We know that our group sessions and the information we provide can really help people with social anxiety / social phobia / shyness build a lot of confidence and increase their quality of life, but we also know that many of those who make lots of progress come to group regularly and invest a lot of time and energy in themselves outside the group too. The group is just one resource to use and we would recommend doing as much as possible to help yourself make progress. On this page you can find some extra tips and suggestions of where you can gain appropriate help and information, and also understand what help might be less appropriate.
The National Health Service (NHS)
Love it or hate it, the NHS is your main healthcare provider (unless you can afford private healthcare). In the past people with social anxiety have only had access to limit help and resources when approaching the NHS for help, but now things are starting to improve. There is still much work to be done, but there is a new initiative called 'Improving Access to Psychological Therapies' (IAPT) which has been put into operation accross the UK in 2010. This initiative has had significantly more funding than the psychological therapy services that used to be accessible (or sometimes inaccessible) through your GP. Depending on your area this service may be provided by the NHS, an independant organisation or a partnership. Either way, you can access the service through your GP by making an appointment and asking to be referred to the Psychological Therapies or IAPT service. Many services are also offering self-referral which mean you can contact the service directly without having to see your GP. This is obivously a useful option for people experiencing social anxiety. The services focus on helping people with anxiety and depression and offer therapies such as cognitive behavioural therapy (CBT) and other therapies that are backed by clinical research. If you see your doctor and they seem unsympathetic to your social anxiety then please make an appointment to see another one. Most doctors take social anxiety very seriously and will do what they can to help, but unfortunately some still lack the right knowledge and understanding. Quality of treatment will vary from doctor to doctor and from therapist to therapist. We have put together a guide to help you understand and access the new IAPT services. Click the link to view this IAPT Service Guide.
Your doctor may offer you medications to help with your social anxiety. Typically these will be SSRI Anti-depressants or Beta-blockers. It is up to you to decide if you want to try medications, but make sure your doctor covers both the pros and cons of taking them fully. You may also want to do some additional research of your own. We would recommend that you never use medications as the only treatment for your social anxiety. There will be certain things about the way you are thinking and behaving that are significantly contributing to your anxiety and these will need to be addressed psychologically. It is becoming more and more clear that medications do not offer a long-term solution for social anxiety, but that for certain people they are beneficial. Always discuss it with your doctor first before starting or stopping a medication as suitability, drug interactions and withdrawal symptoms need to be considered carefully before you make any sudden changes.
Cognitive Behavioural Therapy (CBT)
CBT is generally considered to be the best psychological therapy for social anxiety. It helps by teaching you how your thoughts and behaviours play a part in the maintenance of your social anxiety and then helps you make changes that result in improved confidence. Not everyone reports getting on well with CBT, but we would say that a lot depends on who your therapist is and how ready you are to engage in the therapy. In addition to this, CBT is constantly evolving so CBT today might be much more effective than the CBT you had ten years ago. There are many self-help books and websites where you can find out more about CBT. If you are buying a book we recommend trying one published within the last five years as some of the older books do not cover some important aspects of the therapy. Books are cheap, accessible and you can learn a lot from them, but at the same time many people find having a therapist really helps them stay motivated and apply what they learn to their own situation. If you wish to seek a private therapist then you may find some of the links in the right hand column useful. The quality of CBT therapists varies as it does in all professions. Make sure they have significant experience and success with treating social anxiety and that they belong to a professional and ethical regulating body (usually the BABCP).
Drugs, Alcohol, Caffeine and Tobacco
We are not here to preach about what you can and cannot do with your own body, but if you are serious about wanting to overcome social anxiety, then you may want to consider significantly reducing or eliminating your consumption of recreational drugs, alcohol, caffeine and nicotine from tobacco. Although using these will not make you have social anxiety and stopping them will not make social anxiety go away, they are all strongly linked to higher levels of anxiety. Giving them up will give you the best chance of making progress, and finding out you can cope well without them will be a big boost to your confidence.
Just as with giving up drugs, engaging in regular exercise will not make your social anxiety go away, but it has been proven to help reduce anxiety and depression. Aside from the physical health benefits, regular moderate exercising will mean you sleep better, become more motivated, have increased energy, feel happier, feel more on top of life, feel confident about your appearance and be generally less anxious. This is not only because of the biological changes exercise brings about, but because taking exercise is also about treating yourself well and having respect for yourself. Exercise can therefore be an important part of overcoming social anxiety, but ease into it if you are not used to it. It is much more important to enjoy it at first than it is to work yourself hard.
