Social Anxiety & Panic Attacks
If you’re feeling uncomfortable in social situations and finding this has created an onset of panic attacks, you’ll need to explore where you can make a change that will relieve your distress. You will have found yourself stuck in a cycle that you need to break away from.
Your initial reaction to your discomfort may be to withdraw from social activities in order to reduce the difficulties you are facing and thereby limit the amount of anxiety you experience. This will obviously help protect you from your distressing feelings but unfortunately will also only serve to strengthen the social anxiety as you further associate interactions with others as evidence of panic-inducing events.
As difficult as it may be to engage in social activities, this is precisely what you need to do in order to become more at ease over time. You’ll be pleased to learn however that there are ways to make this much easier on yourself.
Ask yourself these questions:
Which situations am I avoiding?
What thoughts or images pop into my head when I think about engaging in these situations?
What emotions are generated when I begin to consider taking part?
Do I experience any physical sensations in my body when I become anxious and panicky?
How do I respond to all of the above?
Our thoughts, feelings, behaviours, and physical sensations are all inter-connected and you may recognise how one leads to another when you contemplate the above questions e.g. I’m invited to a party (situation), I immediately begin to tell myself that it is going to be unpleasant, I believe people will be judging the way I look or the way I present myself, that they’ll dislike me, or it’ll be overcrowded and warm (thoughts). I may visualise the setting and see myself isolated and lonely or surrounded by people and being bombarded with uncomfortable questions that I don’t know how to respond to (images). Whatever we believe will take place, if we predict this to be difficult and upsetting, we will begin to experience the emotions and sensations in our present situation. We may feel nervous, anxious, scared, worried, vigilant, stressed, sad, low, agitated, frustrated, or even angry (emotions) and we may find our heart racing, our palms sweating, our legs shaking, our stomach churning, or feel detached from the world around us (physical sensations). We will then seek to reduce our extreme discomfort by creating reasons not to attend, making excuses, ignoring our phone etc, or, where we can’t reasonably do this, we may attend the party and leave early, needing to escape to a place that feels safe and comfortable to us (responses).
When we experience the above and we make attempts to reduce our anxieties via withdrawal tactics, we return home (or stay at home) in the full belief that we are correct, parties are not something we can enjoy, we’ve tried and failed over and over and our experiences reinforce our beliefs. What happens then is we begin to feel there is something innately wrong with us, that we just aren’t like other people, that friends will stop inviting us and we will lose these relationships that mean so much to us (thoughts). The behaviours we have implemented to protect us now cause us concern, worry, fear, self-doubt, low self-esteem (emotions) etc and we begin to feel breathless and shaky and nauseous and find it difficult to sleep and so on (physical impact). So you see the cycle.
If you were to map this out, what would it look like? Which link in this chain could you focus on and change? Which element could you identify early on in this cycle and do differently so the chain is cut off at the start and healthier behaviours can occur? This will be different for different people.
Which part of the cycle is most prominent? What are your triggers? You may find this worksheet helpful to help you to map out your own processes and identify where positive change can be made.
The thought patterns that go along with each of the different elements of the cycle will be vitally important, even if these aren’t the first thing you recognise as unhealthy. If for instance you choose to focus on your avoidant behaviour, you will need to implement a healthier way of thinking in order to promote a more positive response. If you are consumed by a particular emotion, challenging the way you are thinking and discovering a more balanced outlook on the situation will help reduce the negative emotions. If you identify a physical response to the perceived threat, you will need to calm the mind in order to calm the body’s response to the trigger and this again will involve altering the way you are thinking about it.
So for example, if I’m finding myself in the cycle, no matter whether I’ve found myself thinking “it’s going to be awful for me” or I’m feeling anxious, or experiencing palpitations, or I’m considering what excuse I’m going to use, if I actively seek to stop for a moment and consider what is going on for me in that moment, I can begin to find a more balanced perspective on my party invitation.
If in that moment I consider what might go well, e.g. “the music might be good” or “it would be good to catch up with my friends” or “I can just relax and observe what’s going on around me” or even “if it gets too much I can leave” these thoughts will combat and balance out the purely negative outcome we were previously considering. This will immediately help reduce the anxiety and palpitations and will help me consider my options more clearly. The more balanced, rational, positive thoughts we can bring to mind the better and it is a good idea to do this when you are feeling well so you can prepare these for when that invitation comes through.
When we are able to put into practice some of the more balanced, rational thoughts and reduce our anxiety enough to test them out, we are able to engage in social activities and find evidence that we can continue to think that way. Things are never as bad as we are capable of making them out to be. If we look for the positive outcomes we will find them. If we can return home from the party and sum up our experiences, identify where things went well and which bits we enjoyed, we are more likely to feel better about the next invitation. Your evidence will suggest that parties are something you actually can enjoy. This worksheet will help you record your experiments.
You can implement this mapping process for any given social situation. Consider the unhelpful thoughts you are bringing to mind. Recognise how these are impacting on you and try to find some balance. At the beginning, you’re unlikely to fully believe a lot of the more rational thoughts so it may not be helpful to be positive, just try to be neutral. Challenge yourself to simply see how it goes, good or bad, and weigh up your evidence. The more you find that things tend to go well, the more you will be able to believe the positive affirmations, and the more easily you will be able to engage in the future as you leave your worries behind.
The only thing left to do will be to understand what brought you to think negatively in the first place. Social anxiety is often brought on as a result of a lack of self-belief or self-confidence but can also relate to self-image or a historic traumatic event. If you need help exploring this, feel free to make contact here.
