Safety Behaviors in Social Anxiety
Playing it safe in social anxiety
Posted March 3, 2013
People with anxiety often perform "safety behaviors" during anxiety provoking situations. These safety behaviors make the person feel more comfortable in the situation by providing temporary relief from anxiety. However, safety behaviors have been described as the major cause of persisting anxiety and the reason why people don't feel relief during exposures (Wells, Clark, Salkovskis, Ludgate, Hackmann, & Gelder, 1995).
An example of a safety behavior in social anxiety is talking fast during a meeting. The person may feel temporarily better by speaking quickly and getting out of the situation. However, this behavior is basically telling the person's body that this situation is dangerous and he or she has to do something to remain safe. That is, whenever a person performs a safety behavior, he or she is reinforcing the idea that the situation is very dangerous. Here are some other examples of safety behaviors in social anxiety (safety behaviors occur across all anxiety disorders, but these examples focus mostly on social anxiety):
- Asking the other person many questions when speaking with someone new (to keep the focus off of oneself).
- Selecting a position in the situation to avoid excessive scrutiny (e.g., sitting in the back of the room)
- Averting eye contact to avoid being noticed by others.
- Taking on roles in social situations so that one does not have to interact (taking pictures or setting up equipment)
- Drinking alcohol or taking drugs to feel less anxious before a situation
- Wearing neutral clothing to avoid calling attention to oneself
- Wearing turtlenecks or wearing hair in certain ways to cover blushing
- Avoiding any substances or activiites that might induce anxiety or symptoms (e.g., caffeine, spicy food, physical exertion, warm clothing)
Multiple research studies have shown that safety seeking behaviors actually harm people's abilities to get past the anxiety in situations (e.g., Furukawa et al., 2009; Kim, 2005; McManus, Sacurda, & Clark, 2008; Wells et al., 1995). We have often heard many clients describe scenarios where they were 'exposed' repeatedly to situations that they fear, but they have not experienced a reduction in anxiety. For example, one client described being in meetings every day and feeling intense anxiety. However, he described standing in the back and leaving the room anytime that it was his department's turn to discuss items. These safety behaviors led his body to believe that the situation was much more dangerous than it actually was.
When we conduct exposures with people with social anxiety, we often start with situations where they use some safety behaviors. However, over time we ask people to reduce them more and more. As they start to feel success, we will often have them push the envelope and do the opposite of what their anxiety tells them ("If it feels bad, do it"). Their anxiety is telling them to play it safe, but to get past it, they must push themselves. For example, we often urge people to drink a sports beverage that contains caffeine and increases blood flow, so that the person can feel both shaky and flushed in social situations. We have them wear bright and outrageous clothing to call attention to themselves. When they do these 'opposite' behaviors, they are basically telling their body that there is nothing to fear and that they have the ability to cope on their own no matter what the circumstance.
Alden and Bieling (1998) found that when people with social anxiety performed safety behaviors, they seemed more awkward and less likeable. Thus, by playing it safe, the person with social anxiety actually got what they feared most: negative evaluation. We often tell clients that they are doing a disservice to others by playing it safe. Others don't get to see their true self.
There is also a measure of Social Anxiety Safety Behaviors that you can complete (Pinto-Gouveia, Cunha, & Do Céu Salvador, 2003).
Alden, L. E., & Bieling, P. (1998). Interpersonal consequences of the pursuit of safety. Behaviour research and therapy, 36(1), 53–64.
Furukawa, T. A., Chen, J., Watanabe, N., Nakano, Y., Ietsugu, T., Ogawa, S., … Noda, Y. (2009). Videotaped experiments to drop safety behaviors and self-focused attention for patients with social anxiety disorder: Do they change subjective and objective evaluations of anxiety and performance? Journal of Behavior Therapy and Experimental Psychiatry, 40(2), 202–210. doi:10.1016/j.jbtep.2008.08.003
Kim, E. J. (2005). The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics. Journal of Anxiety Disorders, 19(1), 69–86. doi:10.1016/j.janxdis.2003.11.002
McManus, F., Sacadura, C., & Clark, D. M. (2008). Why social anxiety persists: An experimental investigation of the role of safety behaviours as a maintaining factor. Journal of Behavior Therapy and Experimental Psychiatry, 39(2), 147–161. doi:10.1016/j.jbtep.2006.12.002
Pinto-Gouveia, J., Cunha, M. I., & Do Céu Salvador, M. (2003). Assessment Of Social Phobia By Self-Report Questionnaires: The Social Interaction And Performance Anxiety And Avoidance Scale And The Social Phobia Safety Behaviours Scale. Behavioural and Cognitive Psychotherapy, 31(03), 291–311. doi:10.1017/S1352465803003059
Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26(1), 153–161.