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Starving for Company

5 ways to help your socially phobic clients


Social phobia causes sufferers to focus inwards and miss positive social connections

Meeting me was a sickening nightmare. I didn’t take it personally, because for Kylie meeting anyone felt like that.

But she had determined to see me because “something had to change.” But what exactly?

More than just shyness, social phobia causes panic. Meetings and minglings with others can feel like a brush with death itself. And it gets worse.

Even just thinking about upcoming social events can whip up painful and bewildering feelings. Overcome with feelings of failure and helplessness, Kylie described a pounding heart, dry mouth, shaky voice, rapid breathing, sweating, blushing, an upset stomach and a torrent of self-torment.

“Meeting new people is the worst, but even seeing old friends for the first time in a while can make me panic”, she told me.

No wonder it can feel easier just to become isolated! And maybe that wouldn’t matter, if it weren’t for one thing.

We need to feel connected to others. To be accepted by the group is to feel safer and more secure, and to have access to greater resources, perspectives and beneficial connections. You might argue that it shouldn’t be like this, but the fact is, it is. We all need people, and we all need to be needed by people.

As we evolved in a world of bigger, faster and sharper-toothed predators, we found there was safety in numbers. Whether or not we were accepted by the group could literally mean the difference between life and death.

And for those too sensitively attuned to social rejection, it can still feel like death. That’s exactly how it felt for Kylie. Social anxiety is often the manifestation of a terrible fear of being not accepted, or even actively rejected, cast out into the bleak and unforgiving wilderness.

But isolation is no solution.

Kylie had become so lonely. Thirty-seven years old and alone, she told me bitterly how friends had eventually dropped away as she’d continually avoided their calls and left their increasingly infrequent messages unreturned. Opportunities for intimacy, love, friendship, laughter, support and connection had been squandered, left to wither and die.

Kylie was starving for company but couldn’t face taking the very nutrition that would give her life meaning. In our first meeting she told me, “I feel like there’s this world outside that I can’t join in. But I need to so much.” Indeed, we all need to join in, to connect, because nothing matters more than relationships, at least for most of us.

Relationships: The juice of life

Money can’t buy you happiness (although research shows that earning a certain amount can help lift it to some extent)1. But above and beyond basic material provision, our relationships really do matter.

Loneliness seems to be a killer. Weak social connections have been shown to be as harmful to health as smoking, lack of exercise, obesity and overindulgence in alcohol.2 Conversely, social connectivity seems to be a life-saving, meaning-making, happiness-producing, central part of our existence.3 We are wired to connect.

But what if the very thing we need is the very thing we are terrified of? Kylie had always been shy. The problem was that despite coming to see me she had become depressingly fatalistic about the inevitability of spending an empty life devoid of friends.

I had to do something about that particular limiting belief.

Being scared is just who I am!

We all have varying natural personalities. Some people are naturally more prone to introversion and self-sufficiency; others feel they need to be around people constantly.

But we all have some crossover as far as personality type is concerned. We are learning machines, and we have a lot of adaptability or ‘wiggle room’ within our basic personality types. This means that a person who is prone to introversion can adapt and become able to operate in a way that is more extroverted but still fits their reflective personality.

When Kylie told me, “I guess being scared of people is just who I am!” I reassured her that we can all modify who we are. I kept mentioning ‘wiggle room’ and epigenetics4.

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First I wanted her to have hope she could feel okay, then we could move onto the possibility that, just sometimes, she could even feel great in social situations. That she could, and would, connect with people.

I told her that I had been naturally shy and introverted myself, and I still had some of that. But I had been able to learn and practise social confidence until it became a developed part of who I am. I told Kylie I would help her do it too. Like everything, articulation and communication get better with practice.

First, though, we had to deal with the terror – not just shyness, but absolute panic – she would feel when trying to connect with others.

But how?

1. Help your client take control

Few people think of worrying as self-programming, but it is. Intense worry about upcoming social situations repeatedly furrows an association between the idea of meeting people with the experience of feeling terrified.

