Recovery from Social Anxiety and Related Conditions

Robert F. Mullen, PhD
Director/ReChanneling

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The distinction between social anxiety and social anxiety disorder is in severity. We are not all affected by the same symptoms or relentlessness. The characteristics and traits are equivalent. These conditions originate homogeneously, their trajectories differentiated by environment, experience, and the diversity of human thought and behavior. While comorbidities dramatically benefit, the recovery methods identified are for social anxiety and social anxiety disorder, and reference to one includes the other.

Coping Strategies

Excerpts from our upcoming book, A Tough Love, Common Sense Approach to Recovery from Social Anxiety, currently in final editing.

A coping strategy is a technique we use to manage stress and negative emotions. It’s crucial to understand that there are both constructive (adaptive) and destructive (maladaptive) ways to cope with stress. Choosing adaptive strategies can significantly improve our mental and emotional well-being.

Adaptive coping strategies include relaxation and breathing techniques, rational coping statements, and exercise, which are healthy and supportive. Unhealthy or maladaptive coping strategies, such as substance abuse, negative verbal outbursts, and avoidance due to fear, can be harmful to the entire body system, causing mental, physical, and emotional distress.

Many people confuse unhealthy coping strategies with defense mechanisms. Both are meant to protect our emotional health from threats. However, defense mechanisms are usually unconscious reactions to unmanageable stress, while maladaptive coping strategies are intentional, like procrastination, codependence, or self-harm.

There are various types of coping strategies; some are listed here. Some of the more effective ones for recovery include:

Active or problem-solving strategies aid in identifying and solving problems that cause stress, such as seeking professional help, grounding, cognitive reframing, and many of the approaches we will utilize in our upcoming fear situation plan. This plan is a structured approach to facing and managing our fears in specific situations, providing step-by-step guidance and tools to help us cope effectively.

Accommodative coping strategies demonstrate how to set reasonable expectations and establish boundaries, which are like a safety net that protects us from overwhelming stress. These strategies, covered later in this chapter, provide a sense of security and control in our lives.

Emotional coping strategies help us regulate and control our emotions. Behavioral strategies include stress-reducing activities such as gardening, hiking, and going to the gym. Cognitive strategies help us change our irrational perspectives and thought patterns.

Let’s discuss the two major clinical approaches we use in recovery to develop the most effective coping strategies for specific problems or situations: cognitive-behavioral therapy and positive psychology.

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Cognitive Behavioral Therapy

Cognitive-behavioral therapy examines the significant relationships among our thoughts, feelings, and behaviors, aiming to transform our negative self-appraisals into more productive, rational thoughts and behaviors. It is a corrective and rehabilitative process based on the concept that our thoughts determine our feelings and behaviors. By identifying their origins and validity, we engage strategies to challenge and overcome them.

Social anxiety distorts our perceptions of reality. As we recover, we learn to recognize that our problems, such as feeling constantly judged or fearing social situations, are primarily based on learned patterns of irrational thinking. CBT equips us with knowledge of the sources of these patterns and develops problem-solving skills and coping strategies to address them, instilling a strong sense of self-assurance as we take control of our mental health.

As previously stated, a one-size-fits-all solution cannot adequately address the complexity of the human experience.  When utilized with complementary methods such as positive psychology and self-esteem-specific exercises, CBT is an effective support tool for recovery from SAD. This individualized approach ensures that each person’s unique needs and experiences are understood and addressed, fostering a sense of being valued and respected throughout the recovery process.

Positive Psychology

Positive psychology, with its focus on character strengths, virtues, and attributes, is a potent tool for reclaiming and rebuilding our self-esteem. It empowers us to become aware of and utilize our dominant, positive traits, gradually counteracting the years of negative self-appraisal caused by our social anxiety.

The first wave of positive psychology, which originated in the late 1990s, focused on our potential well-being by emphasizing our strengths, virtues, attributes, and positive experiences. By nurturing these assets, we can reclaim and rebuild our self-esteem, reintegrate into society, and ultimately improve our overall life satisfaction. This wave laid the foundation for the subsequent developments in positive psychology.

