Social Anxiety Therapy in Melbourne

Causes and Risk Factors

Social anxiety disorder is a complex condition with no single cause. It’s a combination of genetic, environmental and psychological factors. Research suggests that genetics play a role as individuals with family history of social anxiety disorder or other mental health conditions are more likely to develop it. Brain chemistry also contributes with imbalances in neurotransmitters like serotonin and dopamine linked to anxiety disorders.

Environmental factors like upbringing and life experiences can shape one’s vulnerability to social anxiety. For example growing up in an overly critical or protective environment can increase the risk. Social learning where individuals observe and internalize others’ anxious behaviors can also play a role. Traumatic events like bullying or abuse can trigger social anxiety disorder. Knowing these risk factors can help you understand and address the condition.

Social Anxiety Effects

Mental and Emotional

Living with social anxiety is exhausting. You feel ongoing dread, fear and worry about upcoming social interactions which are the key psychological symptoms. These mental and emotional challenges can make even small interactions like ordering food at a restaurant or greeting a neighbour trigger intense anxiety. This stress can manifest physically as increased heart rate, sweating, muscle tension and nausea.

Social anxiety can also lead to the development of secondary mental health issues like depression or substance use disorders as you try to cope with your anxiety.

Relationships and Social Connections

Social anxiety can also affect a person’s ability to form and maintain relationships. Fear of judgment or rejection can prevent people from reaching out to others or deepening existing connections. Social interactions can feel overwhelming and individuals may avoid them altogether.

In romantic relationships social anxiety can also create challenges around intimacy and communication. It can make it difficult for individuals to express their needs and can lead to misunderstandings or strained dynamics in close relationships.

Academic and Career

Social anxiety can also affect academic and career pursuits. For students social anxiety can make it difficult to participate in group projects, ask questions in class or give presentations. In the workplace social anxiety can prevent individuals from pursuing career advancement or taking on leadership roles as people may avoid speaking up in meetings, networking or professional development opportunities.

Social Anxiety Treatment: Evidence Based Approaches

There are several evidence-based therapies available for managing social anxiety, including cognitive-behavioural therapy (CBT), exposure therapy and Eye Movement Desensitisation and Reprocessing (EMDR). These therapeutic approaches aim to alleviate symptoms and enhance confidence in social situations, offering individualized treatment options to suit your specific needs and preferences. While traditional methods like CBT and exposure therapy have a strong evidence base behind them, emerging therapies like EMDR are also showing promising results in treating social anxiety, helping individuals face their fears and build healthier social connections.

Cognitive-Behavioural Therapy (CBT)

Cognitive-behavioural therapy (CBT) is a fundamental and evidence based approach for social anxiety and one of the most effective. CBT addresses the underlying thoughts and behaviours that maintain anxiety in social situations. The therapy involves identifying, challenging and re-framing negative thought patterns to reduce anxiety.

Social anxiety often stems from irrational beliefs or cognitive distortions. For example a person with social anxiety might think “Everyone will think I’m awkward” or “If I embarrass myself people will reject me”. These automatic thoughts can be very distressing and over time reinforce the anxiety. In CBT individuals learn to identify these thoughts, test their validity and consider alternative or more balanced explanations (e.g. “Even if I feel awkward most people probably won’t notice”).

CBT also involves behaviour change, encouraging individuals to face social situations in a gradual and controlled way. This might involve starting with smaller less daunting social interactions and gradually working up to more challenging ones like speaking in front of a group. As individuals face their fears they learn that their worst case scenarios are unlikely to happen or if they do happen they are manageable and they start to develop more positive social experiences and build confidence. Over time these experiences can reduce the anxiety associated with social situations.

Exposure Therapy

Exposure therapy is often used in conjunction with CBT. This involves going into situations and practicing managing anxiety and staying in them long enough for the anxiety to gradually reduce. For example an individual may start by small talk with a friend or ordering food in a restaurant. As they get more comfortable they may work up to speaking up in meetings or attending social events. Exposure therapy reduces the fear response over time and allows you to build up a greater tolerance for anxiety provoking situations.

