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Confronting the Fear of Blushing

Fear of blushing is linked with faulty assumptions and maladaptive beliefs that stem from adverse experiences in childhood. Credit: Lingbeek/iStockphoto

Fear of blushing is linked with faulty assumptions and maladaptive beliefs that stem from adverse experiences in childhood. Credit: Lingbeek/iStockphoto

By Peter Drummond & Sally Gatt

Fear of blushing is complex, but help is closer at hand now that the origin of this fear is becoming clear.

Most people don’t worry too much about blushing but, regrettably, some people are so frightened of blushing that they avoid social contact or resort to surgery – despite the recognised risks of “compensatory sweating” and other distressing side-effects of surgical treatments.

However, relief may be in sight. New findings published in Clinical Psychologist (http://tinyurl.com/kcpa2ll) suggest that fear of blushing is linked with faulty assumptions and maladaptive beliefs that stem from adverse experiences in childhood. Thankfully, once recognised, these harmful beliefs can be amended.

Blushing is a normal everyday experience, yet we don’t fully understand what purpose it serves. Charles Darwin was intrigued by where blushing might fit into his theory of evolution. He famously wrote, “Blushing is the most peculiar and most human of all expressions,” and pondered the role of self-focused attention for triggering blushing. More cynically, Darwin’s contemporary Mark Twain observed: “Man is the only animal that blushes. Or needs to.”

We now think that blushing, at least in fair-skinned people, can act as an involuntary appeasement signal or an unspoken apology during compromising social encounters. Even so, many people are disturbed by blushing, perhaps because their body betrays that they are feeling flustered. In turn, this betrayal threatens their self-confidence and social prestige. Feelings of embarrassment, guilt or shame usually initiate blushing, but it also has close parallels with the flush of rage.

At the most basic level, blushing is caused by a brief surge of blood through dilated vessels in the face, neck and upper chest. Blushing may be most prominent in the face because of the high density and close proximity of blood vessels to the skin’s surface. The blood pools under the skin, which hence looks pink and feels warm.

As an aside, colour vision in primates is well-suited and may even have evolved to detect changes in facial colour, because skin colour offers important information about the mood and intentions of others. Blushing resembles the flush of excitement and the glow of exercise, and appears to be driven by the same physiological processes that help us cool down after strenuous physical activity. Perhaps blushing also helps us cool down (literally) after an intense emotional experience.

But what differentiates blushing from other forms of facial flushing are the thoughts that trigger it and the associated discomfort and fear. At the heart of the problem seems to be a fear of being ridiculed, humiliated or ostracised. This is a primal fear because our survival, particularly when we are young, depends on being accepted by others who share resources (e.g. food and shelter) and protect us from harm.

Some research has shown that blushing helps to repair social bonds after an interpersonal transgression or mishap. Even so, people who are frightened of blushing believe that it leaves them vulnerable to the whim of others. For people with this fear it makes no difference that everyone blushes, some plainly more than they do, and that most of the time blushing passes unnoticed.

Why, then, is this fear so strong in some people? Our research indicates that people with an intense fear of blushing have a compelling need to hide private thoughts and emotions to avoid social disapproval; they feel different from other people – unwanted or flawed – and do not fit in.

That such beliefs might inflate fear about the social costs of blushing seems clear, but why do these beliefs develop in the first place, and what can be done to tackle them?

Early maladaptive schemas are deep-rooted beliefs stemming from damaging experiences that threatened basic emotional needs in childhood or adolescence. If, for example, a young girl had been bullied or abandoned or felt that her needs for safety and security were not being met, she might come to believe that others couldn’t be trusted or that they thought that she was not worth protecting. Or if she had been punished for expressing distress, she might decide to hide strong emotions from then on.

Ultimately, these early beliefs could serve as a template for understanding and responding to the behaviour of others, and for defining the types of strategies to be used to cope with stressful experiences (e.g. to anxiously seek reassurance or support, or to withdraw from others). Unfortunately, choosing faulty or demanding coping strategies based on early maladaptive schemas might ultimately create new difficulties, such as rigid dependency or social isolation.

Clinical psychologists have now developed tools to identify these early maladaptive schemas, and are exploring ways of contesting and altering these entrenched beliefs. This type of therapy can be difficult and lengthy, because the beliefs are based on emotional rather than narrative memories. As well, the emotional memories are often reinforced over a lifetime, and typically defy rational analysis. Situations that trigger these emotional memories can generate the thoughts, feelings and bodily sensations associated with the memory, resulting in anxiety, anger, sadness or fear, and provoke defensive automatic behavioural responses and protective coping strategies. In other words, our initial response to a stressful encounter may be driven by strong ingrained emotional urges rather than a balanced assessment of the facts.

Recognising these maladaptive beliefs for what they are – our first stumbling attempts to protect ourselves from harm – gives us an opportunity to regroup. Given sufficient insight, emotional support and time, these beliefs can be challenged and revised. This approach holds some promise for alleviating the fear of blushing.

Psychologists have also devised other practical ways to overcome the fear of blushing. At least in theory, blushing in a safe environment should help to reduce the fear habitually associated with cues of blushing. Then, through a process of graded exposure to feared situations, psychologists could help people to confront their primal fears.

One successful therapeutic approach hinges on the idea that people who are frightened of blushing are easily distracted by and focus on symptoms of blushing during social encounters, even to the point of confusing the minor changes in facial warmth and sweating that accompany increases in physical activity with blushing. These facial sensations become danger signals, and people learn to associate them with anxious thoughts and feelings.

This focus on anxiety undermines social engagement, thereby strengthening the feared link between blushing and social failure. By learning to concentrate on the social encounter instead of searching for danger signals, concerns about blushing are put aside and social confidence and performance improves.

Another approach is to decrease reliance on safety behaviours triggered by the danger signals, such as clamming up, avoiding eye contact or turning away, to make interpersonal interactions a more positive experience.

Encouragingly, both of these therapeutic approaches seem promising. In a recent head-to-head contrast, decreases in fear of blushing were similar for both techniques.

The logical next step would be to combine the unique components of each therapy in a comprehensive treatment package for people with a chronic fear of blushing. Addressing early maladaptive schemas linked with defectiveness, emotional inhibition and alienation may turn out to be a valuable part of this treatment.


Peter Drummond is a Professor of Psychology at Murdoch University, and Sally Gatt is a clinical psychologist registrar at St Quentins Clinical Psychology in Perth.