The Shyness & Social Anxiety Workbook
144are fearful of experiencing particular feelings (for instance, sweating, shaking, blushing,
racing heart) associated with being anxious or nervous. If you are not fearful of these
behaviors, then the strategies described in chapter 9 will not be as important.
BEHAVIORS THAT CONTRIBUTE TO
SOCIAL ANXIETY
All organisms try to avoid situations that cause fear, pain, or discomfort. Avoidance is a
method of protecting oneself from possible danger. In the short term, staying away from
perceived threats is a very effective way of decreasing or preventing these uncomfort -
able feelings. Your experience has probably taught you that confronting feared situations
causes you to feel overwhelmed and that avoiding or escaping from feared situations
leads to a sense of relief. However, avoiding the situations, objects, and feelings that
make you anxious is also a guaranteed way to ensure that your fear will continue over the
long term. The likelihood of threat in the social situations that you avoid is probably very
low. Avoidance can actually do more harm than good, particularly in the long term.
By avoiding the situations that make you uncomfortable, it may seem as though you
prevent your feared negative consequences from occurring. Just as a person who fears
ﬂying may believe that avoiding a ﬂight has protected him or her from experiencing
a possible plane crash, you may believe that avoiding social or performance situations
protects you from experiencing various social catastrophes, such as being humiliated or
criticized by others. Of course, statistically, the risk of dying in a plane crash is close
to zero (about one in ten million, according to some sources). In other words, the risk


of being in a plane crash is almost identical (close to zero) whether you ﬂy or not! The
same may be said of public speaking, attending parties, and other social situations. The
risk of actual threat or danger is signiﬁcantly less than socially anxious individuals usually
assume. In fact, the long-term consequences of avoiding social situations are often far
greater than the risks of confronting these situations.
Exposure to feared situations and feelings is a very powerful method of learning that
avoidance is neither necessary nor helpful in the long run. By confronting your fears, you
will discover that many of your anxiety-provoking beliefs and interpretations are untrue
or exaggerated. In addition, your interpersonal skills will improve as you will have more
opportunities to practice various types of social interaction and performance. In other
words, not only will you become more comfortable making small talk, giving speeches,
or dealing with conﬂict situations, you will also become more effective and competent
at mastering these challenging situations.
There are three main types of anxious behaviors that we will review here. Each of
these is a potentially harmful habit because it prevents your fear from decreasing over
the long term. These behaviors include (1) avoiding feared social and performance situa -
tions, (2) avoiding feared sensations and feelings, and (3) subtle avoidance strategies and
safety behaviors.


Confronting Your Fears Through Exposure
145Avoidance of Social Situations
Avoiding social situations such as public speaking, making conversation, attending
meetings, dating, and working out at the gym prevents you from learning that these
situations are safe and that your fears are generally unwarranted. Escaping early from
these situations (for instance, leaving a party after a few minutes) can also have a nega -
tive impact on your fear by reinforcing your experience that being in the situation makes
you uncomfortable, and leaving the situation provides relief and a reduction in fear. In
reality, staying in a situation despite the fear that it arouses also leads to a reduction in
fear. Fear may take longer to decrease when you stay in the situation, but the long-term
beneﬁts will be greater. By staying until your fear decreases, you will learn that you can
be right in the middle of the situation and feel relatively comfortable. Strategies for
overcoming avoidance of feared situations are discussed throughout this chapter, as well
as in chapter 8.
Avoidance of Feared Sensations
As we discussed previously, in addition to avoiding certain situations, you may also
avoid feeling certain sensations or feelings, particularly in social situations. Perhaps you
avoid eating hot foods that cause you to feel ﬂushed when you’re dining with friends or
relatives. Alternatively, you may avoid wearing warm clothes while speaking in public, in
case they cause you to sweat. Avoiding sensations such as sweating and blushing reinforces
your beliefs that these sensations and feelings are dangerous. If you are fearful of expe -
riencing particular symptoms in the presence of others, you will likely ﬁnd that exposing
yourself to these feelings can help you to become more comfortable with them. The goal


yourself to these feelings can help you to become more comfortable with them. The goal
is to reach a point at which sensations, like shaking or a racing heartbeat, are, at worst,
mildly uncomfortable but not frightening. The general principles discussed throughout
this chapter will be relevant to overcoming your fear of physical symptoms. However,
speciﬁc exercises for overcoming these fears are discussed more thoroughly in chapter 9.
Subtle Avoidance Strategies and Safety Behaviors
Subtle avoidance behaviors (also called safety behaviors ) are not-so-obvious strate -
gies that people often use to cope with anxiety-provoking situations. Unlike completely
avoiding a feared situation, subtle avoidance strategies involve partial avoidance of the
situation. Often these behaviors are not noticeable to others. In fact, they may be so
subtle that even you are not aware of them. As is the case with more obvious types of
avoidance, learning to let go of your subtle forms of escape will help you to overcome
your fear, just as removing training wheels is an important step in learning to ride a
bicycle, and letting go of crutches is an important step in relearning to walk after an
injury. We will now discuss some examples of subtle avoidance strategies.


The Shyness & Social Anxiety Workbook
146Distraction.  Distraction involves escaping from anxious thoughts and feelings by focus -
ing on thoughts or images that are more pleasant or by keeping yourself busy with
distracting activities. For example, while attending a party, you might offer to help serve
food or drinks so that you are constantly busy with some activity and your mind is dis -
tracted from the anxious feelings that you might otherwise be experiencing. Or, while
traveling on a bus or train, you might always be sure to bring a book or portable radio
to distract yourself from feeling anxious about making eye contact with others or from
thinking about what others might be thinking about you. Such distractions may help you
to feel comfortable while in social or performance situations, but in the long term they
prevent you from learning that you can manage the situation without having to rely on
subtle avoidance.
Overprotective behaviors. Overprotective behaviors are small things that you may do
to feel safer in the situations that you fear. Examples may include the following:
UÊWearing extra makeup or a turtleneck sweater to hide blushing
UÊFinding out who else will be at a party before deciding whether to attend
UÊWearing gloves to hide shaking hands
UÊSitting down or leaning against a podium while giving a presentation
UÊEating in a dimly lit restaurant so your date won’t notice your anxiety
UÊWearing sunglasses to help avoid making eye contact
UÊAlways attending social events with a friend so you can avoid talking to
people who you don’t know well
When designing exposure practices, it is important that you also try to eliminate
these subtle safety behaviors.
Overcompensating for perceived deﬁcits. Overcompensating involves working extra


hard to make sure that your fearful predictions don’t come true. For example, if you
are afraid of looking foolish during a presentation, you may spend days rehearsing and
memorizing what you will say. If you’re fearful of making small talk, you may spend
hours preparing topics of conversation and rehearsing what you might talk about. If
you are afraid of looking unattractive, you may put too much effort into ﬁxing your
hair, choosing your clothes, or building your muscles at the gym. In many cases, these
situations might be managed with less effort, leaving time and energy for other things.
Exposure practices should be designed to eliminate any tendencies to overprepare or
overcompensate for ﬂaws that may not even be present. For example, instead of spend -
ing hours memorizing a presentation, try giving your talk with only minimal (but still
adequate) preparation.


Confronting Your Fears Through Exposure
147Excessive checking and reassurance seeking. Excessive checking involves spending too
much time and effort trying to ﬁnd out whether you are perceived by others in a positive
light. We all engage in occasional checking (for example, looking in the mirror at a party,
asking a coworker whether she enjoyed your presentation). In fact, we recommend that
you occasionally continue to check on other people’s reactions to you and your actions.
Checking and receiving reassurance are helpful ways of testing out your beliefs. However,
if you ask for reassurance or check too frequently, this may be a behavior you want to
decrease. The key is moderation. Occasional checking is helpful, but constant checking
can be a problem. Constantly obtaining reassurance about your performance is like con -
stantly checking with your doctor whenever you experience an unusual sensation. Never
going to the doctor may cause you serious health problems that might otherwise have
been detected early or prevented. But going to the doctor several times a week to check
out every ache and pain can backﬁre; your doctor may stop taking your concerns and
complaints seriously. Constant requests for reassurance can also backﬁre, having the exact
effect that you are trying to avoid—namely a negative response from others.
Substance use. Substance use can undermine the effects of exposure by artiﬁcially low -
ering your level of fear in social and performance situations. For exposure to be effec -
tive, it’s important for you to experience some degree of fear. It is also important for
you to learn that your fear will usually decrease naturally if you stay in the situation.
Drinking alcohol or using other drugs whenever you are in a situation that makes you


Drinking alcohol or using other drugs whenever you are in a situation that makes you
anxious will prevent you from learning that your anxiety will decrease even without the
drug or alcohol. When designing exposure practices, we recommend that you not drink
alcohol or use drugs during the practice. If you want to have a glass of wine or a beer at
a party, try to wait until after your fear has decreased somewhat.
A STEP-BY-STEP OVERVIEW FOR CONDUCTING
EXPOSURE-BASED TREATMENTS
The main steps involved in any exposure-based treatment program are initial assessment,
planning appropriate practices, carrying out the practices, and taking steps to maintain
the improvements over the long term.
Initial Assessment
We discussed the issue of assessment in chapter 3. To plan effective exposure prac -
tices, you will need to know the situations and sensations that you fear and avoid as
well as becoming aware of the different variables that affect your fear level. When you
completed the exercises in chapter 3, you probably identiﬁed a number of variables
that affect your fear level when you are in a social or performance situation that causes
you to feel uncomfortable. You should review the relevant sections of chapter 3 before
 beginning your exposure practices.


