Social anxiety and the fear of being judged

What social anxiety looks like

Nina is 27 and works in an office. She's good at her job, and most days she eats lunch at her desk so she won't have to make small talk in the break room. In meetings she often has an idea, and she rehearses how to say it in her head until the moment has passed. When her phone rings, she lets it go to voicemail and texts back later. Last month she skipped a coworker's birthday drinks, and she spent the evening feeling relieved and lonely at the same time.

Nina is afraid of being judged. She worries that her face will turn red or her voice will shake, and that people will see how nervous she is and decide she's strange or bad at her job. After a conversation, she often replays it for hours, picking out everything she said wrong.

Almost everyone gets nervous before a speech or a first date. Social anxiety is when the fear of embarrassment or rejection makes you avoid ordinary situations, or get through them with dread, for months at a time. It starts to cost you at work, with friends, or in dating. The medical name for this is social anxiety disorder.

Some people only fear performing, like giving a talk or being watched while they eat or sign their name. Others feel it in almost any conversation. For Nina, small talk and meetings are the hardest.

If you've felt this way for a long time, you might think it's just your personality. You aren't weak, and nothing is wrong with who you are. Social anxiety is very treatable. This guide follows Nina as she learns the same tools therapists use to treat social anxiety. They take practice, and they work for a lot of people.

What happens when you feel watched

Your body has an alarm system, and its job is to protect you. When it senses danger, it releases adrenaline and gets you ready to fight or run away. Doctors call this the fight-or-flight response. It works the same way whether the danger is a bear or a staff meeting. With social anxiety, the danger it's reacting to is the chance of being judged.

So when Nina walks into a meeting, her body acts as if she's in danger. Her face gets hot, her heart pounds, her stomach knots up, and her hands and voice get a little shaky. Her mind keeps scanning for trouble, which makes it hard to follow what anyone is saying.

None of these feelings are dangerous. For Nina, though, they're the very things she's afraid people will notice.

Where your attention goes

During a conversation, social anxiety pulls your attention inward. While the other person talks, you're busy checking your face for blushing, your voice for shaking, and your words for mistakes. Therapists call this self-focused attention.

All that checking builds a picture in your head of how you look from the outside. That picture is usually far worse than what anyone else sees. Most people think their nervousness shows much more than it does.

Watching yourself this closely causes two problems. You miss what's happening in front of you, like a nod, a smile, or a sign that the other person is nervous too. And the feelings you're watching get stronger, because you're paying so much attention to them.

In Monday's meeting, Nina is so busy checking whether her face is red that she misses a question from her manager and has to ask him to repeat it. That's the moment she replays all evening.

It can help to picture your attention as split between yourself and the conversation. With social anxiety, most of it goes to watching yourself, and practice can shift it back.

Why social anxiety keeps coming back

Think about what happened when Nina skipped the birthday drinks. As soon as she texted that she couldn't make it, her anxiety dropped. She felt relief.

That relief is what keeps social anxiety going. Nina's brain noticed that skipping made the bad feeling go away, so the next time she's invited somewhere, skipping is the first thing it will reach for. Her brain also decided that going must have been dangerous and that she got out just in time. She never got to find out how the evening would have gone.

Going, but hiding

Some avoidance is easy to spot, like not going at all. Other avoidance is harder to see. You go, and you do things to hide your nervousness or keep people from judging you. Therapists call these safety behaviors.

At work, Nina rehearses every sentence before she says it, keeps her answers short, and looks at her notes instead of at people's faces. When she does go to a party, she holds her drink with both hands so nobody sees them shake, and she plans an excuse to leave early.

Safety behaviors feel like they help, and in the moment they do. The problem is what your brain learns from them. When a conversation goes fine, your brain gives the credit to the safety behavior. It never finds out that you would have been okay without it, so you feel like you need it every time.

In social situations, safety behaviors have an extra cost, because other people can see them. If you avoid eye contact and say very little, you can come across as cold or uninterested, even when you'd like to connect. People may pull back a little in response, and their cooler reaction seems to prove that your fear was right.

