Before going to a social event, Jamie Pavljuk never used to feel well.
“The physical feelings [ranged] from butterflies in my stomach to feeling like I was about to throw up,” the 23 year-old retail assistant says.
Before leaving the house, Jamie’s mind would race and she began worrying about the “worst possible scenarios”.
Often, her anxiety would build to a level where the only way she could get relief was to cancel her plans.
Jamie is far from the only person to suffer from social anxiety.
According to Better Health Channel, up to 13 per cent of the population may develop this condition during their lifetime.
In fact, social anxiety disorder (SAD) is one of the most common anxiety disorders, says Melbourne-based Clinical Psychologist Dr Lillian Nejad, author of Treating Stress and Anxiety: A Practitioner’s Guide to Evidence-Based Approaches.
While prevalence rates for the disorder have been fairly stable, Dr Nejad says it may seem more common now, as people are more willing to talk about this issue and seek treatment.
The current gold standard first line psychological treatment for social anxiety disorder is cognitive behavioural therapy (CBT).
However, Dr Nejad notes that around one third of people will not respond to CBT and therefore require an alternative psychological treatment.
One emerging alternative is acceptance and commitment therapy, ACT.
Dr Nejad explains that CBT is both cognitive and behavioural, focusing on challenging and modifying unhelpful thoughts and exposing yourself to feared situations.
Meanwhile, ACT focuses on accepting your thoughts, feelings and experiences, while committing to ways to improve your life.
Acceptance of anxiety is “absolutely necessary” within all treatment frameworks.
“The reality is that everyone feels socially anxious. Therefore, normalising the experience of anxiety in the face of new experiences and social situations is very important.”
Instead of viewing anxiety as a “scary emotion that must be avoided at all costs,” accepting it reduces associated fear and lessens your physical response.
A new study has tapped into the need for acceptance of social anxiety in managing the condition.
The study, published in the International Journal of Behavioural Consultation and Therapy involved an eight-point checklist to both assess people’s level of social anxiety and measure their acceptance of the condition.
Statements such as, “I disapprove of myself when I feel socially anxious” and, “I make judgements about whether my thoughts about social anxiety are good or bad” are rated on a scale of one (never true) to seven (always true).
Low ratings indicate lower acceptance of the condition.
“Acceptance of social anxiety symptoms appears to be an important predictor of who may experience greater distress related to socially relevant contexts beyond that of social anxiety alone,” the authors write.
“This has direct implications for how the treatment of social anxiety may be approached differently.”
With acceptance-based strategies, people’s scores should hopefully improve over time.
Dr Nejad agrees that a higher score may indicate a less judgemental stance toward anxiety, which may improve your response to treatment.
So if you’re suffering from social anxiety are you better off switching from CBT to ACT?
Not necessarily, says Dr Nejad, who affirms that CBT remains the first line treatment for this condition.
Instead, she incorporates mindfulness and acceptance practices within the CBT framework.
However, she says if you don’t respond to traditional cognitive therapy, an emphasis on acceptance can be particularly helpful.
Instead of pondering which treatment modality may work best for you, Dr Nejad recommends seeking the help of a qualified professional who can work with you to guide you best.
That’s what Jamie did.
Seeing a psychologist has helped her manage her anxiety. But that doesn’t mean her social anxiety is ‘cured’.
“Although I’ve learnt to cope with it most of the time, there are still days… every now and then, where it’s hard to get out of bed and I just want to be alone and I reschedule all of my plans.”
That’s normal, says Dr Nejad, who says the aim of treating social anxiety is not to rid yourself of unpleasant feelings altogether.
“Instead, it’s to tolerate a certain level of discomfort and distress and still be able to live your life without using avoidance as your go-to strategy.”