SOCIAL SKILLS TRAINING

Overview of Social Skills

Social Skills are one of my favorite things to work on with patients. The area is rich and it is naturally something we all are in the process of learning as we get older. Generally speaking, social skills are how to interact other human beings. This current page focuses mostly on how to interact with strangers and acquaintances. The Relationship Skills section focuses on interaction with close friends, family members, and romantic partners. The Assertiveness Skills section discusses how to express your emotions and change the way that people treat you.

The Social Skills I recommend in this section are derived from my colleagues, my personal experience in overcoming social anxiety, and my professional experience as a psychiatrist (with now over 1200 patients). I don’t think that I am always right about my take on these social skills, but I do believe that my suggestions are helpful and are worth a try.

Let’s start with the broadest issue that relates to social interactions: Speaking Human.

Speaking Human

In human beings there is a critical period after which, if you don’t learn a language, you will almost always speak it with an accent. In other words, if you don’t learn how to speak French before a certain age (roughly puberty), you can still become fluent in French, but you will never sound perfectly like a Frenchman. I think the same can be said for “speaking human.” There are certain rules and subtleties of behavior in how people interact with each other. If you do not learn these rules and subtleties at an early enough age, you can still become fluent, but you will always “speak human” with an accent. Luckily, this is not as bad as it sound: we enjoy listening to people who have accents.

In my own case, I experienced quite a bit of difficulty speaking human. Throughout high school and college (and a little bit in medical school), friends and acquaintance would frequently comment that I was socially awkward. I was frequently quiet, had a very unusual and sarcastic sense of humor, made poor eye contact, and was nervous when making and accepting plans with friends. More specifics include: I would frequently flake out, not return calls, wear the same clothes too often, and be absent-minded when people were speaking to me. This was despite my best efforts to make friends and be social. These are all what I would now consider to be deficits in my ability to speak human. As I put more effort into learning how to become fluent in “American Human” I was able to get closer and closer to societal norms and actually found it much easier to make friends and date. I also found it easier to communicate, console, and even confront people in a way that they appreciated and respected. I know that I still speak human with an accent (people still tell me that my humor is a bit unusual and that my ideas are unexpected), but I am fluent enough to be able to develop close bonds and both I and other people enjoy that fact that I have "an accent".

As with many of my patients, I believe that at least some of my difficulty in speaking human came from a lack of parental training in childhood. To start with, my parents were both born and raised as Coptic Christians in Egypt, so a completely different culture. They moved to Canada when they were about 30, and moved to Los Angeles when they were 41 (and I was 5), so their learning of American culture came late in life. To make matters worse in terms of my own social training, my mother had multiple sclerosis from the time I was born and so was not very mentally present when I was a child. My father had to work long hours to support us, so I most of the time I just saw him for 1 hour a day at dinner. I was basically left to myself most of the time, which I enjoyed, but it didn’t do a thing for my social graces. I was abysmal at holding conversations (unless they were very intellectual), I was very uncomfortable with discussing my emotions, and only very recently have I started learning how to small talk with strangers. My parents never taught me how to speak human when I was a kid, but I have been able to become fluent in it with practice as an adult.

Generally speaking, you can improve your ability to speak human in two ways: by decreasing your social anxiety (for example, through Cognitive Behavioral Therapy) or by increasing your social skills. There is an interaction between the two. When you are less anxious, you are better able to develop and use your social skills. When you have better social skills, you function more effectively in social situations and you feel less anxious.

Societal Conventions

Societal conventions are closely intertwined with social skills and can present a problem for people with social anxiety. I, like most people with social anxiety, have always prided myself on being a non-conformist. In fact, most people that have been “hurt” by society (whether by growing up teased, abused, or neglected) learn to hate and rebel against society at an early age. I always thought that going to parties was “stupid” and that the cool people were “lame” (although I also secretly envied them).