Exposure therapy is tailored to each person’s specific fears. There are a couple of key elements to this. One is to get to the “goldilocks level”. Entering and actively engaging in social situations which are “just right”, challenging but not overwhelming. As this is achieved people will gradually become more comfortable and be able to build up to the next “just right” level. The second is to help individuals stay present and engaged in the “exposure” situation rather than focusing on their internal anxiety symptoms or imagining social catastrophes. Therapeutic change is not achieved if an individual attends a social event and is completely consumed by how terrified they are or sits in the corner and doesn’t talk to anyone. The aim is to try and “fully participate” and instead manage their anxiety in an adaptive way. And thirdly they need to stay in the situation until their anxiety reduces so they experientially learn they can cope.

Eye Movement Desensitisation and Reprocessing (EMDR)

Originally developed for trauma treatment EMDR has emerged as a useful tool for social anxiety. EMDR helps individuals process and reframe distressing memories or beliefs that may be contributing to social anxiety. For example an individual may have experienced a traumatic or deeply embarrassing social event in the past which then affects their self perception and creates anxiety for them in future social situations. EMDR might involve recalling specific memories or situations that contribute to anxiety, focusing on the associated negative beliefs and using bilateral stimulation (often eye movements or tapping) to reprocess the memory. The aim is to reduce the emotional intensity of the memory so it has less power over the individual’s current behaviour and allow them to approach situations with less fear and more control.

Mindfulness-Based Approaches

Mindfulness-based approaches such as Mindfulness-Based Stress Reduction (MBSR) or Acceptance and Commitment Therapy (ACT) provide tools for managing social anxiety by encouraging present moment awareness and reducing judgmental thinking. Mindfulness helps individuals focus on the present moment rather than ruminating on past mistakes or worrying about future social interactions.

One of the key benefits of mindfulness for social anxiety is that it helps individuals shift their focus from their anxious thoughts and physical symptoms to other aspects of the present moment, such as what the other person is saying. By practicing non-judgmental awareness the aim is for individuals to learn to observe their thoughts and feelings without becoming overwhelmed by them. This is particularly helpful in social situations where individuals might otherwise get caught up in self criticism or fear of being judged.

ACT in particular focuses on accepting uncomfortable feelings rather than fighting them. This helps individuals learn that anxiety is uncomfortable but doesn’t have to stop them from doing things that matter. By focusing on values and actions ACT encourages individuals to do what they care about even in the presence of anxiety.

Self-Compassion and Self-Reflection

Self-compassion practices have also been shown to be helpful for social anxiety. Social anxiety often involves self criticism and negative self evaluation and self-compassion can counteract this by promoting kindness and understanding towards oneself.

Self-compassion practices involve treating oneself as kindly as you would treat a friend. This can help soften the blow of social mistakes or perceived failures and reduce the shame or inadequacy that often accompanies social anxiety. Research shows that self-compassion practices help reduce the fear of negative evaluation by building a kinder internal dialogue which reduces social anxiety over time.

Self-reflection exercises such as journaling can also give individuals insight into their anxiety triggers and responses. Writing about specific social situations that were distressing, along with the thoughts and feelings that arose, can help individuals identify patterns in their anxiety. With more self awareness they can develop more targeted coping strategies for future interactions.

Interpersonal Skills Training

For some individuals it’s necessary to build skills to be more effective in social situations. This type of social skills training provides individuals with tools to navigate specific social situations more confidently, from small talk to expressing opinions, asserting themselves or responding to criticism. This can help individuals practice specific social interactions that are particularly stressful and provide concrete strategies. This means they can interact more confidently and competently and over time their anxiety will likely reduce.

Lifestyle Changes and Self-Help Strategies

While professional treatment is needed for social anxiety disorder, lifestyle changes and self-help strategies can help reduce symptoms. Regular exercise is one way to reduce anxiety symptoms as physical activity releases endorphins that improve mood and reduce stress.

Practicing mindfulness techniques such as meditation or deep breathing can help individuals stay present and not ruminate on past mistakes or worry about future interactions. Building a support network of friends, family or a support group can give a sense of community and understanding which can be very comforting.

Relaxation techniques such as progressive muscle relaxation or visualization can help manage physical symptoms of anxiety. Engaging in self care activities that bring joy and relaxation like hobbies or spending time in nature can also improve overall mental health. These combined with professional treatment can greatly improve the quality of life for individuals with social anxiety disorder.