Positive Psychology 2.0

Positive Psychology 2.0, in recognizing the dialectical nature of human experience, emphasizes the importance of considering both the positive and negative aspects of our character. This balanced perspective is crucial for healing and advancement, fostering a sense of balance and self-awareness, and leading to a deeper understanding of ourselves.

Positive Psychology 3.0

The latest wave of positive psychology (3.0) has expanded research beyond the individual to include relationships, groups, and organizations, examining how our character and values influence society and how society influences our character and values.

PP 3.0 supports our final objective of reclaiming and rebuilding self-esteem as we reintegrate into society. This wave represents a shift towards a more holistic understanding of positive psychology, considering not only individual well-being but also the broader societal impact of positive character traits and values.

Positive psychology plays a vital role in our recovery. It helps us rediscover and identify our strengths and attributes, which have been dismissed or superseded by our social anxiety.

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Reframing

A core CBT tool is cognitive reframing, which helps us identify, challenge, and replace distorted thought patterns with healthier, positive perspectives. Reframing helps us develop a more positive view of ourselves, others, and the world, alleviating the symptoms of anxiety and depression.

Reframing is a versatile cognitive technique that can be applied in various situations. It prompts us to shift a negative perspective into a positive one. For instance, we can reframe a problem or issue as a challenge or opportunity. We can defuse an argument by considering the other person’s perspective. Similarly, when faced with a difficult task at work, we can reframe the frustration as an opportunity to learn and grow. When stuck in traffic, we can reframe it as a chance to listen to our favorite podcast or audiobook.

In each of these situations, reframing helps us develop a more positive view of ourselves, others, and the world, thereby alleviating the symptoms of anxiety and depression

During a snowstorm, we can feel trapped and despondent, or we can take out the sleds and ice skates and make the most of the day.

Experts agree that reframing is crucial for emotional well-being.

Every situation has multiple perspectives. While we cannot control everything that happens around us, we can manage how we react and respond. We possess the inherent ability to choose how we view people and situations. If given the option to select emotional well-being over anxiety and depression, it is illogical not to seize that opportunity.

Childhood disturbances, negative core and intermediate beliefs, and adverse self-appraisal have rooted themselves in our minds like squatters resisting eviction. Moreover, we are exposed to ongoing cynical input from external sources, including misleading media, adverse public opinion, stigma, and disinformation. Overcoming negative thinking can be a significant challenge.

Reframing is not just an abstract commitment to changing every negative thought or situation into a positive one. Multiple strategies support our efforts to replace disagreeable prospects with a more favorable perspective.

Through these strategies, we create a more nuanced and balanced perspective that encourages positivity, growth, and resilience. A key component of this process is emotional self-regulation, which is the ability to manage and respond to emotional experiences in ways that are healthy and productive.

It’s about being aware of our emotions, understanding what triggers them, and choosing how to respond in a way that aligns with our values and goals. By practicing emotional self-regulation, we reduce the frequency and severity of our adversarial perspectives.

Grounding

This involves intentionally shifting our attention away from anxiety-provoking thoughts or worries by focusing on what surrounds us in our present environment. Grounding techniques help us break free from the grip of traumatic memories or sensations by redirecting our emotional distress into a conscious awareness of the present. When anxiety or stress threatens to overwhelm us, we reframe our focus away from our triggers and other discomforting situations.

The 5-4-3-2-1 method is a practical and accessible grounding technique. It encourages us to connect with one or more of our five senses to anchor ourselves to our physical environment. This practicality makes it easy to remember and apply in various situations.

For instance, if we’re feeling overwhelmed at work, we can take a moment to focus on the click-clack of our typing, the visuals of our computer screen, the reassuring aroma of our cologne, the bitter taste of our coffee, or the sensation of our ergonomic chair against our back. Our anxiety takes a back seat to our senses, and we become more capable of managing our emotions.

For some of us, performing the entire 5-4-3-2-1 sequence is cumbersome. Focusing on one or two senses is just as effective, making the process more manageable.