Despite their initial reservations, I usually recommend that my patients at least experiment with societal norms. The Stoics in ancient Greece used to counsel, “Follow the spirit of your times in whatever age you are born in.” The adage “When in Rome, do as the Romans do” is very relevant to this discussion. In my own life, the more I have followed societal norms (for example, wearing fashionable clothes instead of old sweats and jeans, returning phone calls and keeping plans with friends, and smiling when I meet people), the happier I have become. And this despite the fact that I still hate the idea of being a “conformist”.

Many of my patients complain that they shouldn’t have to follow societal norms at all, especially when they don’t make sense. The most common complaint I hear is, “I shouldn’t have to dress well / wear makeup / comb my hair / make plans ahead of time etc. Other people should just love me for who I am.” My answer to that is a peacock analogy: Imagine that you and I are both male peacocks. That means that we have big colorful tails to attract the females. Now let’s say you and I get together and say “Screw this! These tails don’t tell women how great we are. As a matter of fact, these tails make us worse mates. We’ve got to waste energy growing them and they make it easier for predators to catch us.” So we rebel against the system and pull out all our tail feathers. What happens? Well, the only thing that happens is that neither of us will find a mate. The moral of the story: When you violate societal norms you might suffer, even when the societal norms don’t make any sense!

On a related note, there is another interesting thing about violating societal norms. It’s one of the few things that is hard-wired to produce anger. If I try to eat my dinner in front of you using two spoons, you’ll feel irritated. If I pick my nose while you are talking to me, you’ll get angry. If I never return your texts or phone calls until a week later, you’ll get pissed off. Why is that? Well, there is an evolutionary explanation: In primitive societies, anyone from a different culture was very likely to be an enemy. Couple this with the fact that back then, it’s estimated that 30% of humans died due to murder, manslaughter or warfare (in modern times its 0.004%) and you can see why it was important to be wary of strangers. As a protective measure, I think it’s been hard-wired into us to be uncomfortable around someone who follows different customs (i.e. violates our particular societal norms) because it signals they come from a potentially competing tribe.

In American culture, if you don’t wear deodorant, you wear a sweatshirt to a formal occasion, or you fart at dinner, people will get uncomfortable. If you persist, they will often get angry. It may not be “rational”, but it is predictable and it is consistent. You don’t have to be perfect, but you do have to be close to societal norms if you want people to be comfortable around you and enjoy your company (i.e. they will relax because evolution will signal you are “one of them”).

The flip-side of the societal conventions coin is that it’s OK to rebel. It is hard to enjoy socializing if you feel so constricted by rules that you can’t express yourself. It’s hard to feel happy if you feel forced to do things that are “stupid” all the time. I would estimate that I do the “right” thing about 90% of the time. But I get a huge kick out of doing the “wrong” thing 10% of the time. I do however think it’s wise to master societal conventions first, before you choose to break them. All of the great iconoclastic artists (the impressionists, the cubists, the abstract artists) mastered classical painting first, before they rebelled (and all of them chose to retain paint, canvas and good mixing and brush techniques despite rebelling). That’s the wisest course of action for patients with social anxiety as well. Get a firm grip on the societal conventions, then choose how and when it makes sense to rebel against them.

Eye-Contact

I’d like to address eye contact in two situations: When you are walking past people, and when you are in a conversation.

Eye Contact While Walking Past People: For some reason, this was a huge issue for me from my teens to my late 20’s. I would feel extremely self-conscious when I would walk past a stranger because I wouldn’t know how or when to make eye contact and I was sure that they would think I was “weird” as a result of it. I was known for staring straight at the ground as I walked to class in college. I would literally walk right past my friends without even noticing them. I’m much better at eye contact now and I no longer have social anxiety when I am walking down the street. Part of this improvement was from doing sentence exposures and real-life exposures, but much of it came from learning a rule for eye-contact while walking. Here’s the rule: When you are passing someone (on the street or in a hallway) look straight ahead, hold a slight smile, and then when the other person is within speaking distance (roughly 10 feet away) make eye contact for about 2 seconds while smiling (you can also nod acknowledgement), then look back ahead of you.

