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All articles in NSAC’s social anxiety blog are written by actual human beings, not artificial intelligence. Our authors are all mental health clinicians who have expertise in evidence-based treatment for social anxiety disorder, and who are affiliated with NSAC Regional Clinics and Associates.
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THE SOCIAL ANXIETY OF BLUSHING

Avatar photo By John Montopoli, LMFT, LPCC, A-CBT July 19, 2022

Facial blushing: is it normal?

Rosie checked into a hotel for a weekend getaway with her partner. The hotel receptionist noticed it was Rosie’s birthday and said, “Welcome to our hotel. I see it’s your birthday tomorrow. HAPPY BIRTHDAY!” The nearby receptionist added his birthday wishes as did the people behind her. Rosie sheepishly thanked them. She was mortified of the attention. She was especially worried that everyone would notice her face, ears, and neck had turned a bright shade of red.

Rosie experienced a natural, involuntary physiological response known as blushing. Charles Darwin described the experience of reddening of the face (especially the cheeks), ears, and neck brought on by the “thinking of what others think of us.” Blushing is a psychological experience paired with embarrassment and disruption of mental functioning. Flushing, on the other hand, is the reddening of the face caused by heat, alcohol, or dermatological conditions such as rosacea.

When blushing becomes a problem

Blushing is a normal and common human experience when feeling embarrassed or being the center of attention. Most people will experience it and move on without paying it much attention. For others, the experience can lead to extreme distress and vocational, academic, and social impairment. Rosie experienced extreme distress. If she began to regularly avoid important situations because of the fear of blushing, mental health professionals would then classify it as a disorder.

The phenomena of avoidance, distress and functional impairment related to blushing is a performance anxiety and falls under the broader social anxiety disorder spectrum. The fear of embarrassment, negative evaluation, or judgment is a common feature in social anxiety. While roughly 13% of individuals will meet the criteria of social anxiety disorder (at some point in their lives), about 50% of people diagnosed with SAD report blushing excessively.

It started with our primordial ancestors

Evolutionary psychologists believe that blushing serves a social function. To maintain social inclusion members of the group must display modesty and convey that the person is not brazen or shameless. Blushing softens the negative evaluation from others in the group when a member has done something embarrassing or has become the center of attention. Ironically, people with disordered blushing have a misappraisal of this experience. Instead of viewing it as the softening of negative evaluation, blushers view it as an occasion to be judged for being flawed. Crozier, (2010)

Woman is blushing, but her hands are not over her face

What to do about blushing?

Sufferers of debilitating blushing can use strategies from cognitive behavioral therapy (CBT) to help manage distress associated with blushing.

1. Educate yourself. Learn more about the blushing cycle. Remember that blushing is normal. Focusing on the perceived negative consequence of blushing can have the paradoxical effect of worsening the reddening of your face.

2. Write down your thoughts. After a blushing event, write down the thoughts that went through your mind. Some examples are: “I felt so stupid for blushing. They must have thought I had something to hide. It showed that I was weak and lacking in confidence.”

3. Reframe. When thoughts go through our heads, we tend to take them as facts. Look for evidence that supports and that does not support the beliefs. Ask yourself, “how would I cope with the worst thing happening?”

4. Experiment. Discomfort leads to avoidance. Avoidance leads to missed opportunities for learning. Conduct experiments to test out the feared outcome. Simulate blushing by exerting yourself excessively to the point of getting a red face or apply cosmetic make-up to your face. Start with very easy situations where the consequences are minimal. Ask yourself if your feared outcome occurred. Next, try with harder situations.

5. Practice self-compassion. Be gentle and accepting of your shortcomings. Blushing is only one small facet of yourself. Rather than beating yourself up for blushing, hold it as uniqueness and worthy of gentleness. Lighten the grip you hold about yourself and blushing. Breathe in acceptance. Breathe out resistance.

6. Defend yourself. Develop a canned response to give to others who you believe will judge your blushing. “There I go again, my face going red is a sign that I really care about the subject at hand. I do this when I’m passionate about something.” Rehearse the assertive responses over and over until they feel second nature.

Rosie felt horrible about the response to unwanted attention at the front desk. But blushing is a normal and helpful human experience. Using the strategies highlighted, Rosie can work on coping with the effects of blushing. Over time, the blushing may reduce since she’s less focused on it. Nonetheless, the key is developing coping skills in the light of blushing. Well-trained CBT therapists can help you apply the strategies described previously, should you need professional help.

Written by John Montopoli, LMFT, LPCC, A-CBT

NSAC San Francisco

For further information about the author and their clinic, click here.

How to Get Help for Social Anxiety

The National Social Anxiety Center (NSAC) is an association of independent Regional Clinics and Associates throughout the United States with certified cognitive-behavioral therapists (CBT) specializing in social anxiety and other anxiety-related problems.

Find an NSAC Regional Clinic or Associate which is licensed to help people in the state where you are located.

