Strategies for Social Anxiety | Ellen Hendriksen
Clinical psychologist Ellen Hendriksen discusses how social anxiety has worsened during the pandemic and offers strategies to increase tolerance for uncertainty and face social interactions as the world reopens. She also addresses general anxiety and listener questions.
Deep Dive Analysis
16 Topic Outline
Introduction to the Taming Anxiety Series and Guest Ellen Hendriksen
COVID-19's Dual Impact on Social Anxiety: Reprieve vs. Avoidance
Gradual Re-entry and Exposure to Social Situations
Communicating Boundaries and Vulnerability to Reduce Anxiety
Building Tolerance for Uncertainty as an Anxiety Management Tool
Defining Social Anxiety and Its Diagnostic Criteria
Overcoming Social Anxiety: Addressing Perfectionism
Overcoming Social Anxiety: Shifting Attention Outward
Overcoming Social Anxiety: Dropping Safety Behaviors
Understanding and Accessing Your 'True Self'
Meditation and Mindfulness for Social Anxiety
Creating Supportive Environments for Social Re-entry
Dealing with Post-Social Interaction Anxiety ('Cringe Attacks')
Connecting Intellectual Knowledge to Emotional Calm in Anxiety
Coping with Chronic Anxiety and Panic Attacks
Navigating Vaccine-Related Disagreements in Social Settings
9 Key Concepts
Avoidance
The human tendency to stay away from things that cause anxiety, which, while seemingly easier in the short term, actually exacerbates anxiety over time by reinforcing the belief that the feared situation is dangerous.
Go Slow to Go Fast
A strategy for re-entry into social situations, advocating for starting with small, manageable exposures to build confidence and readiness gradually before tackling larger or more intense social events. This allows for a more sustainable and effective return to social life.
Tolerance for Uncertainty
The crucial ability to accept and function effectively even when outcomes are not 100% guaranteed. Increasing this willingness to be uncertain makes interactions more flexible and reduces the anxiety associated with unknown social outcomes.
Social Anxiety
A profound fear of being judged or rejected by others, often rooted in a perceived 'fatal flaw' that one believes will be exposed and lead to negative evaluation. This fear can drive significant suffering and avoidance of social situations.
Distress or Impairment (Anxiety Disorders)
The two main thresholds for diagnosing an anxiety disorder. Distress involves significant suffering, such as losing sleep or experiencing physical symptoms, while impairment means anxiety interferes with desired life activities, like declining a promotion or avoiding social events.
Perfectionism (in Social Anxiety)
The adherence to rigid internal rules (e.g., 'I have to be interesting' or 'I can never make anyone feel bad'), leading to all-or-nothing thinking where any perceived mistake causes intense self-judgment and anxiety. Rolling back these rigid rules to flexible guidelines can reduce suffering.
Safety Behaviors
Actions taken to prevent feared social outcomes (e.g., over-explaining, over-preparing, excessive friendliness, pointing out one's own flaws). These behaviors inadvertently reinforce anxiety by preventing individuals from learning they can cope without these crutches, thus getting the credit for negative outcomes not happening.
Cognitive Defusion / Non-Attachment
A mental skill, often trained through mindfulness, that allows individuals to observe their thoughts (especially self-critical ones) with distance, rather than being consumed or controlled by them. This helps to decouple one's experience from self-judgmental thoughts and urges.
Worry (Generalized Anxiety Disorder)
A hallmark of GAD characterized by uncontrollable, intellectual rumination that expends a lot of energy without resolving issues. It is theorized to be a form of avoidance, as it keeps individuals in a cognitive realm, preventing them from dropping into and feeling deeper emotions.
12 Questions Answered
The pandemic initially offered a reprieve by providing permission to avoid social situations, which many with social anxiety appreciated. However, long-term, it worsened social anxiety because avoidance is a primary driver of the condition, leading to rustiness and increased anxiety about re-entry into social life.
It's recommended to 'go slow to go fast' by gradually exposing oneself to social interactions, starting with smaller, less intense gatherings like meeting a friend outside, to build confidence and readiness rather than immediately diving into large events. Confidence will follow action, even if you don't feel 100% ready.
Openly discussing comfort levels and acknowledging shared awkwardness increases certainty, lowers anxiety, and builds trust and connection. Showing small vulnerability communicates trust and relatability, prompting others to do the same and fostering a sense of shared humanity.
