What Is Social Anxiety Disorder (SAD) and How Do We Overcome It?

Did you ever avoid doing something, such as public speaking, because you were afraid of being humiliated, embarrassed, or rejected? Most people have. Although it is common, that doesn’t mean it is normal or appropriate. Such feelings clip our wings, preventing us from reaching our potential. Because they impair our ability to function, they are called dysfunctional, and because they create a mental disturbance, they are called a disorder.

The psychological term for this affliction is Social Anxiety Disorder, or SAD for short. It is so prevalent that until 1980 it was more or less considered normal human behavior. That is, nothing much was done to help those suffering from SAD, other than uttering a few stern words such as, “pull yourself together, you can do it.” The problem is no one explained how we could `pull ourselves together.’

Before going any further, let me give an example. Early in her career, Barbra Streisand once forgot the lyrics to a song. She became so terrified of it happening again that she avoided public concerts for 30 years, preferring the safety of the recording studio instead. This is a classic example of how debilitating SAD can be. This is also an example of what psychologists call “maladaptive coping,” which simply means an unproductive way of coping.

She chose to cope with her fear by running away from it, which made her a prisoner of the recording studio, and she lost the freedom to perform before the crowds she loves. Also note that just because a professional singer forgets the lyrics, it doesn’t necessarily follow that it is embarrassing or humiliating. Embarrassment or humiliation isn’t what others do to us, but what we do to ourselves. In other words, it is just our attitude. For example, after forgetting the lyrics she could have said, “Whoops, believe it or not, I forgot the words! Perhaps I was so overwhelmed by your love that my mind went blank. Sorry about that, I may try it again later.” Had she done that, no one would have thought anything about it.

An even better way of coping would be to admit she forgot the lyrics and say, “I may have forgotten them, but I know you haven’t. Who wants to come on stage and help me with the lyrics?” This simple gesture would have created a sensation as Barbra and the audience member sang together. Yes, we always have the option of turning our weakness into our strength.

Now that we have an example we can identify with, let’s move on to more general information about SAD. Perhaps 2~20% of the population suffer from it. Extreme cases, such as that of Barbra Streisand, fall into the 2 or 3% range, whereas 20% of us suffer from less debilitating forms of SAD. In fact, almost everyone on occasion experiences very mild forms of it.

SAD usually starts at the ages of 15~20, although it can happen at any age. It is also slightly more common among women than men. It is a phobia, fear, or anxiety based on three thoughts: How well will I do? How will they react? How will I deal with their reaction?

SAD can be generalized or specific. For example, I know several executives that are highly competent in many areas; yet, when it comes to public speaking, they fall apart. I know one who can speak at a boardroom meeting, but cannot stand while speaking, she must remain seated. These are examples of specific SAD. Some people, however, are uncomfortable in ALL social situations, they will turn down invitations to speak, attend a cocktail party, or even join others in a restaurant, because of their fear. There are examples of generalized SAD. In severe cases, medication (antidepressants) may be prescribed. But, often, all that is needed is a six-step regimen of exposure therapy, which I will fully describe soon.

Although confusing, there is another disorder called SAD. In this case the letters stand for Seasonal Affective Disorder, which is a form of depression caused by the lack of sunlight during the winter. However, today’s subject is on Social Anxiety Disorder and was prompted by questions from a 19-year-old European lady who I will call Sally. She is single, living alone, and attending the university.

Sally writes, “I’ve been working on my personal development, for maybe just over a year… and I’ve come a long way. But there are things that I can’t overcome and are blocking me for any further progress. I have dreams and goals in life, and I try to develop myself so I can achieve them, but you have to be free from anything that holds you back to be able to do so! I have things that hold me back and I cant figure out how to get over them…

“One of my main problems is that I CARE SO MUCH ABOUT WHAT PEOPLE AROUND THINK ABOUT ME… so I feel I can’t be myself. I see people who can dress, talk freely and act themselves wherever they are regardless. And when I’m on the train, some people just sit and get along with their things and have their zone and aren’t aware of what’s around them… I want to be like that, where it doesn’t matter where I am, and who is around me. I just want to be me and do whatever I feel like. I would like to get my books out and make use of my time and work… but I just can’t.”

Why can’t Sally do such a simple thing as study in the train? Because she is afraid that whenever she is engaged in an activity, others are watching and judging her. They may find her behavior strange and mock her. She may become the victim of derision, so to avoid that, she does nothing. Of course no one would really laugh at the way she studies, but Sally is in the grip of an out of control imagination and not ready to respond to logic and common sense.

But not to worry, for Sally is a bright, young lady, fully equipped to overcome her problem. The only reason she was unsuccessful so far is that no one taught her how to overcome SAD. Well, Sally, there’s no need to be SAD because today I’ll show you how easy it is to defeat social anxiety.

To start on the path of self-mastery, you first need to make a list of your personal goals, ranking them from easiest to most difficult. Make the goals as specific as possible. Here is an example of a short list of goals:

*I want to be able to study on the train.

*I want to be able to comb my hair on the train.

*I want to be able to laugh and joke with friends on the train.

*I want to be able to stand up and give my opinions in class.

*At the university, I want to be able to talk to male students that I am attracted to.

*I want to be able to talk to young men I am interested in regardless of where we are (the library, super market, park, coffee shop, elevator, mall).

Now that you have a list of goals, you are ready to embark on an exciting adventure that will culminate in a new you, one that is free to act as she chooses and not be burdened with anxiety. The road that will get you there is The 6-step Exposure Plan. You see, Sally, the cure to SAD is EXPOSURE. Exposure merely means facing your fears, rather than avoiding them. And you can easily learn how to do that by following the six steps.


