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counseling for social anxiety

Sound Familiar?

Sid and Ariel love spending time together.  They know that fairytales don’t always come true, but they both confess on any given day that it really does feel like match made in heaven!  The two just “clicked” from day one, and they have even begun discussing marriage!  There is one thing getting in the way of their wedding plans, however — Sid’s social anxiety.  Anytime he thinks about standing up in front of people, saying his vows, being the focus of the entire ordeal, having to greet everyone after the wedding, etc., his mind goes blank, he starts feeling panicky and jittery, and his armpits get sweaty — realities which only increase his feelings of anxiety.  Sid has always been anxious about being the center of attention, but the idea of constant focus for multiple hours intensifies these feelings to the degree that he becomes physically nauseous if he thinks about it too long.  

By most anyone’s appraisal, Imari is intelligent, thoughtful, and fastidious.  Her interest and expertise in urban agriculture has grown by leaps and bounds since she planted her first city garden over five years ago, and she has become known throughout her community as a source of inspiration at what commitment to a particular set of ideals can accomplish now some 6 gardens later.  What is much less visible to everyone around her, however, is just how vexing all of the social hullabaloo around these gardens is for her.  Because some of the gardens have required significant funding, she’s required to attend fundraising events and parties, but is always wondering what everyone else really thinks of her.  Do they notice how sweaty her palms are?  When she is asked to speak, do they notice how she “ums” and “uhs”?  If Imari thinks about these kinds of questions for too long, she can become downright paranoid and palpably nervous until the event or situation is over.  But that’s just it, part of the package is how these thoughts seem to have a life of their own and don’t go away just because she wants them to. In fact, the harder she tries, the worse it gets.  About the only thing that seems to help is an extra glass of wine, but it feels a bit like putting a bandaid on a bullet wound.  She knows her response is disproportionate, but that knowledge in itself doesn’t seem to change much.  It’s been getting so bad lately, she’s starting to come up with reasons to avoid the events.  This can’t last!

Janice and Terri have historically loved having their adult kids home, especially when throwing parties.  As prominent members of their small, but influential community, their events are always filled with good food, good conversation, and prime opportunities to meet others and gain social upward mobility.  But, according to their children, the big parties they put on create a lot of anxiety.  There is some degree of pressure for them to “put on a good face” and make their parents proud, in addition to simply the large volume of people and varying personality types that must be contended with in any given event.  Janice was shocked to find their college-age daughter crying in the bathroom at their most recent fundraiser, claiming that her heart was pounding out of her chest because she was sure she was going to offend someone.  Terri, on the other hand, is a natural introvert, and said she could understand the anxiety from that perspective if no other.  It was a scary event for all of them!  

What is Social Anxiety?

Social anxiety is the fear of interacting with others in social settings and is, at its most basic level, 100% normal, if by that we mean that it is commonly occurring.  That is, most people have some degree of anxiety in social settings, often referred to as nerves, cold feet, or jitters.  Because social settings often involve large or small but nonetheless at least potentially important or significant interactions with others, we would expect anyone who is truly tuned in to their social environment to feel some degree of apprehension.  However, just because it is normal doesn’t mean that it is pleasant or easy to deal with in a productive manner, especially given that talking about it may at least initially seem to make things worse.

What is Social Anxiety Disorder?

When social anxiety moves out of the range of mild to moderately problematic and into “severe” territory, it may look more like something called Social Anxiety Disorder or Social Phobia, terms which constitute Social Anxiety which is more intense, longer-lasting, and increasingly disproportionate from the more “normal” social anxiety described above (which again, can itself be difficult to work with!). 

Interestingly, social anxiety is the third largest mental health concern in the world! Around 7% of the world’s population struggle with this disorder. Although many individuals experience this mental health concern, the social stigma around mental health concerns stops many from seeking treatment. Many people with social anxiety may feel embarrassed about their thoughts and reactions to social situations. Nevertheless, treatment is possible, and success rates are exceedingly high. The National Institute of Mental Health notes that psychotherapy, medication, and group therapy are all effective at reducing symptoms.

More about Social Anxiety

Social anxiety arises out of fears of judgment from others and can be triggered by a plethora of social situations. As mentioned above, while many of us may become anxious before certain social gatherings (e.g., job interview, first dates, etc.) and find these symptoms troublesome to deal with, the anxiety experienced by those with social anxiety disorder is overwhelming and often debilitating. This form of anxiety can manifest in many different ways, including but not limited to:

  • body twitches
  • shaking
  • sweating
  • dry mouth
  • racing heartbeat
  • irrational or paranoid thinking

In extreme cases, individuals may experience body dysmorphia when their social anxiety is triggered. Unfortunately, individuals with social anxiety do have some idea that their responses are disproportionate to what is happening, but this does not stop their intense feelings and thoughts surrounding the fear of being judged.

For some individuals, their social anxiety may span all kinds of social settings (i.e., generalized social anxiety) while for others their social anxiety is triggered by specific situations (i.e., non-generalized social anxiety). Whatever the social context, it is essential to know that those with social anxiety want to join in on group activities. They don’t want to experience these intense emotional and physical reactions to their fear. Although they may appear shy, irritated, sad, or disinterested, these are just reactions to their internal anxious state. Fear of judgment can stop us from making the most meaningful connections.

How Do I Cope with Social Anxiety?

Many people in St. Louis who have social anxiety find that counseling is immensely helpful.  The warmth and caring of a non-judgmental, outside observer trained in the art of listening goes a long way.  But here are a few things to consider now on your own as well:

  1. Discover what triggers your social anxiety. By understanding where, when, who, and what increases your social anxiety, you may find a good bit of help in untwisting some of the knots.  For example, many people find that their social anxiety is exacerbated only with certain people or situations.  If these people and situations are avoidable without causing social, work-related, or other impairment, why not give yourself a break and stay away?!
  2. On the other hand, remember that by definition, this problem typically primarily exists within your mind.  That is to say, beyond what we might call normal nerves or jitters before big events or in difficult situations, remember that the problem of anxiety is primarily a work of your mind and thinking.  If you are telling yourself catastrophic, untrue, or unhelpful things about the way others are supposedly thinking about or judging you, it should be no shocker that you feel crappy.  A wise person once said, “Your mind is a dangerous place.  Don’t go wandering there alone too often!”  What would it be like to spend less time walking around in your own head, especially alone?  Is there a person or persons you can invite in to help you deconstruct the stinking thinking?
  3. Have you tried mindfulness?  Most people have heard about mindfulness these days, but precious few have actually tried it!  Most people try to run away from distressing thoughts or to stay and fight with them (i.e., think about them over and over as if by thinking about the things they find distressing, they will magically not be distressed any more).  Mindfulness is simply the idea of being present to whatever is transpiring for us, without doing either of those things.  But how?!  The same way you get to Carnegie Hall — practice, practice, practice.  Sitting or formal meditation goes a long way.  Here’s a great starter resource with downloadable meditations to practice.

Need some guidance with all of these?  We can help!

Our therapists aren’t just expert counselors – they’re agents of change!  They can help you reduce your anxiety by improving your thinking, helping you adjust areas of wellness, and guiding you through practices of meditation and mindfulness.


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ST. LOUIS COunseling Locations


Change, Inc. South Hampton & 44:

3460 Hampton Avenue, Suite 204

St. Louis, MO 63139 



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