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  • Q&A with Australian Health Practitioners

    How do I overcome social anxiety (and low self esteem)?

    I think I have Social Anxiety. I avoid social situations, even to the point of driving to a supermarket further away, less chance of running into someone I know. When I do get in a situation where I have to say hello & have a conversation I will stumble my words, I will go red in the face & start to sweat. I'm sure that the person will think I'm a complete idiot. When I am with my husband or children it is a different story, I feel the complete opposite. It is affecting my life atm. I don't want to take medication. I have always been a shy person, but instead of getting more confidence as I have gotten older I have become worse, very low self esteem. Any advice on how to manage?
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  • 1

    Thanks

    Emma Djukic

    Clinical Psychologist, Psychologist

    Emma Djukic is a Clinical Psychologist who specialises in the assessment and treatment of emotional and behavioural problems in children and adolescents. These include: Bullying … View Profile

    Social anxiety can be very situation-specific - some people will be only be nervous when public speaking, some when eating in restaurants and others when approaching shop assistants or signing their name at the bank.  For others, social anxiety can be more generalised and over time fewer and fewer situations may be experienced as ‘safe’.  People with social anxiety will often go to great lengths to avoid the situations that they fear which can have an enormous impact on their ability to get on with things.  Exacerbating social phobia is usually a fear that you will be judged negatively by others…that others, to use your words, will think you're “a complete idiot”.  The underlying assumption that you make about yourself is that you're ‘less than’ or ‘not as good as’ and that others believe this too.  When you are in a ‘safe’ environment like home you are less likely to be troubled by these beliefs.

    Although social anxiety is something that people can learn to live with, this can become harder and more debilitating over time - the more we avoid something, the more we tend to fear it.  There are several good books that can help you to cope with anxiety - you could try ‘Change the Way you Think’ by Sarah Edelman.  However treatment for social anxiety can often require assessment and intervention by a skilled therapist - you could ask your GP for a referral to a Clinical Psychologist - who may help you to reduce anxious feelings and senstations through relaxation and mindfulness exercises.  Your therapist may also teach you how to manage your fears through cognitive behavioural therapy in which you will gently but purposefully confront them and test the beliefs and assumptions that they are associated with.

    Medication can also be a useful adjunct to psychotherapy - discuss this further with your GP.

    For further information you may like to go to the following websites:
    beyondblue.org.au
    moodgym.anu.edu.au (self help, online therapy program)

    For a list of psychologists in your area go to:
    www.psychology.org.au

  • 1

    Thanks

    Matthew Evans

    Psychologist

    I chose psychology as a profession because I wanted to make a contribution to people’s health, happiness and wellbeing. I am interested in the emotional, … View Profile

    Social anxiety and low self-esteem come hand in hand. There is usually two levels you could say. Within the first level there are all those anxious symptoms, and the stress response called, the fight-flight response. So that can come up, things like palpitations and sweats. It can be any number of things where you just want to get out of that social situation. You want to escape as you are feeling fearful, other people can react with the fight response. They get punchy. They get a bit sparky and irritated and a bit aggressive. So that is the social anxious response.

    So you can learn to deal with that and self soothe a little bit around that. Learn to care for yourself a little bit better, being more mindful and calm yourself and tolerate more distress. There is some behavioral strategies for doing that. You are using things like mindfulness, and someone can help you there.

    There is often a story as to why you have got social anxiety or low self esteem. It may stem from childhood and how you were treated then. Maybe a negative relationship or something happening within a relationship. This can give you a low sense of self worth.
    When in social situations you may carry this low sense of self worth which you have developed from a negative event or relationship. You would need to learn the value of yourself and assess yourself in a more favorable way. This differs in time depending on the patient to develop that healthier sense of his your worth. You may have symptoms that have to be treated, but the underlying story is that you are okay, and that even if you feel you are not perfect and the most confident person in the room that is all right; nobody has to be.
    There are classes that could help with low self-esteem, but often you have to do some practical, like set yourself little goals. Such as reading out loud or speaking to someone you would not normally talk to.
    You could go to other things. Such as a class where you had an interest in and maybe start a conversation or just a medium to meet people.
    There is an element of self-esteem, where it is not just how you look at yourself, but it is how you feel you merit in other people's eyes. So you need to work on your relationships to improve your self-esteem too. The idea is that you get validated and mirrored back that you are okay from others because that is part of our self esteem. We all have this sort of question go through our head, “How am I doing?”, we want it reflected back from others, saying “Yeah, you're doing okay” too.

    Not to be isolated and to form some relationships are an integral part of building your confidence. You have to find a way of forming some friendships with people who value you and you can value yourself a bit from.

  • 2

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    Jennifer Grant

    Psychologist

    New practice opened Feb 2018. Seewebsite www.coffspsychneuro.com.au I'm passionate about working with people from all walks of life to help them create a more vital, … View Profile

    Both Emma and Matthew have made some suggestions that may be helpful. Another perspective on social anxiety and low self-esteem can be found in Acceptance and Commitment Therapy (ACT). ACT involves (a) mindfully noticing the bodily sensations of anxiety – without judging them or trying to get rid of them – bringing an attitude of curiosity to the experience; (b) disentangling yourself from your thoughts eg, notice that thought “I’m a complete idiot” as just a thought, and like all thoughts, maybe helpful, maybe not helpful; © developing the ability to be psychologically flexible – to do what matters, to serve your heart’s deepest desires for how you want to behave as a human being (values).
    There’s lots of different self-help ideas out there which promise to “fix” your social anxiety and low self-esteem: visualisation, self-hypnosis, positive affirmations, challenging negative thoughts, relaxation techniques, self-esteem boosting, ‘fake it till you make it’ strategies and so on. You might have tried some of these. And they seem to work for a while. ACT is radically different. And effective. Don’t take my word for it - many ACT therapists will say “don’t believe anything I say” - test everything you're told against your own experience.
    A comment about your observation that from being a shy child, you've gradually become less and less confident as you've gotten older. This isnt unusual. Over time, our efforts to avoid anxiety, to get rid of it, often paradoxically make our anxiety worse. It’s like social anxiety is a stray kitten meowing pitifully at your back door. You don’t like the sound of its distress, so you feed it. And it’s quiet for a while. Then it comes back, meowing louder. And you feed it again. And it’s quiet for a while. It keeps coming back, growing bigger, meowing louder and more insistently. And you keep feeding it to quieten it. Before you know it, the stray cat has brought all the other stray cats in the neighbourhood. Their loud meows have taken over your life. You can keep feeding them. Or…try something different? You feed your anxiety by avoidance – it keeps the feelings at bay. For a while. The more you avoid, the bigger the anxiety grows.
    Many of my clients with social anxiety have found Russ Harris’s book “The Confidence Gap: From Fear to Freedom” (an ACT approach) helpful, especially if used as an adjunct to psychological therapy. In the book, Russ shares his own story of debilitating social anxiety.
    You can find an ACT therapist by going to the “find an ACT therapist” listings at actmindfully.com.au

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