up a false mask that they think will at least prevent people from disliking them," Alden says. "The tragic thing is that this chokes off the very behaviors that facilitate relationship development." A 2016 paper in Clinical Psychological Science reported that patients who deliberately eased their use of safety behaviors felt more authentic during a social interaction, which in turn promoted better mood, a more positive perception of the person they spoke to, and greater willingness to meet again.