Social anxiety

Social anxiety or shyness: the difference

Shyness is a trait. It makes opening up slower, but it doesn't stop you doing things.

Social anxiety is something else. It isn't difficulty talking to strangers; it's the advance certainty of being judged badly — and what you do to prevent that happening.

The practical difference is avoidance. A shy person at a dinner says little. Someone with social anxiety doesn't go to that dinner, or goes and spends the evening monitoring how it's going.

Fear of judgement, and what maintains it

The central mechanism is attention turned the wrong way round.

In social situations attention should sit outside: on the other person, on the conversation, on what's happening. In social anxiety it moves inward: how am I coming across, am I going red, am I sweating, is my voice shaking, did I just say something stupid.

That produces two effects at once. The first is that you miss half the conversation, because part of your attention is engaged elsewhere. The second is that the information you judge your own performance on doesn't come from outside — it comes from how you felt inside.

That's why the verdict is almost always harsher than reality: you're judging your own anxiety, not what anyone actually saw.

The post-mortem

Many people describe the worst part not as the situation but as the hours afterwards.

You go back over the conversation looking for mistakes. You isolate one sentence and reread it dozens of times. You imagine what they must have thought. And each pass makes the memory more negative than the event was.

This review looks useful — it resembles learning from mistakes. It isn't: it consolidates a version of events assembled from inside the anxiety.

Performance anxiety and fear of public speaking

One frequent form concentrates on specific situations: speaking in public, a meeting, an exam, a presentation.

Here the structure is even more explicit: there's a performance, an audience, a judgement. The body responds as it would to a threat, and the signals of that response — shaking voice, flushing, sweating — become reasons for fear in themselves, because they might be seen.

From there comes the attempt to control them, which increases them.

The safety behaviours that make it worse

They aren't always outright avoidance. More often they're fine strategies, invisible from outside.

Rehearsing sentences before saying them. Speaking little to avoid errors. A drink beforehand to loosen up. Holding your phone as an escape route. Staying near someone you know. Avoiding eye contact.

Each reduces anxiety in the moment. Together they prevent the one thing that would genuinely reduce it: discovering that without them nothing would have happened.

Social anxiety therapy in English in Milan and Monza

I'm an Italian psychologist and psychotherapist, registered with the Order of Psychologists of Lombardy, working in English and Italian, in two practices in Milan, in Monza, in Cernusco sul Naviglio, and online.

Social anxiety behaves differently in a second language, and that's worth naming. Speaking a language you're less fluent in gives the monitoring something real to hold onto — an accent, a missing word, a slower reply — and it becomes very hard to tell apart what's anxiety and what's genuinely a language gap. Working in English removes that variable from the room, at least for the hour.

The first session is about which situations it appears in, what exactly you fear will happen, and what you do to prevent it — that third part is usually the least visible to the person doing it.

Then the work concerns three things: moving attention from inside to outside, gradually reducing the safety behaviours, and testing against reality the predictions that feel like certainties.

When it makes sense to ask for help

— Am I giving up things I'd like to do to avoid those situations?

— Do I spend the hours afterwards going back over what I said?

— Are there strategies I always use, without which I wouldn't go?

— Am I choosing work, or friendships, around this?