Social anxiety self-help guide

Work through a self-help guide for social anxiety that uses cognitive behavioural therapy (CBT).

Section 1 of 16

1. Introduction

Urgent help

This self-help guide is intended for people with mild-to-moderate symptoms of social anxiety.

If you're feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

For an emergency ambulance phone 999.

This guide aims to help you:

  • find out if you have symptoms of social anxiety
  • understand more about social anxiety – what it is, what causes it, and what keeps it going
  • find ways to manage or overcome social anxiety

This guide is based on Cognitive Behavioural Therapy (CBT). CBT helps you to examine how you think about your life, and challenge negative automatic thoughts to free yourself from unhelpful thought and behaviour patterns.

How to use the social anxiety self-help guide

Working through this guide can take around 30 to 40 minutes, but you should feel free to work at your own pace.

Work through the guide on your device, using the “Next” button to move forward and use the “Previous” button instead of the Back button in your browser. To type in a graphic or diary, click or tap the part you’d like to fill in and use your keyboard as usual.

If you’d like to save the guide and return to it later, you’ll need to save it as a PDF on your device before you leave the page. You can then continue filling it out on the PDF. We don’t use a login feature on our mental health self-help guides for privacy reasons.

If you’d like to print the guide at any time, you’ll find an option to save and print the whole guide, including the parts you have added, in each section.

Section 2 of 16

2. Problems with social anxiety

  • Do you find being in social situations makes you feel anxious?
  • Do you worry that you don’t have good social skills?
  • Do you worry about being judged in social situations?
  • Do you try and avoid social situations, or stay quiet when you’re around people?
  • Do you worry about other people noticing how anxious you are?

If you answered ‘yes’ to any of these questions, you might have problems with social anxiety.

What happens when you’re socially anxious

Thoughts you might have

  • I have nothing interesting to say, I’m boring and don’t belong here
  • Everyone’s staring at me
  • People can see how anxious I am – they’re laughing and talking about me
  • I’m making a fool of myself
  • Everyone else is very confident

Emotions you might have

  • Anxiety
  • Vulnerable – under the spotlight
  • Self-conscious
  • Embarrassed

How your body might feel

  • Blushing
  • Sweaty
  • Shaking – particularly in your hands or legs, but it could be anywhere
  • Struggling to speak clearly – stumbling over words, stammering, voice changing
  • Stomach churning
  • Dizziness
  • Fast heartbeat
  • Shortness of breath – feeling like it’s hard to breathe

Things you might do

  • Avoid social situations whenever possible
  • Try to blend into the background and not say much
  • Try to leave social situations as quickly as possible
  • Always have someone with you in social situations
  • Use alcohol or illegal drugs to feel more confident in social situations

Section 3 of 16

3. What is social anxiety?

Most people feel shy or anxious in certain social situations – for example, when meeting someone new or performing in front of other people. However, for some people this can be more severe – it can start to interfere with their lives.

Social anxiety might stop you doing things you’d like to do, like attending events (weddings, or work nights out, for example). It could also stop you eating out or pursuing hobbies that may involve other people.

Social anxiety might also affect important things you need to do, like getting to work or college or attending appointments where you have to talk to other people. You might also dread going to unfamiliar places and being around people you don’t know very well.

People who are socially anxious often have certain thoughts:

Before social situations:

  • I’ll make a fool of myself
  • I’ll have nothing to say
  • I’ll go bright red
  • I won’t be able to talk properly

During social situations:

  • Everyone’s staring and judging me
  • I’m shaking
  • I’m making a mess of this

After social situations:

  • Everyone thought I was an idiot
  • I wish I hadn’t gone out
  • I sounded like an idiot

About themselves:

  • I’m weird
  • No one likes me
  • I’m not very interesting

We’ll look at ways of dealing with these thoughts further along in the guide.

Section 4 of 16

4. What causes social anxiety?

People might become socially anxious for lots of different reasons.

Social reasons

The way you’ve been treated by other people in the past – for example, if you’ve been bullied, or if you’ve ever been embarrassed in a social situation. This can make you worry that the same thing will happen again.

Psychological reasons

People with social anxiety often think in certain ways – for example, they tend to think they don’t have good social skills, and that they’re boring. You might also think that everyone’s paying close attention to you and can see how anxious you’re feeling, and that they’re thinking negatively about you for feeling like this. These patterns of thinking can keep social anxiety going.