The vagus nerve is a network of fibers that regulates heart rate, respiration, mood, and stress responses. A significant component of our parasympathetic nervous system, the vagus nerve is the longest nerve in the body, running from our brainstem to the abdomen, and it plays a crucial role in deactivating the fight-or-flight responses.

Other effective grounding methods, such as progressive muscle relaxation and controlled breathing, stimulate the vagus nerve to slow our heart rate and breathing, which also moderates the level of our stress response.

A common symptom of social anxiety is the persistent worry that others will become aware of our condition by observing specific physical reactions such as blushing, hyperventilating, sweating, trembling, or vocal tremors. Grounding reduces our fear of visibility by refocusing our attention on the immediate environment and our presence in it.

Visualization

Visualization involves creating mental images to counteract fear situations, reduce anxiety, and boost performance and confidence. By visualizing a positive experience, we reframe our worst-case scenario projections. For instance, if we feel overly anxious before a public speaking event, visualizing a successful presentation in detail helps us replace negative thoughts and behaviors with healthier, productive ones.

The same activity benefits any fear situation by replacing a negative outlook with a positive, productive one.

All information passes through our brain’s thalamus, which makes no distinction between inner and outer realities. Whether we imagine an action or physically perform it, the same neural regions are activated. Visualizing raising our left hand is, to our brain, the same as physically raising it, providing similar neural benefits.

Visualization is a scientifically supported tool that helps us manage anxiety and fear. It activates our dopaminergic reward system, decreasing the neurotransmission of anxiety- and fear-provoking hormones and accelerating and consolidating the transmission of beneficial hormones.

This dynamic tool helps manage anxiety and fear by activating our dopaminergic reward system, which releases dopamine—the neurotransmitter linked to pleasure and reward. When activated, it reduces the transmission of anxiety-inducing hormones and speeds up the release of beneficial ones.

Additionally, when we visualize, our brain generates alpha waves, which can significantly lessen symptoms of anxiety and depression, making us feel calmer and less stressed.

Research indicates that visualizing a situation beforehand not only improves mental and physical skills but also enhances social abilities. By consciously creating positive scenarios, we can significantly improve social interaction and increase our chances of success in real-life situations.

Since a key goal of visualization is to replace or overcome negative patterns with positive outcomes, it is important to visualize detailed, positive scenarios f situations where we tend to project worst-case outcomes.

Setting Boundaries

One of the best ways to avoid a potential threat is not to put ourselves in that situation in the first place. We do that by establishing boundaries.

Boundaries are the standards of treatment we believe we are entitled to and are comfortable with. They define which behaviors towards us are acceptable or unacceptable and shield us from invasions of our space, feelings, limitations, and expectations. They allow us to assert our identity, empower our goals and objectives, and prevent others from manipulating, exploiting, or taking advantage of us. Boundaries give us the power to shape our lives, instilling a profound sense of control and confidence. 

Our social anxiety has a profound effect on our ability to express ourselves and hold others accountable. Our fear of criticism and rejection can lead to obsessive concern about how people evaluate us. And our yearning for acceptance often overshadows our need to set conditions for our own security and happiness. The fear of upsetting or distancing others can inhibit our ability to set boundaries.

It’s not uncommon for us to create codependent relationships where one partner prioritizes the other’s needs over their own, maintaining excessive emotional reliance on their partner. In these dysfunctional situations, our low self-esteem and craving for approval can lead us to attach ourselves to controlling or manipulative individuals, becoming dependent on them for a sense of worth.

Relationship Boundaries

Our social impotence often leads us to believe that setting boundaries hinders our ability to form and maintain healthy relationships. We fear asserting ourselves will lead to rejection and isolation, and think that setting boundaries will only aggravate our loneliness. Rather than saying no, we often overextend ourselves and prioritize others’ needs above our own, which can leave us feeling inferior, resentful, and exploited.

Learning to say no, however, brings a profound sense of relief, easing the tendency to put others’ needs before our own and lightening our emotional load.

