Within my practice, I often find that people who suffer with social anxiety are concerned about one or more specific issues. Patients mention a particularly embarrassing moment and want to know what was happening and why.
For example, a woman (let's call her Mary) described to me a time when she attempted to return an item of clothing to a shop. The shop wasn't very busy but when it came to her turn Mary realized she couldn't find the receipt. The assistant was patient but Mary became more and more flustered and felt conscious of people staring at her. The assistant asked when the item was purchased and Mary's mind drew a complete blank. She felt increasingly anxious, mumbled her excuses, grabbed the item and left the shop feeling stupid and humiliated.
Mary wanted to know what had happened.
Usually there is more than one example. Sure enough, during our conversation, Mary was able to give examples of other situations when she ended up feeling annoyed with herself for her perceived inadequacies. Mary's examples were all signs of social anxiety. But the causes of social anxiety are somewhat complex and every case is slightly different. That makes it difficult to answer the question, “why?”
We can generalize, however. Many mental health issues have biological, psychological and social underpinnings. In the case of social anxiety, it is important to understand that other people do not cause the problem, but the things they do can trigger symptoms.
Temperament also seems to be influential. Those more shy and less sociable are more inclined to experience social anxiety. Additionally, there is the fact that some of us appear to have arousal systems that trigger more easily and which result in more intense reactions.
Traumatic childhood experiences such as being bullied and teased can cast a long shadow into adulthood. Some socially anxious people were raised in environments that offered little in the way of social and emotional support.
Adolescence is a difficult time. Defining our identity, discovering our sexuality, learning self-reliance and balancing personal needs with those of others is a challenge some people meet more easily than others are. In some cases, it can seem easier to retreat inwards.
Social issues can be quite complex as they occur and influence our psychology. We learn about social relationships when we are very young. What is acceptable and what isn't, what it means to feel loved and valued, or unloved and rejected.
If judgments were too harsh, too random, or unremitting regardless of the actual circumstances, then people feel vulnerable, inadequate and rejected. We carry these experiences with us as we mature and they help to embed our beliefs and assumptions about what others think of us.
Socially anxious people feel people are passing judgments on them. They assume it is a struggle to meet the standards that other people set. Some find certain situations more problematic than others do. For example, the workplace can be quite difficult for some even if they find other social encounters much easier.
Problems with many possible causes are difficult to disentangle. We do know that our thoughts provide the key to understanding social anxiety. Treatment for social anxiety can be very helpful in understanding the mechanisms that maintain it as well as providing structures for overcoming it.