Social Anxiety to Social Confidence

I was recently interviewed on BBC Radio Bristol to help raise awareness of anxiety disorders and also advertise our services at Social Anxiety West. It is something that I would never have thought I would be able to do back when I was socially anxious, so it feels quite an achievement to be able to do it now. Below is an edit of my section. The discussion was an hour in total and starred some of my good friends. You can listen to the whole show for a limited time using this link, Complete radio show on BBC iPlayer. It will only be the correct show if it is dated 6th March 2010. It is the middle hour that is on anxiety.

“It’s not surprising that if you fear interacting with other people, particularly authority figures and that means you find it hard to seek professional help for your social anxiety, then you’re going to be prone to seeking whatever solutions are at hand. Often that means self-medicating with recreational drugs such as cannabis, ecstasy, cocaine, amphetamines or more commonly alcohol.

Obviously this can then lead to additional health problems, financial problems or addictions, but aside from those issues, what I want to discuss in this video is the other processes at play when we use these drugs to cope with anxiety.

Essentially, these drugs, and by saying drugs I’m including alcohol, are attractive to people with social anxiety because they do things such as relieve anxiety, reduce inhibition, provide relaxation and increase a sense of confidence. In the short-term they provide almost immediate relief of anxiety symptoms but usually silently they are also keeping the problem going or even making it worse in the long term.

To just say that drugs and alcohol doesn’t work is a confusing message because it conflicts with the fact that when people use them they feel relief. In one sense, if your goal is to eliminate anxiety, then they do work, but the problem is that they are unsustainable and have other negative effects on our life.

As humans we have an amazing ability to physically adapt to our environment and when we are exposed to a drug our body often adapts to it. Eventually this means to get the same effect you either have to take more of the substance or wait until your body adapts to being without it. This may take a bit of time and because our body has normalised to being with the drug we then experience withdrawal, often including rebound anxiety, as our body adjusts back in the other direction.

This extra anxiety on top of existing high anxiety levels obviously isn’t good and drives a person to continue using drugs to gain relief, and too often leads to addiction. Not all drugs work this way, but many do. Although our body may adapt emotionally to the drug it cannot fully adapt to the ever increasing levels of toxins that are put in the body to get the same effect. Additionally, always being drunk or on drugs while building relationships, working or performing every day social tasks can severally effect your performance and introduce additional social problems into your life. It’s this that makes taking these drugs for social anxiety unsustainable.

So why not use them just for a bit of short-term relief? Well, apart from the problems mentioned already, such as rebound anxiety when not taking them, every time you rely on something else other than your self for confidence you undermine your belief in your own ability to cope with situations. Every time you use drugs or alcohol to cope socially you take another chip out of your self-confidence. Drugs don’t give confidence, they take it away. If you’re using drugs or alcohol to cope socially then when you do well or make progress that success is easily attributed to the drug rather than you. You miss out on the opportunities to build real confidence in your own ability and find sustainable ways of coping with your anxiety.

It can be hard to stop using say alcohol in social situations, because you feel so much worse without it. But really it’s not that you’re worse, it just that you have to face up to the full reality of the situation you’re in, and progress can’t be made unless you do that. Additionally, it’s hard to understand what really helps if any success you have can be attributed to drugs.

Consider that lasting progress will come though choosing to make your goal to increase confidence rather than to eliminate anxiety. That way you will not reach for instant relief in the form of drugs and you will see that it is through learning to cope with anxiety using yourself, rather than a substance, that solid self-confidence will be built.”

In these three videos I explain why improving your social skills is not a successful method of overcoming your social anxiety. I also explain why people with social anxiety often struggle to perform well in social situations. I have already discussed this topic in the blog entry called, Improving Social Skills, but I wanted to revisit it on video and go into a little bit more detail.

I answer the question, “Can social anxiety really be cured?”, and discuss to what extent can social anxiety be overcome, what your realistic goal should be, how long it takes and also touch on pessimism in social anxiety.

In this video I answer the title question, “is it better to avoid or face social situations, even if exposure therapy is not working for you?” and talk about if exposure therapy is helpful, false progress and the effects of avoidance.

More videos, but this time about being yourself and social anxiety. I explore how people with social anxiety find it hard to be themselves and offer some thoughts on the subject. I talk about people pleasing, adopting others opinions, identity, intimacy, honesty and expressing your feelings.

When you have a fear like being scared of speaking in a group of people, the strength of the anxiety you feel can seem unjustifiably strong. There seems to be no apparent reason why you feel so scared but yet you feel terrified. One of the reasons for this is that we often have deeper fears in our unconscious that lie behind the surface fears that we are consciously aware of. These deeper underlying fears relate well to the strength of the emotion you feel and tie in closely with your needs but at the same time they are fairly far removed from the reality of the situation. In contrast, your surface fears are very relevant to the situation you are in but are further removed from the intensity of the emotion you feel and seem less connected with your basic human needs.