Avoiding and hiding work the same way. Both bring quick relief, and both keep you from learning that you can handle the situation without them. Over time, this turns into a cycle.

The replay afterward

For many people, social anxiety keeps going after the event is over. That evening, Nina runs Monday's meeting back in her head again and again, looking for mistakes. "Why did I have to ask him to repeat the question?" "Did everyone see my face turn red?" In therapy, this is called post-event processing.

The replay can feel like a way to figure out what went wrong. It's built from the anxious picture in her head, though, the one that's far worse than what anyone saw. So each time Nina replays the meeting, it looks worse than it was, and she dreads the next one even more.

The way out: face it in small steps

Since avoiding and hiding keep social anxiety going, the way out is to do the opposite, a little at a time. This is called exposure. It means going into the situations you've been avoiding, starting with easier ones, and staying long enough to see what happens when you don't hide.

Being reassured doesn't do much for social anxiety. A friend can tell Nina that nobody cares if her voice shakes, and Nina can tell herself the same thing. Her face still burns in the next meeting. The alarm doesn't change much from being told something is safe. It calms down when you walk into a situation expecting something bad, stay, and see for yourself what happens.

Building up to hard situations works like getting stronger at the gym. You start with a weight you can manage, repeat it until it feels light, and then add a little more. If you grab the heaviest weight first, you'll probably drop it and decide you can't lift.

Exposure is the main part of cognitive behavioral therapy (CBT) for social anxiety. You can start practicing it on your own, and a therapist can help if you get stuck. Nina made her plan in four steps.

Step 1: Make a list of what you avoid

Write down the social situations you avoid, and the safety behaviors you use to get through the ones you can't skip. Aim for 10 to 15 items, and be specific. "Work stuff" is too vague to practice. "Eat lunch in the break room instead of at my desk" is specific enough that you could do it tomorrow.

Step 2: Rate how hard each one would be

Next to each item, write a number from 0 to 100 for how anxious you'd feel doing it without your safety behaviors. Zero is completely calm. A 50 is unpleasant and distracting, and you'd like to leave, but you could stay. A 100 is the most anxious you can imagine. The numbers don't have to be exact. They're only there to help you put the list in order.

Step 3: Put the list in order

Sort your list from easiest to hardest. This is your fear ladder, and you climb it one step at a time, starting at the bottom. Here is Nina's:

If there's a big jump between two steps, add one in between by changing one thing, like how long you stay, what time of day you go, whether someone comes with you, or how many people are there. You can also split a step that turns out harder than you expected. "Ask a question in the meeting" can start as "say one sentence agreeing with someone in the meeting." If everything on your list feels like an 80 or more, you're probably picturing the worst version of each item, so write smaller versions.

Step 4: Pick a starting step

Start with a step you rated somewhere around 30 to 50. It should feel uncomfortable and still doable. If you start too high, you'll probably leave partway through, and leaving early teaches your brain that the situation really was dangerous. If you start too low, you won't learn much. Nina starts with saying one extra sentence to a coworker, which she rated a 35.

How to practice a step

Each practice is a test of what your anxiety says will happen. Don't wait until you feel ready. Almost nobody feels ready, and waiting for that feeling can turn into another way of avoiding.

Before: write down what you're afraid will happen

Write one sentence about what you fear, and rate how sure you feel that it will happen, from 0 to 100%. Make it something you could check. "It'll be awful" can't be checked. "My voice will shake so badly that I'll have to stop talking, and someone will ask if I'm okay" can.

Nina writes, "I'll trip over my words, she'll give me a weird look, and she'll end the conversation as fast as she can." She feels 70% sure.

Then decide which safety behaviors you'll drop, and how long you'll stay or how many times you'll repeat the step. Write that down too, so you don't have to decide while you're anxious. Nina won't rehearse her sentence first, and she'll look at her coworker's face while they talk. She plans to do it with three different coworkers that day.

During: stay with it, and skip the safety behaviors

Do the step and let the anxious feelings be there. You don't have to like them, and you don't have to make them go away. It can help to describe them plainly to yourself, like "face hot, heart fast, about a 60." Try not to leave when your anxiety is at its highest. If you do have to step away, go back as soon as you can.