Sound a bell to a dog while it’s being fed enough times and pretty soon the association between the bell noise and salivation will become automatically established through associative programming.

But it’s not just dogs that fall prey to this phenomenon. If every time I ever think about going out to meet people I feel terrified, pretty soon I too will be programmed with an automatic association between stimulus and response.

Kylie recognized this. “Before I have to meet someone, if I really can’t get out of it, I will worry about it for weeks beforehand. Every time I think about it I feel sick with worry!” I suggested to Kylie that this was a kind of uncontrolled mental preparation, a self-hypnosis, that was preparing her mind and body to respond in a way that she really didn’t want.

I also told her this: “You can start to reverse this trend by taking time to think about the future situation while relaxed.” This made sense to Kylie and helped her realize that she might have more control over her own responses than she had been assuming. I helped her relax deeply through hypnosis there and then.

I then asked her to watch in her mind an upcoming work-related social situation she’d been dreading, but to watch herself in that future time through the medium of deep calm. As she inwardly viewed this upcoming event in a new way, I noticed a smile creep onto her lips.

I encouraged her to see herself looking calm and natural, even enjoying herself in this upcoming time. I taught her self-hypnosis and asked her to take control and practise this every day until the social event. She did, and found with intense happiness that she did feel good in the situation when it came around.

The memory of that good event became a springboard, or, to mash metaphors, a template for other future events.

We also took the charge out of some horrible memories of social terror so that those memories would no longer bother her.

So the takeaway here is: Anxious people already inadvertently prepare by repeatedly imagining upcoming situations in conjunction with anxious feelings. The more they do this, the more they build up an association between feeling fearful and the situation.

We can explain this to clients and teach them to do the opposite so that their body and mind forge a new and better automatic association with these times. This will increase their sense of control and confidence.

Help socially phobic clients form better automatic associations with stressful times

2. Get your client to start looking

Socially anxious people focus inwards, on their feelings. Studies have found that people who rate themselves as shy in social settings have much worse recall of external details of the environment because they’ve been looking inward, not outward.5 Fear makes us self-absorbed, and I mean this in a descriptive, not a judgemental way.

You might be telling me an amazing story of your recent trip to Bognor Regis (or wherever), but I am focusing on my heart rate, or the feeling in my stomach, or what you must be thinking of me. I’m not really seeing you at all – I’m seeing myself through your eyes.

I asked Kylie to go to her local store, a situation that normally made her anxious because the friendly old man behind the counter always chatted to her. I asked her to, this time, make a mental note of three aspects of the external situation, such as:

  • The colour of the walls and the number of windows in the store
  • What he was wearing – the colours and so forth
  • What other people in the store were wearing and buying.

I also asked her to ask him one thing about himself, such as “How are you?” I helped her mentally rehearse all this while deeply relaxed.

This may seem strange, but it will get your client used to focusing away from themselves and onto other people, which is the juice of sociability.

I joked with Kylie that when I had been really shy someone had said to me, “If you want to navel gaze you should go to an ashram, not a party!” Of course, this was my indirect way of saying it to Kylie.

We are hardwired to look at facial expressions when we meet others. If we instead look at the floor or divert our gaze, we appear at best passive, and at worst subservient, disinterested, unfriendly, or shifty.

Looking at others enables us to see what is going on not for us, but for them. We in turn can be reassured, calmed, comforted and humoured by others. But only when we are brave enough to look.

Looking at others (not staring Hannibal Lecter style, mind you) means more than simply eyeballing them. It means really seeing them as the person they are, or at least attempting to. It means asking open questions that prompt more than a simple yes/no answer.

We all need to look at, and out for, one another. Our population has never been bigger, yet so many people miss one another simply because they’re not really looking.

And this relates to the next tip:

3. Harness the transformative power of kindness

Kylie said that sometimes she wished she was “one of those people” who just didn’t care what others thought at all! I replied, “What, you mean a narcissist?” She laughed and said that, no, caring about other people probably was good for a social life.