Biological reasons

People have evolved to be social, as it can often be helpful for survival to have other people to turn to when you need them. It’s in our genes to want other people to approve of us. If you have social anxiety, you might be more sensitive to the idea of this approval not happening, and more afraid of being rejected by other people.

Also, if someone in your family is socially anxious this can make you more likely to be socially anxious yourself, as you could have similar natures and personalities. It’s possible you’ve inherited some socially anxious tendencies from both your immediate family and some very distant ancestors.

It’s most likely that your socially anxious feelings come from a combination of all of these factors.

Section 5 of 16

5. What keeps social anxiety going?

Thoughts and behaviours

As mentioned earlier in the guide, the way you think before, during, and after social situations can contribute to feelings of social anxiety. These thoughts can cause you to behave or respond in a certain way in social situations, which then makes the thought feel more real and powerful – this can maintain social anxiety.

Later on in the guide you will learn some ways of dealing with these thoughts.

Here are some examples of things people with social anxiety often do, and how those ways of thinking and behaving can affect them:

Avoidance

You now know that social anxiety can make you avoid social situations, or try to escape them as soon as possible. This is understandable, but avoidance can keep social anxiety going. Avoiding social situations stops you from having positive social experiences that would help you feel more confident and help change some of your thoughts. Avoidance also means you have less practice at using your social skills, so it can reduce your confidence in your abilities.

Also, the longer you spend avoiding social situations, the more frightening the idea of being in one becomes.

Safety behaviours

When you’re unable to avoid social situations, you might try to manage them by using what are called ‘safety behaviours.’ These are behaviours that can make you feel less anxious at the time, but actually make things worse in the long term.

Safety behaviours can make you think a situation only went well because you used them – this makes you think you need to keep using them. You never get the chance to prove to yourself that you can cope without these behaviours, so they can keep social anxiety going. (Also, it’s unlikely that you’ll always be able to use safety behaviours.)

Here are some examples of safety behaviours:

  • keeping quiet during conversations
  • avoiding eye contact
  • always having someone you know with you
  • using alcohol or illegal drugs to increase your confidence

Safety behaviours can become what are known as ‘self-fulfilling prophecies’ – this is what happens when you think you know what’s going to happen, and your actions end up causing the event or situation to happen. You might stay quiet at an event as a safety behaviour, but being quiet could mean that other people don’t talk to you as much. This can then cause you to think that no one wants to talk to you, or that you’re boring.

Increased self-focus

People who have social anxiety can often find themselves concentrating hard on how their bodies feel and look during social situations. Unfortunately, this can keep social anxiety going. You could be spending a lot of time worrying that you’re blushing, sweating, or stammering, for example.

The truth is people tend to overestimate how much others pay attention to them, and this happens even more if you’re socially anxious. Focusing so closely on these worries can make it hard to concentrate or join in when you’re in a social situation – this then strengthens any belief you have that you’re not performing well.

Also, focusing on your body in this way makes you more likely to notice even small signs of these symptoms – and then your mind is likely to exaggerate how bad and noticeable they are. This can make you feel more anxious, and make the symptoms feel even worse.

Section 6 of 16

6. How social anxiety keeps going – Activity 1

Use the boxes below to write about a situation where you experienced social anxiety.

Filling this in helps you see how your feelings, thoughts, behaviour and how your body feels are all linked, and can all affect each other.

The text you enter will be saved as long as you’re using the guide, but it won’t be sent anywhere.

Section 7 of 16

7. Managing social anxiety

In order to manage social anxiety, the first step is working on the patterns of unhelpful thinking that have formed in your mind. Once you are able to recognise and challenge these unhelpful thoughts, you’ll be able to work on reducing the behaviours that keep social anxiety going.

Patterns of unhelpful thinking

Here are some common patterns of unhelpful thinking:

Mind reading:

People often assume they know what others are thinking, and the assumptions are usually negative.

For example:

  • “They can see how anxious I am, they think I’m weird.”

Labelling:

People who feel socially anxious often label themselves in negative ways.

For example:

  • “I couldn’t speak at the meeting – I’m stupid.”