The Shyness & Social Anxiety Workbook
148Planning Appropriate Practices
Planning your exposure practices starts with developing an exposure  hierarchy . An expo -
sure hierarchy is a list of feared situations ranked in order of difﬁculty, from least fear
provoking at the bottom, to most fear provoking at the top. Chapter 8 provides exam -
ples of hierarchies and includes instructions on how to develop your own hierarchy for
situational exposure. Chapter 9 provides sample hierarchies and instructions for devel -
oping a hierarchy for exposure to feared sensations. Developing an exposure hierarchy
will provide a structure that will allow you to begin with easier exercises and work your
way up to more difﬁcult ones.
Carrying Out the Practices
Once you’ve identiﬁed some practices likely to be helpful, the next step is to begin
carrying them out. Generally, exposure begins with more manageable situations and
works up to more and more difﬁcult situations. As confronting the situations becomes
easier, you should begin to let go of the subtle forms of avoidance that were discussed
earlier. Later, after practicing situational exposure for several weeks (as described in
chapter 8), it may be useful to add exercises involving exposure to feared feelings and
sensations (as described in chapter 9).
Exposure practices should be structured, planned in advance, and carried out fre -
quently. The ways in which exposure practices are carried out affect whether the prac -
tices are helpful or not. Exposure can actually increase your fear if not done properly.
The remaining sections of this chapter provide suggestions for the best ways to conduct
exposure to maximize the chances of decreasing your fear.
Maintaining Your Improvements
In order to maintain your improvements, it’s important that you continue occasional


In order to maintain your improvements, it’s important that you continue occasional
practices even after your fear has decreased. These strategies are explored in greater
detail in chapter 11.
TYPES OF EXPOSURE
This section discusses three different dimensions that should be taken into account when
planning exposure practices. They are (1) exposure to social situations vs. feared sensa -
tions; (2) imagined vs. live exposure; and (3) gradual vs. rapid exposure.


Confronting Your Fears Through Exposure
149Exposure to Social Situations vs. Feared Sensations
Situational exposure involves exposing oneself to places and situations that produce
anxiety. Overcoming social and performance anxiety almost always includes situational
exposure as a component. In other words, to become more comfortable with public
speaking, meeting strangers, or lunching with your coworkers, you will need to practice
these activities.
Some people with social and performance anxiety may also beneﬁt from exposure to
sensations. This form of exposure is sometimes called interoceptive exposure, and it involves
practicing exercises that trigger particular physical sensations. For example, spinning in a
chair can be used to induce dizziness, and running up and down the stairs will make your
heart race. Exposure to sensations is useful for people who are fearful of experiencing
uncomfortable physical feelings.
If you are not afraid of the physical sensations that you experience when anxious,
there is no need to practice these exercises. However, if you are frightened by the physi -
cal sensations you experience in social situations, you may ﬁnd it helpful to practice
experiencing these feelings purposely until they no longer frighten you. Exposure to
sensations can be combined with situational exposure so that feared physical feelings are
purposefully brought on during the course of the exposure to feared situations. Chapter
9 provides a detailed description of how to use interoceptive exposure to reduce your
fear of sensations.
Imagined vs. Live Exposure
Exposure can be conducted in your imagination (imagining being in a feared situa -
tion) or in real life (actually entering the feared situation). Generally, whenever possible,
we recommend that live exposure (also called in vivo exposure ) be used rather than imag -


we recommend that live exposure (also called in vivo exposure ) be used rather than imag -
ined exposure. Although both approaches can lead to a reduction of fear, live exposure
has two big advantages. First, some people have difﬁculty imagining feared situations in
a way that actually arouses their fear; and, second, there is evidence that live exposure
is more effective at reducing fear (Emmelkamp and Wessels 1975).
Nevertheless, under certain circumstances, imagined exposure may be helpful. If
you are too fearful to enter a situation in real life, you can use imagined exposure as a
stepping-stone to the real situation. For example, if you are planning to ask someone out
on a date, you might consider using an imagined exposure to the situation at ﬁrst. Once
you have become more comfortable imagining the situation, trying the real thing might
become easier. Also, imagined exposure can be helpful when the situation is impracti -
cal or impossible to practice in real life. For example, if you must give a presentation
to a group of 200 people, you may not be able to practice it in front of a large group.
Instead, imagining a large group in your mind’s eye might be a good way to practice for
the actual presentation when you are preparing your talk.


The Shyness & Social Anxiety Workbook
150Situational role-play  is a compromise between imagined exposure and live exposure.
Role-play involves rehearsing being in a particular situation with the help of a friend,
family member, or therapist. For example, before exposing yourself to a real job  interview,
you could practice mock interviews with other individuals posing as the interviewers.
Or, you could ask your family or friends to act as the audience while you practice a pre -
sentation. These various forms of situational exposure (imagined, in vivo, and  role-plays)
are discussed more thoroughly in chapter 8.
Gradual vs. Rapid Exposure
Exposure may be conducted gradually or rapidly. Rapid exposure involves taking
steps very quickly, skipping steps, and sometimes trying more difﬁcult situations before
you have completely mastered easier situations. For example, rapid exposure to public
speaking might have you start off with talking in front of large groups of unfamiliar
people instead of to small groups of familiar people.
Gradual exposure tends to begin with easier practices and progresses to the more
difﬁcult practices much more slowly. Compared with rapid exposure, a person who is
working on gradual exposure may spend more time practicing each step before moving
on to the next level of difﬁculty. In addition, gradual exposure is less likely to leave out
intermediate steps, compared with rapid exposure. With gradual exposure, by the time
you get to the top steps of your hierarchy, you will be better prepared and less likely to
feel overwhelmed by the practice.
Gradual exposure is similar to progressing through school one grade at a time. If
you had to jump from ninth grade to twelfth grade, you would likely ﬁnd the increase


in difﬁculty overwhelming. By progressing through high school one grade at a time, you
ﬁnd each grade to be just slightly more difﬁcult than the previous grade. By the time
you get to twelfth grade, the increase in difﬁculty is only a small step compared with
your work in eleventh grade.
Gradual exposure to public speaking might begin by presenting small speeches in
front of a close friend or family member or by asking questions at meetings. After those
practice situations become easier, you might try speaking for longer periods of time
during meetings or practicing a speech in front of a small group of friends or family
members. This could then progress to practicing your speech in front of several cowork -
ers. With gradual exposure, you might not actually speak in front of large groups of
unfamiliar people until many earlier steps have been mastered.
Gradual and rapid exposure are both effective ways of reducing fear, and the end
result of each is usually the same. However, each approach has advantages and disadvan -
tages over the other. With rapid exposure it is likely you will see changes more quickly,
which will save you time. Also, these quick results may motivate you to work even harder
at overcoming your fear, just as seeing quick changes in your weight or ﬁtness level can
motivate you to stick to an exercise and healthy-eating plan. However, compared with
gradual exposure, rapid exposure is associated with higher levels of discomfort and fear.


Confronting Your Fears Through Exposure
151Rapid exposure requires a strong commitment from you to tolerate higher levels of
discomfort.
The differences between these two forms of exposure can be compared to the
difference between jumping into a cold swimming pool and entering the pool slowly.
Jumping into the pool quickly causes more initial discomfort, but you get used to the
water more quickly. On the other hand, getting into the pool slowly and gradually may
be less shocking to your system, but it will take you longer to get used to the water.
We recommend that you practice exposures as quickly as you are willing to. If you
are able to take steps more quickly, you will overcome your anxiety more quickly. If
you prefer a more gradual approach, that’s ﬁne, too. Sometimes, you may ﬁnd it dif -
ﬁcult to judge whether a particular step is too difﬁcult. Remember, there is no harm in
taking steps too quickly. If an exercise ends up becoming too overwhelming, you have
the option of continuing to practice it until it becomes easier or stepping back, trying a
less difﬁcult exercise, and working your way up to the difﬁcult practice more gradually.
Either approach is likely to be helpful. The decision is a matter of personal preference
and how much discomfort you’re willing to tolerate.
HOW EXPOSURE WORKS
Many cognitive-behavioral researchers and therapists believe that exposure works by
providing individuals with an opportunity to test the validity of their fearful thoughts,
assumptions, and interpretations. In chapter 6, we discussed the use of behavioral experi -
ments for challenging anxious beliefs and predictions. Repeated exposure may be thought
of as a form of behavioral experiment. By entering feared situations and exposing your -


of as a form of behavioral experiment. By entering feared situations and exposing your -
self to feared sensations repeatedly, you will discover whether your beliefs about social
and performance situations are true or false.
Why Exposure May Not Have Worked in the Past
People who are about to begin exposure-based treatments often wonder why they
should expect exposure to work now if it hasn’t worked in the past. In all likelihood,
you’ve already been exposed to anxiety-provoking social situations from time to time
and, in many cases, your fear has probably not decreased. In fact, your anxiety may have
increased with repeated exposures. Given such previous experiences with exposure, you
may be skeptical about whether simply exposing yourself again to feared social situations
will lead to a decrease in your fear.
It’s important to acknowledge that exposure is not effective under all circumstances.
For example, unpredictable exposure can lead to an increase in fear, particularly if it
involves a negative event or consequence. Imagine this situation: You are afraid of dogs
and a dog unexpectedly runs out from behind a tree and starts growling at you. That
kind of exposure would only make your fear worse. On the other hand, if you are


The Shyness & Social Anxiety Workbook
152 gradually exposed to your neighbor’s friendly dog, at your own pace, your fear of dogs
might decrease.
In everyday life, exposure to feared situations is often unpredictable. In addition,
such everyday exposures tend to be brief and infrequent. All of these factors make
exposure in everyday life less likely to lead to a decrease in fear, compared with the type
of exposure that is used in cognitive-behavioral therapy. A summary of the main differ -
ences between the type of exposure you may have experienced in the past (previous
exposure) and the type that has been shown as useful for helping people overcome fear
(therapeutic exposure) appears below.
Typical Previous Exposures Typical Therapeutic Exposures
These are often unpredictable and
uncontrollable  (e.g., you “end up” in the
middle of an unexpected conversation;
you are “forced” to go to a party that
you would rather not attend).These are predictable and under your control
(e.g., you make a decision to enter an
anxiety-provoking situation speciﬁcally
so that you can learn to be more
comfortable in the situation).
These have a brief duration  (e.g., you get
into the situation, feel anxious, then
leave. This teaches you that when you
are in the situation you feel frightened,
but when you leave you feel better).These are prolonged  (e.g., you decide to
stay in a situation until the anxiety comes
down on its own or until you learn that
your feared consequence doesn’t occur.
Here, you learn that you can be in the
situation, nothing bad happens, and your
anxiety eventually subsides).