Asking about, showing interest in, and focusing on other people is a way of naturally using reciprocation in human interaction. Give and you shall receive, and if you never receive attention from someone then they are not friend material anyway.

I ask about you, and unless you have been starved of attention and cannot help yourself, you ask about me. Socializing is an exchange of attention. Some people grab a lot, and some are happy to stand back a bit more – and that may be fine too.

But if you give none, if you don’t give a smile or interest or anything at all, then there is no seed from which any kind of friendship can really grow.

If you don’t notice how I, not just you but I, may be feeling and thinking through what I say and how I seem, I am no more than a pair of convenient ears. Likewise, if you see me as a threat, again no true interaction is taking place because you are not actually seeing who I am.

And that never feels good.

Those who, often proudly, claim to “not do small talk” don’t understand that small talk absolutely need not be small. Showing an interest is an opportunity to exchange attention, a most valuable of human rituals because fair and generous attention exchange strengthens human and even animal bonds.

Like the socially terrified, the narcissist, whose interest in others is limited to garnering an audience or exploiting others for their own gain, doesn’t enter into the real and reciprocal nature of social life.

A recent study found that performing acts of kindness can help people with social anxiety mingle with others more easily.6 The researchers found that socially phobic people who’d performed acts of kindness felt more comfortable in social interactions afterwards. Acts of kindness appeared to help people deal with worries about rejection.

And it makes sense. It helps us to be kind, because we focus away from the self and onto the wider context of a situation.

The man in Kylie’s local store was elderly and always seemed keen to chat. I asked if she thought he might be a little lonely, and she said she thought he might be.

I suggested that one morning she take him a cup of coffee, because she had noticed (since she started noticing more) that he liked to drink takeaway coffee. She took him the coffee and she told me afterwards that it almost brought a tear to his eye. She then asked him a little about himself, and he told her a little about himself – but he benefited a lot.

Kylie was beginning to get into the flow of the greatest and most beautiful ‘exchange mechanism’ known to humanity.

4. Externalize the anxiety

When Kylie first came to me, she told me social anxiety was “who I am”. But I was keen to help her realize it was not who she was at all. It was actually an interloper, a parasite, a freeloader that was only weighing down her real self. Social anxiety was not her, but something that had been posing as her.

There are good reasons to help separate a person’s core identity from a problem state. After all, it’s hard to detach from a behavioural and emotional pattern when you’ve come to believe it’s who you intrinsically are. Externalizing a problem (in this case, social anxiety) by finding a different way to frame it can be the first step to helping the client detach from it.

  • How does it try to convince you that you can’t possibly be liked by other people?
  • What lies does it try to convince you of?
  • When you have left it behind, what will the first sign be that you are really starting to enjoy your freedom from it?

I told Kylie about research that shows social anxiety really does lie to those who have it. The socially anxious believe they are perceived by friends much less positively than they are actually perceived by those people.7 It tries to convince them that people like them less than they actually do.

Kylie started to disentangle her identity, who she essentially was, from the social anxiety. And because of that, she became engaged in her own recovery. She told me in her third session that she had “started to listen to the anxiety less”.

What is not us can be left behind. Lastly:

5. Help your clients care less what others think of them

We need to care what others think about things, but not so much about us. There are always going to be people who take a liking to something, or a disliking, or any and all perspectives in between, simply because. That’s it. Simply because. And there really isn’t much we can do about that.

We may be able to influence what others think of us sometimes, but we can’t control it. We can do our best to be decent, attentive, funny, and interesting. But after that someone’s impression of us is none of our business! And frankly I don’t care.

Yes, we need to care what others think – but not, I suggested to Kylie, to just spend time fearing what we imagine they ‘must’ be thinking.

I explained how years of public speaking taught me to switch off my imagination as to what others might be thinking of me and just go with flow. By describing fear as ‘imagination’, I helped reframe it for Kylie as something that she could begin to potentially control.

