Thank you Susanne for replying. Now that I am more calm from the medications, I am having less problems with the blushing. I feel more confident. There are a few other things on that list you gave that also will come in handy to work on slowly. I hate to talk on the phone also, so does my sister. There are many aspects to this problem. I agree the intrusive thought aspect is a big one. I believe that through all the therapy I've had, I have been able to conquer some of these things, but some of them persist. They are deeply ingrained. Once again, thank you for the ideas...it is so hard for me to communicate with others, and so although I am living in a foreign country and cannot always speak to people, or know how to do small talk (which has always been a problem, also pointed out to me by others)...it actually is easier for me to live here, because I am not expected to speak much. On the other hand, I can just crawl into my shell more, which is probably not a good thing. That's why this site is important!

Exposure for social phobia/social anxiety is actually a lot like exposure for panic and agoraphobia. You have to make a list of situations that you currently fear and/or avoid and then gradually expose yourself to those situations. The key, as always is to plan your exposures on advance, and try to select reasonable and reachable goals. Common feared and/or avoided situations in social phobia include: doing things in public (eating, drinking, working, speaking) talking to strangers asking for directions asking questions in class or ina meeting making small talk going to parties going on a date questioning an authority figure answering the phone making eye contact using public washrooms talking about yourself going to the gym joining a club working in small groups telling people about yourself saying "good morning" to people Blushing is a bit tricky for sure partly because the goal of talking to someone without blushing is not a realistic goal for a blusher. The goal should be to talk to the person and perhaps blush, but not to be overcome with anxiety about the blushing. Youi cannot control blushing. However, you can control the catastrophizing about the blushing. The only way to ever possibly acheive the goal of not blushing is to do exposure work to blushing. In terms of thinking, blushers need to challenge their fears about what other people are thinking, i.e. they will notice (will 1000% of peopel notie 100% of the time?) they will care enough to think about it (will 100% of the people bother to think about your blushing 100% of the time?) they will think I am weird, strange, weak, a coward...(will 100% of people be that cruel and judgemental 100% of the time? If somebody is that cruel or judgemental, do you have the problem or do they have the problem? If that is all they notice about you, is there something wrong with them? What if they think that you are a bit shy? So what? What would be so bad about that?) Blushers have to challenge their other anxious thoughts as well. I'll get so worried about my blushing I won't be able to talk...or make the right impression (is that 100% true 100% of the time? What if you were just blushing and not freaking out about it? What if you were ale to say "I blush, so

Thank you Danielle; you understand my dilemma. It is a little difficult to sit down and face a list of the most comfortable situations to the most awkward; but I guess that is the main idea. There could be so many, but I think I will focus on one for starters. I know, if I try to force myself not to panic, I will anyway. At times, the panic feeling has stayed for hours on end. It sounds like you are working on the same things. Thank you for the idea. Tell me your success stories as they happen! I will be waiting for your comments and encouraged by your example!

Redface, yes, that makes perfect sense. I tried exposure therapy without meds for years and suffered terribly. I did the things I had 'planned' but I never got to the point of them not bothering me because I couldn't cope with the symptoms. This time, I am doing it differently. I am going to use the medication as a tool to help me GRADUALLY, bit by bit, master my fears. Also, dealing with social phobia is definitely different than let's say, working with a fear of animals. I do have a suggestion, one that I use for my most difficult fears...visualization! It is so helpful. Visualize yourself in the most comfortable up to the most awkward situations and make your hierarchy in your head. It is very powerful. And most importantly, be gentle with yourself. The more you try to FORCE yourself not to panic or feel very uncomfortable, the more attention you give to the feelings, and the longer it will stay. Peace out, Danielle

Yes, I was one of those who wrote to Suzanne about setting exposure planning. I have printed out the sheets and every day I look at the examples of setting goals; such as wanting to be able to pet a dog...etc., but I too am having trouble setting goals for social phobia. I wrote down, 1. "I want to be able to talk to this particular person I see about twice a week and have a conversation without blushing." 2. But looking at pictures of that person is not going to be too helpful, I believe; but I can try doing it anyway if that's what it requires. 3. I can stand around in the room and watch the person go by, however, I'm sure he will notice I'm watching him, so; is that helpful? 4. Being in the same room with this person may be a good exposure treatment, say, if we were to invite him and his wife over to our home or something; but I am afraid this would be close to a 10 on the richter scale. 5. Touching that person sometimes brings on panic, however, sometimes it does not, like shaking hands... 6. Touching some other person is not likely to help in this situation. 7. Perhaps attempting to have discussions with this person at every opportunity may be a good exposure plan...not sure what to talk about. 8. Lately, for the past week or so, my doctor has doubled my anti-anxiety medications, because I told him I was still panicking, and this has helped a lot! Now I am able to have a short discussion with this person without falling apart. SO I believe the medication is what is helping me now. Exposure is now possible, because I am calm enough to do it. As for the exposure worksheet plans, movies about certain people are not available; I do know that my anxious thoughts are not true; such as I will not need to be afraid of having an affair with this person, as we are both too panicky for that ever to happen. Also, I have learned that if that is the worst possible senario for both of us it will never happen. I know it has never happened in the past, when I had panic attacks around other men. The duration of the exposure can only be limited, unless we invite the people I panic around over to our house to get better acquainted. So far, exposure has only been for about 5 minutes at a time. And some times I have spent two hours in co

Ooops...sorry Susanne, I have no idea where in heck I got Shannon from? hehe. Danielle :-)

Hi Melanie and Shannon, I am at this exact point myself. I basically have made a list of things I would LOVE/HATE to do (as a panic attack/agoraphobia sufferer) but couldn't EVER imagine myself being able to do and go from there. For example...one thing I can't imagine myself ever being able to handle is travel in a foreign country or getting trapped in an elevator. Those are 10's for me! Then, I imagine more everday things that I WANT to do, but don't because they are too difficult, like travel within my own province/country or taking a bus (train), getting dropped off somewhere with no car available. They are more like 8's on the fear scale. Then, I make a third list of things that I do because I have to, but are very uncomfortable because I often have PA's doing them, like shopping in a busy store, driving a busy highway. Now, I have a starting point. I have some 6's, 8's, and 10's to start working with. Then, I choose the one that I think I can be successful at, like going to a busy mall, and break it up into little tiny pieces...baby steps is the key. Anyhow, this is my plan. I may never get to my 10's but I intend to give it my best. If I can systematically rid myself of lower level fears, why not the 10's. It's just one more moment of panic to deal with..moment by moment. Hope this helps. Danielle :-)

Susanne and I are having many e-mails that are asking us how to start Exposure Therapy. An individual e-mailed us the following: "I have been trying to start exposure therapy and can not find a way begin. I have had panic and anxiety since I was 17 (now 34). I really need some help from someone who had been where I am today. My fears are going out in public and facing crowds. I am fine in the grocery store, but when there are long line ups I get all flushed and I feel like I am going to stop breathing. Can anyone help?" Can anyone relate to this individual? If so, can you please post and let him now that he is not alone! Thanks, Melanie and Susanne