Social interactions are a critical part of day-to-day life, and an important part of what it is to be human. Connecting with others helps us to create meaningful bonds with partners and friends, further our careers, enjoy new hobbies, and add overall enjoyment to our lives. Having social connections has also been indicated to help us when experiencing difficult circumstances such as death, divorce, redundancy, moving house, and depression.

Sometimes, however, interacting with others is not easy. Meeting new people, even old friends, can feel daunting. Social anxiety can thus be a crippling experience and impacts people to varying degrees. For some, it might mean not wanting to leave the house or anxiety related to that Zoom work meeting online. For others, it could be hesitation after a good friend asks them for coffee.

When we experience intense social anxiety, it can feel safer to withdraw than to get out and about. Physical distancing restrictions can also lead to limiting of social connection, and anxiety related to ever-changing rules. Social withdrawal can then become more entrenched over time, leading to isolation and loneliness.

In an era of physical distancing, it is more important than ever that we do not lose social connection. To enjoy the endless benefits of social interactions, try the seven steps below to tackling social anxiety using a Cognitive Behavioural Therapy framework.

Important note: anxiety and stress – in manageable amounts - exists to help us to stay alert, perform demanding tasks and keep safe from physical threat. These steps are not aimed at avoiding feelings of anxiety completely, but to take the edge off or help ride out the feelings so that you can continue to live your life.

1. Breathe calmly

Feeling anxious can change the way that you breathe. Stressful breathing might lead to short, shallow breaths or ‘over-breathing’. Learning to breathe calmly can be helpful to slow down your breathing when you start to become anxious. Try the following ‘box breathing’ technique:

1. Sit in a relaxed position, feet firmly on the floor, shoulders, chest and jaw relaxed.

2. Close your eyes or relax your gaze

3. Take a slow deep breath in through your nose for four seconds

4. Hold for four seconds

5. Breathe out slowly through your nose for four seconds

6. Hold for four seconds

7. Continue steps 3-6 for three to five minutes in a slow and even pattern

It is important to practice this technique, and to practice when you are already feeling relaxed (when watching TV for example). If you practice when you are feeling relaxed, ideally if you start to feel anxious or stressed you will be able to use this technique easily.

Try this out for 3-5 minutes daily for maximum benefit

2. Relax your body

It is common for muscles to become tense when you feel anxious for lengthy periods. Engaging in a progressive relaxation of your muscles can assist in reducing muscle tension. This technique involves tensing different muscle groups in your body and then relaxing them. It is also a helpful technique to remind your body and mind of the difference between feelings of tension and relaxation. Steps to progressive muscle relaxation are as follows:

1. Engage in box breathing, as above

2. Tense each muscle group for roughly five seconds – but not to a point of pain

3. Relax the muscle group for 10 seconds

4. Repeat muscle group if desired

5. Notice the difference in sensation in the muscle between tense and relaxed

Try this using the following muscle groups:

• Right hand and forearm

• Right upper arm

• Left hand and forearm

• Left upper arm

• Forehead

• Eyes and cheeks

• Mouth and jaw

• Neck – very carefully face forward then pull head back slowly

• Shoulders

• Shoulder blades and back

• Chest and stomach

• Hips and glutes

• Right upper leg

• Right lower leg

• Right foot

• Left upper leg

• Left lower leg

• Left foot

3. Investigate your thoughts and feelings

It can be easy to confuse how you are feeling with what you are thinking. Feelings and thoughts are in fact separate - thoughts drive our feelings. For example, it would be understandable to be in a crowd of new people and think to yourself “all these new people are making me anxious.” What is likely happening instead is that you are thinking “I won’t know what to say to these new people”, or “these people are looking at me” or “I’m going to say or do something stupid” and as a result of these thoughts you feel anxious.  

A good way of identifying whether you are experiencing a thought or a feeling is to remember that feelings are usually one word, and thoughts are usually a sentence or a few words. For example, feelings might include sad, angry, happy, worried, confused, nervous, or scared. Thoughts might include “it was great to be able to talk to my friends”, or “I wish I hadn’t said that”.

Separating your thoughts from your feelings is important when managing social anxiety. When you are feeling anxious in a social situation, notice that there are steps between being in that social setting and having those uncomfortable feelings.  What is happening is actually that you are 1) likely viewing the social situation, then 2) interpreting it based on your previous experiences, 3) thinking about it in a particular way based on those experiences, and then 4) experiencing associated feelings. In this way, the way you interpret your social surroundings can influence your thoughts, which then results in different feelings.

Practice examining different situations and identifying all of the different thoughts you might have in that situation. This way you can get an idea of the different feelings that might arise from those thoughts.

Try this scenario out as an example:

You are at the supermarket and see an acquaintance walking toward you. You look at them and smile. They look down at the ground and continue to walk past.

What are some of the thoughts you might have in this scenario? What feelings are likely to be associated with these thoughts?

