Exposure Therapy for Social Anxiety Disorder

Exposure therapy is essential if you are to overcome your  social phobia. That is, you must put yourself in the social/performance situations you are worried about. Many social phobia sufferers have got into the habit of either (1) totally avoiding the social occasions  that trigger anxiety  and/or (2) using subtle avoidance behaviours or (3) self medicating with alcohol.


Subtle avoidance behaviours include:

  • speaking softly
  • speaking too fast
  • giving short answers to questions so as to limit the interaction  and get it over and done with as soon as possible
  • avoiding/minimizing eye contact
  • trying to hide  symptoms such as: sweating, blushing and shaking
  • only speaking when spoken to
  • refraining from voicing one’s opinions
  • folding one’s arms across one’s body
  • covering one’s face with one’s hand


Although  confronting your fears  sounds frightening, your therapist will give you the tools to cope with exposure (e.g. rational thinking, slow breathing and isometric relaxation).


The exposure sessions must be

  • graded
  • repeated and regular


Your therapist will work with you to determine what would be an appropriate first step; it should be difficult enough to provoke some anxiety but easy enough for you to be fairly confident you can do it. Once you can cope with Step 1 confidently, then you can move onto a more difficult situation and gradually work up your most feared scenarios.

It is important not to confront a feared situation that is far too difficult for you, as if you tackle something too stressful, without sufficient preparation, you may become extremely anxious or even have a panic attack. Such a negative experience would only strengthen the association between fear and the setting.

There will be various factors which will determine how much anxiety you experience in social or performance scenarios.


Your  level of anxiety experienced may depend on whether

  • the people involved  are male or  female
  • the people you are interacting with are younger , older or the same age as you
  • the social interaction is of a short or long duration
  • you are sitting or standing
  • it is a formal or informal setting
  • you are rehearsed or unrehearsed


Therefore, you need to consider factors such as those listed above when devising your exposure hierarchy.



A sample hierarchy for public speaking anxiety is outlined below:

  • 100 Large audience of 100 people,  difficult questions are being asked, presentation is unrehearsed and am required to stand to present the material
  • 75  Same as 100 above, but audience is  only 20 people
  • 50   Audience of only 20 people, no questions are asked, standing to present the material, the subject matter has been rehearsed
  • 25 Audience of only 10 people,  sitting down to give the presentation, the subkect matter has been rehearsed and there are no questions from the audience


Regain balance and work on social anxiety with a trained health professional. Help is only a phone call away, ring now for an appointment  on (03) 9819 3671 or 0429 88 3671


This article published on Jul 23, 2012. View related Treatment Options

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