Predicting the future:

People who feel socially anxious often spend a lot of time thinking about future social events and predicting what could go wrong, instead of just waiting to see what’ll happen. This can end up making social situations seem worse, both before and after you go to them.

For example:

  • “I’m going to go red and stammer, and everyone’s going to think I’m pathetic.”

Personalisation:

People who think this way believe everything is to do with them, and it’s usually negative – they place blame on themselves for no logical reason.

For example:

  • There’s an awkward silence during a conversation with a work colleague, and you assume it’s your fault for not being able to fill the silence.
  • You walk past a group of people laughing and assume they’re laughing at you.

Over-generalising:

Based on one isolated incident, people with this thinking pattern assume all future events will follow a similar pattern. It becomes hard to see a negative event as a one-off.

For example:

  • Because you think one presentation at work went badly, you believe all the presentations you do are going to be bad from now on.

Focusing on the negatives:

People with this thinking pattern tend to go back over social events in their minds repeatedly after the events are over, and focus on anything they believe went badly. They often ignore all the parts of the event that went well.

For example:

  • You think about one awkward conversation you had at a party, and forget that you had great conversations for the rest of the evening.

Do any of your unhelpful thoughts follow these patterns? Make a list of the ones you have most often, and try to put them in one of the categories above.

People often assume the thoughts that come into their minds are 100% true. However, thoughts are not facts – we often make mistakes with what we think. This is especially true if our thoughts follow some of the patterns of unhelpful thinking described above.

This isn’t something to feel bad about, it’s just the way our brains work. Learning to question and manage these thoughts, rather than accept them as facts, can help reduce social anxiety.

Section 8 of 16

8. How to challenge unhelpful thoughts

In order to challenge unhelpful thoughts, the first thing to do is recognise negative thoughts, and the cycle that negative thoughts create with our minds and bodies. This cycle keeps social anxiety going.

Once you’ve learned how to recognise an unhelpful thought, you can move on the next stage – challenging the thought. To do this, you can ask yourself a series of questions.

The example below outlines the cycle of anxious thoughts and feelings. It shows how a situation triggers negative feelings that leads to a cycle of unhelpful thoughts. When you have an unhelpful thought it makes you feel even more anxious, which then makes the negative thought feel stronger and more believable. This can then lead to more negative thoughts.

In the next section, you can fill out an example of this cycle from your own life.

Section 9 of 16

9. Activity 2

Use the boxes below to write about a time when you had an unhelpful thought. This will help you to understand and remember how the cycle of anxious thoughts and feelings works.

The next time you find yourself feeling anxious or experiencing an unhelpful thought, it will be easier to remind yourself of what is happening and challenge the thought.

The text you enter will be saved as long as you’re using the guide, but it won’t be sent anywhere.

Section 10 of 16

10. Review your responses

Situation


My feelings (emotions and how my body feels)


My unhelpful thought


Section 11 of 16

11. Challenges to an unhelpful thought

Now you can challenge your unhelpful thoughts by asking these questions. Work through the questions below, using the examples to give you ideas.

Example:

“I’m going to a party at my partner’s work and meeting their colleagues for the first time. They’ll all see how anxious I am and they’ll think I’m an idiot.”

1. Is there any evidence against this thought?

  • “My partner says they’re nice people and that they’ll like me.”
  • “I did well when I met my partner’s family – I was anxious but it went well.”

2. Is there any evidence for this thought (based in fact)?

  • “I don’t know anything about my partner’s job so I can’t talk about their work with them.”
  • “I know that one of their colleagues isn’t very friendly.”

3. Can you identify any patterns of unhelpful thinking?

  • “I’m mind reading – I’m believing I can see what other people think about me.”
  • “I’m predicting the future – I’m imagining the event going badly before it’s even started.”

4. What would you say to a friend who had this thought in a similar situation?

  • “I’d say: ‘you’re a nice person who’s easy to get along with, and remember it’s not your job to make sure the whole night goes well. Anyway, everyone will be too busy enjoying themselves to judge you.’”

5. Is there another way of looking at this situation?

  • “It’s normal to feel anxious when meeting new people for the first time. Most of the other partners there will feel the same way. Even if I’m a bit quiet or look a bit anxious, no one’s going to care too much. And I might actually get on well with people there.”

6. Is there a proactive solution to this unhelpful thought?

  • “I could ask my partner who they think I’ll get on well with, and what some of their colleagues are interested in, so we’ve got things to talk about.”

