Therapy for social anxiety, so you can be seen without dread
Social anxiety is the fear of being watched, judged or found lacking by others. Therapy for social anxiety in New York can help you feel safer in your own skin, wherever you are and whoever you are with.
Perhaps you rehearse conversations before they happen and replay them for days afterwards. Perhaps you blush, freeze or go quiet when attention turns to you, or turn down invitations you secretly wish you could accept. My approach to social anxiety is relational, somatic and body-aware. We begin exactly where you are, and build confidence from a foundation of safety and trust.
“Social anxiety convinces you that everyone is looking. Most of the time, the harshest audience in the room is the voice inside your own head.”
Therapy helps you turn down that inner critic and discover how it feels to be with people without constantly watching yourself.
What social anxiety is, and why it feels so exposing
Social anxiety goes far beyond shyness. It is a persistent fear of scrutiny that can quietly shape your career, friendships, relationships and sense of self.
At the heart of social anxiety is a fear of negative evaluation: that others will see you as awkward, boring, foolish or not good enough, and that this will lead to rejection or humiliation. The fear can attach to many situations, from parties and dates to presentations, phone calls, eating in public or simply walking into a room. For some people it is focused on performance. For others it colours almost every interaction.
What makes social anxiety so exhausting is the constant self-monitoring. Instead of being present in a conversation, part of your attention is tracking your face, your voice, your hands and how you are coming across. That split attention makes it harder to connect, which can seem to confirm the fear. Afterwards comes the post-mortem, picking over what you said and how it landed, often long into the night.
Many socially anxious people are warm, perceptive and deeply attuned to others. That sensitivity is a strength, but when it is turned into a weapon against yourself it becomes painful. Therapy does not try to make you into an extrovert or a different person. It helps you feel more at ease being who you already are, so that social life can become a source of nourishment rather than threat.
How avoidance keeps the fear alive
Avoiding social situations brings immediate relief, which is why it is so tempting. Over time, though, avoidance teaches the brain that those situations really were dangerous, and the fear grows. Subtler forms of avoidance, such as staying silent, rehearsing every sentence, avoiding eye contact or leaving early, work the same way. Part of our work is noticing these safety behaviours with compassion and gradually discovering what happens when you no longer need them.
Identity, belonging and being judged
For some people, fear of judgement is not only internal. If you are queer, trans, neurodivergent, a person of colour, an immigrant or anyone who has been genuinely judged for who you are, social vigilance can be a realistic response to real experiences. I hold that context with care. As an LGBTQIA+ affirming practitioner, I will never ask you to pretend the world is safer than it is, but I can help you find relationships and spaces where you can relax.
When fear of judgement shrinks your life
Social anxiety can be loud or almost invisible to others. You might appear confident at work while dreading every meeting, or have close friends yet find new people overwhelming. If several of these experiences feel familiar, therapy can help you understand them and loosen their hold.
- Dreading meetings, parties or dates
- Blushing, shaking or a wavering voice
- Rehearsing conversations in advance
- Replaying interactions for days
- Fear of saying something foolish
- Avoiding phone calls or eating in public
- Mind going blank when speaking
- Leaving events early to escape
- Feeling watched in ordinary places
- Holding back opinions and needs
Body-aware, relational treatment for social anxiety
Social anxiety is learned in relationships, so it heals best in a relationship too. Our work together is itself a social experience, one where you can be seen without being judged. From that foundation we gradually expand what feels possible in the rest of your life.
A safe relationship to practise in
Being genuinely listened to without evaluation can be quietly transformative. Relational therapy uses our connection as a place to notice what happens when you feel seen, to speak more freely and to experience a different kind of response from another person.
Working with the body's alarm
Blushing, a racing heart, a tight throat or shaking hands can feel like they give you away. Somatic work helps you notice these sensations early, meet them without panic and calm your nervous system so they lose some of their power.
Untangling the inner critic
We explore the beliefs that fuel social fear, such as 'people will think I am stupid' or 'I must not show anxiety', and where they came from. CBT-informed tools help you test them; psychoanalytic inquiry helps you understand why they took root.
