Notes
This book gives general information. It isn't medical or psychological advice, and it's no substitute for a GP or a therapist who knows you. The NHS services I describe are those for England as I found them in September 2026. Arrangements differ elsewhere, and they change.
I've kept sources out of the chapters where I could so they read easily. Here they are by chapter, with the limits I'm aware of. Unless I say otherwise, I read the published summary of each paper and not the full text. I checked each paper for a retraction or correction notice in September 2026 and found none. Where a chapter isn't listed, it rests on my own reasoning. That includes chapters 1, 3, 6, 14, 15 and 20, and most of chapters 4, 11 and 12. The person in the examples is invented, along with the colleague, the leaving drinks, the fortieth, the roof terrace and every figure in the log.
Before you start. The description of social anxiety disorder, the advice to see a GP, and the statement that for many people it doesn't go away without treatment are from the NHS page "Social anxiety (social phobia)", last reviewed in May 2023. The two-week guide for low mood is from the NHS pages on depression.
Chapter 2. Givi and Kirk, "Saying no: the negative ramifications from invitation declines are less severe than we think", Journal of Personality and Social Psychology 126, 2024, pages 1103 to 1115. The invitations in the studies were to ordinary fun activities, and the studies measured reactions to a single decline. Nobody, as far as I know, has studied what a run of declines does. The list of four needs is mine.
Chapter 3. That behaviour which removes an unpleasant feeling gets repeated is a basic principle of learning, usually called negative reinforcement. The account of relief marking the event as dangerous is how cognitive behavioural therapists commonly explain avoidance. I've given it in my own words and haven't tied it to a single source.
Chapter 4. Rachman, Grüter-Andrew and Shafran, "Post-event processing in social anxiety", Behaviour Research and Therapy 38, 2000, pages 611 to 617. It was a questionnaire study, so it shows that going over events and avoidance go together and can't show which causes which. The four ways that refusing makes the next time harder are my reasoning.
Chapter 5. Hinrichsen and Clark, "Anticipatory processing in social anxiety: two pilot studies", Journal of Behavior Therapy and Experimental Psychiatry 34, 2003, pages 205 to 218. The authors call them pilot studies. The summary I read doesn't list the kinds of thinking involved. The three I name are from the account by Clark and Wells that the study set out to test, as it's generally described. Zelenski, Whelan, Nealis, Besner, Santoro and Wynn, "Personality and affective forecasting: trait introverts underpredict the hedonic benefits of acting extraverted", Journal of Personality and Social Psychology 104, 2013, pages 1092 to 1108. The first study had 97 participants and the other four had 495 between them. The studies concern introversion, which isn't the same as social nerves, and chapter 10 says so. The prediction exercise is mine, though therapists use similar ones.
Chapter 7. Gilovich, Savitsky and Medvec, "The illusion of transparency: biased assessments of others' ability to read one's emotional states", Journal of Personality and Social Psychology 75, 1998, pages 332 to 346. Savitsky, Epley and Gilovich, "Do others judge us as harshly as we think? Overestimating the impact of our failures, shortcomings, and mishaps", Journal of Personality and Social Psychology 81, 2001, pages 44 to 56. Neither paper studied people with social nerves in particular. A later paper by Brown and Stopa in the Journal of Anxiety Disorders, 2007, tested both ideas in a socially stressful task and got mixed results for the illusion of transparency, so I'd hold my extension loosely. What I say about gatherings you've been to is an invitation to check your own memory.
Chapter 8. McManus, Sacadura and Clark, "Why social anxiety persists: an experimental investigation of the role of safety behaviours as a maintaining factor", Journal of Behavior Therapy and Experimental Psychiatry 39, 2008, pages 147 to 161. The summary says safety behaviours and self-focused attention were unhelpful "in a number of ways" without listing them. The advice to focus on what people are saying is quoted from the NHS page. That people with this habit are often good listeners is my impression.
Chapter 9. McManus and colleagues as above. The three reasons props backfire are from the clinical literature as I understand it and from my own reasoning, and the chapter says the experiments didn't measure them.
Chapter 10. Zelenski and colleagues 2013 as above. Zelenski, Santoro and Whelan, "Would introverts be better off if they acted more like extraverts? Exploring emotional and cognitive consequences of counterdispositional behavior", Emotion 12, 2012, pages 290 to 303. The test of concentration was the Stroop task. The cost they did find fell on extraverts asked to act introverted. The distinction between a preference and a fear is mine.
Chapter 11. The NHS statement is from the page named above. The comparison with learning to drive is mine.
Chapter 12. Givi and Kirk as above. That hosts stop asking out of consideration is my observation and I've no study for it.
Chapter 13. Rachman and colleagues as above. The correlation between going over events and social anxiety was 0.40, which is moderate. Writing three facts on the night is my suggestion. It resembles exercises used in therapy and hasn't been tested as I describe it.
Chapter 14. The list of everyday activities is quoted from the NHS page.
Chapter 16. Breaking situations into smaller parts is NHS advice. The rest is mine. That anxiety falls if you stay in a situation is the basis of exposure in cognitive behavioural therapy. I've stated it from general knowledge, and the hour is my own figure.
Chapter 17. The description of panic attacks and the suggestion of breathing exercises are from the NHS page.
Chapter 18. Gollwitzer and Sheeran, "Implementation intentions and goal achievement: a meta-analysis of effects and processes", Advances in Experimental Social Psychology 38, 2006, pages 69 to 119. The rule and its parts haven't been tested together, and what I say to expect is my expectation and not a finding.
Chapter 19. Mayo-Wilson, Dias, Mavranezouli, Kew, Clark, Ades and Pilling, "Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis", Lancet Psychiatry 1, 2014, pages 368 to 376. There were 101 trials and 13,164 participants. Individual CBT and one class of antidepressants were the only treatments that beat an appropriate placebo as well as a waiting list. The work was funded by the National Institute for Health and Care Excellence. Treatment options, self-referral and the NHS's own self-help guide are described on the NHS page. Medicines are a matter for you and your doctor, and nothing here is advice about them.