situation, nothing bad happens, and your
anxiety eventually subsides).
These are infrequent  (e.g., because you
usually avoid when anxious, you are
not in the feared situation very often.
Each time you are in the situation, it’s
like starting over).These are frequent  (e.g., you practice your
exposures over and over again and close
together. The beneﬁts of exposures start
to add up).
These usually involve anxious thinking
(e.g., “People think I’m an idiot,”
“People will think I’m incompetent
if they notice my shaky hands”).These include countering of your anxious
thoughts  (e.g., you ask yourself questions
to counter or challenge the anxious
beliefs and predictions).
These include subtle ways of avoiding  the
situation (e.g., by distracting yourself,
using alcohol, bringing someone with
you, sitting in a certain “safe” location).These do not include subtle avoidance strategies
(e.g., you make a decision to not use
these strategies so that you teach your -
self to master the situation on your own).
Adapted from Antony, M. M. and R. P. Swinson. 2000. Phobic Disorders and Panic in Adults: A Guide to Assessment
and Treatment . Washington, DC: American Psychological Association. Used with permission.


Confronting Your Fears Through Exposure
153OBSTACLES TO COMPLETING
EXPOSURE PRACTICES
There are many different reasons why people sometimes don’t follow through on expo -
sure practices. We suggest that you anticipate the possible obstacles in advance and try
to think of ways to overcome them. There are always going to be reasons not to practice.
To combat the excuses you will undoubtedly come up with, you will need to remind
yourself of your reasons to continue to practice despite lack of desire, lack of time, or
being overwhelmed with the idea of confronting situations that make you anxious and
uncomfortable. Here is a listing of some of the most common reasons why people pro -
crastinate when it comes to doing exposure exercises. We’ve also offered some possible
solutions to these problems.
Obstacle:   My practices are never planned in enough detail, so I am not sure
exactly what I am supposed to do.
Solution:   At the beginning of each week, plan your exposure practices thoroughly.
You should know exactly what you’re going to do, where you’re going to
do it, and when you’re going to practice (dates and times).
Obstacle:   Although I have good intentions, my plans never seem to work out. For
example, when I plan to have lunch with a friend, I often ﬁnd that my
friend isn’t available when I call.
Solutions:   Make sure you make plans early. Leaving things for the last minute will
make it much more likely that your plans won’t work out.
Be sure to have a backup plan. For example, if you’re planning to have
lunch with a coworker, make sure you have an alternative second plan


lunch with a coworker, make sure you have an alternative second plan
and, sometimes, even a third plan, just in case your friend isn’t available
for lunch.
Obstacle:  I always forget to practice.
Solutions:   Plan your practices the way you would any other activity in your day.
Set aside blocks of time to practice and record them in your appoint -
ment calendar just as you would for any other appointments, so you
don’t forget.
Set an alarm (e.g., on your wristwatch or a small clock) as a reminder
to practice.
Ask other people to remind you, if necessary.
Obstacle:   The idea of doing therapeutic exposure work seems overwhelming. I am
just too scared.


The Shyness & Social Anxiety Workbook
154Solutions:   Start with an easier practice. The activity that you choose should be
challenging but not completely overwhelming. If a particular task seems
impossible, start with an easier task that does seem possible.
Use the cognitive strategies discussed in chapter 6 to challenge your
anxious thoughts before entering a feared situation.
Obstacle:  I’m too busy. There never seems to be enough time to do the work.
Solutions:   Put aside small blocks of time to be used exclusively for your social
anxiety exposure practices. If time is reserved just for this purpose, you
will be less likely to feel as if your practices are getting in the way of
your other important activities. This is something you want to do for
yourself. If you really want to deal with your social anxiety, you know
you can ﬁnd the small blocks of time to reserve for the practices. Think
of practice times as taking a class. You may not always want to go to a
class, but if you want to learn what is being taught there, you ﬁnd the
time to go.
Choose practices that can be completed during the course of your
regular routine. For example, you need to eat every day—you might as
well eat some of your meals with other people instead of always eating
alone.
Set aside a large block of time (e.g., clear a week-long vacation from
work) and spend the whole time practicing exposure nonstop.
Obstacle:  I am not convinced that exposure practices will be helpful.
Solutions:   Begin with a smaller exposure practice in which you have little to lose,
but in which you can still test whether exposing yourself to the situation
leads to a decrease in your fear.


leads to a decrease in your fear.
The belief that exposure won’t work is probably just an example of a
negative thought that isn’t necessarily true. Examine the validity of your
beliefs regarding exposure. For example, can you think of reasons why
exposure may not have worked in the past? After you ﬁnish reading this
chapter, you may have some new ideas about how to ensure that expo -
sure will be more likely to work now.
Obstacle:   My feared situations are difﬁcult to create. For example, I can’t think of
any places to practice public speaking.
Solutions:   Chapter 8 contains a large number of possible situations in which to prac -
tice exposure. Reading chapter 8 should help you to generate ideas.
Talk to family members and friends. They may be able to help you to
come up with some ideas for practices.


Confronting Your Fears Through Exposure
155HOW TO CONDUCT EXPOSURE PRACTICES
This section provides suggestions for getting the most out of your exposure practices.
These include instructions for how to prepare for practices, suggestions to keep in mind
when planning practices, what to do during a particular practice, and what to do follow -
ing the practice. Some of the most important suggestions are summarized in a checklist
following this section.
Preparing for Exposure Practices
As much as possible, it’s important to plan your exposure practices in advance. As
discussed earlier, planning involves making decisions at the beginning of the week about
particular practices that you intend to try, as well as coming up with backup practices in
case your original plans don’t work out. It is very likely that planning will involve setting
aside speciﬁc times during which to practice. You should also have an idea of how a prac -
tice ﬁts in with your short-term and long-term goals. For example, if your long-term goal
is to be able to give a presentation to a large group of coworkers, practicing speaking to
smaller groups may be an important step in your plan.
Before beginning any particular practice, we suggest that you make some very spe -
ciﬁc predictions about what might happen during the practice. Once you are aware of
your anxiety-provoking thoughts and predictions, use the cognitive strategies described
in chapter 6 to challenge your thoughts. Challenging your anxious thoughts before
entering into the situation will help you to manage your fear and discomfort.
Importance of Predictability and Control
As we discussed earlier, exposure works better if it is predictable and if you have a
sense of control over what’s happening in the situation. Therefore, it’s best to start with


exposure practices in which you have a pretty good idea of what is likely to happen.
Some situations, however, are inherently unpredictable. For example, if you decide to
ask another person out on a date, it may be impossible to know how the other person
will respond. In these cases, you can make the situation somewhat more predictable by
considering in advance all of the possible outcomes that could occur. For example, the
person might accept your invitation, turn it down, or put off responding for the time
being (for example, by not returning your call or saying, “I’m not sure, let me get back to
you”). The person may be warm or may come across as cold or uninterested. By antici -
pating as many outcomes as possible (as well as how you might cope with each outcome),
you will be less likely to be surprised.


The Shyness & Social Anxiety Workbook
156Duration of Exposure
Exposure works better if it lasts long enough for you to learn that your feared
outcome doesn’t occur. We suggest that you try to stay in the situation for as long as
possible. For example, if you are at a party, try to stay for at least a couple of hours. If
you’re giving a presentation and have the option of making it longer, try to take advan -
tage of the opportunity to speak for a longer time. Ideally, you should stay in the situ -
ation until your anxiety decreases to a mild or moderate level. However, even if your
anxiety doesn’t decrease during a particular practice, exposure will still likely be helpful,
especially if you don’t leave the situation too quickly.
If you are practicing being in a situation that is naturally very brief (something like
asking a stranger for the time or directions), you can prolong the anxiety-provoking situ -
ation by repeating the exposure over and over for a longer period. For example, instead
of asking one person for information while walking through a shopping mall (“Where is
the food court?”), you can ask twenty or thirty different people for the same information
over the course of an hour or more. The chances are good that your fear will decrease
over time.
Frequency of Exposure
Exposure works better if practices are repeated close together. For example, giving a
speech once a week is more effective than giving a speech once a month. Daily speeches
will decrease your fear more effectively than once a week, even if the number of prac -
tices is the same. In other words, giving a presentation ﬁve days in a row will likely lead
to a greater decrease in fear than giving a presentation once per week for ﬁve consecu -


tive weeks. So, try to schedule practices as frequently as possible. We recommend that
you set aside at least an hour to practice exposure on most days. Once your fear has
begun to decrease considerably, it is a good idea to gradually spread out the practices
to every few weeks or even to every few months, depending on the situation and how
often it arises in your day-to-day life. Occasional practices will help to maintain the
 improvements you have made in decreasing your fear.
Practice in a Variety of Situations
To some extent, working on decreasing your fear in a particular social or performance
situation will help you to feel more comfortable in other social situations as well. This
process is called generalization , and research has shown that generalization often occurs
as a result of exposure. For example, if you learn to feel comfortable asking questions
in class, some of that success may “spread,” or generalize, to other situations, making it
easier for you to speak up at meetings at work. However, generalization will not cause
your success to spread to every situation you fear. Therefore, to get the most out of