For something quick, like a short conversation, repeat it several times. For something you can stay in, like a party or lunch in the break room, plan on about 20 to 45 minutes.

Nina walks over to her coworker Dana's desk and asks how her weekend was. Her anxiety jumps to about 65, and she feels her face get hot. She stays for the whole conversation and goes back to her desk with her heart still pounding. Later that day, she does the same thing with two other coworkers.

After: write down what happened

Afterward, write down what happened, sticking to what a camera would have recorded. Then rate your original fear again, and write one sentence about what you learned.

Nina writes, "I talked a little fast. Dana smiled and told me about her weekend for a couple of minutes. Nobody gave me a weird look." Her fear now feels about 25% likely. She adds what she learned: "My face can feel hot, and I can still have a normal conversation."

Judge each practice by what you did. If you stayed for the time you planned and dropped the safety behaviors on your list, it counts, even if you felt anxious from start to finish. In a short conversation, your anxiety may not have time to come down at all, and that's okay. What calms the alarm over time is finding out whether the thing you feared came true.

How often to practice

Practice most days if you can, and at least three or four times a week. Once a week usually isn't enough for the new learning to stick.

Keep practicing the same step until it feels noticeably easier. A good sign is when your anxiety during the step is about half of what it was the first time, or when it's clear that the thing you feared isn't happening. That usually takes several tries. Then move up to the next step. One step often gets easier within a handful of practices, and a whole ladder usually takes several weeks to a few months.

Once a step feels easier, change it up. Practice with different people and in different places, at different times of day, and on days when you're tired or stressed. That helps what you learned carry over to new situations.

Progress won't be a straight line. Fear often comes back a little after a break, during a stressful stretch, or when you're sick or sleeping badly. That's normal, and it doesn't erase what you've learned. If a step that felt easy is suddenly hard, go back down one step for two or three practices, then climb again. If life got busy and you stopped, restart with the last step that felt comfortable, and put your next three practices on your calendar.

If it isn't getting easier

If you've practiced a step for a couple of weeks and it still isn't getting easier, one of these is usually the reason:

• A safety behavior is sneaking in, like rehearsing in your head or only going when a certain friend comes along. Find it and drop it. If you rely on a friend, fade them out in steps: they come with you, then they arrive after you, then you go on your own.
• The step is too big. Do a smaller version twice, then go back to the original.
• You aren't practicing often enough. Put the exact day and time on your calendar, and aim for most days.

Tools for social anxiety

These tools work alongside your fear ladder. Use them during your practice steps and in ordinary conversations.

Tool 1: Move your attention outward

Self-focused attention is a habit, and you can practice a different one. The goal is to spend less attention watching yourself and more on the people you're with. Build up to it in stages:

1. Start with no one watching. For five minutes, put all your attention on a podcast or a TV interview: the words, the tone of voice, and what the speaker might say next. Whenever your attention drifts to yourself, silently say "inward" and bring it back.
2. Move on to easy conversations, like with a cashier or a neighbor. Keep your attention on the other person's words and face.
3. In harder conversations, give yourself a job that points outward. Try to learn one specific thing about each person, or find out what they're looking forward to this week.
4. Afterward, rate how much of your attention was on yourself, how anxious you felt from 0 to 100, and how the conversation went.

Do the five-minute listening practice every day for two weeks, and use an outward job in every conversation you can, including the steps on your ladder. When Nina eats lunch in the break room, her job is to learn one thing about each person at the table. She finds out that one coworker just adopted a dog, and she realizes afterward that she went several minutes without checking her face.

Tool 2: Drop the safety behaviors that backfire

The safety behaviors below are common in social situations. Each one is meant to protect you from something, and each tends to cause a problem of its own. The last column is an experiment to try instead:

Pick one and try its experiment in your next few conversations. Before you start, write down what you think will happen, and afterward, write down what did. Your anxiety will probably go up at first, and it tends to settle as you keep practicing.

