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Exposure therapy forsocial anxiety disorder(SAD) can help you overcome fears of specific social and performance situations. Although exposure training is normally conducted with the assistance of a therapist as part of a cognitive-behavioraltreatmentprogram, it can also be incorporated into your daily life.
If you have social anxiety, you most likely face these types of situations with fear and dread or avoid them completely. This strategy can sustain your anxiety in the long term.
While avoiding situations you fear might alleviate your distress in the short term, you are teaching yourself that you can’t handle those triggers.
Leaving situations in a state of panic also teaches you they are to be feared. Ideally, you need to gradually introduce yourself to increasingly more difficult situations and stay in those situations until your fear subsides.This type of exposure training can be done in real life (in vivo) or in your imagination.
At a GlanceExposure therapy can be a highly effective treatment for social anxiety and social fears.If you are trying to address symptoms of social anxiety, you can also use these strategies on your own to learn to face your fears. Keep reading to learn more about how to use exposure therapy to address different situations that may trigger symptoms of social anxiety disorder.
At a Glance
Exposure therapy can be a highly effective treatment for social anxiety and social fears.If you are trying to address symptoms of social anxiety, you can also use these strategies on your own to learn to face your fears. Keep reading to learn more about how to use exposure therapy to address different situations that may trigger symptoms of social anxiety disorder.
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Exposure for Eating Fears
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People with social anxiety disorder (SAD) who are afraid to eat in public are generally fearful that they will embarrass themselves while eating.
Such fears may be triggered when a person faces eating in certain situations, with certain people, or in certain settings. Fears vary from person to person but may involve the fear that their hands will shake, they’ll spill something, or that they might choke.
Understanding the Fear of Eating in Front of Others
2Exposure Therapy for Paruresis (aka “Shy Bladder”)The Image Bank / Jonathan Kim/The Image Bank/Getty ImagesOne of the more difficult fears associated with social anxiety disorder is a phobia of using public restrooms.Paruresis (sometimes referred to as “shy bladder syndrome”) is a phenomenon where people find it difficult or impossible to urinate when other people are around. This fear can impact your ability to function and may lead to isolation and the desire not to leave home.Paruresis is a type of specific phobia, which is a phobia related to a specific situation, object, or situation.Estimates suggest that around 2.8% and 16.4% of all people experience this phobia, and around 5.1% to 22.2% of people with this phobia also have social anxiety disorder.If you have this fear, it is possible to use the principles of exposure therapy to gradually become more comfortable using restrooms in public. You might imagine using a public restroom and then gradually work your way up to using a public facility. You might start in an uncrowded setting and progressively use restrooms in increasingly crowded settings.Specific Phobia DSM-5 Diagnostic Criteria
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Exposure Therapy for Paruresis (aka “Shy Bladder”)The Image Bank / Jonathan Kim/The Image Bank/Getty ImagesOne of the more difficult fears associated with social anxiety disorder is a phobia of using public restrooms.Paruresis (sometimes referred to as “shy bladder syndrome”) is a phenomenon where people find it difficult or impossible to urinate when other people are around. This fear can impact your ability to function and may lead to isolation and the desire not to leave home.Paruresis is a type of specific phobia, which is a phobia related to a specific situation, object, or situation.Estimates suggest that around 2.8% and 16.4% of all people experience this phobia, and around 5.1% to 22.2% of people with this phobia also have social anxiety disorder.If you have this fear, it is possible to use the principles of exposure therapy to gradually become more comfortable using restrooms in public. You might imagine using a public restroom and then gradually work your way up to using a public facility. You might start in an uncrowded setting and progressively use restrooms in increasingly crowded settings.Specific Phobia DSM-5 Diagnostic Criteria
Exposure Therapy for Paruresis (aka “Shy Bladder”)
The Image Bank / Jonathan Kim/The Image Bank/Getty Images
One of the more difficult fears associated with social anxiety disorder is a phobia of using public restrooms.Paruresis (sometimes referred to as “shy bladder syndrome”) is a phenomenon where people find it difficult or impossible to urinate when other people are around. This fear can impact your ability to function and may lead to isolation and the desire not to leave home.
Paruresis is a type of specific phobia, which is a phobia related to a specific situation, object, or situation.
Estimates suggest that around 2.8% and 16.4% of all people experience this phobia, and around 5.1% to 22.2% of people with this phobia also have social anxiety disorder.
If you have this fear, it is possible to use the principles of exposure therapy to gradually become more comfortable using restrooms in public. You might imagine using a public restroom and then gradually work your way up to using a public facility. You might start in an uncrowded setting and progressively use restrooms in increasingly crowded settings.
Specific Phobia DSM-5 Diagnostic Criteria
3
Exposure for Phone Phobia
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Are you afraid to talk on the phone?Do you become particularly anxious when talking on the phone in front of other people? Do you sometimes avoid the phone or let the answering machine pick up?
