Feeling watched: self-focused attention and social anxiety

The impression of being at the centre

Somebody enters a room and detects two glances. They begin controlling how they walk, where they put their hands and whether they are red. Because every movement feels intense, they imagine that others see it in the same way.

Fear of evaluation and self-focused attention are common in social anxiety. This does not mean that nobody ever looks, but estimating how long attention lasts and what it means becomes difficult.

An image constructed from sensations

Facial warmth becomes an image of vivid blushing; a pause appears enormous; internal trembling is interpreted as visible. The person uses sensations and memories to construct how they believe they appear to others.

While monitoring that image, they hear less of the conversation. A neutral response may be missed and an ambiguous expression receives greater weight.

Behaviours that reduce information

• Avoiding looking in order not to see reactions.
• Hiding the hands, face or clothing.
• Rehearsing every movement or sentence.
• Always remaining at edges or near exits.
• Reviewing every gesture made by other people afterwards.

These behaviours may reduce immediate anxiety but make an ordinary interaction harder to observe.

What treatment addresses

Cognitive behavioural therapy for social anxiety includes externally focused attention, reduction of safety behaviours, graded exposure and comparison of the self-image with observable information. The aim is not to act as though nobody looks, but to stop treating every glance as a negative evaluation.

‘They are watching me’ needs another assessment when there is bullying, actual control, threats, violence or a fixed conviction that does not change with evidence. These situations should not automatically be classified as social anxiety.