4. Challenge your thoughts

When experiencing social anxiety, we commonly adopt unhelpful thoughts to go along with our social interactions. When looking at the example scenario above, based on your previous social experiences and the way you interpret the current situation, some associated thoughts might be:

“That person must hate me”

“I wonder if I look stupid”

“I must have something on my face”

“I must surely be blushing”

“Why wouldn’t they want to talk to me?”

“I must have done something wrong”

“I hope nobody saw them ignore me”

The feelings associated with such thoughts are likely to be unpleasant. You may be left feeling sad, worried, embarrassed, confused, or angry.  

For some people, creating more manageable feelings includes challenging these unhelpful thought patterns. It pays to remember - just because your mind created these thoughts does not mean they're accurate!

It is really important to examine all of the evidence thoughtfully and critically before you start believing your unhelpful thoughts. Some good questions to challenge unhelpful thoughts include:

Have there been any other times where this has been true?

Have there been any other times where this has not been true?

Is this completely true all of the time?

What is some evidence that might contradict this thought?

If somebody else was watching this happen, what might they say?

What would I say to a friend if they were in this scenario?

Are there any other ways of looking at this scenario?

What would be the worst thing to happen if this thought were actually true?

What might be a more balanced way of looking at this?

What was the outcome last time I had this thought in this situation?

Would I have these same thoughts if I were less tired, hungry etc.?

After adopting some of this thought challenging, a more balanced thought following the above scenario might be: “That person did not acknowledge me, but they might not have seen me. Even if they did see me, they might be having a difficult day, or they might not have recognised me in this context.”

Creating a more balanced thought such as this is more likely to lead to more neutral or comfortable feelings. Creating balanced thoughts will not typically come easily though, so the key is to practice!

5. Create a stepladder of feared situations

It is understandable that if you feel anxious in social settings you would not willingly want to place yourself in these situations. In fact, you have probably come up with some really great strategies to avoid socialising without even realising it. Some examples might be scrolling through your phone while waiting for your coffee, having headphones on in public transport, making sure you have a close friend or spouse in unfamiliar settings, sitting in the backseat of an uber, having a friend order your drink at a bar, making a booking online instead of over the phone, or standing close to the food table at the party. The problem is, the more you continue to avoid social situations for fear of discomfort or anxiety, the more difficult it will become when you eventually need to face these social situations.

Think carefully about all of the ways you try to avoid social interactions. These might include the examples above, or be more obvious such as avoiding parties, avoiding trying new hobbies or avoiding other group activities. Now attempt to rate all of your uncomfortable social settings from 0-100%. A score of 0% represents no feelings of discomfort whatsoever, and 100% represents feeling as anxious as you could possibly feel - absolutely unable to stand it. Write down all of your ranked uncomfortable social settings in order from 0-100. Make sure to place some situations at the bottom that you already feel reasonably comfortable with (maybe scored 0-10%), such as ordering your daily takeaway coffee.

6. Climb the stepladder

After some considerable practice following steps 1-4, you now have the tools to face your feared social situations. Calm breathing, relaxation, and thought challenging will all help you to face each of the situations on your stepladder. This may seem like a daunting task. It is important to remember the reasons you want to tackle your social anxiety – is it to make new friends? Join a local sports club? Meet a partner? Or just leave the house more often?

By starting small at the bottom of your ladder and exposing yourself to manageable social environments, you will learn that you have what it takes to face these difficult situations and others. As you work your way up the ladder and the situations become more uncomfortable, your anxiety will feel stronger - this is to be expected. Remember to breathe calmly, relax your muscles, and challenge your thoughts. By really sticking with it and staying in the situation, these feelings will diminish over time. The more you work your way up your ladder, you will begin to learn that you are able to stand the uncomfortable feelings of anxiety. Over time with more and more exposure, those feelings will become weaker, and last for less time.

Remember: the idea is not to remove anxiety altogether, but to learn that you can ride out the uncomfortable feelings so that you can continue to live your life. However, with enough practice, familiar social situations might bring not bring up anxious feelings after all!

7. Keep it up and celebrate!

Keep exposing yourself to those uncomfortable situations! Celebrate your milestones! There will be setbacks, and some days will be more difficult than others. This is to be expected and does not mean you have failed.  Think about reasons for those possible setbacks – are you getting enough sleep? Are you getting enough exercise? Maintaining a healthy diet? Go back to the drawing board, what might be getting in the way? What strategies have helped in the past? If you begin to feel discouraged, just remind yourself that it likely took many years to develop these feelings of social anxiety, so it is reasonable for them not to disappear overnight. Remember to look at how far you have come already.

Be kind to yourself, breathe calmly, relax your muscles, challenge your thinking, and try again next time. Go back to the start of the stepladder or even back a few steps if you need to. Consistent practice will pay off!

Enjoy the fruits of all of your hard work – you’ve earned it 

Pro-tip: maintaining a conversation with someone else is only 50% your responsibility!