If you answered yes to any of these questions, you might want to consider exposure therapy for phone phobia. The fear of talking on the phone is a common problem for many people, particularly those who have social anxiety disorder.
You might start with simple situations that don’t induce much anxiety before slowly working your way up to more challenging scenarios. As you gain more experience and confidence with making phone calls and talking on the phone, your anxiety will gradually lessen.
Phone Anxiety
4Exposure for the Fear of Social SituationsHero Images/Getty ImagesPeople with SAD commonly fear a range of social situations. Examples of social situations that can trigger symptoms of anxiety include:Meeting new peopleGoing out on a dateHaving a job interviewSpeaking in classTalking to a cashier at the storeSpeaking in publicGoing to a partyEntering an unfamiliar placeExposure therapy for the fear of socializing can involve a hierarchy including these situations and any others that cause you anxiety.This is one of the easier exposures to conduct because it is relatively straightforward to find and involve yourself in the situations that you fear.How Do I Get Over My Fear of Social Situations?
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Exposure for the Fear of Social SituationsHero Images/Getty ImagesPeople with SAD commonly fear a range of social situations. Examples of social situations that can trigger symptoms of anxiety include:Meeting new peopleGoing out on a dateHaving a job interviewSpeaking in classTalking to a cashier at the storeSpeaking in publicGoing to a partyEntering an unfamiliar placeExposure therapy for the fear of socializing can involve a hierarchy including these situations and any others that cause you anxiety.This is one of the easier exposures to conduct because it is relatively straightforward to find and involve yourself in the situations that you fear.How Do I Get Over My Fear of Social Situations?
Exposure for the Fear of Social Situations
Hero Images/Getty Images
People with SAD commonly fear a range of social situations. Examples of social situations that can trigger symptoms of anxiety include:
Exposure therapy for the fear of socializing can involve a hierarchy including these situations and any others that cause you anxiety.
This is one of the easier exposures to conduct because it is relatively straightforward to find and involve yourself in the situations that you fear.
How Do I Get Over My Fear of Social Situations?
5
Exposure for the Fear of Being the Center of Attention
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Often, those with SAD have a debilitating fear of being the center of attention. You might blush or shake when thrust into the spotlight or quickly try to deflect the conversation if the topic turns to you.
The problem is that constantly trying to avoid the limelight can increase fear and anxiety about these situations. This can have a severe impact on your life, limiting your ability to participate in activities and succeed in school and at work.
This can lead to missed opportunities, reduce your achievement, create additional anxiety, and contribute tosocial isolation.
Fear of Being the Center of Attention
6
Exposure for Public Speaking Fears
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Fears of public speaking are common. It is one of the most common types of social fear. Research suggests that 15% to 30% of all people have public speaking anxiety.
However, when anxiety about speaking in front of others has a severe impact on your personal and professional life, it may be diagnosed as SAD.This fear can also be considered a type of specific phobia known asglossophobia.
Gradually facing increasingly difficult public speaking scenarios is one way to overcome your fears.
How to Manage Public Speaking Anxiety
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Exposure for the Fear of Conflict with Others
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Instead of shying away from conflict, exposure therapy will help you to gradually face potential conflict and learn that you can handle it when others disagree.
A key part of this exposure is also learning tobe more assertiveand practicingassertive behaviors. Strategies such as learning how to say no, avoidingpeople-pleasing, and being direct can help.
Overcome the Fear of Conflict With Therapy
TakeawaysSelf-administered exposure techniques can be helpful for social anxiety that is not so extreme that it renders you housebound or facing severe panic attacks in most social or performance situations. If you do find yourself with severe symptoms, exposure therapy practiced on your own may be too difficult.In this case, it’s best to work with a mental health professional who can guide you gradually through the situations that you fear, being sure to first work on the thought patterns that keep you stuck.The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
Takeaways
Self-administered exposure techniques can be helpful for social anxiety that is not so extreme that it renders you housebound or facing severe panic attacks in most social or performance situations. If you do find yourself with severe symptoms, exposure therapy practiced on your own may be too difficult.
In this case, it’s best to work with a mental health professional who can guide you gradually through the situations that you fear, being sure to first work on the thought patterns that keep you stuck.
