You want to join in the conversation, laugh, and enjoy yourself. You want people to see you as friendly and outgoing, interested in what they have to say and easy to talk to. But instead . . . you feel like a deer in headlights. You’re overwhelmed and flooded with emotion. Your heart is racing. Your hands are trembling. Your face feels frozen. And the worst part is, you know everyone can see exactly how anxious you are, and they’re wondering what the hell is wrong with you. Does this scenario sound familiar? If this is your typical reaction in social situations, you may be dealing with social anxiety disorder. But what can make social anxiety even more difficult is dealing with it as an empath. A study published on PubMed shows that people with social anxiety are highly sensitive to the emotions of other people. It appears that those who are social anxious are able to discern the mental states of people much more accurately. The study administrators measured the levels of empathy within specific people, and learned that those same people demonstrated high levels of behavior related to social anxiety. It seems ability to feel the emotions and feelings of others can be extremely overwhelming to the point of inducing social anxiety for the average empathic person. If you are around people with toxic emotions, you’ll pick up on that and feel their negative energy, which can make you very anxious. Although not every empathic person has social anxiety, and not everyone with social anxiety is an empath, it’s clear there’s a strong link between the two. If you suffer from social anxiety, you may very well relate to the symptoms of highly sensitive people.  Before I get into more about the disorder, I’d like to begin with some positive news: social anxiety is treatable as an empath or otherwise. You CAN overcome it, and I’ll talk more about how in a minute. As an empath, you may need to learn specific skills to manage your environment, as well as your anxiety disorder. But first, let’s talk more about what social anxiety disorder is and why you might be suffering from it. If you think you have a social anxiety disorder, you definitely aren’t alone. According to WebMD, “An estimated 19.2 million Americans have social anxiety disorder. The disorder most often surfaces in adolescence or early adulthood but can occur at any time, including early childhood. It is more common in women than in men.” It is the second most common anxiety disorder and is the third most common mental disorder in the U.S. Before you diagnose yourself with social anxiety disorder, let me mention that all of us have some degree of social anxiety. We all feel uncomfortable in new situations or speaking in front of big groups. But when this discomfort becomes debilitating and interferes with your daily life, then it becomes a disorder. Like most anxiety disorders, this one exists on a continuum based on your physical and emotional symptoms. The Leibowitz Social Anxiety Scale can help you determine where you fall on the continuum. Why do some of us suffer with social anxiety while others don’t? There are several possible reasons. It is thought to be triggered by abnormal functioning of brain circuits that regulate emotion and the “fight or flight” areas of the brain. Also, there may be a genetic component, as social anxiety may be somewhat more likely to occur when you have a first-degree relative (parent, sibling, or child) who also has social anxiety. There are psychological and environmental reasons for social anxiety as well. Past experiences in which you were humiliated or teased could have contributed to your intense anxiety, or you may have observed someone else being humiliated this way. Having over-protective parents who didn’t allow you to learn proper social skills could be a reason as well. And as mentioned earlier, if you are highly sensitive and empathic, you may develop social anxiety as a result of your intense feelings when around other people. Let’s look at the specific emotional and physical symptoms of social anxiety disorder: The physical symptoms include:

blushingprofuse sweatingtremblingnausea or abdominal distressrapid heartbeatshortness of breathdizziness or lightheadednessheadachefeelings of detachment or loss of control

The emotional symptoms include:

anxiety in social settingshigh levels of fear of being judged or that others will notice your anxietynervousness and worry about being embarrassed or humiliatedrumination about your anxietyfear of being the center of attentionavoidance of doing things or being with people due to anxietyusing drugs or alcohol to manage social anxietyas an empath, you feel overwhelmed and emotional in certain social settings

People with social anxiety tend to arrange their lives around their anxiety. They try to avoid people and situations that trigger their fears or extreme emotions. But when they do attend social gatherings, they worry excessively before the event, and they spend a lot of time afterward mentally reviewing perceived negative social situations and how they believe others evaluated them. Empaths also have to spend time decompressing from all of the intense emotions they experience with certain groups of people. Unfortunately, social anxiety often goes hand in hand with alcohol abuse, depression, and other disorders. So it’s critical to your health and emotional well-being to take action to treat the disorder and learn how to manage the symptoms.

How to Overcome Social Anxiety (as an empath or non-empath)

According to the Social Anxiety Institute, “large-scale, long-range (i.e., longitudinal) studies over the past decade have consistently shown cognitive–behavioral therapy (CBT) to be the only therapy that can be dependably relied upon to help people overcome clinical anxiety disorders.” CBT has been the only type of therapy to permanently alleviate anxiety disorders. CBT basically involves learning to change the way you think about your social anxiety (the cognitive part), as well as learning new behaviors in the situations that trigger your anxiety (the behavioral part). The most important aspect of CBT for social anxiety is to help you approach social situations and stay with them so you eventually learn that nothing really bad will happen to you. Over time, your anxiety will subside. If you are an empath and highly sensitive, you may need to structure CBT in a way teaches you how to select positive people and environments that don’t flood your feelings or overwhelm you. Cognitive behavioral therapy should be conducted with a licensed counselor trained in CBT. Your therapist will work with you in an individual or group setting and will likely assigned homework to practice between sessions. If you believe you are highly sensitive, let your therapist know so that he or she can tailor your therapy to your specific reactions and beliefs. One of the main goals of CBT is to help you identify the irrational beliefs and thought patterns you have about yourself and your social anxiety, and then replace those beliefs with a more realistic perspective. Some of the beliefs and feelings you might work on would include:

misperceptions about your abilities and self-worthguilt, embarrassment, or anger over past situationshaving a lack of assertiveness and confidencereleasing perfectionism and being more realistic about yourselfdealing with avoidance and procrastination related to social anxietyfeelings that you are weird, overly sensitive, or too emotional

