Sullivan + Associates Clinical Psychology’s Post

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Social anxiety disorder is one of�� the most common anxiety disorders,���� affecting roughly 7 to 13% of the population. That number is significant, yet it�� doesn���t account for the number of���� people who struggle with this issue but�� don���t meet the criteria for the disorder. One of the very inconvenient truths about�� social anxiety or anxiety disorder is the���� more you avoid what makes you anxious,�� the more entrenched this problem becomes. So, it���s important to develop a plan�� to gradually and consistently increase���� your exposure to anxiety-provoking places. And I have a 6-step plan to help you do just that. For my first step, I suggest starting with a plan���� to go out in public that takes your�� current level of anxiety into account. So, if you���re uncomfortable going out in�� public, a good place to start is by writing���� down all of the places you can go to at this�� time and places you would like to be able to go. Once you list them, I suggest�� rating each place on a scale of���� 0 to 10 based on how much stress or�� anxiety you feel about going there. For our purposes, a rating�� of 0 would be no anxiety,���� a 10 would be a feeling of extreme anxiety,�� and a 5 would be a moderate level of anxiety. Now, if you are more of a visual learner,���� I���d suggest grabbing a pen and a piece�� of paper and drawing a line graph. Places to visit with anxiety�� ratings could include: Walking down the sidewalk ��� 2 Going to a public park ��� 4 Health appointments ��� 5 Shopping at a retail store ��� 6 Going to the hospital ��� 9 Shopping at a large retail store�� during the busiest time ��� 10 You���ll notice that on the far left-hand side of�� the line, there is a 0 to represent no anxiety,���� a 5 to represent moderate anxiety and�� a 10 to represent extreme anxiety. What we���re going to do next is slot in each public�� place you can visit that you find stressful or���� anxiety-provoking, but we will place them on�� the graph according to their anxiety rating. This is called an anxiety hierarchy. As you can see on the sample I created,���� I have walked down the sidewalk as�� a 2, gone to a public park as a 5,���� shopped at the grocery store as a 10, and a few�� other places you can go slotted in there as well. And the place to start is to�� prioritize going to places���� where you have minimal to moderate�� anxiety at the thought of going. So, essentially, any place on your list�� where your anxiety rating is a five or less. Establish a goal of visiting these�� places consistently until your���� anxiety rating drops, ideally to a two or less. The key here is to be consistent because the more�� you consistently challenge feelings of anxiety,���� the more likely you are to habituate�� to it, which means that over time,���� your feelings of anxiety don���t bother�� you as much, and they begin to go down. As you become less anxious going to places that�� used to create feelings of moderate anxiety,���� you are now ready to start�� going to places higher up on���� the list that cause stronger feelings of anxiety. If you continue to follow this routine and�� remain consistent, eventually, you will be���� able to visit all of the places on your�� list with a manageable level of anxiety. For the second step,���� it���s important to be prepared physically�� and mentally before going out in public. You���ve probably had the experience of�� going out somewhere when you already���� felt frazzled from a stressful day and�� noticed that any extra stressors you���� encountered while you were out made�� you feel more uptight and anxious. So, if you find going out stressful�� before you ever leave the house,���� it���s important to be calm�� before you go out in public. Ideally, when you go out, you don���t want your�� anxiety level to exceed a 7, so it���s important���� to use anxiety-reduction strategies such as deep�� breathing or mindfulness to help calm your body. It���s also important to settle your mind,�� and a good way to do that is to focus on���� the facts as you know them rather than�� on feelings of fear or uncertainty. For example, you could focus�� on how feelings aren���t facts. Just because you feel anxious,�� it doesn���t mean that there is���� a real threat or danger that�� warrants this level of anxiety. Essentially, the goal of self-talk is to say to�� yourself, ���If I put my anxiety aside for a moment,���� based on all the facts I have, does this�� activity have a high probability of being safe.��� If the answer is ���yes,��� it doesn���t�� mean that your anxiety will be gone. What it does mean is that when�� you use your logical mind,���� you���ve decided that the�� activity is reasonably safe,���� so it���s time to push forward, participate�� in the activity, and manage your anxiety. Because if anxiety begins to take�� over, your world starts to get smaller. For my third step, wherever you choose to go, I���d�� encourage you to slow down a little bit instead of���� having the mindset of, ���I���m just going to get in�� and get out.��� (Step Three ��� Slow down in public) I want you to avoid this mindset because�� thinking this way is basically making going���� out in public an anxious activity that�� you need to get done as fast as possible. And remember, when you used your�� logical mind a few moments ago,���� you already decided that this�� activity was reasonably safe. So, once you are in a store, a business,�� or a public area, the goal is to minimize���� your anxiety and try to bring some comfort and,�� hopefully, some enjoyment back to the process. The good news is that you probably already�� have a recipe or formula for doing this,���� even though you���ve probably�� never thought about it that way. For example, chances are there are�� places you currently go to or have���� gone to in the past that make you feel relaxed. So, you already instinctively know what�� to do to feel comfortable in public,���� and you do those things automatically�� without thinking about