Eye Contact in Conversation: Usually this comes naturally to me, but it sometimes causes me trouble when I start “thinking about it”. The best rules I have found are as follows: When you are listening to someone, look right at them (I.e. in the vicinity of their eyes), nod every few seconds to acknowledge their points, and glance away occasionally (about 10% of the time). If they are communicating a theory or complex idea, look off to the side and nod to acknowledge that it is a good idea and you are considering it. When you are speaking: Make eye contact initially, but then look off to the side (about 15 degrees) as you are talking. Just make eye contact occasionally with the person listening to you (to make sure that they are paying attention and/or to emphasize a particular point that you are making). It’s a mistake to stare right at people the whole time you are speaking because then you will be starting at each other and it will make the other person feel uncomfortable.

Physical Spacing

If you stand or sit too close to people they will become uncomfortable. The amount of physical spacing you should maintain depends on the closeness of your relationships. For strangers, its customary to keep a distance of about 4-5 feet when you are talking to them. For close friends, 2-3 feet can be ok. For lovers, you can hold hands, hug, sit in each other’s laps while talking.

Grooming and Fashion

This section covers only the basics/bear minimum. However, even these basics can change with the culture of whatever city you live in and with whoever your friends are. When all else fails, try to emulate the makeup and fashion of people your age who you admire and want to socialize with. If you have an acquaintance whose style you admire, they will often be flattered (and become better friends) if you say to them “I really like your style and am trying to work on mine. Can we go shopping together sometime so you can give me tips?”

Before reading these “rules,” I want you keep in mind that I am trying to reference and communicate societal norms. You don’t have to follow them. However, remember what I said earlier about societal conventions: All of the great iconoclastic artists (the impressionists, the cubists, the abstract artists) mastered classical painting first, before they rebelled (and all of them chose to retain paint, canvas and good mixing and brush techniques despite “rebelling”). Get a firm grip on the societal conventions, then choose how and when it’s personally worth it for you to rebel against them.

Hygiene: This is most often an issue for people who have experienced some level of emotional or physical neglect in childhood (i.e. their parents didn’t train them when they were young). The bare minimum is easy to make a habit of. Shower at least three times a week (once a day is preferable, depending on how much you sweat). Brush your teeth and floss twice a day (flossing is actually crucial for your breath… little bits of food start to smell bad if they remain between your teeth). Wear deodorant every day (even skipping one day can lead to odor, which you may not notice yourself because you get used to smells fairly quickly). Also, wash your clothes the instant you notice any odor on them (even a slight smell is too much).

Grooming: I’ll need to be a little vague here because it depends on gender, local culture and personal preference. Generally speaking, brush your hair every day. Get your hair cut or trimmed regularly. Shave regularly. For men, this means shaving your face every day if clean shaven, or grooming your facial hair or stubble roughly twice a week. For women in American Culture, this means shaving legs and armpits and tweezing/waxing upper lip whenever hair is noticeable to the sight or to the touch. Again, all of these rules are subject to local culture so reference what the people you admire seem to be doing (and/or ask them). Rebelling is okay, but you'd be surprised at the amount that similar grooming puts people at ease when they are around you.

Makeup: In modern American culture, women usually wear light makeup (light powder and mascara) when they leave the house (unless your religion precludes it, you are just going shopping in the morning, or you are working out). On dates or going out at night with friends, it is more typical to wear full makeup (foundation, powder, blush, eye liner, eye shadow, and mascara). These rules are for women living in big cities. I’m fairly sure that the social norm is to use much less make up (and often none at all) in smaller towns unless it is a formal occasion. Look at what the women around you who you admire are doing.

If you don’t know how to apply makeup, ask a female friend to help you/go shopping with you. If you don’t know anybody who can do that, go to a cosmetics store and tell the clerk “I know nothing about makeup. Can you help me figure out what to buy and how to use it? I want to keep it simple though.”

Wearing makeup is actually an exposure, so be prepared to feel nervous the first few times you do it and go out in public. After a week or two, it should feel fairly natural and should expand your options for personal appearance considerably. You can then feel free to rebel depending on how the makeup makes you feel.