Again, you will not overcome your social anxiety through a change in diet, but it is another area where you can make some changes that will significantly improve your chances of success. Try and cut down on foods that are high in sugar or white flour (e.g. white bread or pasta, whole-wheat is O.K.). These foods are quickly broken down by the body and made available as energy, but the problem is that it is too much too fast. You will feel good for a short while, but then your body will release insulin to counteract the situation which will leave you feeling, tired, hungry, unfocused and more unstable emotionally. If you eat healthy balanced meals that contain protein (meat, fish, dairy, beans), complex carbohydrates (e.g. oats, whole-wheat, potatoes) and vegetables or salads then you will feel more stable and less emotional. This will not only help you be less prone to anxiety, but it will also help you be in a better state of mind to work on your anxiety and make quicker progress.
Meditation and Relaxation Techniques
These are a traditional solution for anxiety. Tried and tested, they do help people reduce their levels of anxiety. There is lots of information on the internet about relaxation techniques which you may wish to explore. These techniques and meditation are good ways to de-stress and relax, but you would be best to combine them with CBT or a similar therapy. Generally, meditation and relaxation techniques are helpful for reducing anxiety and stress that has already built up, but other changes will likely need to take place if you want to prevent yourself from getting anxious in social situations. They are something worth learning about, but best results will come from combining them with other methods that work on your thoughts and behaviours.
Counselling involves talking over your problems with a trained listener who will help you explore your difficulties and possible solutions. Counselling can be beneficial for people with social anxiety, particularly if they have been through distressing circumstances and have never talked to anyone about them before, but generally, in our experience, people do not find counselling helpful for reducing social anxiety, and in some cases it seems to make it worse. This is mainly because overcoming social anxiety needs to be about learning new things. Just exploring your issues and coming up with your own solutions can draw you into your anxiety further. As with CBT therapists, the skills of counsellors and their experience with social anxiety varies greatly, so you may still find counselling beneficial with the right therapist.* (see notes at the bottom of this page)
This is a therapy that focuses very much on the past and your past relationships. It can be helpful in some ways, but many people do not find it helpful for their social anxiety. If you feel like you need to explore your past as something separate from social anxiety, then Psychodynamic therapy might be useful and interesting to you, but you will likely want to explore other options for your social anxiety.* (see notes at the bottom of this page)
Neuro Linguistic Programming (NLP)
NLP takes a positive approach to your social anxiety and has similarities with CBT in that it helps you change the way you think, and it is a relatively short-term therapy compared to therapies like Psychodynamic Psychotherapy. NLP is an unregulated therapy where no single organisation makes sure that practitioners are trained to a high standard and are practicing ethically. We would say that some elements of NLP are very beneficial to people with social anxiety while others are a little dubious. It is definitely worth buying a book or two on the subject and practicing what you learn on yourself, but you may want to be hesitant about paying for a practitioner unless you have a good recommendation from someone who has made progress. Some practitioners could be very good and helpful, while others could have just completed a couple of weeks of training, have no experience of social anxiety and will not be practicing ethically.
Hypnosis is an interesting therapy that often appeals to people with social anxiety. It can be helpful in that it helps people learn to go into relaxed states. Many people say that this is the main benefit they got from it, but that they were not necessarily able to go into relaxed states when in social situations. While in a relaxed or trance-like state, a hypnotherapist will give suggestions to your subconscious mind to try and bring about change. As usual, the skill and experience of the practitioner is of the greatest importance here, but there are few reports of people finding lasting change through Hypnosis when trying to overcome their social anxiety. Pure hypnosis (i.e. not incorporating other therapeutic methods) has the appeal of being a passive approach, but there are likely many more benefits to be had from a more interactive therapy.* (see notes at the bottom of this page)
There are numerous alternative therapies and remedies available to help with anxiety. A lot of them are appealing because they advertise fast and natural solutions. Nearly all of the alternative therapies have yet to prove their effectiveness scientifically, and that is what puts them in the alternative category. Most alternative therapies work through the placebo effect at best - a change that comes about psychologically because the client is expecting it, but the therapy has actually had no effect. It would be wrong to paint all alternative therapies with the same brush, and there is not space here to explore them all fully, but there appears to be a significant lack of lasting change in the social anxiety sufferers who have tried them, even though they have seen short-term benefits. Be particularly wary of therapies that claim to heal a lot of different unrelated conditions, especially if they promise to cure you of anxiety very quickly with virtually no effort. A lot of them are unregulated and you might be paying a lot for nothing or even be risking your health.
*Some counsellors, hypnotherapists and psychodynamic therapists will also be trained in CBT and will use this approach with you. If this is the case then the therapy could be much more beneficial for you, but please be aware that some therapists seem to be training in CBT and advertising CBT to draw in business, but then only use the approach minimally or not at all with their clients. Check that the CBT you are getting generally reflects descriptions of CBT you have read elsewhere. If possible it is best to choose someone whose main approach is CBT if that is the type of therapy you are looking for.