Section 12 of 16

12. Activity 3

The aim of this activity is to use these challenging questions to create a helpful thought, and then use it to replace the unhelpful thought. By doing this you can reduce your anxiety.

You’ll also be able to record how much your anxiety reduces, so you can see the process working.

Now complete the table below to challenge your own unhelpful thoughts.

Section 13 of 16

13. Changing how you see yourself in social situations

People with social anxiety often think their anxiety is obvious to everyone, and that issues like feeling sweaty, shaking, or blushing are causing everybody to stare at them. You can end up spending more time focused on these physical worries, and on efforts to hide your anxiety, than you do on the situation itself.

This concentration on your own feelings and emotions – often called internal focus – can lead you to see yourself one way, when reality is different and nowhere near as bad as you’re imagining. For example, you might think your entire head has turned bright red from blushing – but in reality, your cheeks are a little flushed and that’s it.

This internal focus can make social anxiety much worse, especially as people who are focused internally can often struggle to keep up with conversations or fully take part in activities. It becomes another self-fulfilling prophecy: worrying about events going badly means they end up going more poorly than they would have otherwise.

Here are some tips for reducing internal focus and seeing yourself in a more realistic and positive way:

Try to focus your attention on the situation you’re in, instead of any physical symptoms you’re experiencing. Also, don’t try to judge yourself on how well you’re doing when you’re in the situation – it won’t help you feel better.

Although the anxiety may feel terrible, it usually doesn’t look as bad as it feels.

Even if people can see that you’re anxious, it doesn’t mean that they’ll think badly of you. Everybody feels anxious sometimes – most people would understand, and might even want to be supportive.

Just because you’re feeling anxious, it doesn’t mean that you’re performing poorly. We often need some anxiety in our minds to do things at our best.

Remember that your anxiety isn’t the main focus of everyone’s attention. There are lots of other things for people around you to focus on and discuss – including the things that are happening inside their own minds and bodies.

You don’t have to perform perfectly or brilliantly in every conversation and at every event – no one can achieve such high standards.

Try not to rehearse what to say and do in detail before social events – this can make you feel more anxious, particularly as you don’t know what other people will say and do. It’s okay to come up with some ideas for conversations and questions ahead of time, but remember to let interactions happen naturally.

Don’t worry too much if there are silences. Everyone has a responsibility to keep a conversation going, not just you. Also, silences are okay and don’t always need to be filled.

Just be yourself – there’s no need to pretend to be someone you’re not. It’s impossible for everyone to like everyone else, so trying to make that happen will end up making you feel more anxious.

Section 14 of 16

14. Facing the things you avoid – Activity 4

People often get into the habit of avoiding social situations that make them feel anxious. This can, unfortunately, make the problem worse. The longer you avoid something, the more intimidating it becomes. Also, if you always avoid situations that cause social anxiety, it’s harder to prove to yourself that you can manage them – as a result, you may lose confidence.

You’ll find that trying these frightening activities will give you important information that you can use to manage the symptoms of social anxiety. For example, you might be scared that everyone will laugh at you when you speak up in a meeting – then once you do it, you discover that everyone is pleasant and happy to hear what you have to say. This makes it much easier to challenge negative thoughts in the future.

There are 6 steps to this activity:

  1. Make a list of situations that you often try to escape from or avoid. For example, you could write “work nights out” or “giving presentations”.
  2. Give each situation a “difficulty score” out of 10. If a situation causes you no anxiety, rate it 0. If it causes extreme anxiety, rate it 10.
  3. Try to put the situations in order, from least anxiety to most anxiety.

Here’s an example:

Situation

 

Difficulty score (0 = no anxiety, 10 = extreme anxiety)

 

Initiating a conversation with someone at work 5
Talking about your ideas in a meeting 7
Joining a class or hobby club 9
Eating in a public place 4

4. Start with the lowest-ranked item on your list to see what happens. This should be the one that causes you the least anxiety.

