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Social Anxiety Lesson 1

Social Anxiety Explained
Welcome
Congratulations on finishing the first lesson of the social anxiety course!

Course Overview
This course is designed to help you learn practical skills that you can use every day to tackle
your social anxiety. Here’s an overview of all the lessons in this course:

• Lesson 1 – Social Anxiety Explained: Learn about how social anxiety affects you and
how it can be treated.

• Lesson 2 – Tackling Avoidance: Understand how avoidance keeps anxiety going, and
how anxiety can be overcome using exposure therapy.

• Lesson 3 – Troubleshooting Exposure: Review how exposure therapy is progressing

and learn how to do behavioural experiments.

• Lesson 4 – Unhelpful Thinking Styles: Learn to identify unhelpful thinking styles.

• Lesson 5 – Thought Challenging and Social Skills: Challenge unhelpful thinking styles
and learn about social skills.

• Lesson 6 – Relapse Prevention: Summarising the course and preventing relapses.

Jack and Kat’s stories will be used to explain the strategies covered in this course. Of course,
your own experiences will be very personal, but you may relate to aspects of Jack and Kat’s
stories.

Don’t hesitate to contact us if you have any questions, by email at

contact@thiswayupclinic.org or by telephone on 02 8382 1437.

Good luck!

The THIS WAY UP Team

www.thiswayup.org.au

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 Social Anxiety Explained

1. What is Social Anxiety?

Social anxiety is the excessive and persistent fear of being negatively evaluated. People
with social anxiety worry about:

• Being the centre of attention

• Embarrassing themselves
• Being judged as incompetent, strange or stupid
• Being judged for looking anxious (for example, for blushing or sweating)
• Being unlikeable
• Being rejected

How does social anxiety differ from shyness?

Shyness is feeling nervous around other people, especially large groups. It’s normal to feel
shy in some social situations, like public speaking or meeting a large group of strangers.
Normally, shyness is not overwhelming and it doesn’t stop people from socialising. On the
other hand, people with social anxiety avoid socialising and worry about social events a long
way in advance. Severe shyness that causes significant avoidance of or distress in social
situations is most likely social anxiety.

Situations that trigger anxiety

People with social anxiety can feel anxious in many different situations, for example:
• Talking to other people • Talking on the phone
• Going to parties or being in a crowd • Eating in public
• Replying to emails • Workplace meetings or events
• Using social media • Asking shop assistants for help
• Using public toilets • Ordering food at a restaurant

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2. The Three Parts of Social Anxiety
People with social anxiety have three types of symptoms: thoughts, physical symptoms, and
behaviours. These symptoms interact with each other to keep social anxiety going.

For example, in class, Jack experiences the physiological symptoms of anxiety, like
sweating, blushing, and shaking. He feels embarrassed by these symptoms and has thoughts
such as, “The other students will laugh at me,” which make him more anxious. To stop
feeling anxious, Jack leaves his classes. Leaving is a form of avoidance, a behaviour that is
common in social anxiety. Avoidance feels good in the short-term; however, by leaving his
classroom Jack doesn’t have the chance to learn that he can manage his anxiety, or perhaps
that others won’t laugh at him. Therefore, avoidance keeps his anxiety going in the long-
term.

Similarly, when Kat picks her children up from school, she worries about what the other
parents will think about her. She has thoughts such as, “If I tell them about my work, they’ll
think I’m arrogant”. To avoid talking about herself, Kat asks the other parents lots of
questions. This is a safety behaviour that stops Kat learning that the other parents might be
interested to hear about her work (which maintains her social anxiety).

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3. My Social Anxiety Symptoms
What thoughts, physical symptoms, and behaviours maintain your anxiety?

Thoughts
People with social anxiety are often self-critical and worry that others will judge them
negatively. They often have the following sorts of thoughts. Select those that you think
regularly:

 People will think I’m an idiot  People will think I’m weak or pathetic
 People will think I’m stupid  People will be able to tell I’m nervous
 People will think I’m boring  People don’t like me
 I’m not interesting  People will think I’m arrogant
 People will think I’m weird  Others are judgmental
 What if I offend someone?  People will laugh at me
 People think I’m hopeless  I’ll embarrass myself

Physical Symptoms

Here are some common physical symptoms of anxiety. Select those that apply to you:

 Heart pounding or beating quickly

 Blushing
 Sweating
 Clammy hands
 Trembling or shaking
 Feeling dizzy or light-headed
 Nausea
 Weakness or feeling faint
 Shortness of breath
 Stomach upset

Some physical symptoms, like blushing and sweating, can make you feel even more
anxious, particularly if you start to worry that other people will notice these symptoms.