them. And in the next few steps,���� I will go over a few ideas that you were�� likely doing before we can reintroduce. For my fourth step, I���d encourage�� you to use mindful walking. In case you are wondering what that is, it���s not�� like the Travolta strut or anything like that. And if you have no idea what a Travolta strut is,���� you really need to watch the�� movie Saturday Night Fever. Mindful walking involves staying present in the�� moment, avoiding engaging with your thoughts,���� and taking in your surroundings�� while taking slow, calming breaths. For example, I have a mother-in-law�� who does this very well. She looks at shopping as an experience. When shopping for groceries,�� she takes her time looking at���� the different items on the shelves,�� especially when in the wine section. She enjoys the temperature-controlled environment�� and happily focuses on shopping for a great deal. She���s so good at this that in the time it takes�� her to go up and down a few aisles of the store,���� I���ve already finished shopping, waited in line,���� cashed out and started waiting�� for her outside the store. But to be fair to my mother-in-law,�� she���s onto something here. In a 2018 study, Dr. Chih Yang and�� colleagues found that simply adding���� mindfulness to walking or moving around helps�� lower stress and anxiety and improve mood. And chances are good that slowing down a�� little bit, taking in your surroundings���� and enjoying the present moment is part of�� the formula when you go to places where you���� currently feel comfortable or where you�� once felt comfortable when out in public. For my fifth step, I���d encourage you to be open to���� engaging in acts of kindness�� while you are out in public. Acts of kindness can include many things,�� such as holding a door open for someone,���� saying a quick ���hello,��� smiling at someone,���� complimenting, or even a pleasant gaze�� or head nod to acknowledge someone. In a 2015 study, Dr. Jennifer Trew and Dr.�� Lynn Alden studied people who were socially���� anxious and found that simply performing acts of�� kindness reliably reduced feelings of anxiety. One of the reasons I suspect this works so well is���� that not only does it feel good to�� do something nice for someone else,���� but it helps to take the focus off your�� internal feelings of anxiety and discomfort. And when we take the focus off ourselves and�� put it on someone else, we tend to feel better. But you might wonder, do people�� want to engage in public anymore? Nowadays, it���s common to see people�� with their faces buried in their phones. This has contributed to�� feelings of anxiety for people,���� as engaging with strangers in�� public has become less frequent. In a 2014 study by Nicholas�� Epley and Juliana Schroeder,���� they had study participants talk to complete�� strangers while they were commuting. Although the study participants�� predicted that it would be a���� negative experience talking to strangers,���� they found that it ended up being a positive�� experience that helped elevate their mood. For my sixth and final step, I encourage���� you to prioritize socializing�� while you are out in public. So, now that we���ve established that talking to�� someone in public won���t be as bad as you think���� let���s take it a step further and prioritize�� doing this on at least one or two occasions. I don���t think we need to look at a scientific�� study to know that we all benefit from a little���� human interaction, especially given that we are�� all naturally social creatures to some extent. However, I do want to take a quick look at a study���� that shows how powerful the benefits of�� socializing and providing support can be. In a 2016 study by Dr. Tristen Inagaki and�� colleagues, they found that giving support���� to others, such as saying something�� positive to someone or attempting to���� cheer someone up who you see working�� while you are out in public, not only���� helps them feel good but also reduces�� your feelings of stress and anxiety by���� literally rewiring the areas of the�� brain related to stress and reward. So, taking the time to follow�� these steps should help you���� feel less anxious about being out in�� public than when you first started. This is very important because you want to end on�� a positive note, which means your anxiety should���� be lower than when you first went out in public,�� so you associate positive feelings with going out. You���ll be more likely to do it again. And, of course, consistency is key. Go to a place that is�� anxiety-provoking over and over again. Eventually, it will become less bothersome as your�� body and mind become habituated to being there. So, to provide a quick recap, you should�� have a plan before you go out in public. Create an anxiety hierarchy and start by�� visiting the places that cause the least���� amount of anxiety before attempting to visit�� places that cause higher levels of anxiety. Second, make sure your mind and body�� are calm before you go out in public. Your anxiety level is bound�� to rise when you go out,���� so you don���t want it to be too�� high before you even start. Third, slow down in public. You already know, logically speaking, that�� it is safe to be there, so now the goal is���� to associate being calm and relaxed with being�� in a place that is currently anxiety-provoking. Fourth, use mindful walking. This will help you stay in the present moment,���� promote calm feelings, and avoid�� engaging with anxious thoughts. Number five, engage in acts of kindness. A smile, a quick ���hello,��� or a�� compliment not only helps other���� people feel good but can also lower your anxiety. And lastly, socialize in public if you can. Whether you know the person or not,�� socializing can help lower anxiety. So, I hope you found these steps helpful. If you want to learn more�� about managing social anxiety,���� please get in touch with us at Sullivan�� + Associates Clinical Psychology. If you enjoyed this video, like it,�� share it, and subscribe to the channel. Thank you for watching.