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Social Anxiety (And Other Things I Didn't Know About Myself)

By John R. Cook, Ph.D.

Mid life for me, as most people, is a time of personal review, trying to fathom the twists and turns in life that have brought me to where I am today. Among the questions I have asked myself is: What led me to specialize in treating social anxiety? Upon private reflection, the most compelling reason is that I, like many of my clients, have suffered from that disorder. We are in good company. Just over 10% of North Americans can expect to suffer from social anxiety at some time in our lives.

Social phobia (social anxiety disorder) is characterized by excessive or unreasonable fear of being judged by others in social or performance situations such as public speaking, eating, or working. The anxious anticipation, avoidance, and distress we suffer in these feared situation(s) interferes significantly with our everyday activities, and can lead to a life of underachievement and loneliness.

The good news for people suffering from social anxiety is that the condition is entirely treatable using Cognitive Behavioral therapy. To understand how this treatment works, it is important to understand two things about social phobia. The first is that it is a learned response. This means, like any bad habit, these learned responses can be replaced with other, more adaptive behaviours - ones that leave us feeling calm and confident rather than fearful and avoidant.

The second thing to be aware of, although social phobia can seem like an overwhelmingly huge problem, it can be broken into three parts. The three parts are physical reactions in our body, distortions in our thinking, and changes in our behavior associated with high anxiety. Once broken into parts, each of these three parts may be targeted with a set of treatment techniques that can be readily taught to practically anyone.

Physical reactions such as changes in breathing, muscle tension, flushing, and sweating can be relieved through the use of relaxation techniques. Distortions in our thinking, that cause us to perceive social situations as more dangerous or threatening than they really are, can be managed through a procedure called cognitive restructuring. Last, and most important, behavior changes can be dealt with through exposure. Exposure works by teaching our nervous system not to overreact.

In my experience, the most effective way to provide the combined treatments of relaxation, cognitive restructuring and exposure is in a weekly group of 6 to 8 people, over a 12 week period. Over the past 8 years, my cognitive behavioral groups have been 80 to 90 percent successful with socially anxious people as young as 13 and as old as 85. Of course, most people with social anxiety have to be encouraged to join a therapy group. I simply tell them, "Invest your anxiety in a calmer future!". Check out our Web page at for further information.

Do you suffer from an Anxiety Disorder?

It's normal to get anxious once in a while. It's a problem if you answer "yes to all of the following.

1. I often feel more tense or upset than can be explained by the level of threat or danger at the time.

2. I sometimes take extreme measures to reduce my anxiety such as drugs/alcohol, being angry or withdrawing.

3. I experience significant distress and/or loss of ability to function in important areas of my life as a consequence of my anxiety.

If your anxiety is about social or performance situations where you fear embarrassment or humiliation, you could have social phobia.

About The Author
John R. Cook, Ph.D.

Dr. Cook is a clinical psychologist registered in the Province of British Columbia (Registration #1025), and the founder of Aegis Psychological Services Inc.. Find your path to peace and calm through Dr. Cook's home study programs, electronic motivational aids and light therapy products, and self-help links at


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