Social anxiety disorder, also known as social phobia, is an anxiety disorder characterized by the extreme fear of being embarrassed in public or being socially scrutinized. Because of this intense fear of social scrutiny, sufferers avoid crowded places and avoid performing in front of people. Social phobia develops from multiple factors, including situational triggers, thoughts and beliefs about the situation, anxiety induced by the thoughts, and behaviors which serve to decrease the distress from anxiety. Let’s look at an example social phobia formulation diagram, also known as a negative cycle of social phobia:

So in this example, the feared situation is a presentation to coworkers. If you have social phobia, then the situation induces thoughts about the event. You may have the thoughts: “everyone will make fun of me,” or “they will think I’m stupid,” or “I will embarrass myself,” or “they will not like me.” These thoughts about the presentation to coworkers induce anxiety, fear, and self-consciousness. In addition, the fear triggers the release of adrenaline, leading to the fight or flight response, the physical symptoms of anxiety.With this anxiety induced by your thoughts and beliefs about the situation, you then resort to safety behaviors to decrease your distress and discomfort. The safety behaviors, which are also avoidant behaviors, mainly involve avoiding social situations. However, if social situations can’t be avoided, then the following safety behaviors may take place: avoiding eye contact; not talking to people; hiding away from the crowd; drinking more alcohol to take the edge off; planning your route of escape; or just leaving early.
Unfortunately, the avoidant behaviors, or safety behaviors, maintain the belief that people are making fun of you. So the next time you have a social situation, your belief that people are making fun of you continues to trigger the anxiety, which then lead to the safety behaviors. This forms a never-ending, vicious, negative cycle of self-focus and social anxiety. The solution is to stop the safety behaviors and find another solution to reducing the anxiety, which includes changing your beliefs and thoughts about the feared situation, and learning relaxation techniques to calm your overall level of anxiety.

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