Having a drink to loosen up works like a safety behavior too. Alcohol can calm you for a few hours, and then anxiety often comes back stronger as it wears off. Keep it out of your practice steps, so your brain doesn't give the drink the credit. If you drink heavily every day, don't stop suddenly on your own, because withdrawal can be dangerous. Talk to a doctor first.

Tool 3: Check the picture in your head against a video

The picture in your head of how you look when you're nervous is usually much worse than what other people see. A video lets you check it against something real.

1. Before a five-minute conversation or practice talk, rate from 0 to 100 how anxious you think you'll look. List what you think people will notice, like shaking hands, a red face, or long pauses.
2. Record it on your phone. If someone else will be in the video, ask their permission first.
3. The next day, watch the video as if the person on screen were a stranger. Rate how anxious that person looks, and count how many things from your list you can see.
4. Compare the two ratings.

Most people look much calmer on video than they felt. Nina records a practice run of her two-minute update in front of a friend. Beforehand, she guesses she'll look like an 80 and is sure her red face will be obvious. On the video, she rates the woman on screen a 30, and she can barely see any red.

Tool 4: Make small mistakes on purpose

Social anxiety follows a rule: any slip will make people judge you, and they'll remember it for a long time. You can test that rule by making small, harmless mistakes on purpose and watching what people do. Before each one, write down what you expect people to do and how long you think they'll remember it. Afterward, write down what they did. Some ideas, from easier to harder:

• Walk into a store, look around, and leave without buying anything
• Send a work message with a small typo, and don't correct it
• Ask for directions to a place you're standing right next to
• Pause for five seconds in the middle of a sentence
• Mispronounce a word, and don't fix it
• Count out exact change slowly while a line waits
• Wear your shirt inside out on an errand
• Drop something that won't break in a coffee shop, and pick it up

Keep these harmless and legal, and skip anything that inconveniences someone else for more than a moment. When Nina sends a team email with a typo in the first line, she expects someone to point it out and people to think she's careless for weeks. Nobody mentions it.

Tool 5: Put a time limit on the replay

The replay after a social event can take up a whole evening, and each time through, the event looks worse. A time limit keeps it from taking over. Start by picking a daily worry time: the same time and place each day, somewhere other than your bed, and at least a couple of hours before bedtime. Then, whenever you catch yourself replaying:

1. Write three lines: what happened, what I'm afraid people thought, and what evidence I have that they thought it.
2. If there's something to fix, like a real mistake or an apology you owe, plan when you'll do it, and stop there.
3. Put anything else on a worry list, like a note on your phone, and save it for worry time. When worry time comes, set a timer and give social replays 10 minutes. If you have other worries too, worry time can run 15 to 30 minutes in all.
4. Bring your attention back outward, to whatever you're doing right now.

When Nina catches herself replaying Monday's meeting, she writes: "What happened: I missed my manager's question and asked him to repeat it. What I'm afraid he thought: that I wasn't paying attention. Evidence: he repeated it and moved on." There's nothing to fix, so she writes "meeting" on her worry list for 7:00 and goes back to making dinner.

Guides for other kinds of anxiety

If your anxiety shows up in other ways too, these guides explain those patterns and the tools for each:

• Principles of handling anxietyThe general guide: what anxiety does to your body, why it keeps coming back, and tools for worry and a tense body.
• Panic attacksSudden waves of fear with a racing heart, dizziness, or trouble breathing, and worry about when the next one will hit.
• Health anxietyWorry about having a serious illness, checking your body, and searching your symptoms online.
• Intrusive thoughts and OCDDisturbing thoughts that won't leave, and things you feel driven to do over and over, like checking or washing.

A workbook

If you'd like more structure, this workbook is a good place to start:

• Managing Social Anxiety: Workbook by Debra Hope, Richard Heimberg, and Cynthia Turk. The workbook that goes with a CBT program for social anxiety, with exposure practice and tools for self-focused attention.

The book link is an Amazon affiliate link. As an Amazon Associate, Psychofarm earns from qualifying purchases, at no extra cost to you. See our disclosures.

The tools in this guide are based on cognitive behavioral therapy research, including David M. Clark and Adrian Wells's model of social anxiety.