Social Anxiety: How Online Therapy Can Help
By Keira Ayoub
Social anxiety is commonly brushed off as being “shy” or “introverted.” In reality, social anxiety is a long-term fear of being judged, embarrassed, or rejected in social settings. For many people, it manifests as sweaty palms when conversing with new people, an overwhelming fear of eating in public, replaying what they have said in a social situation, or even avoiding gatherings altogether because of the emotional and cognitive load involved. Left untreated, social anxiety with unwanted avoidance behaviours may limit your opportunities, impair relationships, and perpetuate feelings of loneliness and disconnection.
Although social anxiety is a pressing issue for many people, the good news is that therapy offers effective, evidence-based approaches to help you manage your feelings. Whether through talk therapy or skill-building strategies, therapy can help you feel more at ease in social situations to regain a sense of freedom.
Signs of Social Anxiety
Acknowledging the signs you are struggling is the first step to seeking support. We can’t change what we’re not aware of. Not everyone who experiences social anxiety has Social Anxiety Disorder (SAD). The DSM-5 diagnostic criteria for SAD is as follows:
“DSM-5 criteria for social anxiety disorder (SAD) require a marked and persistent fear of one or more social situations where the person might be scrutinized by others, fearing they will act in a way that will be embarrassing or humiliating. This fear must cause significant distress or impairment in daily life, and the anxiety must be out of proportion to the actual threat posed. The fear is either avoided entirely or endured with intense anxiety, and the symptoms must persist for at least six months.”
For many, social anxiety shows up as a constant worry about upcoming interactions. This worry often begins well before the event itself and can grow into a sense of dread. At the moment, social anxiety can bring physical symptoms such as a racing heart, shaky hands, or nausea. Over time, these patterns can lead to avoidance of social situations. You might decline invitations to special events, withdraw from social opportunities, or feel hesitant to speak up in front of others. This avoidance can create a painful cycle that leaves you feeling stuck and alone. If these experiences resonate with you, it may be a sign that social anxiety is affecting your daily life and that you would benefit from professional care and support.
How Therapy Helps Social Anxiety
Cognitive Behavioural Therapy (CBT)
CBT is one of the most effective treatments for social anxiety. In a CBT session, you work with a therapist to explore how your current way of dealing with stress and anxiety is impacting your life. You uncover insights into perpetuating patterns of thinking, feeling, and doing. In a supportive environment, insight, understanding, and willingness to experiment alternative ways of responding to thoughts and feelings can help you grow. Cognitive behaviour therapy might include behavioural techniques, such as gradual exposure, thought exercises, mindfulness, reframing, and re-evaluating through a lens of compassion, curiosity, and objectivity. In time, CBT can help transform what was once overwhelming to manageable.
Acceptance and Commitment Therapy (ACT)
ACT focuses on helping people relate differently to anxious thoughts and feelings rather than trying to eliminate them. ACT specifically enables you to learn mindfulness techniques, acceptance strategies, and ways to take action when anxiety shows up. For instance, instead of avoiding an event because of discomfort, ACT helps you connect with your deeper values and find ways to participate in the event despite the feelings of anxiety. It’s the deep connection with your values that helps magnetically pull you towards facing difficult experiences, rather than pushing you towards change you’re not sure that you want.
Somatic and Body-Based Approaches
Social anxiety doesn’t just live in the mind; it often shows up through physical symptoms as well. Some common physical symptoms that are signs of social anxiety include a racing heart, shortness of breath, or tense muscles. Somatic therapy and body-based approaches help people learn grounding, breathing, and relaxation techniques to regulate the parasympathetic nervous system (PNS). By increasing self-awareness and becoming more compassionate, therapy can help you break cycles of avoidance and learn healthier ways of relating to yourself when you’re feeling fragile and the world feels scary.
Building Practical Skills and Confidence
Therapists often work with clients to build practical communication and social skills. For example, role-playing conversations, practising assertiveness, or developing strategies for small talk with strangers can help you feel more comfortable in real-life social situations. These skills, combined with introspection, understanding, compassion, and courage can help you feel more capable in daily life.
Benefits of Therapy for Social Anxiety
Engaging in therapy for social anxiety can lead to meaningful and long-lasting changes in how you move through the world. Many people begin to notice that their symptoms decrease over time with the help of therapy sessions, allowing them to enter social situations with less fear. Even if the thought of social gatherings once felt overwhelming, therapy can help make being in those situations feel manageable. With this anxiety reduction often comes increased self-confidence in both social interactions and everyday life.
Further, therapy supports the development self-esteem. Rather than defining yourself by anxious thoughts and perceived mistakes, therapy can help you see yourself more clearly and compassionately. You are more than your thoughts and feelings. This shift in perspective enables a strong sense of identity, and in place of avoidance, you develop coping strategies to help you navigate challenging situations. When see ourselves respond to challenges in ways aligned with our values, confidence grows. When confidence grows, intensity of fear tends to dwindle.
Over time, therapy can create changes that open the doors to new opportunities. You may find yourself more open and willing to pursue life goals and engage in experiences that you had once avoided. The therapy process may be gradual, but the effects are also often profound.
What Can I Expect in Therapy?
If you’re considering therapy for social anxiety, you might wonder what the process feels like. Sessions often provide a safe space to talk openly about your experiences without judgment. With your therapist, you may set goals for facing social situations, explore specific patterns that increase your anxiety, and learn calming techniques for daily life. With consistency and support, therapy helps build new skills and fosters a stronger sense of self-trust.
If social anxiety has been keeping you from daily activities and living up to your full potential, therapy can help. Whether your goal is to reduce anxiety symptoms or build confidence, changes are possible. The first step is reaching out for support. Change may take time, but every step brings you closer to personal growth.
How to Prepare for Your Online Therapy Session
If you’re considering online therapy, here are some simple tips to set yourself up for success:
1. Find a private space. It’s okay if it’s not ideal every time. We understand new parents who need to be around their baby or little ones, or people with busy schedules are doing their best. It’s helpful if you can have a private space that’s free from distractions [for the most part]. This helps to be present and get the most out of your sessions.
2. Check your tech. Ensure your internet connection and sound is working ahead of time to avoid taking away from your session time once it begins. If possible, silence your phone from distractions.
3. Create a ritual. A felt sense of safety and security can be cultivated. It can be helpful to create a small routine for yourself before and after therapy sessions. Rituals help bring a sense of intention and presence into a session, and unwinding or debriefing after a session as a practice of containment. These can be particularly helpful for heavy, emotional work.
4. Allow transition time. Just as you would commute to an office, give yourself a few minutes before and after to reflect, ground yourself, and integrate what you discussed.
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