The Key to Effective Social Anxiety Therapy for New Yorkers

Social confidence can be hard to achieve in New York City. In fact, it’s quite common for New Yorkers to grapple with periods of overwhelming social anxiety and stress in anticipation of relating to other people.

As a psychologist in private practice in NYC, I have come to understand what makes therapy for social anxiety effective. I’m going to share with you what I believe needs to be part of your therapy process in order to maximize your efforts to gain social confidence and reduce anxiety. That is, to feel highly prepared to manage the challenges that arise in social settings and in the time leading up to social events.

When we talk about social anxiety, a.k.a. ‘social phobia’, we’re referring to persistent fear of and intense worry about being judged and/or observed by others in social settings. This fear promotes avoidance behaviors and can be associated with depression, as isolation from the need to avoid promotes a lot of negativity directed toward the self, sometimes including a deep regret for failed or missed opportunities.

I’m going to talk about getting started in the process of improving your social anxiety, but most importantly, I’m going to discuss what actually makes therapy for social anxiety effective for New Yorkers. I’ve been doing this work for a long time as a psychologist, and I believe many people don’t realize what is needed to feel more socially prepared and adept.

Sometimes our social anxiety fears do come true. The very outcome we ruminated about can happen. CBT therapy prepares you for this situation.

CBT for social anxiety can help you identify hot thoughts that keep the vicious cycle of self-judgment and avoidance in motion. By learning to gain control of painful mental images, negative self-judgment and personal rules, you can work on creating small victories in social settings.

But there’s more to that’s required for social anxiety therapy to be effective.

Therapy Key #1: Managing Social Expectations

The very first step toward improving social anxiety is about managing your expectations. (In truth, it’s also about acknowledging that you’re going to need to go outside of your comfort zone to make any appreciable change, which includes a willingness to sit in the discomfort that comes up when facing the embarrassment, shame and self-defeating thoughts and behaviors associated with social anxiety, but more on this in a bit.)

Your expectations determine whether or not you feel pleased or dissatisfied with reality. They can promote avoidance behaviors or push you to try hard things. Expectations of social success in New York can be tainted by all of the influences that NYC throws at you.

For New Yorkers who are sensitive to social failure, models of social success may feel like they are everywhere they go. New York City, particularly Manhattan, bombards its inhabitants with massive exposure to material wealth goes hand in hand with feelings of intimidation, the need to “catch up.” This all starts with what you expect to happen when you aim to grow your professional network, make new friends, find love in the big city or all of the above.

Of course, it’s beautiful to aim for the stars and hope for an amazing social outcome. However, a having healthy social expectations involves being realistic about the time it takes to establish connections in the city and a deep understanding of the impact of who you choose for social comparison on how you view yourself and your chances.

When there is a constant discrepancy between social expectations and your social reality, it can create periods of social avoidance and despair. On the flip side, if you just assume that you’re going to fail and you use evidence of past failures to project into the future, your expectations are also messing with your chances of improving your social anxiety.

So the first step is all about expectations. Try to be open to the idea that what you define as social success might need to be adjusted. The illusion of massive social success is all around us. Social media makes this worse.

Then there are the select few who have amazing social success, but I promise you that you don’t know the whole story.

Ask Yourself These Questions About Your Expectations of Social Success

1. Where does my benchmark for social success come from? Is this a realistic goal? Am I willing to look deeper into my standards in an effort to improve my social confidence?
2. Does my model of social success match my personality style? (i.e., Extroversion/Introversion)
3. Are there teenage experiences of social success or failure that I’m trying to repeat or correct for?
4. Am I aware of the extent to which social media plays a role in feeling like a social failure? Which social media accounts make me feel the best/worst?
5. Are my expectations for how I feel and act in social situations rarely being matched by reality?
6. Are my expectations of social failure too high? Do I recognize the small social wins?
7. Do I stay away from taking social chances because I assume I’ll fail?

These questions represent a small sample of what to start thinking about in any initiative to improve your social anxiety. Going into therapy with a keen eye on your expectations is a good first step, but real, appreciable change in therapy for social anxiety requires an understanding that your anxiety is not all that needs to be targeted in therapy. It will certainly be the primary focus, but to do social anxiety therapy the right way, you need to target “second level” emotions as well.

Therapy Key #2: Embracing Second Level Emotions

Effective therapy for social anxiety will help you feel less in your own head when you’re socializing, networking or around strangers. You will be more in the moment and less preoccupied with how you think you’re being perceived. You’ll be more likely to feel self-expressed and vulnerable. In order to achieve these gains, you not only need to focus on anxiety reduction, but also on how you feel about your struggle with anxiety. I’m essentially referring to how you feel about how you feel.

Anxiety is considered a primary emotion. So is anger, disgust, surprise, happiness and sadness. Primary emotions are more brief and instinctive. Once they sweep in, they start to effect your thought process, which opens the door for secondary or “second level” emotions.

Second level emotions last longer. (I like the term “second level” as a metaphor because it makes me think of a cover or a ceiling that locks in the problem.) These emotions tend to have increasing influence over time and even may be operating out of awareness. While primary emotions are more universal, secondary emotions are specific to the individual. Examples of second level emotions are shame, guilt, embarrassment, frustration, withdrawal, regret and jealousy.

For people with moderate to severe social anxiety, I have found that second level emotions function as the mental glue that keeps social anxiety in place.

In my experience as a clinical psychologist in private practice in NYC, I have come to understand that effective therapy for social anxiety must include an examination of second level emotion. That is, you need to cultivate an awareness of how you feel about how feel.

Second level emotions make the experience of social avoidance much worse. If you decide to stay home and avoid a social situation, you might feel an initial sense of relief as you sit in the safety of your home because you avoided a potentially mentally dangerous situation. You succeeding in avoiding the potentially negative social experience, but this avoidance, if repeated, begets more avoidance. Before you know it, you’re making excuses on a consistent basis to avoid all kinds of social events.

It’s quite common for people to feel a painful sense of shame about their perceived social failures and avoidance. Some people judge themselves intensely for feeling socially anxious, even panicky, being too quiet or having nothing interesting to say.

For example, let’s say you attended a social event and felt so nervous that you could barely speak. You also questioned what you had to offer in various conversations. Maybe with one person you know well you felt fine, but you judge yourself for how you performed in other conversations. Maybe you felt hyperaware of having no hobbies or exciting topics to discuss. Following the event, you felt such negative self-loathing that any positive aspects of the event were canceled by your extremely negative evaluation of your social performance.

The shame you feel might compel you to mentally beat yourself up, question your character and your future. Depression might kick in because you’re grieving what you think you’ll never be able to accomplish.

This shame kind of seals the deal for your social anxiety to maintain control over your choices and self-evaluation. It is the mental glue that keeps your suffering in place because it contributes to a vicious cycle of negative self-evaluation and avoidance. The more you judge yourself about your social anxiety, the more you’re likely to avoid. The more you avoid social situations, the more likely you are to judge yourself negatively. This pattern limits your chances for social success, even little wins that could give you a sense of hope.

When shame and low self-worth are too easily accessible or too dominant relative to other emotions, your social anxiety cannot be fixed with exposure therapy alone. 

Effective social anxiety therapy requires a focus on what is triggered in you as you judge yourself for having the anxiety.

Of course, social anxiety therapy does require some form of exposure, as well as the acquisition of new skills so you can feel prepared to handle social challenges. That sense of social readiness is crucial to the success of your social anxiety therapy. 

Feel free to reach out with any questions you have about CBT therapy for anxiety. And please click on the link for FAQ about social anxiety therapy.

I wish you all the best!

Greg Kushnick