Confronting Your Fears Through Exposure
157exposure, it’s best to practice in a variety of different contexts, places, and situations.
For example, if you want to be more comfortable making small talk, we recommend that
you practice with your coworkers, family members, strangers in the elevator, at parties,
and in as many other situations as possible.
Choose Practices That Are Challenging but
Not Impossible
You may feel discouraged if while trying a particular practice, you become anxious
or uncomfortable. There is no need to feel discouraged. In fact, it is helpful for you to
feel some discomfort during exposure practices. That’s why you are doing the practices
in the ﬁrst place. Over time, you will begin to feel less anxious. A successful practice is
one that you complete, regardless of how anxious you feel.
On the other hand, it’s not necessary to choose practices that are completely terrify -
ing or for which you ﬁnd it impossible to stay in the situation. If a situation seems too
difﬁcult, we encourage you to try something easier. But do try something.
Choose Practices with Minimal Risk
Choose practices in which the likely consequences are minimal, except for a period
of feeling anxious. For example, if you want to be more comfortable with the possibility
of seeming foolish or being the center of attention, there are lots of safe practices that
you can try (for example, walking around with your shirt inside out, telling the cashier
that you have forgotten your wallet when you reach the front of the grocery line). There
is no need to take unnecessary risks, such as telling your boss what a jerk he is or yelling
out a dirty joke at your best friend’s wedding. If you’re not sure about the realistic risks


associated with a particular practice, ask someone whose judgment you trust (perhaps a
friend or family member).
Measure Your Improvement
It will be helpful to assess your anxiety from time to time using the forms and sugges -
tions in chapter 3. Evaluating your improvement periodically will remind you of how far
you have come and will also let you know when it is time to move on to new situations.
Include a Helper or Coach
Consider including a friend, coworker, or therapist to act as a coach during exposure
practices. This individual can help you with role-play practices (for instance, a mock


The Shyness & Social Anxiety Workbook
158job interview, practicing making small talk) and can provide you with feedback follow -
ing your practices. If you choose to include a helper during some exposure exercises,
that person should be familiar with the basic principles of exposure. Either you should
instruct the person about what their role as helper or coach entails, or you should have
the person read the relevant sections of this book. In fact, some combination of both
approaches may work best. In addition, the person you choose to work with should be
supportive and unlikely to become frustrated if things don’t work out as planned.
Keep Your Expectations Realistic
Don’t expect your anxiety to change overnight. It will likely take weeks or months
for it to improve. Also, you won’t be able to follow your improvement like a straight line
on a graph. You may ﬁnd that in some situations your anxiety decreases fairly quickly,
whereas in other situations success takes longer. Also, you may ﬁnd that some exposure
practices don’t lead to any improvement in your fear. You may even have weeks during
which your fear and anxiety worsen. A good rule of thumb is to expect one step back
for every two or three steps forward.
Don’t Fight Your Feelings
For years, you have probably been trying to control your anxiety, to prevent it from
occurring, and to get rid of it as soon as possible—no matter what the cost. By now,
you have probably discovered that trying to control your emotions doesn’t work. In fact,
attempts to control your anxiety are likely to make it worse rather than better. Fighting
your fear is like lying in bed trying hard to fall asleep by a particular time, telling your -


self, “I must fall asleep!” Often, the more you try to sleep, the harder it becomes. In fact,
for some people who have trouble sleeping, trying to stay awake is a productive strategy.
As soon as they stop trying  to sleep, they fall asleep quite quickly.
When you can allow yourself to become anxious without ﬁghting the feelings, even -
tually you will become much more comfortable in social and performance situations.
This sounds contradictory, but it really works this way. Instead of ﬁghting your feelings,
just let them happen. Instead of evaluating your experiences (for example, “sweating in
front of others is unacceptable”), accept them. When practicing exposure, you should
observe your responses and experiences without evaluating them. Your fear will likely
pass more quickly if you are not trying so hard to get rid of it. Remember, the worst
thing that can happen is that you will feel uncomfortable for a while. Being anxious is
not dangerous, and anxiety always passes.
As reviewed in chapter 4, variations of cognitive behavioral therapy have recently
been developed that emphasize the importance of accepting one’s experiences rather
than trying to change them. Examples include mindfulness meditation and a form of psy -
chotherapy called acceptance and commitment therapy (Hayes and Smith 2005).  These


Confronting Your Fears Through Exposure
159treatments have been found to be effective for treating certain types of anxiety prob -
lems, as well as for preventing depression from returning in people who have recently
overcome an episode of depression (Eifert and Forsyth 2005; Orsillo and Roemer 2005;
Williams et al. 2007). Learning to accept your uncomfortable feelings rather than ﬁght
them will ultimately help you to feel more comfortable in the situations you fear.
Eliminate Subtle Avoidance Behaviors
As discussed earlier in this chapter, it is important that you stop the subtle avoidance
strategies you use to feel safer in social and performance situations. For example, if you
tend to sit on your hands so people won’t notice them shaking, try letting your hands
show. If you avoid talking about yourself when conversing with others, purposely try to
talk about your own interests and opinions. For example, mention a book that you’ve
recently read or a movie that you’ve seen, and share your opinions. If it’s a best seller
or a big hit, and you liked it, try to convey your enthusiasm to the person with whom
you’re talking; if you didn’t like it, don’t hide your opinion. Express yourself and take a
chance on engaging in an exciting dialogue.
Eliminating safety behaviors such as overpreparing for presentations, drinking
alcohol at parties, and wearing makeup to hide blushing will help you to learn that social
situations can be managed, even without using these strategies and behaviors.
Ending a Practice and Moving On to the Next One
Ideally, an exposure practice should not end before your fear has decreased to a mild


Ideally, an exposure practice should not end before your fear has decreased to a mild
or moderate level (such as 20 to 40 on a 0- to 100-point scale). Sometimes, this will take
a few minutes; other times, it may take several hours. If possible, try to stay in the situa -
tion until you feel more comfortable. However, even if your fear doesn’t decrease within
a practice, you will still likely beneﬁt from the practice over the long term.
In reality, you may not always have control over when an exposure practice ends. For
example, if you’re practicing eating lunch with coworkers during a half-hour lunch break,
you may not have the option of stretching the lunch into two hours just to give your
anxiety a chance to decrease. If the situation ends before your anxiety has decreased, try
to practice the same situation again as soon as possible. Continue to repeat the practice
until it becomes easier. At that point, you can move on to another practice.
Using Exposure Records and Diaries
To get the most out of your exposure practices, we suggest that you use the diaries
and forms provided in chapters 8 and 9 to monitor your progress.


The Shyness & Social Anxiety Workbook
160The Aftermath of Exposure: Processing What Happened
Chances are that you will feel good following your exposure practices. Although
you may be tired, you likely will also feel relieved to have completed the practice and
proud of your accomplishments. Nevertheless, some people tend to analyze their every
move and criticize their performances during the practice (for example, “People surely
noticed my anxiety,” “I came across like a bumbling idiot”). If you tend to dwell on what
happened during your practices, we suggest that you try to put a more positive spin on
the experience.
Remember that the main reason you are practicing exposure is to eventually  feel
more comfortable in social and performance situations. However, for now, expect to
feel uncomfortable during practices. Expect that your performance won’t be perfect (in
fact, the goal isn’t perfection anyway). Rather than dwelling on what happened or didn’t
happen, try to use the cognitive techniques from chapter 6 to challenge your negative
thinking. Also, try to take something positive from the experience. Even if things didn’t
go the way you had hoped they would, you can still use the experience to plan future
practices and to generate ideas for what you might do differently the next time.
A WORD TO SIGNIFICANT OTHERS, FRIENDS,
AND FAMILY MEMBERS
If you are reading this book in order to help a loved one, here are a few suggestions to
keep in mind. First, your loved one must be on board with this treatment. Treatment is
not something that can be forced on someone who isn’t willing to make the necessary
changes. In addition, you should avoid the temptation to trick, force, bribe, or coerce


a person into doing exposure practices. In order to get the most out of treatment, it’s
important that the decision to do exposure comes from the individual.
Your role in exposure therapy is to help brainstorm possible exposure practices,
to provide support, to participate in exposure role-plays (for example, a simulated job
interview), and to be involved in actual exposure practices when you’re asked to do so.
For example, if your loved one fears attending parties, he may ask you to attend a party
with him. If your loved one fears eating in restaurants, she may ask you to join her for
a meal. In advance of any exposure practices, discuss with your loved one what he or
she would like you to do in the situation (for example, provide reassurance, provide
company, probe for anxiety-provoking thoughts, and so on).
SUMMARY OF EXPOSURE GUIDELINES
This chapter described a long list of guidelines for how to get the most out of your expo -
sure practices. Following is a list of the most important suggestions, in summary form.


