Social Anxiety Treatment in California (ERP Therapy)

Social anxiety shows up across thoughts, physical sensations, and behaviors:

Common experiences include:

• Fear of being judged, embarrassed, or rejected
• Overthinking conversations before, during, or after
• Avoiding social situations or enduring them with distress
• Difficulty making eye contact or speaking up
• Blushing, sweating, shaking, or a racing heart
• Mind going blank in conversations
• Expecting negative outcomes or assuming you “messed up”
   

Many people also replay interactions afterward, focusing on perceived mistakes. 

Social anxiety isn’t just about big events—it often shows up in everyday situations:

• Avoiding speaking in meetings or classes
• Over-preparing or scripting what to say
• Replaying conversations for hours afterward
• Avoiding eye contact or keeping interactions short
• Turning down invitations or canceling plans
• Staying quiet even when you have something to say
• Feeling “on edge” in public (restaurants, stores, social gatherings)
   

For some people, it’s performance-specific (like presentations). For others, it shows up across most interactions.

 There isn’t a single cause, but social anxiety is often shaped by a combination of:

• Temperament (being more sensitive to social evaluation)
• Past experiences (criticism, bullying, embarrassment)
• Learning patterns (becoming hyper-aware of how you’re perceived)
• Brain-based threat sensitivity to social judgment
   

Over time, the brain starts treating social situations as high-risk, even when they’re not.

Social anxiety is maintained by a cycle of fear and avoidance:

Trigger → Anxiety → Safety Behaviors → Temporary Relief → Stronger Fear

Examples of safety behaviors include:

• Avoiding eye contact
• Rehearsing sentences mentally
• Over-explaining or apologizing
• Leaving situations early
• Seeking reassurance (“Did I sound weird?”)
   

These strategies reduce anxiety short-term—but teach your brain that social situations are dangerous, keeping the cycle going. Avoidance, in particular, prevents new learning and keeps the fear intact. 

No. While shyness is a personality trait, social anxiety is:

• More intense
• More persistent
• Interferes with functioning
• Driven by fear, not preference
   

People with social anxiety often want connection—but feel blocked by fear.

Exposure and Response Prevention (ERP) is an active, evidence-based approach that helps you:

• Gradually face feared social situations
• Reduce avoidance and “safety behaviors”
• Learn that anxiety is tolerable—and doesn’t need to control your actions
  

Instead of trying to eliminate anxiety, ERP helps you change your relationship to it. This often involves building a structured exposure plan (hierarchy) and practicing real-world interactions step-by-step.

ERP is practical and collaborative. Examples might include:

• Making brief eye contact with strangers
• Starting small conversations
• Speaking up in a meeting
• Letting pauses or awkward moments happen
• Saying something imperfect on purpose
• Attending social events without rehearsing or escaping
   

The goal isn’t to feel confident first—it’s to take action while anxious, and let confidence develop over time.

Yes. Social anxiety is highly treatable.

With the right approach, people can:

• Reduce avoidance
• Feel more comfortable in social situations
• Build confidence through experience (not reassurance)
• Re-engage with relationships, work, and life
   

Therapy that focuses on behavior change—not just insight—tends to be most effective.

Specialized treatments like Exposure and Response Prevention therapy typically cost more than general talk therapy due to the advanced training, structure, and clinical expertise involved. Fees reflect the intensity of treatment, session length, and the therapist’s specialization. Many clients find that evidence-based, targeted treatment leads to faster and more durable improvement, reducing long-term therapy costs overall. 

For specific rates and insurance information, please visit the Fees & Insurance page.