Therapy for social anxiety

The dread starts days before. You rehearse what you will say, plan an exit, work out who else will be there. During it, you are only half in the room — the other half is watching yourself from the outside, checking whether you are going red, whether that was too much, whether the pause was too long.

Afterwards comes the post-mortem. You replay it in detail, find the moment you got it wrong, and carry that around for days. Other people describe the same event as perfectly ordinary. You do not believe them.

So the world narrows. You stop putting your hand up, avoid the phone, decline the invitation, take the job that involves less contact. From outside it can look like shyness or aloofness. From inside it is exhausting, and it is treatable.

It rarely stays social for long. Careers stall because you will not speak in the meeting or apply for the role that involves presenting. Friendships thin out, because declining is easier each time than explaining. And the loneliness that follows gets read as more evidence that there is something wrong with you, rather than as the predictable result of avoiding people.

We begin with one or two assessment sessions, then build your personal model of what keeps the anxiety going. A typical course runs 12–16 weekly sessions of 50 minutes. Nothing is thrown at you: every experiment is designed with you first, and you always know what we are testing and why.

The video work usually comes in the first few weeks and is worth flagging in advance, because most people dread it and most people describe it afterwards as the moment something shifted. Seeing yourself as you actually appeared, rather than as you felt, does more in ten minutes than weeks of reassurance.

Online sessions work well here, and starting from your own home is often easier than a waiting room; I work online across the UK and worldwide, and in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge. If you would find a first phone call hard, you are welcome to send a written enquiry instead.

Is this just shyness? Shyness is a temperament. Social anxiety is a condition that shrinks your life — turning down opportunities, avoiding people you like, choosing work below what you can do. If it is costing you things, it is worth treating.

Will you make me do something embarrassing? No. Experiments are planned together, you agree to each one in advance, and we start well within what you can manage. The point is information, not endurance.

I have relied on alcohol to get through social events. Can I still come? Yes, and please say so — it is common and it is worth being honest about. We would look at it as one of the safety behaviours, and I will tell you plainly if I think you need specialist alcohol support alongside.

Can therapy help with performance or presentation anxiety? Yes. Public speaking and presenting respond well to the same model, and are often where people notice the change first.

How long before I notice a difference? Most people notice something within the first four to six weeks, usually once the safety behaviours start coming down. The bigger changes — applying for the job, going to the thing — tend to come in the second half of the work.

Does group therapy work better for this? Groups can be helpful and they are not necessary. The evidence for individual CBT based on the cognitive model is very strong, and individual work lets us build your particular model in detail and design experiments around the situations that actually matter to you — your team meeting, your family, your phone calls. If a group would suit you better at some point, or alongside, I will say so. Starting individually is also simply easier when the problem is other people watching you.

Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.