Confronting Your Fears Through Exposure
161UÊPlan practices in advance. Set aside time to practice exposure.
UÊExposure practices should be predictable and under your control (particu -
larly early in treatment).
UÊExposure should be frequent (almost daily), especially at the start.
UÊExposure should be prolonged. Try to stay in the situation until your fear
has decreased.
UÊUse cognitive strategies to challenge anxious thoughts before entering the
situation.
UÊUse cognitive strategies to challenge anxious thoughts during the practice.
UÊUse cognitive strategies to challenge anxious thoughts after leaving the
situation.
UÊDon’t ﬁght your anxious feelings in the situation. Just let the feelings
happen.
UÊEliminate subtle avoidance strategies like distraction, alcohol use, and over -
protective behaviors.
UÊPractice in a number of different situations.
UÊChoose practices in which the actual risk is minimal, especially at ﬁrst.
UÊChoose practices that are challenging, but not impossible.
UÊComplete exposure records (see chapters 8 and 9) with each practice.
TROUBLESHOOTING
Problem:  My fear does not decrease during my exposure practices.
Solutions:   This is normal to some extent. Although anxiety and fear usually decrease
during the course of a particular exposure practice, most people experi -
ence occasional practices in which their anxiety doesn’t decrease. Here
are some suggestions for dealing with this situation.
Make sure that you are staying in the situation long enough. Sometimes
it can take several hours for a person’s fear to diminish.
Make sure that you are not using subtle avoidance strategies. The
normal pattern during exposure is for fear to increase and then gradu -


normal pattern during exposure is for fear to increase and then gradu -
ally to decrease. Using subtle avoidance strategies such as distraction


The Shyness & Social Anxiety Workbook
162may cause the fear to go up and down repeatedly over the course of the
practice, because most people are not very good at distracting them -
selves for long periods.
Negative thinking can sometimes interfere with the effects of exposure.
If your fear does not decrease during a particular exposure practice,
challenge your anxious thoughts using the techniques described in
chapter 6.
If all else fails, just keep practicing. Sometimes it takes repeated expo -
sure practices before a person’s fear begins to lessen.
Problem:  My fear returns between exposure practices.
Solution:   This is normal for most people. With more and more practice, your
fear will decrease more quickly during practices and will not return as
intensely between them. One way of preventing your fear from return -
ing between exposures is to increase the frequency of your practices,
particularly early in treatment.
Problem:   My physical symptoms (for instance, stuttering, shaking, sweating) are
very noticeable.
Solution:   Remember that, despite how it seems to you, the chances are good that
your symptoms are not as noticeable to others as you think they are.
Furthermore, as your anxiety decreases, the intensity of these symp -
toms will likely decrease. If you are concerned about people noticing
your symptoms, use the cognitive techniques from chapter 6 to chal -
lenge your anxious thinking. Remember that there are lots of people
who blush, shake, or lose their train of thought and who couldn’t care
less about what other people think. The problem is not that you experi -
ence these symptoms, but rather your beliefs about the consequences
of having these symptoms.
Problem:   I am just not good at             (making small talk,
public speaking, and so on).


public speaking, and so on).
Solution:   Your social skills are likely much better than you think they are. As
discussed in earlier chapters, people who are socially anxious tend to be
overly critical of their social and performance skills. Nevertheless, there
may be ways in which certain skills can be improved. It is likely that
exposure alone will contribute to an improvement of your skills. For
example, practicing making small talk will help you to learn what works
during a casual conversation and what doesn’t. In addition, we suggest
that you read chapter 10, which includes speciﬁc strategies for improv -
ing social and communication skills.


Confronting Your Fears Through Exposure
163Problem:  My fear is too high to beneﬁt from exposure.
Solutions:   Ideally, you should choose practices that arouse a fear level of 70 to
80 out of 100, although it is also okay if your fear reaches even higher
levels. One method for keeping your fear in check is to use the cog -
nitive strategies from chapter 6 to challenge your anxious thoughts
before entering the situation. At times, however, even using the cogni -
tive techniques beforehand won’t prevent your fear from becoming very
intense.
If you ﬁnd that your fear is completely overwhelming, you have three
options. First, you can try to wait a while longer to see if your fear
decreases. Alternatively, you may consider taking a short break and
then trying the same exercise again. Finally, you can try switching to a
less difﬁcult practice. Any of these approaches is usually ﬁne. The main
point is not to give up completely.
Problem:   The situations that I fear are very brief in duration, so there isn’t enough
time for my fear to decrease.
Solution:   This issue was discussed earlier in the chapter, but it’s worth highlight -
ing again here. Ideally, if an exposure practice is brief, you should try
to ﬁnd creative ways to lengthen the duration of the practice, if pos -
sible. For example, if you are fearful of chatting with the cashier at the
front of a supermarket line, try lining up repeatedly over the course of
an hour or two and buying only a few items at a time. This approach
will give you more opportunities to talk to the cashiers, compared with
paying for all your groceries at once.


paying for all your groceries at once.
Problem:   I just had something terrible happen during an exposure practice (for
example, my boss criticized my presentation). How can I ever try expo -
sure again?
Solutions:   Although rare, it is possible that an unexpected negative event will
occur during an exposure practice. For example, you could experience
a bad panic attack during a job interview, or you may be laughed at
during a presentation. If something bad does happen during an expo -
sure practice, it’s natural for some of your fear to return. It may be
helpful to “rethink” the meaning of the negative event using the cogni -
tive techniques described in chapter 6. In addition, we recommend that
you resume your exposure practices. If necessary, you can return to a
previous item in your hierarchy and work your way back to where you
were when the unfortunate incident took place.


The Shyness & Social Anxiety Workbook
164Problem:  I don’t avoid the situation, and yet my fear persists.
Solutions:   Although exposure usually leads to a decrease in fear, occasionally
people report having intense fear in social situations despite almost
never avoiding these situations. For example, a person may eat with
others on a regular basis but still get anxious in the situation. If you
continue to experience fear, despite never avoiding the feared situation,
you may ﬁnd it difﬁcult to come up with appropriate exposure exercises.
Here are three strategies to consider.
First, if you fear experiencing arousal symptoms while in social situa -
tions, try the interoceptive exposure exercises discussed in chapter 9.
Second, assess whether you are engaging in subtle avoidance strategies,
overprotective behaviors, alcohol or drug use, or other strategies that
may be undermining the effects of the exposure. If so, try to discontinue
these behaviors. Finally, a special effort should be used to identify and
challenge the anxious predictions and beliefs that continue to maintain
your fear (see chapter 6).


CHAPTER 8
Exposure to Social Situations
In chapter 7, we provided an overview of the basic principles underlying exposure-based
treatments for social anxiety. In this chapter, we’ll present additional information about
how to use these strategies to confront the social and performance situations that make
you anxious or uncomfortable. You should be very familiar with the material in chapter
7 before moving on to this chapter. As noted earlier, we suggest that you use the cogni -
tive strategies described in chapter 6 to combat anxious thinking before, during, and
after exposure practices. During practices, you should refrain from using subtle avoid -
ance techniques such as distraction, drugs or alcohol, and safety behaviors (for example,
eating in a dimly lit restaurant so people don’t notice your blushing). Finally, a reminder
that exposure works best when practices are:
UÊFrequent (daily, if possible)
UÊProlonged (until the anxiety decreases)
UÊPredictable and controllable
UÊPlanned in advance
UÊConducted in a variety of different situations
SITUATIONAL EXPOSURE PRACTICES
This section provides suggestions for exposure practices involving different types of
social and performance situations, including public speaking, making small talk, meeting
new friends and dating, situations involving conﬂict with others, being the center of


The Shyness & Social Anxiety Workbook
166attention, eating and drinking in public, writing in front of others, job interviews, being
in public, and talking to people in authority. In addition to the suggestions provided
here, there is space in each section for you to record additional ideas for practices that
might be relevant to your own social and performance anxiety.
At ﬁrst, many of the items suggested in this section may seem overwhelming.
However, as suggested in chapter 7, you should begin with challenging but manageable
practices. Over time, you will become more comfortable and most likely you will be able
to try some of the more difﬁcult practices. In addition, some of these practices may seem
very easy to you. If you have no trouble with a particular type of social or performance
situation, there is no need to practice confronting it. Instead, focus on the situations that
are anxiety-provoking for you.
Practices Involving Public Speaking
To overcome a fear of speaking in front of others, it is helpful to take advantage of
opportunities that come up during the course of your job or other activities in your day-
to-day life. If public speaking opportunities don’t normally arise in your life, there are
many ways of creating these situations. Some of these include the following:
UÊSpeak up in meetings at work . For example, share your opinions about
issues being discussed. Ask and answer questions. If the opportunity to
make a brief presentation arises, take advantage of it.
UÊOffer to give a presentation at work or in another situation . For example,
if you belong to a book club or reading group, offer to present a summary
of the book that your group is reading. If you have some special expertise,


of the book that your group is reading. If you have some special expertise,
offer to share it with your coworkers, colleagues, or friends by giving a
formal presentation.
UÊGo to a public lecture and ask questions . Public lectures are often adver -
tised in the newspaper, on the Internet, on the radio, or on television (for
example, on your local cable access channel). Also, check out advertisements
on community bulletin boards and posters at the library, supermarket, local
colleges, or other public places.
UÊTake a course at a college, university, or any school that offers adult
education courses . Try to choose courses that provide the opportunity to
give presentations. If these are not available, make a point of asking ques -
tions several times during each class. If you are unable to enroll in a course,
another option is to simply audit or sit in on a large class at a local univer -
sity. Professors will sometimes give guests permission to observe a class
without formally enrolling. Often, undergraduate classes contain hundreds
of students, so no one would notice an extra person in the room. Auditing


Exposure to Social Situations
167a large class will save you from having to pay registration fees while still
providing you with an opportunity to ask questions in public.
UÊMake an impromptu speech or toast at a wedding, party, group dinner,
or other social gathering . If you are invited to a party or are planning to
have a party of your own, offer to make a short speech in front of the other
guests.
UÊTake a public speaking course . There are numerous companies that offer
public speaking courses (especially for businesspeople). These classes are
sometimes expensive, but it may be worth ﬁnding out more about the avail -
able options (perhaps your workplace would help to cover the costs). Check
the Internet or your local Yellow Pages to learn about courses. There are
many options available, including, for example, courses by Dale Carnegie
Training (www.dalecarnegie.com) and The Leader’s Institute (www.leaders
institute.com).
UÊJoin Toastmasters International . Toastmasters is an organization that holds
meetings for individuals who are interested in learning to speak more effec -
tively in front of others. They have more than 11,000 clubs located in ninety
countries around the world. Typically, groups include about twenty indi -
viduals who meet for one to two hours each week. Annual membership is
inexpensive. For more information, visit www.toastmasters.org.
UÊTake a drama or music class . Taking a theater, drama, or music class will
provide you with opportunities to perform in front of others. Classes may
be available at local high schools or colleges, professional theater or music
schools, the YMCA, or through other agencies.


schools, the YMCA, or through other agencies.
UÊGive a lecture at a local elementary school, high school, or college about
your work . Sometimes schools will hold career days through which students
have opportunities to learn about particular jobs or careers. Additionally,
teachers sometimes invite guests to speak to their classes about particu -
lar types of careers or jobs. Call a local school principal to ﬁnd out about
opportunities in your neighborhood school. Or, if you have a child in school,
you may have the opportunity to speak to his or her class about what you
do at work.
UÊRead a passage in front of others . For some people, reading a newspaper
article or a passage from a book in front of a few family members may
be anxiety provoking. For others, it may be important to try something
more challenging, such as reading an introduction for a guest speaker who
is about to give a presentation at your workplace.