Places where NSAC Regional Clinics and Associates are Based

ARIZONA: Phoenix ● CALIFORNIA: Bixby Knolls ● Long Beach ● Los Angeles ● Newport Beach / Orange County ● San Diego ● San Francisco ● Santa Barbara ● Silicon Valley / San Jose ● COLORADO: Denver ● CONNECTICUT: Avon ● DELAWARE: Coastal Delaware ● DISTRICT OF COLUMBIA: Washington, DC ● FLORIDA: South Florida ● IDAHO: South Central Idaho ● ILLINOIS: Chicago ● Chicago Associate ● IOWA: Des Moines ● KENTUCKY: Louisville ● MARYLAND: Baltimore ● MASSACHUSETTS: Western Massachusetts ● Children & Teens ● MICHIGAN: Kalamazoo ● MISSOURI: St. Louis ● MONTANA: Bozeman ● NEW JERSEY: North Jersey ● NEW YORK: Brooklyn ● New York City ● Staten Island ● NORTH CAROLINA: Asheville / Western North Carolina ● PENNSYLVANIA: Philadelphia ● Pittsburgh ● TEXAS: Houston / Sugar Land

Social Anxiety Self-Help Books by NSAC Therapists

Overcoming Shame-Based Social Anxiety & Shyness: A CBT Workbook
by Larry Cohen, LICSW, A-CBT
— NSAC cofounder and Chair
— Representing NSAC District of Columbia

Social Anxiety for Dummies by Laura Johnson, LMFT, LPCC, A-CBT
— Representing NSAC Silicon Valley / San Jose

Click here for more information about these and other CBT books by NSAC therapists.

Written by,
John Montopoli, LMFT, LPCC
National Social Anxiety Center – San Francisco

References:
Crozier, R. (2010), “The Puzzle of Blushing”, The Psychologist, Vol 23. No 5, May 2010, pp. 390–393.

This entry was posted in acceptance, Blog, Cognitive Behavior Therapy, Exposure Therapy, pandemic, Relationships, Social Anxiety and tagged anxiety, CBT, cognitive behavior therapy, cognitive-behavioral therapy, social anxiety, social anxiety baltimore, social anxiety disorder, social anxiety therapy, social connection, social phobia. Bookmark the permalink.

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← POST-PANDEMIC SOCIAL ANXIETY: SIMPLE STEPS TO START LIVING AGAIN AFTER COVID
OVERCOMING SOCIAL ANXIETY BY EMBRACING UNCERTAINTY →

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DISCLAIMER: The National Social Anxiety Center (NSAC) exists solely to promote evidence-based treatment for social anxiety, and education about social anxiety. NSAC is not a group psychotherapy practice, and does not provide any psychotherapy services. NSAC assumes no liability for its regional clinics’ work or practices. Books, essays, articles, posts, audio and video recordings on this website all reflect evidence-based research. The views contained therein are those of the authors, and do not necessary reflect the views of NSAC as an organization.

How to Get Help for Social Anxiety

The National Social Anxiety Center (NSAC) is an association of independent Regional Clinics and Associates throughout the United States with certified cognitive-behavioral therapists (CBT) specializing in social anxiety and other anxiety-related problems.

Find an NSAC Regional Clinic or Associate which is licensed to help people in the state where you are located.

Places where NSAC Regional Clinics and Associates are Based

ARIZONA: Phoenix ● CALIFORNIA: Bixby Knolls ● Long Beach ● Los Angeles ● Newport Beach / Orange County ● San Diego ● San Francisco ● Santa Barbara ● Silicon Valley / San Jose ● COLORADO: Denver ● CONNECTICUT: Avon ● DELAWARE: Coastal Delaware ● DISTRICT OF COLUMBIA: Washington, DC ● FLORIDA: South Florida ● IDAHO: South Central Idaho ● ILLINOIS: Chicago ● Chicago Associate ● IOWA: Des Moines ● KENTUCKY: Louisville ● MARYLAND: Baltimore ● Montgomery County ● MASSACHUSETTS: Western Massachusetts ● Children & Teens ● MICHIGAN: Kalamazoo ● MISSOURI: St. Louis ● MONTANA: Bozeman ● NEW JERSEY: North Jersey ● NEW YORK: Brooklyn ● New York City ● Staten Island ● NORTH CAROLINA: Asheville / Western North Carolina ● PENNSYLVANIA: Philadelphia ● Pittsburgh ● TEXAS: Houston / Sugar Land

Social Anxiety Self-Help Books by NSAC Therapists

Overcoming Shame-Based Social Anxiety & Shyness: A CBT Workbook
by Larry Cohen, LICSW, A-CBT
— NSAC cofounder and Chair
— Representing NSAC District of Columbia

Social Anxiety for Dummies by Laura Johnson, LMFT, LPCC, A-CBT
— Representing NSAC Silicon Valley / San Jose

Click here for more information about these and other CBT books by NSAC therapists.

Standing Up for Marginalized Persons

There is rising violence, abuse and discrimination in the United States directed against Blacks, Jews, Hispanics, Asians, Muslims, women, LGBTQ persons, immigrants, and other marginalized groups. The National Social Anxiety Center (NSAC) stands for the welfare, dignity and equality of all people, regardless of individual differences and societal standards. In all our clinical and educational work, NSAC stands against racism, antisemitism, misogyny, homophobia and all other forms of bigotry and abuse.
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