Shame, not low self-esteem, is often the hidden engine of social anxiety.

When shame is reduced, social anxiety is often dramatically reduced, too—or even eliminated.

We often dramatically overestimate how critical and judgmental other people really are.

Deliberately making a fool of yourself can be terrifying, and profoundly liberating.

Disclaimer: This article is nonfiction but describes events that happened many years ago. The dialogue and other details were reconstructed as accurately as possible from the author's memory.

A young man named Martin came to see me in Philadelphia for treatment of intense social anxiety. He explained that he sweated profusely—far more than the average person—and was absolutely convinced that if women saw how sweaty he was, they’d be totally grossed out and reject him.

He said he’d used every deodorant and chemical imaginable, but it made no difference. He described himself as a veritable sprinkler, with sweat pouring from his face, armpits, and entire body. He was so humiliated that he rarely left his apartment during the day and only ventured out at night to do his shopping.

He told me he’d had this problem since adolescence. Now in his early 30s, he had never had a date. He asked me if he was a “hopeless case.”

I was surprised, because to me, he seemed incredibly good-looking. That summer, my daughter was working as a receptionist in my clinic, so I asked her for a woman’s perspective. Was I imagining things?

She said, “Dad, Martin is in the category we call drop-dead gorgeous.”

So much for hopeless.

Around that time, I had learned about a technique developed by the legendary New York psychologist Albert Ellis for people struggling with social anxiety and shame. It’s called a shame-attacking exercise: a deliberate attempt to do something super-embarrassing in public in order to discover that the feared consequences never........

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