This is actually quite a cleaver system that your brain has in place. Your deep fears cause anxiety to motivate you to take action to protect the fulfilment of you basic human needs while surface fears help you work out what action would be relevant to the situation. When our fears are appropriate to a situation this system works very well to keep us safe and helps us meet our needs, but of course when our fears are inappropriate to the situation, as is often the case in social anxiety, our strong anxiety and behaviours can of course be more of a hindrance than a help.

These deeper fears that lie in your unconscious are not so buried that they are unreachable. In fact, you may be aware of many of them already. They do not have to be uncovered through dream analysis or by describing ambiguous pictures as some very traditional therapists may have you believe. A simple line of questioning and some quiet thinking time actually suffices very well and gives much more accurate results. This questioning basically asks you what would you fear happening next if the thing you are currently scared of took place. You then keep asking this question for every answer given until you get down to a final needs related fear.

For example, if you had a surface fear such as being scared of blushing you would ask yourself, ‘well, what if I do blush, what do I fear would happen then?’. Your answer might be that you fear people would notice the blushing, so your next question would be, ‘well, what if people do notice the blushing, what do I fear would happen then?’. Your answer might be that you fear that people will think you are hiding something, so your next question would be, ‘well, what if people do think I’m hiding something, what do I fear would happen then?’. Your answer might be that if people think you are hiding something then they might not trust you enough to want to spend time with you, so your next question would be, ‘well, what if they don’t trust me and don’t want to spend time with me, what do I fear would happen then?’ Your answer might be that you fear that you will not be able to make them understand that you actually are trustworthy, so your next question would be, ‘well, what if I can’t make them understand that I am trustworthy, what do I fear would happen then?’ Your answer might then be your final needs based fear; that you will end up lonely and be unable to fulfil your social needs.

As you can see, the fears string together like a chain taking you from the situation to your needs with each link connecting the next. In the example, the deeper fears, such as someone rejecting you for being untrustworthy and you not being able to fulfil your social needs, are quite far removed from the original situation but are easily related to the strong feelings of fear, shame or embarrassment that you might feel in that situation. Also, the surface fears, such as fear of blushing and people noticing that blushing , are very relevant to the situation but seem more disconnected from the emotions until you peal back the layers and are able to relate them to the deeper fears. Understanding your own versions of these ‘fear chains’ can help you understand your emotional responses better and can help you take some of the power out of your fears. As discussed in the comments below though, this is not a complete solution to social anxiety and I will include the more significant steps you need to take in my audio program when it is finished.

Below I have set out the six main links of socially anxious fear chains going from surface situational fears right down to deep needs based fears. I have also given some examples of the types of fears that go with each. These six links are not strict and you may find smaller more subtle fears that link inbetween them.

SURFACE FEARS (Related to the situation)

1. Fear of showing vulnerability
Fear of showing signs of anxiety (blushing, shaking, being unable to speak, sweating etc.). Fear of doing anything embarrassing that might put you in a bad light. Fear of making mistakes or showing inadequacy. Fear of saying or doing something that annoys people. Fear of revealing personal opinions and preferences.

2. Fear of vulnerability being noticed
Fear of being put under the spotlight. Fear of drawing attention to yourself. Fear of people watching you. Fear of people staring at you. Fear of having your inadequacies and mistakes highlighted. Fear of people noticing your anxiety symptoms. Fear of people noticing your mistakes or inadequacies. Fear of people knowing personal things about you.

3. Fear of negative evaluation
Fear of people looking down on you. Fear of people judging you. Fear of people criticising you. Fear of people thinking bad things about you. Fear of people thinking you are stupid, boring, strange, weak, useless, unpleasant, anti-social, arrogant, ugly, repulsive or lacking in personality. Fear of people disliking you. Fear of people misinterpreting your symptoms and behaviours.

4. Fear of rejection
Fear of being humiliated. Fear of people laughing at you. Fear of people telling you off. Fear of people getting angry or aggressive with you. Fear of people physically harming you. Fear of people ganging up against you. Fear of people poisoning others against you. Fear of people leaving you. Fear of people not wanting to be with you romantically. Fear of people punishing you. Fear of being disadvantaged. Fear of people taking or damaging your possessions. Fear of being asked to move out of your home.

5. Fear of being unable to counter rejection
Fear of being assertive and standing up for yourself. Fear of not being physically strong enough to defend yourself. Fear of people not listening or believing you. Fear of not being able to correct untrue information or rumours that have been spread about you. Fear of not being able to make people like you. Fear of not being able to get people to understand you. Fear of not being able regain or replace lost relationships. Fear of not being able to cope with intense and unpleasant emotions.

