The Socially Anxious: Part Two

This is a continuation of an article earlier this week, Socially Anxious Humanity. Please note: the following includes advice and recommendations based on clinical research. Only you and your health care provider can make appropriate decisions for your own care.

A man parks his car outside a bar. Inside are a couple of his close friends and a few of their friends, with whom he is only an acquaintance. Like clockwork, he projects his thoughts into the near future and becomes nervous about what could go wrong. His stomach churns and his face contorts slightly to reflect it. As he walks to the entrance his symptoms worsen. His palms get clammy, his heart races. His subconscious is kicking and screaming, urging him to turn around and text his friends “something came up.” His stress response seems to have shot upward too fast to control.

Those readers who are familiar with the struggle to control their composure in the face of social interaction will be pleased to know that their ability to do so can be practiced and improved. The reigns to our emotional state exist simultaneously in our heads and in our bodies. In a cyclical manner, stress must be curtailed to calm the body, to calm the mind, to calm the body, to calm…etc.

Stale wisdom has most of us thinking that we experience emotions consciously before our bodies react. We see a beautiful person, then feel attraction, then our hearts quicken. Contrary to this model is the modern theory of emotion, seen by most as having more scientific potential than the traditional model. It advances the possibility that the order of an emotional response goes like this: (1) stimulus (we sense something), (2) sub-conscious analysis (our brains are interpreting the data before we have any feeling about it), (3) autonomic response (the brain informs the body of an “appropriate” course of action), and (4) conscious arousal (we feel an emotion) (Lang, 2014). Starkly supporting this model, individuals with an impaired autonomic nervous system experience emotions differently, as seen by fMRI (Critchley et al, 2005). An example of the modern theory would be if you find yourself in front of a wild bear, insulin will probably course through your veins before you know that your life is in danger and you are unhappy about it.

So while the scientists are solving the chicken-or-egg problem of emotion, our best recourse is to act on both fronts. One of the most effective forms of psychotherapy for social anxiety is “exposure therapy” (Hofmann et al, 2006). There are countless studies which follow the exposure pattern and produce the same resounding results. They are structured such that the physical stress response is dampened with a drug before the individual is exposed to repeated social interaction. After this stage, the individual is taken off the drug and observed in unaided social interaction. The predominant outcome is significantly less social anxiety (Hofmann et al, 2006). The technique hinges on extinction learning, which is a psychologist’s term for learning to respond less severely to a particular stimulus (socializing) after the stimulus is present without the typical negative reinforcement (anxiety). When you stop getting the proverbial slap on the wrist of social anxiety symptoms every time you socialize, you unlearn the fear of socialization.

The self-helper can do this without pharmaceutical drugs. A review of 24 studies involving 2,619 participants concludes unequivocally that using nutritional and herbal supplements to curb anxiety is both an effective and safe method for treating anxiety disorders (Lakhan, 2010). From this same study, the most effective supplements were found to be:

  • extract of kava
  • combinations of L-lysine and L-arginine
  • magnesium

Others which have endured an anxiolytic (anti-anxiety) reputation are:

  • ashwagandha extract
  • niacin/niacinimide
  • L-theanine
  • rhodiola rosea

To conduct your own exposure therapy, read about these compounds and decide on one to try. Be careful combining two or more—research any possibility they may interfere with each other and cause problems. It’s rare among herbs but not unfounded. After a few “fortified” socializations, try it again without the help.

On the mental side, you might be able to trick yourself into feeling more confident and at ease. Harvard professor Amy Cuddy ran experiments designed to test the impact of faking confidence on actual confidence by having subjects pose in a powerful position for two minutes. She found that after the powerful pose (sprawled out, arms behind head, sitting tall), people were much more likely to gamble than those who had just posed powerlessly (hunched, head down, arms in). Next time you’re feeling anxious, try tweaking your posture.

A purely mental trick is to reverse the direction of your mind’s eye. People with social phobia tend to get lost in their own thoughts, focusing too much on piecing together a narrative of their own performance. This habit of self-seeing and self-judgment can be drowned out by diverting the brain’s processing power toward other tasks, specifically the external world. Observe the room, the people, try and recall names and life details. Ask questions, get somewhere in the conversation so that your curiosity is aroused. Any time your attention falls back inward, force it out again (eventually you’ll discover the healthy balance between introspection and extrospection).

If you’re having trouble getting out there in order to practice the above, consider joining a club or sport team with structured meetings and a focus which is not purely social.

Over time, either by the methods explained here or some other means (mindfulness/meditation), you should strive for lasting, effortless comfort in social situations. It can be done. The brain rewires itself every time you condition it, many times a second. The rub is in arriving at a hospitable brain-state. Staying there is much easier, because it is self-rewarding and self-reinforcing. While there is excellent advice in this article, only you and your healthcare professional can make decisions about your treatment.

This is a continuation of a piece earlier this week, Socially Anxious Humanity.


1. Critchley, Hugo; Dolan, Raymond; Mathias, Christopher; Nicotra, Alessia. “Emotional and autonomic consequences of spinal cord injury explored using functional brain imaging.” Brain: A Journal of Neurology. Dec 2005, 718-728.

2. Hofmann SG, Meuret AE, Smits JJ, et al. “Augmentation of Exposure Therapy With D-Cycloserine for Social Anxiety Disorder.” Arch Gen Psychiatry. 2006;63(3):298-304. doi:10.1001/archpsyc.63.3.298.

3. Lakhan SE, Vieira KF. “Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review.” Nutrition Journal. 2010; 9: 42. PMCID: PMC2959081

4. Lang, Peter. “Emotion’s Response Patterns: The Brain and the Autonomic Nervous System.” Emotion Review. Apr 2014 vol. 6 no. 2 93-99.

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