Boundaries serve as the foundation of all healthy relationships. They don’t distance us from others but bring us closer by clearly defining our needs and wants. By setting boundaries, we encourage open communication, ensuring we live in alignment with our values while respecting those of others, fostering a deep sense of connection and understanding.

Social Anxiety’s Impact on Boundaries

Our obsession with perfection consistently reminds us of our insecurities. Our symptomatic negative self-analysis provokes those core beliefs of helplessness, hopelessness, undesirability, and worthlessness. 

The long and short of it is that we want to be loved, but we don’t believe we are because we think we are unworthy. In pursuing perfectionism, we become consummate enablers and codependents, compensating for our feelings of inadequacy. We seek affirmation and appreciation, yet we allow ourselves to be bullied and taken advantage of.

Boundaries not only establish the standard of treatment we believe we are entitled to, but they also empower us to assert our rights. Like fences that provide us with privacy and help us feel safe, boundaries protect our emotional and mental well-being.

One client who held a degreeless job in the college system felt intimidated and frustrated at social events where everyone discussed their academic accomplishments and publications. He simply set a boundary with his employer, where he would not be required to attend these sessions. It may seem like an insignificant demand, but it helped him maintain his sense of self-esteem and value to the institution.

Setting boundaries can be particularly daunting for those grappling with issues of self-worth. However, there are strategies we can employ to prioritize our needs and avoid feelings of inferiority, resentment, and loneliness.

Let’s focus on eight types of boundaries that we should consider establishing.

Physical boundaries include the autonomy of our bodies and personal space. Healthy boundaries establish our comfort zone. We might say, ‘I prefer not to hug people,’ to set a physical boundary. ‘It’s a personal choice,’ or ‘It’s a cultural thing.’

Intellectual boundaries comprise our ideas, beliefs, and thoughts.  A thoughtful boundary also respects others’ boundaries. Dismissing or belittling ideas, beliefs, thoughts, and opinions about us invalidates our intellectual boundary. If we disagree, it’s better to say, ‘I appreciate your opinion, but I don’t fully support it,’ or ‘Let’s agree to disagree.’

Our feelings and personal details are part of our emotional boundaries. When someone criticizes, minimizes, or shares our feelings or personal information without our permission, they violate these boundaries, leading to feelings of betrayal, loss of trust, and emotional distress.

Material boundaries refer to our financial resources and possessions. When we feel pressured to lend or give things away or to spend money when we prefer not to, our boundaries for financial resources and belongings are breached. One effective response might be, ‘I’m on a tight budget. I prefer to share expenses this evening.’

Internal boundaries support self-regulation. Occasionally, we prioritize the energy we expend upon others over our personal needs. This is especially relevant to our desire for acceptance and companionship. When someone attempts to invade our internal boundaries, an acceptable response might be, ‘I’ve been working all week. I need time to recoup and spend quality time with myself. I’ll call you tomorrow.’

Conversational boundaries establish topics we may or may not feel comfortable discussing. Money, religion, and politics easily fall within this category. So, an adequate response to someone infringing on these boundaries might be, ‘ I am uncomfortable discussing this and would rather not be part of this conversation.’

Maintaining healthy time boundaries can be challenging as we juggle a job, relationships, children, and other responsibilities. These boundaries are crossed when others make unreasonable demands or requests for our time and attention. We overextend ourselves by taking on more than we can handle. Establishing time boundaries early avoids miscommunication. ‘I can only stay for half an hour. I have another commitment later this afternoon.’

Sexual boundaries protect our intimate personal space. When someone pressures us into unwanted or unwarranted intimacy, touching, or sexual activity, or when someone expresses hostility toward our choices, they invade our sexual boundaries.

We establish and maintain healthy boundaries when we:

1. Retain the ability to decline anything we don’t want to do.
2. Express our feelings responsibly.
3. Talk about our shared experiences freely and honestly.
4. Set our boundaries in the moment.
5. Address problems directly with the person involved rather than with a third party.
6. Make our expectations clear. It is irrational to assume people will figure them out.
7. Can say ‘no’ comfortably and accept when someone else says ‘no.’
8. Communicate our wants and needs clearly.
9. Honor and respect the needs of others without compromising our own.
10. Respect the values and beliefs of others even if they conflict with our own.

