Feeling Bashful?
Tackling extreme shyness and social anxiety.
by Martin M. Antony, Ph.D.
TWEENS & TEENS NEWS June 2006
Shyness is a tendency to be somewhat withdrawn,
introverted and anxious around other people.
Up to 80 percent of individuals describe themselves
as having been shy at some point in their
lives.
In most cases, a bit of anxiety in social
situations is not a problem. In fact, anxiety
about being scrutinized by others can keep
a person from doing things that may lead to
negative social consequences, such as getting
rejected from peers, saying things that might
offend others, talking too loudly or disclosing
too much personal information. For tweens
and teens, the fear of embarrassment may help
students to get to school on time, complete
their assignments and do their best to fit
in with friends.
When anxiety becomes too intense, however,
it can interfere with a person’s day-to-day
functioning. About one in ten people experiences
social anxiety at an impairing level—
a problem known as social phobia or social
anxiety disorder. Social phobia may lead people
to fear and avoid a variety of situations,
including talking to peers, sitting in class,
going to parties, speaking with people of
authority, giving presentations, talking on
the phone, asking others on dates, eating
or drinking in front of others, writing for
others or being in public places.
Depending on the severity of the problem,
social phobia can have a devastating effect
on an adolescent’s life, as it is very
hard to avoid these situations without paying
a price. People with social phobia have difficulty
functioning at school, at work and in relationships.
Also, having social phobia can increase a
person’s risk for developing other problems,
such as other anxiety disorders, depression
and dependence with alcohol or drugs.
What Causes Social Phobia?
Social phobia often occurs in the teen years,
though it can begin earlier or later. People
with social phobia typically report having
been somewhat shy since early childhood. The
exact cause of social phobia is unknown, though
we do know quite a bit about variables that
may contribute to the problem. First, social
phobia often runs in families, and genetics
seem to play a role in the transmission of
social phobia from one generation to the next.
Having social phobia is not a guarantee that
your children will develop the problem, but
it does increase the likelihood.
A person’s experiences and development
may also contribute to the problem. For example,
people with social phobia are more likely
than people without the problem to report
having been teased or bullied as children,
and to have parents who place a great deal
of importance on making a good impression
on others.
Regardless of what initially causes social
phobia, many experts believe it is most important
to understand why the problem persists.
Two factors seem to be responsible for sustaining
social anxiety. The first factor is a person’s
anxiety-provoking beliefs, predictions and
assumptions. People with excessive social
anxiety are often convinced that it’s
essential to make a good impression on others,
and that they are likely to do just the opposite.
They assume that others will judge them to
be incompetent, unattractive, boring, stupid,
and that disastrous consequences will result.
The second factor contributing to ongoing
social anxiety is avoidance. Avoidance can
include staying away from social situations
or leaving them early. Avoidance also includes
relying on safety behaviors for “protection”
in social situations. Examples of safety behaviors
include sitting at the back of classes, drinking
alcohol before entering social situations
or wearing extra makeup to hide blushing.
Strategies for Overcoming Shyness
and Social Anxiety
Fortunately, effective treatments have been
developed for extreme shyness and social anxiety,
including cognitive behavioral therapy (CBT),
medications and combinations of these approaches.
The best long-term outcomes have been obtained
with CBT, so it is often recommended that
an individual begin with this approach if
available, and consider adding medications
later if the desired results are not obtained
with CBT alone. This is particularly true
for children and adolescents, for which there
are fewer studies available on the use of
medications for social anxiety. When medications
are used, they typically include SSRI antidepressants
(paroxetine, sertraline, etc.) or venlafaxine,
though there are other medication options
available.
CBT includes several strategies, all designed
to change the anxious thoughts and behaviors.
First, cognitive therapy is used to help the
individual to identify predictions and beliefs
contributing to the anxiety and to replace
them with more realistic thoughts. A person
convinced that it would be a disaster to make
a mistake during a presentation might be asked
to examine the evidence for that thought.
He or she might be asked: Have you ever made
a mistake before? Was it a disaster? What
if you did make a mistake— would it
matter as much as it feels like it would?
What are some other ways of thinking about
the situation? How might an anxiety-free person
view the importance of mistakes?
Next, exposure to feared situations is used
to help the individual to discover that his
or her feared consequences don’t come
true after all. Exposure is most effective
when it is repeated at least several times
per week and when practices are prolonged
(for example, going to a party for an hour
or two instead of just a few minutes).
With repeated exposure, anxiety tends to decrease,
especially when the individual makes an effort
to challenge any anxious thoughts that arise
during exposure. If a person needs to develop
certain basic social skills, such as improved
eye contact, conversation and presentation
skills, then social skills training may be
incorporated into the treatment, as well.
The best thing for parents to do is support
and encourage kids with social phobia. Help
your tween or teen recognize the role that
negative thinking plays in maintaining anxiety,
without being critical or judgmental. Without
nagging or forcing, motivate your child to
confront feared situations— beginning
with easier situations and gradually working
up to more difficult ones. Also, reward your
tween or teen for taking social risks. Exposure
therapy seems to work best when the person
doing the exposure feels a sense of control
and accomplishment. If needed, seek referrals
for professional help from the Anxiety Disorders
Association of America (www.adaa.org).
Dr. Martin M. Antony, Ph.D. is director
of the Anxiety Treatment and Research Centre
and psychologist-in-chief at St. Joseph’s
Healthcare, Hamilton, Ontario, Canada. He
is the author of 16 books, including 10 Simple
Solutions to Shyness, and the Shyness and
Social Anxiety Workbook, both published by
New Harbinger Publications (www.newharbinger.com).
Dr. Antony’s Web site is www.martinantony.com.