6. Fear of needs being unfulfilled
Fear of being alone and lonely. Fear of being unable to fulfil social needs. Fear of being homeless. Fear of being seriously harmed. Fear of never being able to fulfil sexual and physical intimacy needs. Fear of having to endure unbearable emotional pain. Fear of not being able to achieve what you want in life.

DEEP FEARS (Related to your basic human needs)

If you decide to write out your own fear chains then be sure to avoid these common pitfalls.

• Giving your answer to what you fear happening as something that moves you up the chain rather down it. e.g. What do you fear happening next if people do laugh at you? – Then they might notice that I’m shaking. This moves up from link 4 to link 2 rather than down to link 5.
• Giving an answer that moves down the chain but skips a link. e.g. What do you fear happening if they do notice that you are quiet? – That they won’t want to spend time with me. This jumps from link 2 to link 4 without explaining why you think being quiet would make them not want to spend time with you. The inbetween link 3 might be that you fear that they think you are boring.
• Giving your answer as an emotion rather than a fear. e.g. What do you fear happening if people see you blushing? – I would get embarassed. Embarassment is an emotion rather than a fear.
• Not giving yourself enough time to identify what you fear happening. Often because it is not immediately obvious what the fear is people will conclude that they do not know or that they are not scared of anything. Because as you go down the links you are connecting with deeper and more unconscious fears you need to give you mind time to look for the answers. If you keep searching and think about the question, the answer to what you are scared of will eventually come to the forefront of your mind.

As a final note, notice that these fears cause anxiety and anxiety symptoms which can be the very object of our fears creating a loop. Also, the behaviours our anxiety motivates us to perform can have negative social consequences which can also be the object of our fears.  For example, fearing that you might make a mistake and that someone will get angry with you and harm you causes you to become very anxious meaning you are much more likely to make a mistake.  Breaking these vicious cycles is the main goal in overcoming social anxiety.

I hope the subject of this entry is as interesting for you as it is for me. My interest keeps me developing my understanding of social anxiety and I hope that through sharing my knowledge I can help you understand and overcome it. I also hope that through developing my own theories and understanding I offer insights that you will not find elsewhere. Thanks for reading

Public toilets seem to prove problematic for many people who experience social anxiety. Self-consciousness about performance, noise, smells, size, etiquette, time and technique can all be a source of anxiety potentially making this basic need significantly challenging. Understandably, such issues are often embarrassing for people to talk about meaning they do not realise that many others are struggling with them too and they often do not seek help to address them. The problems are generally associated with public toilets where privacy is more limited, but they can also extend to other situations such as using someone else’s toilet or using a toilet in shared accommodation.

One particularly common issue is that anxiety about going to the toilet can mean that it actually becomes physically impossible to go due to muscle tension. It’s a condition which has many names and applies to both urination and defecation. Being unable to urinate due to anxiety usually comes under the names of Paruresis, Shy Bladder Syndrome, Bashful Bladder, Urophobia and several other names, while being unable to defecate due to anxiety comes under the names of Parcopresis, Psychogenic Fecal Retention and Shy Bowel

As far as I know, being unable to urinate is a far more common problem than Shy Bowel and can be particularly problematic given that often we need to urinate several times a day. The problem can end up causing a restrictive lifestyle for a person meaning they do not travel far from their home or meaning that they do not go out for too long in case they need to urinate. People may also develop unhealthy habits such as restricting their fluid intake to manage how often they need to go. In more severe cases people may be so unable to urinate that they still cannot go even when they are in pain and in some cases this can cause damage meaning complications for them in the future.

Research seems to indicate that this problem is equally split between men and women, although it seems men are more likely to seek help with it. Although essentially the problem is the same for men and women – anxiety causing tensing making it physically impossible to go – there are some distinct differences. This is mainly due to the differences in male and female public toilets. Due to the exposed urinals that are commonly found in men’s toilets, men are more likely to be concerned with issues such as performance, other people seeing their private parts, etiquette and technique, while women can be more concerned with issues such as being overheard and taking too long when there is a queue. There is an amusing game that I am sure many men can relate to on the UK Paruresis Trust website. Just click on this link to play it. For my friends in the US there is the International Paruresis Association, although unfortunately they do not have any games to play.

Some people may not have so much or an issue about being unable to go, but may just get anxious about using public toilets in general. This was an issue for me and was something I developed at school, although it also extended to using toilets anywhere, including my own home sometimes. I seem to remember it started when some of the boys at my school realised that it was quite amusing to push someone on the back while they were using the men’s urinal trough meaning they had to put their hands on the splash-back to prevent them falling into it. After experiencing this one or two times and seeing it happen to several others I started getting anxious about using the toilets. As a consequence I stopped using them and would only go when I was really desperate. I remember I would often try and go the whole day without going which was quite uncomfortable at times. I have also suffered with Paruresis at times meaning I could only go when a cubicle was available, when I was really desperate or when no one else was in the toilet room. That is probably more about me than you wanted to know, but hopefully it is helpful for those who have experienced similar issues.