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Behaviours

People with social anxiety often avoid social situations or use safety behaviours in social
situations to reduce their anxiety. Safety behaviours are a type of avoidance. They are things
you do to help you enter or endure an anxiety-provoking situation (i.e. help you feel “safe”),
as opposed to avoiding an anxiety-provoking situation altogether. Avoidance makes your
anxiety go down in the short-term, but actually maintains your anxiety in the long-term.
Select the following behaviours that you might have done before:

 Avoiding making eye contact with others

 Leaving social situations early
 Leaving social situations without saying goodbye
 Asking other people lots of questions, to avoid talking about yourself
 Declining social invitations
 Wearing heavy makeup to hide blushing
 Pretending not to notice an acquaintance in public, to avoid having to talk to them
 Drinking alcohol or using other drugs to feel less anxious before social situations
 Wearing plain clothing to avoid being the centre of attention
 Texting or playing on your phone to avoid making conversation with others
 Excessively planning what you will say or do at a social event

These behaviours decrease anxiety in the moment. However, each time you use one of the
behaviours, you’re more likely to use them next time.

A note on safety behaviours…

Safety behaviours can actually bring about unwanted negative attention. For example, if
you never offer an opinion because you don’t want to be the centre of attention, people
may deliberately ask you for your opinion.

People who use safety behaviours can also look like they don’t have good social skills. For
example, talking softly and avoiding eye contact can make you seem unapproachable or
disinterested. So, in trying to minimise negative attention, safety behaviours can
inadvertently bring about the feared consequence – negative evaluation! This keeps the
anxiety going.

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4. What is Cognitive Behavioural Therapy?
Cognitive Behavioural Therapy (CBT) involves learning skills to manage your symptoms. CBT
teaches you new ways of thinking and behaving that can help you break the vicious cycle
of anxiety. There are a few things you should know about CBT:

CBT focuses on the here and now. CBT deals with the present rather than analysing
your past. CBT aims to give you the practical skills you need to make changes to your life
now and in the future.

CBT involves practice tasks. A key component of CBT is skills practice, so you can
transfer the skills you learn into your day-to-day life. There are 168 hours in a week. One
hour of therapy a week will not make much difference if you don’t make any changes in the
other 167 hours. Practice tasks impact on those 167 hours – if you don’t practise the skills,
this treatment will not be very effective.

CBT is not a quick fix. To get the most out of this course, allocate about 4 hours a week
to read the lesson slides, summaries, and extra resources, and practise the skills shown
throughout the program. No one expects you to be an expert overnight.

The road to recovery is filled with ups and downs. Many people with anxiety and
depression have very high expectations of themselves. It is important that you have realistic
expectations about treatment. During treatment, it is common to experience ups and
downs. Indeed, setbacks are to be expected. However, improvement during treatment
generally heads in the right direction with more and more improvement being seen over
time.

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5. What Do You Want To Achieve Here?

Treatment is more likely to be effective if it is goal-oriented. Goals

make it easier for you to know what you are working toward and
stay motivated (especially during challenging times), and give you a
sense of achievement when you have mastered them. It is
important that your goals are meaningful to you.

What do you want to achieve by doing this program?

To help you with goal setting, you can scroll up to the section on the three parts of social
anxiety and identify what you want to change in each of these components.

6. The Fight-or-Flight Response Explained

The first step in managing the physical symptoms of anxiety is understanding why our
bodies react the way they do. When our brain detects possible danger or threat, our body
reacts with an automatic biological response called ‘fight-or-flight’. The fight-or-flight
response is a series of normal biological reactions that keep you safe in the face of possible
danger or threat. Some physical changes in the body include:
• Sweating
• Tense or shaking muscles
• Nausea
• Increased heart rate
• Faster, shallower breathing (which can cause dizziness and tingling)

The fight-or-flight response is a normal mechanism. It prepares us to fight or flee (escape)

dangerous situations. The symptoms of the fight-or-flight response are not harmful.
However, in anxiety, the fight-or-flight response is triggered by situations that are not
actually dangerous, even though the situations are perceived to be dangerous. This can be
unhelpful. If the fight-or-flight response is triggered too often, you can start to feel
chronically stressed, anxious and frightened of the anxiety symptoms.