Fashion: I have many patients with social anxiety who wear sweats, black outfits, or jeans and a t-shirt every single day. They usually notice a more positive social response and a pick-up in their mood when they start wearing a wider variety of clothing.

In my late 20’s, I had a fashionable female friend go shopping with me once a month and it helped me develop a personal and more varied sense of style. Another good approach (which I do about once a year) is to go to the trendy clothing district in your town and buy three tops and one bottom. Again, for ideas, look at what the people around you who you admire are doing. “Fashion Exposures” include more details how to get comfortable wearing different clothing.

Greetings and Goodbyes

Greetings: It’s important to participate in the greetings/introduction process rather than staying seated and/or silent. It makes a much better impression (even if you are silent for the rest of the encounter) and puts people at ease (I.e. because you are following the societal norm). I usually stand to greet people as we are saying hello. For new people and acquaintances, I shake hands with men and let women initiate either waving hello, hand shaking, or hugging based on their preference. When meeting with a close friend or family member, I hug if it’s a woman and hug or shake hands if it’s a man (I throw in a fist bump after the handshake for a good male friend if they are in their 20’s or 30’s). For new people I say “Hi my name is Lindsay.” If we’ve met before but I forgot their name I’ll say “I’m sorry but I forgot your name. I’m Lindsay.” If I know their name, I’ll always use it when saying hello: “Hi Bob” or “Bob!.” It’s important to smile and use an animated voice during all of these greetings. It signals that you are happy to see them.

Goodbyes: I love goodbyes and have found them to leave an even stronger impression then hello’s. I go to each and every person and shake hands or hug while using their name: “Bye John.” “See you later Mike.” “Good seeing you Sally.” or “Nice meeting you Jane.” I always try do this with a smile and an animated voice. There have been several times where I was generally quiet during a social event but then left a good impression based on the strength of my goodbye. People were like “Who was that nice guy and how did he remember my name?”

Remembering Names

This is an unusually important social skill. I used to be horrible at remembering names and it caused me lots of problems. It would make me reluctant to say hello, say goodbye, or even talk to people I already knew because I was afraid that they would notice that I forgot their name. The problem was a little worse for me than usual because people had an easy time remembering my name (since I’m a guy with a girl's name).

I’m much better at remembering names now, but it’s because I use a few tricks. If I’m about to meet with new people, I ask my friend beforehand what their names are and write them down next to the event in my phone’s calendar. When I can’t get the names beforehand, I wait until we’re introduced and then I pull out my phone and write it down about a minute later (to disguise what I’m doing). When I’m leaving (or if I want to catch someone’s attention), I’ll first glance at my phone so I can use their name. If I meet them again, I look up the event in my calendar to find their name.

If I think it’s likely that I’ll see someone several times, I then use a visual mnemonic to remember their name: I choose a picture that “looks” like their name. For Sally, maybe I’ll remember a salad. For Shelly, maybe a seashell. For David, maybe the statue David. For Mike, maybe a microphone. I’ll try to picture them holding or wearing the item as I’m looking at them to help me remember it the next time I see them.

Small Talk and Spontaneous Conversation Skills

For many people with social anxiety, spontaneous conversation is one of the hardest skill to pick up. Small talk may not only be uncomfortable, but it may also bore and/or irritated you depending on the day. There are several rules that can help you generate and maintain both small talk and spontaneous conversation. The more you practice these rules, the more likely you will be to actually enjoy the process. Here are the rules that have helped me generate and maintain spontaneous conversation in American society: use an animated voice, ask how/why/what questions, paraphrase the other person’s content or emotions, be impulsive, and don’t be afraid to ask boring questions.

