Social anxiety is an anxiety disorder characterised by an irrational fear of social situations. The person behaves anxiously in these types of settings, and this makes it difficult to engage or interact with other people, which can have a tangible impact on the person’s daily life.
Social anxiety comprises three unique features: 1) Emotions of embarrassment and shame are often the strongest feelings experienced, rather than anxiety alone, 2) the elevated anxiety related to social contexts often produces automatic inhibitory behaviours and efforts to hide the anxiety, which has the paradoxical effect of negatively impact social performance, what in turn, causes the catastrophe the persons fear to become true: the negative evaluation of others, 3) anxiety itself becomes the secondary threat, as people with the disorder think they must hide it to avoid negative social evaluation.
To explain how these processes work in developing and maintaining social anxiety, a model based on the contributions of Beck et al. (1985, 2005), Clark and Wells (1995), and Rapee and Heimberg (1997) is explained by Clark and Beck (2010).
Clark and Beck (2010) distinguish three phases of social anxiety: the anticipatory phase, actual exposure to the social situation, and post-event processing.
The anticipatory phase
In most cases, social anxiety starts with the expectation of a social event ahead of time that can cause as much anxiety as exposure to the social situation. This phase can be triggered by a range of contextual cues (e.g., being told of a future social event, checking one’s work calendar, being invited to an event, etc.).
The anticipatory anxiety can last from a few minutes to days or even weeks, and it usually increases as the event approaches. Furthermore, the stronger the anticipatory anxiety, the more likely the person is to avoid the social event.
During this phase, pre-existing maladaptive beliefs will be activated as the social event approaches. These beliefs include ideas about one’s perceived social incompetence, imagined negative evaluations of others, inability to perform socially as expected, or the distressing nature of anxiety. These beliefs tend to govern the person’s thinking, and the inclination is to focus on elements of the situation that could be threatening. Anything that could disconfirm the pre-existing beliefs is discounted or ignored.
Similarly, the memory of past social events where the person experienced heightened anxiety and shame, or embarrassment will be biased for retrieval, causing an increased perception of threat and personal vulnerability in the future event. Hence, worry processes are triggered, as the person becomes more and more concerned with the social situation. The perceived probability and severity of the feared consequences will become heightened the longer the person is trapped in this ruminative state.
Situational exposure phase
In some instances, people with social phobia will be able to avoid the social situation; however, often they will see themselves in social contexts they can’t escape. Exposure to social situations will bring the highest levels of anxiety and both automatic and effortful thought processes will be triggered during feared events.
The main cognitive process initiated during this phase is faulty social beliefs about the threat and own vulnerability. Clark and Beck (2010) summarised in the following table the most common beliefs that characterised social phobia:
|Core beliefs of the helpless, weak, or inferior social self||“I’m boring”, “I’m not a friendly person”, “People don’t tend to like me”, “I’m socially awkward”, “I don’t fit in.”|
|Beliefs about others||“People are critical of others”, “In social situations, people are always forming evaluations of each other”, “Individuals are constantly scrutinizing other people, looking for their flaws and weaknesses.”|
|Beliefs about disapproval||“It is awful when others disapprove of you”, “It would be horrible if others thought I was weak or incompetent”, “To embarrass yourself in front of others would be unbearable, a personal catastrophe.”|
|Beliefs about social performance standards||“It is important not to show any signs of weakness or loss of control to others”, “I must appear confident and interpersonally competent in all my social interactions”, “I must always sound intelligent and interesting to others.”|
|Beliefs about anxiety and its effects||“Anxiety is a sign of emotional weakness and loss of control”, “It is important not to show any signs of anxiety around others”, “If people see that I’m blushing, perspiring, have shaking hands, etc., they will wonder what is wrong with me”, “If I am anxious, I won’t be about to function in this social situation”, “I can’t stand to feel anxious around others.”|
These maladaptive beliefs lead to a series of consequences:
- Attentional bias for threat: verbal or nonverbal signals from peers that can be interpreted as negative evaluation will be given priority focus, while cues that indicate safety, approval, or acceptance, will be minimized, or disregarded.
- Increased attention to internal signs of anxiety: the beliefs explained in the above table trigger hypervigilance of one’s physical, emotional, or behavioural state. The socially anxious person looks for internal cues that might be perceived as proof of anxiety and loss of control. They will suppose other people can notice these anxiety indicators, which then become the reason for their negative social evaluation. As a result, these internal cues of anxiety reinforce the socially anxious person’s ideas about how others perceive them.
- Automatic inhibitory behaviours: people with social anxiety are inhibited in social situations. For instance, they can show a stiff posture or rigid facial expression and have difficulties with their speech (e.g., stuttering, having issues finding the appropriate word, etc.).
- Negative appraisal of one’s feelings and social performance: individuals affected are often aware of these difficulties and they believe others are aware as well, which in turn leads to the idea that others are negatively evaluating them. These automatic inhibitory behaviours are taken as a loss of control, increased vulnerability, and lack of social skills. All these processes increase the anxiety experienced during the event.
- Maladaptive use of safety behaviours: with safety behaviours, we refer to any technique employed to reduce anxiety during a social context. They can be overt actions, such as avoiding eye contact or rubbing one’s hands, or mental strategies, like memorising conversation topics to use during the social encounter. Nevertheless, these strategies reinforce the idea of threat, increasing anxiety in the long term.
Post-event processing phase
An additional cognitive process takes place after the social event has finished and has an important role in the maintenance of social anxiety. This process involves the socially anxious person reviewing and re-evaluating his or her performance during the event. Such re-evaluation has negative connotations and is biased to agree with the maladaptive beliefs of social threat and vulnerability. As a result, they are likely to assume that their performance and other people’s evaluations were much more negative than in reality.
Rumination can also take place during the post-event processing phase, which can lead to developing an even worse evaluation of one’s performance and the peer’s opinion.
Beck, A., Emery, G., & Greenberg, R. (1985). Anxiety Disorders and Phobias. A Cognitive Perspective (pp. 300-368). New York: Basic Books
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective. Basic Books/Hachette Book Group.
Clark, D. A., & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders: Science and practice. Guilford Press.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). The Guilford Press.
Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour research and therapy, 35(8), 741–756. https://doi.org/10.1016/s0005-7967(97)00022-3
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