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7. Managing Physical Symptoms of Anxiety
You can use controlled breathing, aerobic exercise, and progressive muscle relaxation to
manage the physical symptoms of the fight-or-flight response.

Controlled Breathing

STEP 1
A normal resting breathing rate is 10 – 12 breaths per minute. What is yours now? Use a
watch with a second hand (or timer) and count the number of breaths you take over one
minute.

breaths per minute

STEP 2
Sit comfortably in a chair. Breathe in and out gently through your nose. Rest your hands on
your tummy to check that you are using your stomach muscles (and therefore, your
diaphragm) to drive your breathing rather than your upper chest.

STEP 3
Now, breathe in for 3 seconds, and out for 3 seconds. As you breathe out, relax your body
(and say the word ‘relax’ to yourself). Do this for 3 minutes and notice the difference in your
tension or anxiety.

Record your breathing rate after this exercise. Did it change?

breaths per minute.

We recommend practising this technique at least 3 times per day every day.

Aerobic Exercise

Regular physical activity can relieve anxiety symptoms such as muscle tension.
Cardiovascular exercise has many positive benefits including:

• Releasing the body’s ‘feel good’ chemicals (endorphins) that counteract anxiety and
depression.
• Giving you time away from your worries. When you exercise, your attention is
shifted away from the worry and onto the task you are doing.
• Working off excess ‘nervous energy’ and lactic acid, which can contribute to sore
muscles.
We recommend that you do at least 30 minutes a day, three days a week of cardio exercise
– the type of exercise that makes you huff and puff! Being inactive means you’ll end up
feeling more tired, miss out on positive opportunities that could make you feel better, and
you’ll stay stuck in the vicious cycle of anxiety.

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Tips for exercise:
• Pick an exercise goal and stick to it!
• Pick a task that you can succeed at. If you aren’t confident that you will be able to
complete a task, then chose another one. E.g. walk for 30 minutes instead of
running.
• Pick exercise you will enjoy, not just one you feel you ‘should’ do.
• Exercise regularly and consistently. Make time in your week to exercise. Write it in
your diary, stick to it, and leave yourself reminders.
• See your GP if you have any health complaints. GPs and physiotherapists can often
recommend exercise you can do even if you have a health complaint.
• If you stop – just start again! Don’t beat yourself up about stopping. Focus on
what you have achieved and turn this into what you will do and start again!
• Reward yourself for your hard work. It’s not all sweat and hard work – build in
some rewards to congratulate yourself and to motivate you.

Progressive Muscle Relaxation (PMR)

Elevated stress and anxiety can cause muscle tension. Unfortunately, long periods of muscle
tension can cause muscle pain, headaches, and fatigue. Ongoing muscle tension may also
contribute to the feelings of constant apprehension, irritability, and jumpiness.

PMR helps you relax your mind and body by progressively tensing and relaxing different
muscle groups in your body. In PMR, the muscles are relaxed in a progressive manner as
you work your way around the body. With practice, you will be able to better recognise and
voluntarily reduce muscle tension.

We have a recording to help you try PMR. To access this recording, click here and follow the
on-screen instructions. Download and save the file to your computer or phone, for easy to
access in the future. The entire PMR sequence should take you about 15 minutes to
complete.

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8. Summary and Action Plan
Congratulations on finishing your first lesson in the social anxiety course! This is the first
step in the right direction. Before you finish, we’d like to briefly review the key skills you
learned in today’s lesson.

In this lesson you learned to:

• Identify your physical, thought, and behavioural symptoms of anxiety,
• Recognise the fight-or-flight response, and
• Manage the physical symptoms through engaging in regular exercise, slowing your
breathing, and releasing tension by consciously relaxing your muscles.

Below is your action plan for the coming week.

LESSON 1: MY ACTION PLAN

 Set some goals for this course.
 Put together my own anxiety cycle, which includes identifying:
o Worrisome or unhelpful thoughts
o Unpleasant physical sensations and feelings
o What I do or don’t do in response to anxiety
 Exercise at least 30 minutes per day 3 times per week.
 Practise Controlled Breathing 2 to 3 times per day.
 Download the audio and give Progressive Muscle Relaxation a go.

Please log back into www.thiswayup.org.au later this week and complete Lesson 2.
Remember, you can come back whenever you like and re-read Lesson 1.

Most people with social anxiety find this CBT course very helpful, and we hope that you do
as well!

Good luck!

The THIS WAY UP Team

www.thiswayup.org.au

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