As you begin to change your core beliefs about yourself, the way others perceive you, and your feelings about social anxiety, you’ll begin to see an improvement in your anxiety symptoms. Negative Thought Patterns One of the most debilitating problems you encounter with social anxiety is the tendency to have looping negative thinking patterns. You’ve developed these automatic ways of thinking over time, but they aren’t aligned with reality, and they increase your anxiety and lessen your ability to cope. You likely find these negative thoughts occur the moment you think about an anxiety-provoking situation. If you’re an empath, you may assume that every social situation will be overwhelming and painful. Over time your brain has become wired through repetition to have negative, anxious thoughts. It needs to be re-trained to think in a new way through practice and repetition, every day for several months. An effective way of neutralizing negative beliefs is by challenging them. Ask yourself these questions to help you diffuse the power of  your beliefs:

How are your beliefs making you behave?Would you judge someone else who felt like you do in the same way?Are you being fair to yourself?Are you going in for character assassination rather then sticking to what happened on one particular occasion?Are you forgetting that everyone makes mistakes and feels socially uncomfortable at times?Are you ignoring your strengths and focusing on your weaknesses?Are you falling into a biased pattern of thinking?Are you drawing conclusions based upon your childhood or adolescent experiences?Are you judging yourself as you have once been judged?

(Butler, 1999 p174) There are generally more perspectives to a situation than your perceptions and beliefs reveal. By examining your beliefs and challenging them, you’ll begin to see alternative points of view or even how your perceptions might be completely false. As you practice catching yourself in negative thinking patterns, and you neutralize those thoughts, your memory processes will be impacted and the neural pathways in your brain will change. You’ll begin to think, act and feel differently — but this isn’t a one and done solution. It will take persistence, practice, and patience for progress to be made. Changing Your Behaviors Another necessary part of treating social anxiety through CBT is changing your automatic behaviors. Often people with social anxiety develop “safety behaviors” to keep themselves at arm’s distance from uncomfortable situations, or to help them cope with physical reactions to their anxiety. For example, they may avoid certain situations, hang out on the periphery of a social gathering, over-rehearse things to say at a party, or keep their knees locked together so others won’t notice them trembling. Empaths may develop safety behaviors to help them avoid feelings overstimulation and negativity. But even empaths can learn to adapt to certain situations and stretch themselves in order to succeed at work and in social settings. Once you become aware of these “safety behaviors,” you can gently challenge them and stretch yourself to move past them. Try writing down all of your own safety behaviors and think about the ones you might be able to release or alter. However, awareness of your thoughts and behaviors is just the first step toward lasting change. You also need to go further in challenging yourself in order to overcome social anxiety. Exposure Training One of the best ways to do this is through exposure training or systematic desensitization. With exposure training, you gradually expose yourself to the anxiety-provoking situations in small, manageable ways so that over time you don’t feel as much anxiety. This may seem counterintuitive, especially if your main self-management tool was avoiding these situations. However, exposure training is managed by a trained therapist and structured in a gradual step-by-step process so it doesn’t backfire and overwhelm you. At first, you may imagine or role-play a fear-inducing situation with your therapist. Once that becomes easier, you’ll move on to real-world situations. You may also participate in group therapy sessions for social anxiety disorder in which members are asked to speak in front of the group as a way of exposure training. Stefan G. Hofmann, the director of the Social Anxiety Program at Boston University, also works with patients using something called a “social mishap exercise.” In an interview in The Atlantic, Hofmann says, “We expose them to their worst-case scenario. For example, if someone is not engaging in any dating behaviors because they are concerned about being rejected, we would ask them to go to a restaurant and ask every woman at the table for her number. And obviously, he would get rejected a lot, and that’s the purpose of it.” Facing these worst-case situations in such an exaggerated way, with the expectation of rejection, diffuses the power over the feared scenarios. For an empath, first determine the situations you want to include in your life based on your highly sensitive nature. There are work and social environments better suited to your natural personality. You may never enjoy being in a huge crowd or sitting in meeting full of aggressive people. But you can lessen your discomfort when you do encounter these situations. Success with CBT Research on CBT suggests there are several keys to success in treating social anxiety — including your own expectations about success. Also, you must be willing to complete homework assignments, participate in your therapy sessions, and be willing to confront uncomfortable thoughts and behaviors. If you are willing to work hard and believe that CBT will help you, you are far more likely to improve. Fortunately, the improvement shown with CBT tends to be long-lasting and well worth the effort invested. As a highly sensitive person, you’ll have a bit more work to do, as you’ll need to develop coping strategies for your intense feelings beyond those related to social anxiety. But please don’t use your empathic nature as a reason to isolate yourself or remain anxious. Treat the anxiety, and work to find people and environments that are calm, supportive, peaceful, and low stress. The combination of the right therapy and the right environments can be the road to recovery for you. Other Treatments Social anxiety can be treated with anti-anxiety and antidepressant medications alone or in combination with therapy. Relaxation techniques such as meditation, yoga, guided imagery, and visualization can support the work you do with your therapist. Hypnotherapy also has been used to treat social anxiety. Regular exercise, healthy food, and good sleep also help reduce stress and anxiety in general. Don’t allow social anxiety to derail your relationships and prevent you from enjoying an active, fun social life as an empath or non-empath. Find a therapist who specializes in CBT and one who understands highly sensitive people. Do the work to change your perceptions about yourself and how others see you and manage your interactions and environments based on your natural personality. The only way to change is through action, so take action now so you can become the confident, social person you want to be.