Social anxiety is a fear of being judged or rejected by others, often stemming from a perceived fatal flaw that one believes will be exposed. A diagnosis requires experiencing significant distress (suffering, like losing sleep) or impairment (hindrance to desired life activities, like passing up a promotion).
Key strategies include rolling back perfectionistic standards to allow for 'good-ish' behavior, deliberately shifting attention outward from self-monitoring to focusing on others, and dropping 'safety behaviors' that prevent genuine connection and learning that one can cope without them.
The 'true self' is the self one is without fear, accessed by dropping the behaviors used to control situations or manage one's image, and by allowing for imperfections and foibles rather than striving for constant perfection. It involves showing up and being human, rather than superhuman.
Meditation and mindfulness help by training the ability to observe thoughts and feelings with distance (cognitive defusion/non-attachment), reducing rumination about past perceived misdeeds or awkwardness, and allowing for more natural and present responses in social moments.
By setting clear expectations, allowing time for reacclimation, and if possible, starting with smaller group interactions before moving to larger gatherings. It's important to acknowledge the shared uncertainty and awkwardness of re-entry.
These are intense feelings of embarrassment or rumination about past social interactions, often occurring when alone. They are common and can be managed by acknowledging them as normal brain activity (surfing the wave) or by challenging the thoughts with distance (e.g., 'I'm having the thought that...').
When intellectual approaches fail, one can access 'backdoors' through the body (e.g., relaxation exercises to reduce physical tension) or emotions (e.g., allowing oneself to feel the feared emotions in a safe context, like imaginal exposure with a therapist).
Yes, anxiety can be chronic but is treatable, and there is always hope for expanding one's world and boosting coping capacities. While one may not 'magically turn their experience inside out,' there is always room to get to the top end of one's personal range of functioning.
Listen with compassion and without judgment, share your own doubts and vulnerabilities rather than lecturing, and focus on finding common ground. This approach connects you through a willingness to meet them on an equal level and fosters a safer environment for discussion.
13 Actionable Insights
1. Practice Gradual Exposure
To overcome anxiety, especially social anxiety, engage in feared activities slowly and incrementally, rather than avoiding them entirely. Start with small, manageable steps to build confidence and allow your feelings and thoughts to catch up to your actions.
2. Increase Uncertainty Tolerance
Actively cultivate a willingness to accept some level of uncertainty, even small percentages, rather than constantly seeking complete certainty. This flexibility allows for mistakes and do-overs, which can be inherently freeing and help you move forward.
3. Reduce Perfectionistic Standards
Replace rigid, all-or-nothing rules about how you ‘must’ behave with more flexible guidelines, such as aiming for a desired trait ‘most of the time’ or being ‘good-ish.’ This creates wiggle room, reduces self-judgment, and allows for human imperfection in social interactions.
4. Shift Attention Outward
During social interactions, deliberately redirect your attention spotlight away from self-monitoring (e.g., ‘Am I boring?’) and onto the other person. Focus on listening closely, observing their face, and engaging with them, which frees up mental bandwidth and allows for more natural responses.
5. Drop Safety Behaviors
Identify and gradually eliminate ‘safety behaviors’—actions you take to compensate for anxiety, like over-explaining, over-preparing, or being overly friendly. These behaviors prevent you from realizing that your feared outcomes won’t happen, so dropping them allows you to take credit for positive social outcomes.
6. Communicate Boundaries & Vulnerability
Proactively discuss your comfort levels and boundaries with others, especially during times of social reentry, to increase certainty and lower anxiety. Additionally, showing ‘small V’ vulnerability by admitting to feeling rusty or uncertain can build trust and connection, as it communicates shared human experience.
7. Practice Cognitive Defusion
When caught in anxious thoughts or post-event rumination, create distance from your thoughts rather than fusing with them. Use techniques like the ‘Hands as Thoughts’ exercise or preface thoughts with ‘I’m having the thought that…’ to acknowledge them without letting them obscure your perspective.
8. Address Anxiety via Body & Emotions
When intellectual understanding alone doesn’t calm anxiety, access ‘back doors’ through your body and emotions. Practice relaxation exercises to reduce physical tension, and with professional guidance, allow yourself to feel the emotions associated with feared outcomes (imaginal exposure) to loosen their power.
9. Seek Professional Help
If experiencing chronic anxiety that significantly impairs your life, seek a mental health professional you like and trust. Anxiety is treatable, and while you may not ‘fix’ it entirely, you can expand your capacity to cope and improve your quality of life.