The Shyness & Social Anxiety Workbook
168Now, can you think of other possible practices that involve public speaking? If so,
record them in the space below:
Other Practices
Practices Involving Making Small Talk, Casual
Conversation, and Informal Socializing
Casual conversation and small talk can take place anywhere. The list below provides
a few examples of situations where you might have the opportunity to practice these
skills. In addition to planning several large practices per week, you should try to engage
in several mini-practices throughout the day.
UÊHave friends over for a get-together . For example, invite several cowork -
ers over for dinner or to watch a movie or sports event on TV. Or, have a
birthday party for a friend or family member. Make sure that you interact
with your guests! Don’t come up with excuses to avoid them (like serving
food and drinks to the exclusion of conversation, cleaning up, or washing
the dishes).
UÊSpeak to strangers on elevators, while waiting in lines, at bus stops, or
at other public locations . With repeated practice, making small talk will
become easier. Prolonged exposure works best, so try to talk to many dif -
ferent people over the course of an hour or two to get the most beneﬁt.
Smile, say hello, and use humor, if appropriate. Although you should be
prepared for some people to react negatively (remember, other people may
also be shy or they may be uninterested in making small talk), most people
will probably react positively.
UÊAsk for directions or for the time . Walk up to a stranger in a mall or store
and ask what time it is. Or, ask how to ﬁnd a particular location. As men -


tioned earlier, prolonged exposure works best, so try to do this repeatedly
over an hour or two or until your anxiety decreases.
UÊTalk to coworkers or classmates . Try arriving at school or work a bit early
so that you will have the opportunity to chat with others. Make a point of
saying hello to your coworkers or classmates during breaks. Simple ques -
tions such as, “How was your weekend?” are often a great way to get a
conversation started.


Exposure to Social Situations
169UÊTalk to dog owners who are walking their dogs . Dog owners often love to
talk about their dogs. If you have a dog, try going for walks in areas where
other people walk their pets. Make comments or ask questions about other
people’s dogs (for example, “Nice dog” or “What kind of dog is that?”). If
you return to the same routes frequently, you will likely see the same people
over and over again. You may even make some new friends.
UÊTalk to cashiers or other staff personnel in stores . For example, comment
on the weather, ask for advice or information (“Does this shirt go with these
pants?”), or special order a book or CD.
UÊGive or receive compliments . Offer someone else a compliment. For
example, tell a coworker that you like her sweater or new haircut, tell an
artist that you like his work, or compliment a waiter on the quality of your
food. If you are uncomfortable receiving compliments, just say “Thank you”
when someone praises you. Don’t discount the praise by telling the person
all the reasons why you don’t deserve it.
UÊExpress a controversial opinion . If you have a controversial opinion about
some issue, express it, particularly in situations where the consequences are
likely to be minimal. For example, if you didn’t like a movie that someone
else is raving about, let them know what you didn’t like about the ﬁlm. If
you disagree with someone else’s political views, explain your perspective
on the issue. Try not to put down the other person or to discount that
person’s views when you are expressing your own opinions. Differing views


person’s views when you are expressing your own opinions. Differing views
should be expressed in a friendly and supportive way, and you should make
an effort to communicate understanding of the other person’s perspective.
UÊJoin an ongoing conversation . In some circumstances, it is perfectly appro -
priate to join an ongoing conversation. For example, at parties people often
walk about, moving in and out of different conversations. See if you can join
in with a group of people who are discussing some issue that interests you.
UÊTalk to parents of other children . Just as pet owners enjoy talking to other
pet owners, parents usually enjoy talking about their children with other
parents. If you have children, get involved in situations where you might
have the opportunity to talk to other parents. For example, attend parents’
night at your children’s school or enroll your children in a class (such as
swimming, hockey, crafts, music) with other children. Take advantage of any
opportunities to talk to the other parents.
UÊMeet two or three friends at a café . Invite several coworkers or friends to
meet you after work or school for a coffee, drink, or snack. Alternatively,
invite others to join you for lunch.


The Shyness & Social Anxiety Workbook
170Can you think of other possible practices that involve informal socializing, casual
conversation, or making small talk? If so, record them in the space below:
Other Practices
Practices Involving Meeting New Friends and Dating
Many of the situations listed in the previous section on practices involving small
talk and casual conversation also provide opportunities to meet new people. Similarly,
several of the situations listed in this section also provide opportunities for casual con -
versation. Most new friendships and relationships start with a casual conversation, so it’s
no surprise that these sections might overlap. Also, developing new relationships often
requires repeated encounters with new people you meet. In other words, two people
will typically become acquaintances before they become friends. The list below provides
examples of practices that involve a possibility of meeting new people, developing new
friendships, developing new business relationships, or fostering opportunities for dating.
Remember that the main goal of an exposure practice should be to become more com -
fortable in these situations. For now, developing new relationships should be a secondary
goal. Focus on the process of reducing your fear rather than whether you develop new
friends or relationships through these practices.
UÊGo to a social event . For example, attend your annual ofﬁce holiday party,
a class reunion, a community dance, a local art gallery opening, or a book
signing. Situations such as these will provide you with opportunities to meet
people, as well as to mingle and make small talk. Be sure to take social risks
in these situations (for example, talking to other people).
UÊTalk to your neighbors . Go for walks in the neighborhood and say hello
to your neighbors—particularly those you have not had a chance to meet.


to your neighbors—particularly those you have not had a chance to meet.
If you have a new neighbor, consider asking him or her over for a drink or
dessert. Invite some of your other neighbors as well.
UÊJoin a club, take a class, or join an organization . For example, join a bowling
league, aerobics class, volleyball league, bingo group, self-help group, church
group, art class, or other group. Ideally, the group should meet frequently
(for instance, weekly) for you to get the most beneﬁt from attending it.


Exposure to Social Situations
171UÊAsk friends or colleagues to introduce you to new people . Take advantage
of opportunities to meet new people through friends, coworkers, or other
people you know.
UÊInvite people you know to socialize . For example, invite several coworkers
or acquaintances for lunch, dinner, a movie, or a concert. Or, invite several
coworkers or acquaintances away on a vacation, ski weekend, or conference-
related trip.
UÊMeet people through online social networks or dating services . Consider
joining an online social networking site, such as Facebook (www.facebook
.com) or MySpace (www.myspace.com). Join online chat rooms. Meet
people through online dating services (for example, www.match.com). Two
cautions: ﬁrst, although the Internet can be a useful tool for meeting people,
it’s important that you not rely exclusively on online relationships instead
of in-person relationships. Rather, consider using the Internet as a tool for
meeting people who you might eventually meet in person. Second, if you
are meeting people in person for the ﬁrst time, use appropriate caution. For
example, a ﬁrst date should happen in a public place, and you should not
give others your home address until you know them fairly well.
UÊArrange for dates through personal ads or dating services . In addition
to meeting people through the Internet, you can also ﬁnd opportunities
for dating through professional dating services and through personal ads in
local newspapers.
Can you think of other possible practices that involve meeting new friends, dating,
or related situations? If so, record them in the space below:
Other Practices
Practices Involving Possible Conﬂict with Others


Other Practices
Practices Involving Possible Conﬂict with Others
These practices should be planned carefully. Unlike the other practices recom -
mended in this chapter, these are likely to cause another person to become a bit angry
or impatient with your behavior. Choose practices in which the risks are minimal—if you
are unsure of the risks, ask a friend or family member for a second opinion. You may also


The Shyness & Social Anxiety Workbook
172want to skip ahead to the sections on assertive communication in chapter 10 to prepare
yourself for this kind of interaction. It’s important that potential conﬂict situations be
dealt with assertively rather than with aggression, which is likely to escalate the other
person’s anger.
It may seem rude to do things purposefully that will inconvenience others. On the
other hand, as you continue to read this section, you will see that most of these practices
involve only minor inconvenience to other people, and many of these are situations that
people often encounter anyway. The substantial gains that you may obtain from these
practices are likely to outweigh any inconvenience that you create for others.
Listed below are some examples of practices that others have found useful for
becoming more comfortable with conﬂict situations:
UÊAsk someone else to change his or her behavior . For example, ask your
roommate to wash his or her dishes rather than leaving dirty dishes lying
around. Or, ask another person to stop talking in a movie theater.
UÊStay stopped in your car for a few seconds when the light turns green .
Pretend you are changing the radio station or that you didn’t notice the
light turn green. The drivers who are backed up behind you eventually may
become frustrated and honk their horns. This should be your signal to drive
away.
UÊSay no when you don’t want to do something . If someone asks you to do
something that you don’t want to do (for example, donate money that you
can’t afford, purchase an item from a telemarketer, do more than your fair


share of work, and so on), say no in an assertive (though polite) way. Again,
we recommend that you read chapter 10 for suggestions regarding assertive
communication.
UÊReturn an item to a store . Return a book, an article of clothing, or some
other item to a store. In most cases, the staff at the store will gladly take
back the item. However, sometimes you may encounter a negative response,
which will provide you with the opportunity to get used to this uncom -
fortable situation. To really test yourself, try to return an item without
a receipt, without the original packaging, or after the allowed period for
returns has passed. The store may not take back the item, but you will get
an  opportunity to practice dealing with possible conﬂict.
UÊSend food back in a restaurant . Ask your server to take your food back (for
instance, to change the dressing on your salad, make your soup hotter, cook
your food more thoroughly, or bring you a different drink).
UÊTake an extra long time at a bank machine when there are people waiting
behind you . For example, make several deposits, transfer funds from one