Use an Animated Voice: This one takes a little while to get the hang of (especially pulling it off when you are in a bad mood) and you should practice out loud a few times when you are alone. Using an animated voice means speaking with a slightly higher pitch than usual, varying the tone of your voice up and down within each sentence, smiling or grinning while you speak, and (usually) putting emphasis on the last word(s) of each sentence. To show you what I mean, try this experiment: say the following sentence in a monotone low voice, without emphasis on any words and without smiling: “I heard you went to the beach yesterday.” Now say the same sentence in a slightly higher voice than usual, modulate your tone up and down, grin, and emphasize the last two word in the sentence: “I heard you went to the *beach yesterday*” Can you feel the difference? When you use an animated voice it usually lifts your mood and the mood of the person you are speaking to. It also indicates interest in what you or the other person is saying and encourages you both to focus on the conversation. The key is to be able to pull this off when you are in a bad mood, but that comes with practice (and can be done in front of a mirror).

Ask How/Why/What Questions: This is an easy way to remember to ask “open-ended questions”. Open-ended questions encourage people to elaborate or tell a story. Close-ended questions, in contrast, force people to give you a one-word answer. If I tell you “I went to the beach yesterday” a closed-ended question would be “Which beach?” or “Was it nice?” or “Did you go to Malibu?” Closed-ended questions have a tendency to cut off conversations by prompting a one-word answer. An open-ended question would be “How was it?” or “Why the beach?” or “What did you do there?” One of the keys to having good conversations is actually to get the other person to speak more. Asking How/Why/What questions encourages the person to do that by prompting a several word or several sentence answer.

Paraphrase Content or Emotion: This is also known as “reflective listening” and it’s surprising how well such a simple technique is at encouraging people to keep talking. Whenever it is your turn to speak in conversation, either paraphrase the content (i.e. facts) or the emotions of what the other person just said. For example, If I tell you, “I went to the beach yesterday.” you can reply “Oh, you went to the beach.” (in an animated voice). Or you can assume my emotion and reply “I bet that made you happy.” This lets the other people know that you are actually paying attention. It’s also prompts the person to elaborate and they will sometimes launch into a story they were hoping to tell. Reflective listening is also useful in that it helps you focus your attention on what the other person is saying.

Be Impulsive: The experience that I used to have in group conversations (for example, dinner with three other people) used to follow a particular pattern. At first, I would be listening and things would pop into my mind to say. But, if I didn’t say the first two or three things that popped into my head, then it was almost like my brain would punish me by giving me nothing else to say from then on. If I was silent for long enough, I would then start to feel disconnected, lose concentration, and be unable to follow the conversation even if I tried. At that point, I would often experience a frozen face and barely be able to force a smile. It was a regular occurrence that friends would ask if I was “feeling OK” because I was so detached and quiet by the end of a group dinner.

My antidote to this situation (which I still use to this day) is to be impulsive. I tell myself, “Lindsay, you’ve got to say whatever pops into your mind if you want to stay in the conversation.” In the past, I typically suppressed whatever popped into my mind because I was afraid that it was boring, or offensive, or would make me sound foolish. Now I refuse to censor those comments and people seem to like it.

An important caveat: If someone is in the middle of a story, I will try to wait until they are finished speaking. In that case, I just remember the first letter of what I was going to say. For example, if I want to tell a story about a concert, I might just remember the letter “C” and start listening again until the person is finished speaking.

Don’t Be Afraid to Ask Boring Questions and Make Boring Comments: My wife is a great conversationalist. I still marvel at her ability to make and enjoy small talk. One of the keys I’ve noticed in her conversation is that she is not afraid to ask questions that I would otherwise have considered to be boring. “How was the traffic?” “How was the weather?” “How did you to meet?” “Where are you from?” She asks these questions using an animated voice. The comments she initially makes are similar: “I got caught in traffic on the freeway” “It was a cloudy day, but then the sun came out and it was perfect.” As "boring" as these types of questions and statements may seem, they actually put people at ease. They are easy to answer, easy to follow, and they demonstrate interest in the other person. In addition, most people without social anxiety seem to enjoy and appreciate these types of questions and comments. Eventually, my wife or the other person finds an opportunity to bridge into a story, say something funny, or share an insight. Then the conversation progresses to a more humorous or deeper level. “Boring” questions and comments are not only okay, they are desirable, especially at the beginning of a conversation (if you use an animated voice).