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Social anxiety: how to deal with the elephant in the room
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© 2025 IamExpat Media B.V.
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Melania Zampieri
I am a licensed psychologist and support internationals living in the Netherlands. I run my private practice in Utrecht, in Amsterdam and on Skype both for English and Italian speakers who are experiencing emotional distress or some degree of confusion. I can help, for example, while integrating in a new country, dealing with stressful life changes, problematic relationship dynamics, emotional distress, conflict management at home or at work, burnout/work-stress, feelings of anxiety, depression and insecurity. I offer my clients guidance to find what they are searching for and to give them back the perspective they feel they have lost. I am also one of the founders and psychologists at ExpatCare4U. I am also certified with the Italian Order of Psychologist and I am continuously expanding my knowledge following different workshops and specialization courses such as further develop. In the Netherlands I am member of the Nederlandse Federatie Gezongheidszorg. Read more

Social anxiety: how to deal with the elephant in the room

Oct 29, 2015

Our mind never rests. You can also think of it this way: listening to everything that is going on inside your head - memories, worries, plans, dreams and judgments - is draining and can often lead to anxiety.

It goes without saying that this stress can interfere with how we live in the present and how we build our future.

Living with anxiety

Nowadays there seem to be many more people struggling with some degree of anxiety and trying to handle the burden of experiencing a decreased quality of life.

As a psychologist I meet people on a daily basis who seek help to find a way of coping. They experience such an unbearable load of thoughts and emotions that it impacts their ability to take decisions, handle relationships and live with a sense of satisfaction.

Thought overload

Although anxiety feels like it can happen instantly, it is in fact the culmination of thoughts and emotions that have already been occurring subconsciously for a longer time.

What you are in fact experiencing is what they call an "amygdala hijack": an impulsive emotional state activated by our brain being overloaded with thoughts related to real or perceived dangers.

This leads to an inability to rationally analyse the situation and react in a constructive way.

Millions affected

Research shows that social anxiety affects millions of people - men and women in equal fashion - and can develop at any stage in life.

Experiencing some degree of anxiety in a social context is more common than we can imagine.

For some, however, such a state becomes so unbearable and constant that they prefer to avoid social situations, even if this may damage important areas in their lives.

In more extreme situations it can be accompanied by other anxiety disorders or even by depression.

Before zooming in on social anxiety, let’s shed some light on the different types of anxiety.

The facets of anxiety

It’s important to mention that there are several types of anxiety, each requiring different types of specialised treatments. These are few of the most common types of anxiety disorders:

› Generalised anxiety disorder (GAD)

The most widespread type of anxiety. An ongoing state of mental and/or physical tension, without a specific cause or without a break from this state.

› Panic disorder

Severe feelings of catastrophe, disaster, or even death, that cause intense mental and physical symptoms.

› Agoraphobia

Either the fear of open spaces or the fear of being in unfamiliar places.

› Specific phobias

Intense fears such as of objects, animals, situations and in general that a disaster may occur.

› Post-traumatic stress disorder (PTSD)

This affects individuals after they experienced a traumatic event - either physically or emotionally.

› Social anxiety disorder

An irrational fear of being scrutinised and judged in social or performance situations.

Back to social anxiety, how does it work?

It starts with memory. In the very moment you perceive that the anxiety is triggered, you are actually (even out of awareness) recalling previous negative experiences.

At this very moment, these memories activate old feelings that you felt back in time - such as fear - and your body starts reacting accordingly (with sweat, localised pain, irregular breathing, accelerated heart beat and suchlike).

That’s it! The "What if?" questioning begins to overwhelm your thoughts. "What if I start stuttering? What if everybody notices that I’m insecure? What if they think that I’m making no sense?"

Many of these thoughts may not even reach your awareness and actually happen irrationally and out of your control.

What’s happening now is that you are being anxious about your anxiety. You are there, in front of people staring at you. They all have poker faces waiting for you to say something and all you can think of is that your body and your thoughts are out of control.

To make it worse, you don’t even really know why you are anxious - because rationally you know it’s all in your mind, that most people around you won’t even notice what’s happening inside you.

Some techniques for when social anxiety strikes

Although it’s always advisable to seek the advice of a mental health professional if you suspect your anxiety goes beyond a tolerable level, there are some techniques to regain your balance when experiencing anxiety in social situations.

› Breathe and talk slowly

You need to consciously slow down and reduce your breathing, try to take deeper breaths.

› Focus on the here-and-now

You are focusing too much on how you feel, your worries about what could happen or how you might come across. Train your attention and focus, for example on something, even an object in the room, that has no emotional value.

› Find a mantra

Make up an empowering motto for yourself and repeat it in your mind like a mantra. It will make you feel better. For example, "My anxiety does not control me. I control it!"

Working towards a lasting change

In the long run, you should take some time to understand what your emotions are trying to tell you. Your emotions are the mirror of your needs.

Therefore if you feel anxious, there is probably a need that you are not fulfilling. Try to keep a question checklist:
› Is there a realistic reason to believe something is wrong?
› What is the evidence that something is wrong?
› Is there a chance that you are blowing this out of proportion?

Above all, increase your tolerance to uncertainties. Trying to increase certainty decreases tolerance of uncertainty and only serves to increase worry. Increasing your tolerance to uncertainty, on the other hand, will help to decrease your worries.

First, you will need to identify your personal reactions to uncertainty. Make a list and then choose to perform certain actions that will help you to gradually increase your tolerance of uncertainty.

This is called exposure to uncertainty. One last tip: begin with actions that are not too difficult for you to perform.

You can overcome anxiety

Whether you find a solution by yourself, or you seek the assistance of a health professional, you can definitely lessen your anxiety. However it will take time and effort.

Most important is that you recognise that you have a problem and are prepared to do something about it. Once you have acknowledged these factors then you have already made the first step in working through your anxiety.

By Melania Zampieri