Exposure to Social Situations
173account to another, and withdraw cash from two or more different accounts.
Make eye contact with others in line to see if they are looking impatient.
UÊForget your money when paying for an item in a store . For example, when
you reach the front of a supermarket line, tell the cashier that you have
forgotten your wallet. Or, have more items in your cart than you can afford
to purchase. This will help you to better tolerate the possibility of inconve -
niencing the cashier and the people in line behind you.
UÊAsk a stranger to stop smoking . If you are in a restaurant or bar, or even in
a public place outdoors, try asking the person next to you to stop smoking.
Use some discretion. For example, don’t practice this if the other person
seems aggressive, likely to get angry, or is much bigger than you are.
Now, can you think of other possible practices that involve some risk of mild con -
ﬂict? If so, record them in the space below:
Other Practices
Practices Involving Being the Center of Attention
Here are some suggestions for ways to draw attention to yourself. If you are afraid
of looking foolish, standing out in a crowd, or simply being observed by others, try some
of these exercises:
UÊSay something incorrectly . Purposefully answer a question incorrectly in class,
provide someone with incorrect information, or mispronounce a word.
UÊSpeak loudly . Speak loudly in a public place (for example, at a mall, in a bus,
or on the subway), so that others around you can hear your conversation.
UÊHave a mobile phone or pager go off in a public place . Arrange for someone


to page you or call you on your cell phone while you are at the dentist, eating
at a restaurant, or walking through a public place. Use some discretion here.
For example, don’t try this practice during a college exam, a job interview, or
while at a movie, unless your intention is to annoy the people around you.
UÊDrop something . Drop your keys, your books, or some other item in a
public place. Or, spill water all over your shirt.


The Shyness & Social Anxiety Workbook
174UÊTalk about yourself.  When speaking with other people, talk about your
family, your job, your hobbies, or some other aspect of your personal life.
Offer your opinions about political issues, books that you have read recently,
or movies that you have seen.
UÊParticipate in a party game . For example, play Twister, Pictionary,
Scattergories, Outburst, Trivial Pursuit, or some other game with friends,
coworkers, or your family.
UÊWear your shirt or dress inside out or backward . Walk around a public
place while making a fashion faux pas. The more outrageous, the better.
For example, wear shoes that don’t match. Wear a plaid shirt with striped
pants. Wear your dress or shirt inside out (this exercise is even better if your
dress or shirt has shoulder pads), or wear a formal evening gown during the
day. With practice, you will become much less concerned about looking
conspicuous.
UÊKnock over a display in a store . For example, knock over a few rolls of
paper towels or toilet paper in the supermarket. Again, it is important to use
good judgment. For example, don’t knock over glass jars of tomato sauce.
That would be going too far!
Now, can you think of other possible practices that involve being the center of
attention? If so, record them in the space below:
Other Practices
Practices Involving Eating or Drinking with Others
People who fear drinking in front of others are often concerned about having shaky
hands and spilling their drinks. Those who are fearful of eating in front of others may be


nervous about making a mess, looking unattractive while eating, or feeling ﬂushed from
eating hot foods. You should choose to practice exposure in situations that will challenge
your speciﬁc anxieties. For example, if you are more anxious when eating messy foods,
you should order foods that are more likely to be messy. If you’re nervous about blushing
or sweating, order hot soup or a spicy meal. A list of situations offering an opportunity
to eat or drink in front of others is provided here:


Exposure to Social Situations
175UÊEat a snack at your desk. If your desk at work is in an open area, eat a snack
at your desk. This may be easier than eating with your coworkers. When
this exercise becomes easier, you can move to other practices, such as those
in the rest of this list.
UÊHold a drink at a party or gathering . If you tend to be anxious when holding
a glass of wine or a soft drink in front of others, try doing just that the next
time you’re at a party or other social gathering. Try not to hide your hands
if they begin to shake. If alcohol tends to decrease your anxiety, make sure
you don’t drink wine, beer, or spirits until after your anxiety has decreased
on its own.
UÊHave lunch with coworkers . You probably eat lunch every day. You might
as well eat with other people, if the opportunity arises. If your natural ten -
dency is to eat at your desk or to eat lunch in restaurants alone, invite a
coworker to join you for lunch once or twice every week.
UÊMeet a friend at a restaurant for dinner . If you tend to feel safer in dark
restaurants, challenge yourself by choosing a more brightly lit location. Try
to choose a seat where you are more likely to be observed by the other
people in the restaurant.
UÊInvite people over for a meal . For example, invite two or three friends or
neighbors over for dinner.
UÊDine at other people’s homes . If you tend to decline invitations to eat at
other people’s homes, accept the invitation next time. You may ﬁnd it more
difﬁcult to do so if you are concerned about not being able to control the


difﬁcult to do so if you are concerned about not being able to control the
environment (such as the lighting), who the other guests are, and what types
of food are served, but don’t use these as reasons to avoid the situation.
UÊDine alone in a restaurant, food court, or another public place . If eating
alone in public makes you anxious, having lunch alone in a restaurant or
food court is an appropriate practice. You might also want to consider eating
in other public places, such as sitting on a bench in a park or in a shopping
mall.
Can you think of other possible practices that involve eating or drinking in front of
others? If so, record them in the space below:
Other Practices


The Shyness & Social Anxiety Workbook
176Practices Involving Writing in Front of Others
As a rule, people who are uncomfortable writing in front of others are concerned
about having shaky hands while they are writing. They also may be fearful of others
judging their handwriting or noticing personal information that they may be record -
ing. Examples of situations that can provide an opportunity to write in front of others
include the following:
UÊPay for items using a check . Instead of paying with cash or a debit card,
write a check when purchasing merchandise in a store. Be sure to complete
the check in front of the cashier (don’t write out the check before you get
to the store: that’s cheating). If you’re concerned about having the cashier
notice your shaky hands, try making your hands shake purposefully. In fact,
to really challenge your fear, let your hands shake so much that you have to
write a whole new check.
UÊWrite a letter while seated in a public place . Write a letter to a friend while
sitting in a café, riding on a bus, or relaxing on a public bench. Make sure
that there are others around who can see you writing.
UÊFill out forms or applications in front of other people . For example, com -
plete an application for a new credit card or loan at a bank (with the bank
ofﬁcer watching), complete an application for a new video-store member -
ship, ﬁll out a contest ballot in front of a cashier, or sign documents in front
of your coworkers.
Can you think of other possible practices that involve writing in front of other
people? If so, record them in the space below:
Other Practices
Practices Involving Job Interviews


Other Practices
Practices Involving Job Interviews
To become more comfortable with job interviews, the best exposure practices are
those that provide experiences similar to real job interviews. Some examples include:
UÊApply for a volunteer position.  Many volunteer opportunities (for example,
in hospitals, schools, theater companies, charitable organizations,  community


Exposure to Social Situations
177agencies, and so on) begin with an interview process that is very similar to
an interview for a paying job. You may feel less pressure if you know that
you’re applying for a nonpaying position. If so, this would be a good place
to start. In addition to giving the employer the opportunity to meet you,
another purpose of an interview is to give you a chance to evaluate the posi -
tion. Applying for a volunteer position does not commit you to accepting it
if it’s offered. If you decide it isn’t for you, you can always turn it down. If
you apply for several volunteer jobs, you will become more comfortable with
the entire interview process.
UÊPractice interviews with family members or friends . Practicing job inter -
views with friends or family members is another good way to begin the
process of overcoming anxiety over job interviews. You will need to coach
your friend or family member about the nature of the interview and the role
that he or she should take. You may also want to work up to having some
of these role-play interviews become particularly challenging (for example,
have your helper play the role of a hostile interviewer), so you can learn to
be more comfortable with difﬁcult interviews in real life.
UÊApply for jobs that are not particularly interesting to you . A great way of
learning to overcome a fear of job interviews is to practice interviewing for
jobs that are not high on your list. You might as well learn how to interview
more effectively in situations in which you have little to lose. By practicing
interviewing for jobs you don’t particularly want, you will be better pre -
pared when it comes time to interview for a job that interests you.


pared when it comes time to interview for a job that interests you.
UÊApply for jobs that interest you . If you are looking for a new job, eventu -
ally you must be able to interview for the job you want. The more jobs you
apply for, the more interviews you will be offered. The more interviews that
you get, the more opportunities you will have to practice your interviewing
skills and to overcome your fear of being interviewed. Although it’s reason -
able to start the process by interviewing for jobs that are not particularly
interesting to you, you should also be applying for jobs that you might really
be interested in accepting.
Can you think of other possible practices that involve interviewing for a job? If so,
record them in the space below:
Other Practices


The Shyness & Social Anxiety Workbook
178Practices Involving Being in Public
For some people, just being around other people is anxiety provoking, even if there
is no interaction or direct social contact. If being in a public place is difﬁcult for you,
here are some examples of public places where you may be able to practice exposure.
Remember to practice frequently and to stay long enough for your fear to decrease. If
you must leave the situation, try to return to it as soon as possible.
UÊGo to a mall or supermarket . Shopping is a good way of exposing yourself
to other people in a public place. Try shopping when the stores are more
crowded to challenge your fearful thoughts even more.
UÊMake eye contact in a public place . If appropriate, make eye contact with
other people while you walk down the street or while sitting on a bus or
subway. Of course, for safety reasons, this may not be wise in some cities,
particularly at night, or in dangerous parts of town.
UÊGo to a concert or sporting event . A guaranteed place to encounter lots
of other people is at a large concert, sporting event, movie theater, or other
entertainment venue. If you prefer to sit in an aisle seat or near the exit (for
a quick escape), try sitting in the middle of the row and away from the exit.
UÊRead in a public place . Spend some time reading your favorite book, a
newspaper, or a new novel at a coffee shop or library.
UÊJoin a gym or take an aerobics class . Rather than exercising alone, practice
exercising in front of others. For example, join an aerobics class and take a


spot near the front of the room. Or, lift weights near other people who are
more experienced and stronger than you are.
Can you think of other possible practices that involve being in public? If so, record
them in the space below:
Other Practices
Practices Involving Speaking to Authority Figures
Going out of your way to make contact with people in authority who make you feel
uncomfortable is an effective way to learn how to be more comfortable with authority