By our third session I felt I could, with sincerity, say: “You’re a good person, Kylie. You’re decent and you’ve got a great sense of humour [I knew that for a fact because she laughed at my jokes]. If someone doesn’t like you, that may tell us more about them than you. Unless of course they have supreme, infinitely wise, calm and completely objective knowledge of you. Which, obviously, they don’t!

Social phobia gets us caring too much about what others think. Trying to present a perfect front drives out spontaneity, making us stilted.

Typical self-conscious thoughts are:

  • “I hope no one notices I’m tense.”
  • “What if I say the wrong thing?”
  • “What if people think I’m stupid?”
  • “Who would want to hear what I have to say?”
  • “I think I’m coming across as a weirdo!”

These all imply that occasional tenseness, even weirdness and inappropriate speech, are somehow outside the norm for human interaction. They are not.

Part of social phobia treatment involves teaching people to be relaxed enough to be able to present a less than perfect image. People who are prepared to sometimes make a bit of a fool of themselves tend to be much more socially confident.

On the other hand, worrying about ever ‘putting a foot wrong’ is a form of perfectionism. Even telling a joke is a ‘risk’, because it might just produce a stony silence (it’s happened to me – I know, it’s hard to imagine!). But perfection isn’t just unattainable, it’s undesirable.

Being a perfectionist is fine if you are doing surgery. But not if you are meeting the in-laws or going to that party down the street. In fact, you may need to show some vulnerability to make you more likable and approachable. Sharing mild secrets with strangers can form connections quickly.

“Sorry if I’m a little tired; the neighbour’s cat was fighting last night. At least, I think it was fighting!” This shares a little about yourself and a little vulnerability, and maybe a touch of humour and therefore an invitation to friendliness. The opposite of trying to seem perfect, which may be a drive away from friendliness.

Like many anxious people, in her drive towards wanting to feel more control Kylie had started to assume that she had to be perfect to have friends. I suggested gently and in different ways that the opposite may be true. Being prepared to show a less than perfect side to yourself is a sign of great confidence and humanity.

It’s not that socially confident people never act a little weird, or get the wrong end of a conversation, or feel flustered occasionally. It’s that they relax when these things do happen – which they inevitably will.

Kylie started to socialize more. She found that her life started to provide her with a greater sense of meaning and interest. She made new contacts, which led to a new career and several romances, and finally she found the man she wanted to settle down with.

It’s important to understand that we need to help clients calm their emotional state before attempting to reframe social contexts or help them overcome limiting assumptions about what others think and so forth.

I liken overcoming social phobia to rubbing the rust from a valuable, beautiful object. It takes a little while, but we can find the real beauty underneath – and let its radiance, imperfectly perfect, finally become clear for all to enjoy.

And you can learn to lift phobias and PTSD rapidly and effectively with our Rewind Technique Online Course. Read about the course here and sign up to be notified when it’s open for booking.

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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Notes:

  1. https://socialmediaweek.org/blog/2015/01/83000-new-75000-happiness-benchmark-annual-income/
  2. Brigham Young University researchers conducted a review of 148 studies that tracked the social habits of more than 300,000 people. It was found that those who have strong connections to family, co-workers or friends have a 50 percent lower risk of dying over a given period than people with fewer social connections: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316#top
  3. http://www.huffingtonpost.com/2015/01/23/happify-friends-happiness_n_6526844.html
  4. The emerging science of epigenetics indicates that what we do in life – our experiences and learnings – influences which genes are activated and expressed, and which are not. So you (and I) may be a born introvert, but learning to be more extroverted and practising social confidence can have an epigenetic effect, helping you actually become more extroverted. Genes are not the architects of our destiny: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/
  5. For example, http://www.sciencedirect.com/science/article/pii/S0005796799000406
  6. http://psych.ubc.ca/kindness-may-help-socially-anxious-people-relax-says-new-research-by-dr-lynn-alden/
  7. http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/abn0000015

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