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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

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.

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