Exposure with consent
When it feels useful, we design small, meaningful steps towards situations you have been avoiding. You choose the steps and the pace. Exposure only works when it happens within safety and trust, so nothing is pushed on you before you are ready.
Shifting attention outwards
Much social anxiety is driven by self-focused attention. Mindfulness practices help you move attention from monitoring yourself to genuinely engaging with others and your surroundings, which often makes conversations feel easier and more natural.
Medication support if wanted
For some people, particularly when social anxiety is intense or long-standing, medication can make therapy more accessible. I can assess whether it may help, prescribe it and monitor it carefully, with any changes made gradually and collaboratively.
Knowing the difference
Shyness and introversion are ways of being, not problems. Social anxiety is different because fear, rather than preference, is making the choices.
Shyness or introversion
- Preferring smaller groups or quiet
- Warming up slowly with new people
- Feeling drained but not afraid
- Choosing solitude because you enjoy it
- Little distress before or after events
Social anxiety
- Intense fear of judgement or embarrassment
- Physical panic in social moments
- Avoiding things you actually want
- Long periods of anxious anticipation
- Painful replaying and self-criticism afterwards
Beginning social anxiety therapy at your pace
Even reaching out can feel daunting with social anxiety, so I keep the first steps simple.
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1
Free consultation 15 minutes
A short, relaxed conversation where you can share as much or as little as you like. There is no pressure to perform, and you are welcome to tell me that the call itself feels uncomfortable. We will simply see whether working together feels right.
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2
Getting to know you 90 minutes
In our first longer session we explore where social fear shows up, how long it has been present, what you avoid and what you long to do. We also look at your health, history and any other concerns, such as low mood or past experiences of exclusion.
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3
Agreeing your goals
Together we identify what matters most to you, whether that is speaking up at work, dating, making friends or simply feeling less self-conscious. We shape a plan that combines relational, somatic and practical approaches around those goals.
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4
Building confidence gradually 60 or 90 minutes
Through regular sessions you develop new ways of meeting social fear, practise small steps between sessions if you choose, and begin to experience interactions differently. We reflect on what you notice and adjust as your confidence grows.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Therapy for Social Anxiety FAQs
How does therapy for social anxiety in New York work with you?
We begin by understanding where your fear of judgement shows up and how it affects your life. From there we combine relational therapy, somatic work to calm the body's alarm, CBT-informed tools for anxious beliefs and, if you wish, gentle exposure to situations you have been avoiding. Sessions are unhurried, which gives us time to explore the roots of social fear as well as practical ways forward.
Is social anxiety just extreme shyness?
Not quite. Shyness is a temperament that many people are perfectly comfortable with. Social anxiety involves significant fear and distress about being judged, embarrassed or rejected, often leading to avoidance of things you would otherwise want to do. You can be outgoing and still have social anxiety, and you can be shy without it. The question is whether fear is limiting your life.
I am anxious about the first session itself. Is that normal?
Completely. For someone with social anxiety, meeting a new practitioner can be one of the harder parts. You are welcome to say so, and we can go slowly. There is no right way to present yourself and nothing you need to prepare. Many people find that once they experience being listened to without judgement, the anxiety about therapy eases quite quickly.
Will I have to do things that terrify me?
No. Exposure can be helpful, but it is never forced. If we use it, you choose the steps, starting with ones that feel challenging yet manageable, and we always prepare and reflect together. Some people prefer to focus first on understanding their fear and calming their body before trying anything new, and that is a perfectly valid way to begin.
Can medication help with social anxiety?
For some people it can, particularly when social fear is severe or has persisted for many years. As a psychiatric nurse practitioner I can talk you through the options, potential benefits and side effects, and prescribe if you decide it is right for you. Medication works best alongside therapy rather than instead of it, and any changes are gradual and carefully monitored.
Do you work with social anxiety linked to identity or past rejection?
Yes. Social fear is often shaped by real experiences of being excluded, bullied or judged, including for sexuality, gender, race, neurodivergence or body. I take those experiences seriously rather than treating your vigilance as irrational. Our work can include processing past hurts, finding communities where you feel you belong and building confidence that does not depend on hiding parts of yourself.
Take a small step towards feeling at ease
Book a free 15-minute consultation. You can go at your own pace, and you never have to perform.