Rachel is anxious about the presentation she has to make to the company tomorrow. She is trying to get a good night’s rest, but finds herself tossing and turning. Her heart is racing, and thoughts of failure run through her head. The last time she had to give a presentation to the company, she felt sick to her stomach and almost passed out. All she could think about was getting out of the room as soon as possible.

Rachel suffers from a type of anxiety called social phobia or social anxiety. It is one of the most common forms of anxiety disorders and involves a fear of being embarrassed in a social setting.

Rachel began to experience social anxiety as a teenager. She struggled to give class presentations and always sat in the back of the classroom hoping not to be called on by the teacher. Her story is typical in that social anxiety begins early in life for most people–around the age of 11 and usually manifests by age 20. A concern with social anxiety is that it is a risk factor for depression and substance use if untreated. So, it is best to treat it early.

To begin, Rachel has to commit to face her fear and not avoid social situations. Successful treatment approaches generally involve a type of treatment called exposure, a type of cognitive-behavioral therapy. Under the care of a therapist, you expose yourself to the feared situation, working through the anxiety until it no longer causes you great anxiety. Medication combined with psychotherapy are also a possibility. However, cognitive-behavioral therapies have proven superior in placebo-controlled trials.

Basically, Rachel would face the social situations she fears. She would become aware of her worried and anxious thoughts. Then she would practice substituting rational thoughts for those anxious thoughts. Rachel would also learn relaxation exercises to practice in the moments of feeling anxious. Finally, she would be gradually exposed to social situations that would prompt her anxiety, working through the anxiety until the situation was over. The more Rachel exposes herself to anxious situations, the easier they become, and she builds confidence to manage social situations. Eventually, her anxiety decreases and becomes manageable.

In some cases, people like Rachel might start this process by simply imagining situations like giving the presentation. In her imagination, she would notice how she feels, practice calming, and be aware of her thoughts. Once she can manage her anxiety during the imagination, she moves on to real life attempts as described above.

A key to successful exposure work is knowing that submitting yourself to the anxious situation will allow you to eventually overcome it. The temptation is to avoid anxious situations rather than learn to power through them. But it is the exposure to the anxious situation that helps a person learn to overcome it.

God tells us not to be anxious even though He knows our human tendency runs opposite. But here is the good news. He would not tell us to do something without providing a way to do it. He doesn’t leave us alone, expecting us to figure out how to be less anxious on our own.

So, remember, when you are anxious, God is an ever-present help in those troubled times. Ask Him to give you the courage to face the fear and walk you through it.

Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be known to God; and the peace of God, which passes all understanding, will guard your hearts and minds through Christ Jesus. Finally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy—meditate on these things. Philippians 4:6-8

Overcoming social anxiety

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