1. Imaginal Exposure. Step 1 is a form of imagery or visualization. Practice for five to ten minutes, two or three times a day. Practice carrying out one of your goals, but do it in your imagination. Start out with an easy goal and break it down into the smallest possible baby steps. As an example, I’ll start with the goal of studying in the train.

To make this as easy as possible, start out with an ultra small baby step. For instance, place a bookmark in a textbook. When seated in the train, place the textbook in your lap. After the train has traveled a couple of stops, look down at the book. Open it to where the bookmark is, glance at the page, and nod your head as if you just checked something. Now that the exercise on the train is over, relax.

Since you are doing this in your imagination, in the safety of your own apartment, you have nothing to fear. As you can see, it is an easy exercise. As you practice it in your mind, keep your eyes closed and try to recall as many details of the train as possible. Imagine people around you surreptitiously watching you. It’s only your imagination, so you can’t be hurt.

2. Real Life Exposure. This is the fun part. This is where you get to practice what you already rehearsed in your mind. Follow the script exactly. The purpose of this step is to make discoveries. Your first discovery will be that what happens is never as bad as you had imagined it would be. You may feel anxious, but you will not die. You will also discover that it is easier to do than you had imagined, so you will breathe a sigh of relief.

After you are comfortable taking this step, you then increase the size of the baby step. For example, now after opening the book, rather than quickly glancing at the page, you put your finger on the top of the page and S-L-O-W-L-Y move it down to the bottom of the page, nod your head as if you were `studying’ something, and close the book. You would first practice this new baby step in your mind (Step 1) before you do it in real life (Step 2).

You would slowly keep increasing the size of the baby steps. The next time you did it, for example, you may run your finger down two pages rather than one. Later you would actually READ a single paragraph, increasing that to two, then three, then four, and before you know it you’ll be reading an entire chapter and actually studying.

I have a couple of pet cats. The first time we turned on the vacuum cleaner they were startled by the noise and ran away. As you can imagine, now they just ignore it because they have learned the noise is perfectly safe. This is another purpose of Step 2. As you repeat your exposures, you will become desensitized, and like my cats ignoring the noise, you will ignore the people around you.

Speaking about the people surrounding you, do you remember when I said they were surreptitiously looking at you? Well, guess what, it isn’t true. Those strangers on the train are merely bored, have nothing to do, so they are looking around, whiling the time away, and you happen to be in their vicinity. It may appear like they’re looking at you, but it has nothing to do with you and everything to do with their boredom. This is something you will discover for yourself later on.

One more purpose of Step 2 is to build confidence, which will pave the way for bigger and better baby steps.

3. Imaginal Intentional Mistake. You are uncomfortable in social situations because you are afraid of making mistakes, which may embarrass or humiliate you. So, in this fun step you deliberately make a mistake, but you do it in your imagination, where it’s perfectly safe.

Let’s say whenever you see a group of acquaintances on the university campus you would like to join the group and chime in with your own comments, but you are afraid someone will say, “What did you say? I can’t hear you. You speak too softly” If that were the case, in your mind, practice DELIBERATELY speaking too softly. The purpose of this mental practice is to build up the courage to speak too softly, or make a mistake, in public.

4. Real Life Intentional Mistake. Now that you mentally practiced speaking too softly, you get to do it in real life. So, go ahead and do it. Like in Step 2, you will discover the consequences of your `mistake’ were not nearly as harsh as you had imangined. In other words, you will learn thay you can easily survive mistakes. This is a valuable learning experience and can be a lot of fun if approached as a game.

5. Imaginal Coping. In this exercise you make a mistake and try to recover from it. Of course, this is all done in your mind. For example, you may imagine approaching a group of guys you usually see on the campus. Once they greet you, you deliberately speak too softly. As a result, in your imagination, one of the guys speaks up and disapprovingly says, “Gee, Sally, why on earth do you speak so softly? I can’t hear a word you’re saying.” Now, you job is to recover from your mistake. That is, you have to develop a coping strategy. Let’s say you decide to recover by saying, “Sorry, I guess you guys are so good looking you make me nervous!”

That’s a great way to cope, by the way, because you probably will end up laughing, and the laughter will dissipate your anxiety.
The guys are also sure to laugh and feel good about themselves. So, use this step to imagine what may go wrong and how you could recover. In other words, use this step to develop coping strategies. This is a powerful technique because it allows you to enter threatening situations fully armed and prepared for the worse.

6. Real Life Coping. This is your graduation. Here is where you use in real life the coping strategies you previously practiced in your mind. So, now you deliberately speak too softly to the guys, hoping they will make a disapproving comment so you can practice your recovery technique. Step 6 gives you the opportunity to prove to yourself that you can handle whatever comes up. With practice you become so skillful all anxiety drops away and you become free at last!

I said this is your graduation, but remember, “graduate” means a small step, and you will need to take many of them before you graduate. But rest assured that it will be an exciting and rewarding journey, and it is one that you can easily do. Sally, up until now, your imagination was your worst enemy and the source of your anxiety, but now, using this 6-step plan and visualization, you can make your imagination your best friend. Use it to consciously create a new, exciting world, and enter into it.

If you need further help with the 6-Step Exposure Plan, the following book goes into many more details: Dying of Embarrassment: Help for Social Anxiety & Phobia by Barbara G.Markway, C. Alec Pollard, Teresa Flynn, and Cheryl N. Carmin, New Harbinger Publications, 1992.