The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
10 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychological Association.What is exposure therapy?Chowdhury N, Khandoker AH.The gold-standard treatment for social anxiety disorder: A roadmap for the future.Front Psychol. 2023;13:1070975. doi:10.3389/fpsyg.2022.1070975National Institutes of Health.Social anxiety disorder: More than just shyness.Kuoch KLJ, Meyer D, Austin DW, Knowles SR.A systematic review of paruresis: Clinical implications and future directions.J Psychosom Res. 2017;98:122-129. doi:10.1016/j.jpsychores.2017.05.015Boston Children’s Hospital.Phobias: Symptoms and causes.Gao Y, Li A, Zhu T, Liu X, Liu X.How smartphone usage correlates with social anxiety and loneliness.PeerJ. 2016;4:e2197. doi:10.7717/peerj.2197Social Anxiety: Clinical, Developmental, and Social Perspectives (Third Edition).Academic Press. 2014.Tejwani V, Ha D, Isada C.Observations: Public speaking anxiety in graduate medical education–A matter of interpersonal and communication skills?J Grad Med Educ. 2016;8(1):111. doi:10.4300/JGME-D-15-00500.1US National Library of Medicine.Social anxiety disorder.Feng C, Cao J, Li Y, Wu H, Mobbs D.The pursuit of social acceptance: aberrant conformity in social anxiety disorder.Soc Cogn Affect Neurosci. 2018;13(8):809-817. doi:10.1093/scan/nsy052
10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychological Association.What is exposure therapy?Chowdhury N, Khandoker AH.The gold-standard treatment for social anxiety disorder: A roadmap for the future.Front Psychol. 2023;13:1070975. doi:10.3389/fpsyg.2022.1070975National Institutes of Health.Social anxiety disorder: More than just shyness.Kuoch KLJ, Meyer D, Austin DW, Knowles SR.A systematic review of paruresis: Clinical implications and future directions.J Psychosom Res. 2017;98:122-129. doi:10.1016/j.jpsychores.2017.05.015Boston Children’s Hospital.Phobias: Symptoms and causes.Gao Y, Li A, Zhu T, Liu X, Liu X.How smartphone usage correlates with social anxiety and loneliness.PeerJ. 2016;4:e2197. doi:10.7717/peerj.2197Social Anxiety: Clinical, Developmental, and Social Perspectives (Third Edition).Academic Press. 2014.Tejwani V, Ha D, Isada C.Observations: Public speaking anxiety in graduate medical education–A matter of interpersonal and communication skills?J Grad Med Educ. 2016;8(1):111. doi:10.4300/JGME-D-15-00500.1US National Library of Medicine.Social anxiety disorder.Feng C, Cao J, Li Y, Wu H, Mobbs D.The pursuit of social acceptance: aberrant conformity in social anxiety disorder.Soc Cogn Affect Neurosci. 2018;13(8):809-817. doi:10.1093/scan/nsy052
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychological Association.What is exposure therapy?Chowdhury N, Khandoker AH.The gold-standard treatment for social anxiety disorder: A roadmap for the future.Front Psychol. 2023;13:1070975. doi:10.3389/fpsyg.2022.1070975National Institutes of Health.Social anxiety disorder: More than just shyness.Kuoch KLJ, Meyer D, Austin DW, Knowles SR.A systematic review of paruresis: Clinical implications and future directions.J Psychosom Res. 2017;98:122-129. doi:10.1016/j.jpsychores.2017.05.015Boston Children’s Hospital.Phobias: Symptoms and causes.Gao Y, Li A, Zhu T, Liu X, Liu X.How smartphone usage correlates with social anxiety and loneliness.PeerJ. 2016;4:e2197. doi:10.7717/peerj.2197Social Anxiety: Clinical, Developmental, and Social Perspectives (Third Edition).Academic Press. 2014.Tejwani V, Ha D, Isada C.Observations: Public speaking anxiety in graduate medical education–A matter of interpersonal and communication skills?J Grad Med Educ. 2016;8(1):111. doi:10.4300/JGME-D-15-00500.1US National Library of Medicine.Social anxiety disorder.Feng C, Cao J, Li Y, Wu H, Mobbs D.The pursuit of social acceptance: aberrant conformity in social anxiety disorder.Soc Cogn Affect Neurosci. 2018;13(8):809-817. doi:10.1093/scan/nsy052
American Psychological Association.What is exposure therapy?
Chowdhury N, Khandoker AH.The gold-standard treatment for social anxiety disorder: A roadmap for the future.Front Psychol. 2023;13:1070975. doi:10.3389/fpsyg.2022.1070975
National Institutes of Health.Social anxiety disorder: More than just shyness.
Kuoch KLJ, Meyer D, Austin DW, Knowles SR.A systematic review of paruresis: Clinical implications and future directions.J Psychosom Res. 2017;98:122-129. doi:10.1016/j.jpsychores.2017.05.015
Boston Children’s Hospital.Phobias: Symptoms and causes.
Gao Y, Li A, Zhu T, Liu X, Liu X.How smartphone usage correlates with social anxiety and loneliness.PeerJ. 2016;4:e2197. doi:10.7717/peerj.2197
Social Anxiety: Clinical, Developmental, and Social Perspectives (Third Edition).Academic Press. 2014.
Tejwani V, Ha D, Isada C.Observations: Public speaking anxiety in graduate medical education–A matter of interpersonal and communication skills?J Grad Med Educ. 2016;8(1):111. doi:10.4300/JGME-D-15-00500.1
US National Library of Medicine.Social anxiety disorder.
Feng C, Cao J, Li Y, Wu H, Mobbs D.The pursuit of social acceptance: aberrant conformity in social anxiety disorder.Soc Cogn Affect Neurosci. 2018;13(8):809-817. doi:10.1093/scan/nsy052
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