Mindfulness can help with social anxiety, but CBT has the stronger evidence for easing social anxiety itself. In a trial of 53 adults with generalised social anxiety disorder, an eight-week mindfulness course and group CBT both helped, yet group CBT produced lower social anxiety scores and higher response and remission rates. [koszycki-2007-mbsr-cbgt] This guide covers what mindfulness training involves, what the trials found, and how to practise it alongside the treatment with the best evidence. Our overview of social anxiety covers the wider condition.
What is mindfulness for social anxiety?
It is training in noticing your thoughts, feelings and surroundings in the present moment without judging them, usually taught in an eight-week group course such as mindfulness-based stress reduction (MBSR). MBSR programmes usually run for eight weeks and include formal practices such as body scans, sitting meditation and yoga. [liu-2021-mbi-sad]
The researchers behind the first trial reasoned that mindfulness might help because social anxiety keeps attention turned inward on threat and self-criticism. Mindfulness, they argued, can help people step back from self-critical thoughts and direct attention to the social situation itself. [koszycki-2007-mbsr-cbgt] That is close to the loop CBT targets, which our guide to CBT for social anxiety explains.
Does mindfulness work for social anxiety?
It can help, and it does not clearly beat CBT. Three pieces of evidence give the picture.
| Source | What it looked at | What it found | What limits it |
|---|---|---|---|
| Koszycki and colleagues (2007) | 53 adults with generalised social anxiety disorder, randomised to an 8-week MBSR course or 12 weeks of group CBT | Both improved. Group CBT gave lower social anxiety scores and higher response and remission rates. Mood, daily functioning and quality of life improved about equally | A small trial |
| Goldin and colleagues (2016) | 108 unmedicated adults with generalised social anxiety disorder, randomised to group CBT, MBSR or a waitlist | Both treatments beat the waitlist on most measures. Symptom improvement was similar. Subtle avoidance behaviours fell more after CBT | Group formats only |
| Liu and colleagues (2021) | A meta-analysis of 11 randomised trials (729 people) and 5 single-arm trials | Mindfulness beat no treatment, was about even with other active treatments and slightly behind CBT, with effects still present at 12 months | Few, small trials, and the authors call for larger ones |
The first two trials disagree on how big the gap is. The first found CBT clearly ahead on social anxiety scores, and the second found similar symptom improvement. [koszycki-2007-mbsr-cbgt] [goldin-2016-cbgt-mbsr]
The pooled analysis sits between them. Against no treatment, mindfulness did much better (a standardised difference of 0.89, which is large). Against other specific active treatments it was about even, and against evidence-based treatments such as CBT it was behind by a small margin (0.29 in CBT’s favour). Longer programmes were linked with larger effects, and the benefit was still present at 12 months. [liu-2021-mbi-sad]
The authors concluded that mindfulness may be an effective and safe alternative for people who do not respond to CBT. They note that only 11 randomised trials were available, most with few participants, and call for larger ones. [liu-2021-mbi-sad]
How does mindfulness compare with CBT?
CBT designed for social anxiety has the stronger evidence, so it is the better first choice if you can get it. A network meta-analysis of psychological and drug treatments for social anxiety disorder in adults found individual CBT the most effective of the interventions compared. [mayowilson-2014-sad-nma]
The two ask different things of you. CBT works by dropping the precautions you take to feel safe and testing what happens, which our guide to safety behaviours explains. Mindfulness trains a different skill: noticing a thought, letting it pass, and returning attention to the present. In practice the two can sit side by side, and mindfulness is a reasonable thing to try if CBT is not available or has not helped. That is our reading of the evidence and not a finding.
How do you practise mindfulness with social anxiety?
Start small, and use it to turn your attention outward rather than to hide your anxiety. The steps below are our practical outline of the reasoning in the trials and not a tested programme.
- Practise a few minutes a day. Sit, notice your breathing, and when your attention wanders, note it and come back.
- Notice the inward spotlight. In a conversation, catch the moment your attention drifts to how you look or sound.
- Turn attention outward. Bring it back to what the other person is saying and to sounds and sights in the room.
- Let thoughts such as “they can tell I am nervous” pass. Note them without arguing with them or acting on them.
- Do not use it as a safety behaviour. Counting breaths to avoid speaking, or breathing carefully so nobody notices you are anxious, keeps the fear in place.
- Consider a guided course. The trials used eight-week courses with a teacher. Our guide to MBSR covers what one involves, and our guide to mindfulness for anxiety covers the wider evidence.
Five minutes of mindful breathing
Sit comfortably and rest your attention on your breathing. When you notice your mind drifting to how you look or sound, note it without judging and return to the breath.
3:00
This is practice and not treatment. Short and regular beats long and rare.
Done. Notice where your attention went most often, and try the same pause in your next conversation.
Is mindfulness a sensible next step for you?
Tick anything that is true for you right now. This is a planning prompt, not a test, and it produces no diagnosis.
0 of 5 ticked
Most of the pieces are in place. Mindfulness can sit alongside CBT, and a guided course gives it structure.
A few are in place. Ask about CBT designed for social anxiety first, and start with the short daily practice above while you arrange it.
Few are in place, so a conversation with a doctor or therapist is the best first step. Ask about CBT for social anxiety by name.
When to seek help
Speak to a doctor or therapist if social anxiety keeps you from working, studying or seeing people, or if you are using alcohol to get through social situations. Our guide to alcohol and anxiety covers why that matters. Ask for CBT designed for social anxiety by name, and for the protocol the therapist uses.
No screener on this site measures social anxiety itself. Our anxiety self-assessment measures general anxiety symptoms, which overlap, and it is a screener and not a diagnosis.
If you feel unable to keep yourself safe, contact your local emergency services or a crisis helpline.
How MyFreud can help
Whether practice is changing how social situations feel is hard to judge from memory. Daily mood tracking in MyFreud shows the pattern across weeks, so you can compare the days after you practised with the days you did not. It does not replace CBT, a doctor or a therapist.
Download MyFreud and start today: App Store or Google Play.