Social Anxiety operates in a negative feedback-loop or rinse cycle.

In this cycle, negative self-beliefs generate anxiety and in social situations the individual gets so worried and self-focussed they are unable to focus on the task at hand.

Inevitably, the individual's performance falls below par and this feeds the pre-existing negative beliefs.

Sarah's story below illustrates this process.

Sarah is a first year geography student who is required to give an assessed presentation to her peers: The cycle starts with Sarah's distorted self-image. She imagines how she will appear to others during the presentation and she thinks 'I'm going to look nervous and silly if I have to present to the group'. This image combines with her pre-existing beliefs to form the thought 'I just know I'll forget everything and make a mess of it'. This thought is so anxiety provoking she spends the weekend worrying about what will happen and sleeps badly the night before the presentation.

On Monday, the day of the presentation, she sits in class, tense and already exhausted, waiting her turn to present. She is second from last and she's not learnt anything much from the previous speakers, because she has become increasingly focussed on her own internal state of alarm and intrusive thoughts telling her it will all go badly. By the time Sarah stands up to speak she is so anxious and self-focused that she is unable to focus on the content of her presentation. Her mind seems to go blank and she stumbles through the ten minute presentation, with the aid of cue cards.

A key element in learning to cope with social anxiety involves understanding how the rinse cycle works and being able to make changes that halt the negative process.

This typically involves learning and practising key elements, which are shown in the diagram below.

• The 1st element involves identification and substituting negative beliefs with more positive ones.
  
  
• The 2nd element focuses on helping the individual develop their social skills by being aware of their body language and use of speech during social interactions.
  
  
• The 3rd element focuses on controlling anxiety and excessive self-focus so that attention is directed towards social interaction or the task in hand.