Exposure to Social Situations
179ﬁgures. Examples of relevant exposure practices are listed below. If any of these are
situations in which you would like to feel more comfortable, they may be appropriate
practices for you to try.
UÊHave a meeting with your boss or teacher . If you are a student, ask your
teacher to meet with you to discuss a difﬁcult homework assignment. If you
are working, ask your boss for an appointment to discuss your performance
or some other aspect of your job.
UÊAsk a pharmacist questions about a medication . If you are taking any medi -
cations, ask a pharmacist to answer particular questions about the medica -
tion (for example, side effects, interactions with other medications, how to
get reﬁlls, and so on). If you’re not taking any medications, you can still ask
questions, perhaps on behalf of a friend or family member.
UÊAsk your doctor to explain a particular medical issue . Make an appoint -
ment with your family doctor to ask questions about symptoms that you
may be experiencing. Be sure to have your questions answered.
UÊMeet with your bank manager . For example, arrange to meet with your
bank’s manager or loan ofﬁcer to discuss the possibility of obtaining a loan
or mortgage.
UÊMeet with a lawyer . For example, meet with a lawyer to discuss estate plan -
ning (writing a will) or some other legal issue that you are dealing with.
UÊMeet with an accountant or ﬁnancial advisor . Hire an accountant with
whom you feel intimidated to do your taxes, or meet with an intimidating
ﬁnancial advisor to get investment advice.
Can you think of other possible practices that involve interacting with people in


Can you think of other possible practices that involve interacting with people in
authority? If so, record them in the space below:
Other Practices
CHALLENGING YOUR WORST FEARS
By repeatedly exposing yourself to anxiety-provoking situations, you will continue to
challenge most of your deeply held beliefs and predictions concerning your ability


The Shyness & Social Anxiety Workbook
180to cope with social and performance situations. Ideally, exposure practices should be
designed to test the validity of your anxious assumptions. For example, if you are fearful
of saying something foolish during a conversation at a party, it’s not enough simply to
attend parties, although just attending may be a reasonable ﬁrst step. To more thor -
oughly challenge such an anxiety-provoking belief, you also would need to talk to other
people at the party. By having numerous conversations with others, eventually you will
learn that most of what you say is not foolish at all.
After reaching a certain level of comfort talking to other people at parties, the next
step might be to practice saying something silly or foolish purposefully and to evalu -
ate the consequences. This exercise would help to challenge your anxious beliefs at an
even deeper level. Chances are that even if you did say something foolish at a party, the
consequences would be minimal. With this type of exposure practice, you would learn
not only that you can engage in effective conversations with others, but that even if you
make a mistake from time to time, it doesn’t really matter.
The strategies discussed in this section are useful for increasing the intensity of your
exposure practices by testing out the validity of your “What if?” thoughts. Rather than
dwelling on questions like “What if I make a mistake?” or “What if I draw attention to
myself?” we suggest that you try to answer these questions by purposefully making a
mistake or purposefully drawing attention to your behavior. In all likelihood, you will
discover that nothing terrible happens.
Purposefully Making Mistakes or Trying to Look Stupid
When you have begun feeling more comfortable in some of your feared situations,


When you have begun feeling more comfortable in some of your feared situations,
a reasonable next step is to make some small mistakes purposefully, or to do things that
make you look foolish or stupid. Examples of this kind of purposeful behavior include
pronouncing a word incorrectly while speaking to your boss, asking an obvious question
in class, or bumping into a door. There is no need to make big mistakes (for example,
purposefully failing an exam or crashing your car). Small mistakes will work just ﬁne, and
the consequences will be minimal.
Purposefully Drawing Attention to Yourself
If being the center of attention is difﬁcult for you, your exposure practices should
include attempts to draw the attention of others to your behavior. For example, rather
than arriving early or on time for a movie or a class, try arriving a few minutes late,
so that everyone is aware of you when you enter the room. You may feel  embarrassed
momentarily, but you will learn from the practice that the whole experience doesn’t
matter, even minutes later. Your embarrassment will be temporary. Also, people prob -
ably will forget about your late arrival almost instantly and soon will be thinking about
other things.


Exposure to Social Situations
181Purposefully Increasing Your Anxiety Symptoms
In addition to entering the situations you fear, a more complete test of your anxiety-
provoking beliefs is to deliberately arouse some of the symptoms that frighten you in
social or performance situations. Chapter 9 discusses these strategies in some detail.
Some examples of possible exposure exercises include the following: wetting your fore -
head (to simulate sweating) before giving a presentation, purposefully appearing to lose
your train of thought during a meeting or presentation, and purposefully allowing your
hands to shake while writing or holding a drink. By deliberately bringing on the symp -
toms you fear (in a predictable and controlled way), you will learn to be less frightened
of having these symptoms show in front of others.
Expressing Personal Opinions
Finally, if you are afraid to express personal opinions during a conversation, just
engaging in conversations, without expressing personal opinions, will not be enough to
test the validity of your fearful beliefs. Conversation alone will not teach you that your
fears are unfounded. Instead, you should make sure that you express your feelings or
opinions during your exposure practices.
DEVELOPING A SITUATIONAL EXPOSURE
HIERARCHY
Before beginning exposure therapy, it is helpful to generate a list of very speciﬁc situ -
ations that range in difﬁculty from mildly to extremely anxiety-producing. This list of
situations, called a situational exposure hierarchy , will help to guide your exposure practices.
Usually, the situations on the hierarchy include details that take into account particular
themes that contribute to how much fear you are likely to experience. These themes may
include the size of the group or audience (for example, it may be easier to talk to one person


than ﬁve people; ﬁve people may be easier to handle than ﬁfty), the length of time involved
(for instance, a ﬁve-minute conversation vs. a thirty-minute conversation), your relationship
with the other person (for example, a family member vs. a stranger), and so on.
Two examples of situational exposure hierarchies follow. The ﬁrst hierarchy is for a
person with the fear of public speaking, and the second is for someone who experiences
social anxiety in many different situations (in other words, generalized social anxiety).
Note that the hierarchy items are very speciﬁc with respect to the duration of the prac -
tice, the types of people present, and other relevant variables. Developing speciﬁc items
is important because it’s difﬁcult to develop practices based on overly vague hierar -
chy items. Fear and avoidance ratings are based on a scale ranging from 0 (no fear, no
 avoidance) to 100 (maximum fear, complete avoidance).


The Shyness & Social Anxiety Workbook
182Sample Situational Exposure Hierarchy: Public Speaking
Situation Fear Avoidance
1. Give a 1-hour, formal lecture to 200 strangers about a
topic that I don’t know well.100 100
2. Give a 1-hour, formal lecture to 30 strangers about a topic
that I don’t know well.99 100
3. Give a 1-hour, formal lecture to 200 strangers about a
familiar topic.90 100
4. Give a 1-hour, formal lecture to 30 strangers about a
familiar topic.85 100
5. Give a 1-hour, informal presentation to 20 coworkers
about an unfamiliar topic.85 90
6. Give a 1-hour, informal presentation to 20 coworkers
about a familiar topic.70 70
7. Give a 1-hour, informal presentation to 20 young children
about my work.65 65
8. Make comments or ask questions in a large meeting (more
than 15 people).50 60
9. Make comments or ask questions in a small meeting (5 or
6 people).40 40
10. Offer to make a toast at a family dinner. 35 35


Exposure to Social Situations
183Sample Situational Exposure Hierarchy: Generalized Social Anxiety
Situation Fear Avoidance
1. Give a 1-hour, formal lecture to 30 coworkers about a
familiar topic.100 100
2. Have a party at my home for my coworkers. 95 95
3. Ask Pat out for a dinner date. 90 100
4. Answer a personal ad in the newspaper. 85 100
5. Attend the annual holiday party at work without drinking
alcohol.85 85
6. Attend a tea for a coworker who is retiring. 70 70
7. Have a formal dinner with Rita (a friend). 70 75
8. Talk about personal feelings or opinions with my
coworkers.60 60
9. Have a fast-food lunch with Rita. 60 50
10.  Have a conversation with the person sitting next to me on
a bus.50 50
11. Ask someone for directions or for the time. 45 45
12. Call Rita on the telephone. 40 40
13. Eat alone in a crowded food court at the mall. 40 40
14. Walk around at a crowded mall. 35 35
15. Answer the telephone without checking my caller ID. 30 30
To generate your own hierarchy, refer back to the suggested exposure practices in
this chapter as well as to the results of your self-assessment in chapter 3. Choose situations
that range in difﬁculty from slightly anxiety-provoking to completely overwhelming.
Record these situations in order of difﬁculty (starting with the most anxiety-pro -
voking at the top) in the spaces provided on the following blank Situational Exposure


voking at the top) in the spaces provided on the following blank Situational Exposure
Hierarchy Form. Next, rate each situation to describe the level of fear you would feel
if you were in that situation right now (use any number from 0 to 100, where 0 = no
fear; 25 = mild fear; 50 = moderate fear; 75 = intense fear; and 100 = very intense
fear). Finally, using a 0- to 100-point scale, indicate how much you would tend to avoid
each situation on your hierarchy (0 = do not avoid the situation; 25 = hesitate to enter
situation, but rarely avoid it; 50 = sometimes avoid the situation; 75 = usually avoid the
situation; 100 = always avoid the situation).


The Shyness & Social Anxiety Workbook
184Situational Exposure Hierarchy Form
Situation Fear
(0–100)Avoidance
(0–100)
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.