5. Keep repeating the lowest-ranked item on your list until the anxiety has reduced.

6. Move onto the next situation – there’s more information about that in the next section.

Download a table to fill out

Tips for facing the things you avoid

Here are some tips that will help you to benefit from this exercise:

  • When you’re working through your list, try your best to avoid engaging in safety behaviours. The aim of these tasks is to expose you to social situations and give you the chance to overcome the anxiety they cause, so using safety behaviours can make it harder for you to feel better in the long term. Safety behaviours take away your chance to find out you can face these situations without them.
  • Add an item to your list that focuses on avoiding safety behaviours – for example, you could say “when I’m eating in public, I’m scared to make eye contact with people”, and challenge yourself to overcome that fear.
  • Some situations that make you feel anxious are ones that go on for a long time – for example, parties or presentations at work. Try to remain in these situations for as long as you can, and your anxiety will begin to reduce. If possible, stay in the situation for 45 minutes. There’s more information on situations that go on for less time in the next section.
  • As discussed in the previous section, try and focus on the situation itself and concentrate less on how you’re feeling. This might help you get information to change your negative beliefs – for example, if you make eye contact with someone and say hello, you’ll find out if they respond in a nice way.

Remember, you don’t have to feel scared or self-conscious about the symptoms of social anxiety. They might feel terrible, but they aren’t obvious to others, and other people aren’t likely to judge you negatively because of them.

Section 15 of 16

15. Continuing to face the things you avoid

Often with social anxiety, you’re forced to be brave in short bursts when it comes to facing a situation that makes you feel anxious. For example, your main challenge could be speaking up for a few minutes in a meeting – when you do that, there isn’t much time for you to settle into the situation and relax, because it only lasts a few minutes. This means that you’ll have to repeat the challenge a few times before it becomes easier for you. Every time you experience the situation that makes you feel anxious, you should notice your symptoms get a little better.

You can download a diary sheet below that’ll help you keep track of your anxiety level for each attempt – you should see it getting lower.

It’s important not to leave too big a gap between your attempts to face challenging situations – if you wait too long, it can feel like you’re starting from the beginning every time.

Moving on to the next situation

For this activity, after you’ve started with the lowest item on your list, stick with it until you feel comfortable and then move onto the next one. This gives you time to gradually work your way up the list and practice using your coping skills and building your confidence before you face the most challenging situation.

Download this diary to record your attempts at the items from your list in the previous section. You can save different versions of the diary and complete them on your device – try keeping one for each item on your list.

Download diary

You might confront a situation that doesn’t go as well as you hoped. Try not to give up. If you keep going, it’ll get easier.

If there’s something on your list that seems too much, see if there’s something smaller you can do to build up to it. For example, if you’re anxious about going to an exercise class, start by calling the gym to ask about the class and get more information. This will help you build more confidence before you tackle the main situation.

Look out for other situations that you avoid due to social anxiety, and try to reduce your avoidance more and more. In time, you’ll feel much more confident and experience fewer anxiety symptoms.

Section 16 of 16

16. Next steps

Urgent help

This self-help guide is intended for people with mild-to-moderate symptoms of social anxiety.

If you're feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

For an emergency ambulance phone 999.

Keep using the techniques you found helpful from this guide – they should continue to benefit you. If there are some things that you didn’t find helpful to begin with, stick with them for a few weeks – CBT can take a little time to work.

Further help

If you’re feeling distressed, in a state of despair, suicidal or in need of emotional support you can phone NHS 24 on 111.

If you feel you need more help with your mental health, try speaking to your GP, or search for mental health and wellbeing services in your area.

For information and advice when you’re feeling down, you can phone Breathing Space on 0800 83 85 87.

The Breathing Space phoneline is available:

  • 24 hours at weekends (6pm Friday to 6am Monday)
  • 6pm to 2am on weekdays (Monday to Thursday)

If you found this guide helpful and would like to do more work like this, Living Life offers a range of structured psychological interventions and therapies to improve mental health and wellbeing. This service is appointment-based and specifically for low mood, or mild/moderate depression or anxiety. Living Life are open Monday to Friday, from 1pm to 9pm, and you can phone them on 0800 328 9655 for an assessment appointment.

Learn more

To learn more about coping with social anxiety and related issues, you can visit some other parts of NHS inform:

Complete a self-help guide for anxiety

Learn more about anxiety and your mental wellbeing

Learn about panic attacks

Read about dealing with panic attacks

Find out about stress

Read our 10 stress busters

Try some breathing and relaxation exercises to help you feel more relaxed day to day

Last updated:
27 May 2021