Unhealthy Boundaries

Where unhealthy boundaries exist, safety in the relationship is compromised, leading to dysfunctional relationships where needs remain unmet. Here are some examples of times we failed to set appropriate boundaries. When we:

1. Find it challenging to say ‘no’ or have difficulty accepting ‘no’ from others.
2. Neglect to communicate our needs and wants clearly.
3. Easily compromise our personal values, beliefs, and opinions to satisfy others.
4. Become coercive or manipulative to persuade others to do something they don’t want.
5. Overshare personal information.

How to Set Healthy Boundaries

Setting healthy boundaries is about being transparent about our expectations and creating a safe and respectful space where needs are met. It requires good communication skills that convey clarity and assertiveness, ensuring that our interests are valued and that we are in control of our lives.

Assertiveness is a key component of setting healthy boundaries. It’s not about making demands, but about expressing our feelings openly, respectfully, and without hostility. It’s a communication style that fosters understanding and respect by asserting our needs and priorities.

Here are a few things to consider when we set our boundaries:

• Have a Clear Goal. What is the outcome we want to achieve in setting this boundary?
• Understand Our Motivations. Why do we need to set this boundary?
• Be Courageous. Setting boundaries can have repercussions, such as people becoming defensive, argumentative, or even ending the relationship.
• Keep It Simple. Setting boundaries doesN’t have to be complicated. In fact, less is often more when it comes to communicating our boundaries. It’s prudent not to overload the other with too many details. 

Be kind to yourself and others. Remember, setting boundaries is not about being biased or manipulative. It’s about respecting yourself and others. So, be thoughtful with your words and actions, and always consider others’ feelings and needs.

Completions

Our need for perfectionism causes us to procrastinate completing tasks because we fear they will not meet our expectations. Our constant fear and worry that we will be criticized or rejected causes us to put off attending social events or scheduling classes. Delaying or postponing things leaves things we need or want to do unfinished, creating self-disappointment and resentment.

Completion is not just about ticking off a task from our to-do list; it’s about achieving a sense of accomplishment and satisfaction. It involves taking action, finding resolutions, and achieving fulfillment. When we finally complete tasks, especially those we’ve been procrastinating on, we experience a profound sense of relief and liberation.

Completions create mental space for new learning, ideas, and concepts to emerge. Psychologically, these completions provide a sense of closure, crucial for our emotional well-being.

Experts recommend adding items to an active list whenever a task or idea comes to mind. Sometimes, small projects seem unimportant, causing us to skip listing them and forget about them. Writing down ideas, projects, and other important or productive tasks does two things: it prevents us from forgetting something crucial and frees up our minds for other activities.

I prioritize my tasks using a color-coding system: turquoise for urgent tasks, pink for high-priority projects, and so on. This system helps me stay organized and in control. I review this list regularly to see how well I am managing my tasks.

During recovery, we use graded exposure (systematic desensitization) to address completion anxiety – the fear or discomfort that can happen when facing a task that needs finishing. We start with smaller projects, like cleaning out the garage, weeding the garden, or reconnecting with family members.

These small victories are not insignificant; they are formidable steps to greater accomplishments. Achieving a sense of completion and closure is essential for our emotional health. And it also clears mental space for other pursuits.

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INDIVIDUAL RECOVERY. The symptoms of social anxiety make it challenging for some to participate in a collective workshop. Dr. Mullen works one-on-one with a select group of individuals uneasy in a group setting. ReChanneling offers scholarships to accommodate the costs. What is absent in group activities is provided in our monthly Graduate Recovery Group. In this supportive community, graduates interact with others who have completed the program.  Contact ‘rmullenphd@gmail.com’.

Committing to recovery is one of the hardest things you will ever do.
It takes enormous courage and the realization that you are of value, 
consequential, and deserving of happiness.