Both Shy Bladder and Shy Bowel are both considered a form of social anxiety, although Toilet Phobia can be related as well as unrelated to social situations. If you are struggling with Paruresis then there is a book called Shy Bladder Syndrome: Your Step-by-step Guide to Overcoming Paruresis which you may find useful. You may also like to try contacting the UK and US organisations linked above who offer workshops and may be able to put you in contact with a support group. Typically the recommended treatment is Cognitive Behavioural Therapy, as it is with many issues relating to anxiety, although in the case of Paruresis there is an option to use a Catheter which is basically a tube that can be inserted into the urethra past the muscle that keeps the bladder closed meaning it can empty through the tube. Although this is not a very attractive option for many people, if you are desperate (literally) then it might be a serious consideration.

Do you know what you really want in life? Do you have a plan for overcoming your social anxiety? When I was struggling with my anxiety I could easily answer ‘no’ to both of those questions. I was really stuck to know what direction to take my life in and making a plan for overcoming my social anxiety was definitely not something I was actively thinking about. I felt twisted up inside about knowing what I should do with my life, nothing felt right and I just felt stuck with it. I have spoken to many people with social anxiety who feel the same and that is why I have created a three part audio presentation on goal setting to help address this problem. Sometimes it is not knowing what the answers are that is the problem, but rather how we are trying to answer the question, and that is what I address in this new free download. I also address issues surrounding fears of failure.

To access it, just login to the Free Downloads Area, or if you are not already a member then it only takes a minute to Register Your Details. I promise you will not get lots of spam emails and the only emails you will get are occasional updates from Socialanxiety.co.uk. You can delete your account yourself at any time.

Click the play button below to listen to a sample of the audio.

Did you know that improving social skills is not the answer to social anxiety? Because of the continuous social struggles people with social anxiety face, many people come to believe their problem is social inadequacy. It then seems logical that improving social skills is the answer, but this is not the case.

It is true that many people with social anxiety lack social experience and may not have had the opportunities to hone their social skills, but there are also many people with social anxiety who have perfectly acceptable social skills. This gives us our first reason to doubt that social inadequacy is the problem for people with social anxiety. A second reason is the fact that there are many people in the world who are very confident in themselves, but yet have atrocious social skills. Surely, if social anxiety was caused by a lack of social skills, then all people who lack social skills would experience social anxiety, and conversely, all people with social anxiety would lack social skills, but this is not what we find.

Instead, what is usually the case is most people with social anxiety believe they are socially inadequate, because of their struggles, but it is actually their anxiety that causes their struggles rather than a lack of skill. This means problems with socialising are a symptom of social anxiety rather than a cause of it. What people with social anxiety experience is usually more like hindered social ability, rather than social inadequacy. It is the way anxiety causes symptoms such as poor concentration, and also how we react to anxious feelings (i.e. avoidance) that stop us interacting with people effectively, not poor social skills. Once the anxiety is absent most people find that their natural ability to socialise shines through, or at the very least, improves greatly.

People can easily get caught up in trying to read social skills books to learn the ‘correct’ social rules that it seems everyone else seems to know, but this can mean people with social anxiety end up trying to achieve social perfection before they have had much social experience.  This is a recipe for feelings of failure and anxiety. Really, social skills need to be learnt through a trial and error process where mistakes are made and sense of what works is developed.  A well written social skills book may help to some degree, but nothing beats experience and books on social skills will not remove the anxiety.

Confidence is developed through learning that we can cope with our mistakes rather than through being socially perfect. This is a key point as many people with social anxiety are trying to achieve social perfection to gain confidence, but that is fairly unattainable as well as unstable. It only takes one mistake for it all to come crashing down, so better to be confident about your mistakes rather than your abilities.

As already mentioned, people with social anxiety really can lack social skills due to a lack of experience, and improving them can help in some ways, but doing this should not be seen as a solution to social anxiety. In fact, putting lots of effort into improving social skills with the aim to overcome social anxiety can do more harm than good. This is because however hard they try to improve socially, they still experience anxiety, which then carries on affecting their ability to socialise. Since they do not make much progress, feelings of frustration and hopelessness can set in which only feeds their sense of inadequacy further. This can then increase anxiety in social situations and make socialising even harder. It is a paradox where the thing that seems it should help, only makes the situation worse.

Make sure you are not feeding your sense of social inadequacy with social skills books and tips. A series of videos I have made on this subject can be viewed here.