10. Validate Survival Techniques
Recognize that anxiety symptoms, such as being a ‘control freak’ or ‘perfectionist,’ often originated as necessary survival techniques in past situations. Validate these past coping mechanisms, but then work to update them to better match your current, safer circumstances.
11. Facilitate Incremental Reacclimation
For those organizing social or professional gatherings, set clear expectations and allow time for participants to reacclimate. Consider starting with smaller groups or less intense scenarios before diving into large-scale interactions to ease anxiety.
12. Thoughtful Post-Event Processing
After social interactions, differentiate between genuine need for repair and anxiety-driven rumination (‘cringe attacks’). If a true repair is needed, reach out; otherwise, practice acceptance by acknowledging that your brain focuses on flaws, or challenge the thoughts by questioning their likelihood or impact.
13. Navigate Vaccine Discussions
When discussing vaccines with those who hold different views, prioritize listening with compassion and without judgment, rather than sending articles or facts. Share your own doubts and vulnerabilities to establish common ground and an equal footing, which can be more effective than lecturing.
9 Key Quotes
Avoidance is a primary driver of social anxiety.
Ellen Hendriksen
You don't have to feel 100% ready before you can move forward.
Ellen Hendriksen
Anxiety is driven by uncertainty.
Ellen Hendriksen
When we stop trying to pull the lever of certainty and allow for, you know, that 10%, that 5%, that 1% uncertainty, then oddly, things get a lot, maybe not easier, maybe that's the wrong word, but they get a lot more flexible.
Ellen Hendriksen
Social anxiety is ultimately, it's a fear of being judged or rejected.
Ellen Hendriksen
People are not our friends because we are competent and confident or capable. They're our friends because of our silliness and foibles and quirks just as much as our strengths that we like to show the world.
Ellen Hendriksen
If we present the world as a little too perfect, it actually creates a distance. It creates a wall between us and other people.
Ellen Hendriksen
Symptoms are often just survival techniques.
Ellen Hendriksen
Listening with compassion, listening without judgment is something that folks who meditate are probably uniquely suited to do.
Ellen Hendriksen
4 Protocols
Gradual Re-entry to Social Life ('Go Slow to Go Fast')
Ellen Hendriksen- Start with small, low-stakes social interactions (e.g., hang out with a friend outside, go for a walk, meet in a backyard).
- Build up confidence and readiness gradually, taking as long as needed.
- Acknowledge that some anxiety is normal and expected as you chip away at avoidance.
- Don't wait until you feel 100% confident to begin; lead with action, and confidence will follow.
Three Core Strategies for Social Anxiety Treatment
Ellen Hendriksen- Roll back perfectionism: Replace rigid inner rules (e.g., 'I have to be interesting') with flexible guidelines (e.g., 'I aim to be curious 70% of the time') to allow for 'good-ish' behavior and wiggle room.
- Turn attention spotlight outward: Deliberately shift focus from self-monitoring (e.g., 'What should I do with my hands?') to the external environment, such as listening closely to the person you're talking to or observing their face.
- Drop safety behaviors: Identify and gradually stop actions taken to compensate for anxiety (e.g., over-explaining, over-preparing, being overly friendly) to allow yourself to get credit for feared outcomes not happening.
Hands as Thoughts Exercise (Cognitive Defusion)
Ellen Hendriksen- Hold your hands out in front of you, fingers relaxed and spread apart, palms up, as if supporting a book. (Your hands represent your thoughts).
- Raise your hands to your face, peeking through parted fingers, as if watching a horror movie. (This represents a socially anxious moment when thoughts are right in your face, obscuring your vision).
- Lower your hands, keeping them present but away from your face. (The thoughts are still there, but you create distance and clarity of vision, allowing you to see the moment more clearly).
Navigating Social Interactions with Vaccine Disagreements
Ellen Hendriksen- Set boundaries: Clearly communicate what you are and are not willing to do regarding masks, indoor/outdoor settings, etc., for social gatherings.
- Listen without judgment: When discussing differing views, practice compassionate listening without immediately offering facts or articles, as this can lead to arguments.
- Share your own doubts and vulnerabilities: Express your own fears or mixed feelings about the vaccine process to show trust and relatability, rather than adopting an expert or teacher role.
- Explore ambivalence: Ask about and genuinely listen to both sides of a person's ambivalence regarding the vaccine to connect on an equal level, which can be more effective than preaching.