Before COVID-19, if you had to attend a relatively large meeting, class, or presentation, you didn’t necessarily have to show your face. You could sit in a corner away from public view, and no one would notice. For people with social anxiety disorder (SAD), this was a perfect way to avoid the embarrassment that can cause such distress. The only problem would occur when they had to make a presentation in which they had to stand up at the front of a room, potentially under what they would consider critical public scrutiny. However, these individuals could protect themselves by choosing roles in which they could minimize the frequency of such fear-inducing experiences.
COVID-19, among its many other changes to daily life, has forced people who prefer to stay out of the shadows into the front and center of the unforgiving screens required by work, school, or family gatherings. Even if you don’t have a speaking role in one of your video chats, your face will appear just as large that of other people, given that there is no “front” or “back” row. When you are called on to speak, your face can now pop out to dominate the entire screen. What’s more, you can actually see your face while you talk, a situation that does not occur in most real-life settings.
Research on people with SAD in this new world of video communication has obviously not yet caught up with the current reality. However, a recent study by the University of Waterloo’s Mia Romano and colleagues (2020) provides insight into what COVID-19’s impact might be, and how people with SAD can navigate the demands of video chats.
Romano et al. note that in addition to the fear of public scrutiny, people with SAD have a difficult time seeing themselves in anything but a negative light when they’re in social situations. Even if they get a morale boost when someone congratulates them on their performance, people with SAD can savor this only for a short time. If the feedback is less clearly positive, these individuals put their own pessimistic spin on the situation and can only see when things went wrong. They can’t turn off their self-critical interpretations in which they can only view their flaws.
As people's negative interpretations grow, so do their emotions. Indeed, as the authors note, “individuals with SAD may be less effective at using cognitive reappraisal in their day to day lives” (p. 2) so that as their anxiety builds, they don’t have the coping skills to manage by rethinking the experience in a more measured fashion.
In cognitive reappraisal, you’re able to take what was even potentially a bad situation such as misspeaking in front of your audience, and calm yourself down by thinking about the possibility that no one even noticed your slip of the tongue. Maybe you’re the only one who realized the mistake, and maybe it wasn’t even such a bad mistake. This process is at the crux of the Romano et al. approach.
The Canadian author and her colleagues recruited 38 individuals with diagnosed SAD who they compared with 31 so-called “healthy” controls (i.e. people without the diagnosis). Both groups, slightly over half of whom were female, were on average in their late 20s, and the largest ethnic minority among the sample was Asian (15 percent). Most were single (65 percent), and almost half (45 percent) had another anxiety disorder as well.
To measure the tendency of people with SAD to regard neutral situations in negative terms, the authors administered a sentence completion task that contained an ambiguous stem, such as “After your first date with someone, they think you are …” To put them in a socially demanding situation, the researchers asked participants to give a 3-minute speech in which they were to state their opinion on one of three controversial topics. The experimental induction therefore actually mimicked the social demands of a video chat (minus the feedback provided by the screen). Participants next rated their emotion in the aftermath of the speech with a brief positive-negative affect scale.
Observers, not present in the room at the time of the speech, subsequently rated the actual performance of the participant, as did the participants. This provided an “objective” vs. subjective estimate of how well the participant performed while giving the speech.
Prior to giving the speech, participants had actually rated their typical cognitive reappraisal strategies on items such as “I tried to reevaluate the situation more positively.” They also rated their overall emotion regulation strategies including distraction (thinking about something else), brooding, and acceptance. The reason these measures were administered before the speech was to avoid any contamination in the responses based on the participant's performance.
As the authors predicted, people with SAD did regard their performance more negatively, compared to the observers, than did the healthy controls. Furthermore, positive interpretations of performance predicted greater use of cognitive reappraisal for people whose positive affect after the task wasn’t all that high. In contrast, people who felt very good after the task were less likely to change their perceptions of their actual performance, and the more likely they were to use cognitive reappraisal.
Romano et al. interpret these complex findings from what’s called an “affect-as-information” model in which the way you feel about your performance becomes its own basis for evaluation. You’re less likely to worry about how well you actually did, in an objective sense, as long as you felt good about it. At lower levels of positive affect, you may engage in more mental gymnastics as you try to impose a positive interpretation of what just happened, bringing cognitive reappraisal into the process.
What can people with SAD do to counteract their tendency to see themselves in a negative light during a social task? As the authors suggest, “it might be beneficial for clinicians to guide individuals explicitly to recount and savour positive aspects of their experiences even in instances when these experiences were initially judged as neutral or negative, as well as identify aspects of their own behaviour that allowed for the positive outcomes to occur” (p. 7). In other words, they can redirect their attention to what went well rather than what went wrong. The confidence they gain in the process can carry forward to similar situations in the future.
To sum up, it may be beneficial for everyone to give themselves a bit of a break after appearing in a video chat. For people with SAD, it can make the difference between having their emotions escalate out of control vs. being able to see that their performance wasn’t as bad as they thought it was. Video chats may even have the potential to help people with SAD achieve this higher level of comfort and forgiveness. The need for video chats may eventually dissipate, but the benefits of gaining greater self-acceptance might help individuals with social anxiety become more comfortable when the face-to-face world returns.
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Romano, M., Moscovitch, D. A., Saini, P., & Huppert, J. D. (2020). The effects of positive interpretation bias on cognitive reappraisal and social performance: Implications for social anxiety disorder. Behaviour Research and Therapy, 131. doi: 10.1016/j.brat.2020.103651