'Recently I find myself shaking, sweating and feeling ill when I go out with friends. I am also due to give a presentation at work and I can't face it. The last time I gave a presentation I panicked and couldn't speak. I seem to be afraid of being around people.' Brian.

Step 1: The distressing symptoms you describe are common to a condition known as social phobia – a fear of social situations – an extremely debilitating form of shyness. It might be that the fear you experienced when giving your presentation triggered a generalised fear of socialising, particularly with the pressure of another presentation looming. The first step is to acknowledge your anxiety, while accepting that the only way to overcome it is to expose yourself to as much social interaction as possible.

Step 2: To help you cope with exposure therapy, learn a relaxation technique that works for you. Some people find a guided relaxation CD works well, others a breathing exercise (try http://comment.independent.co.uk/commentators/article2253884.ece). Another technique is to practice distracting yourself prior to giving your presentation or meeting up with friends. The aim is to stem the negative thoughts and anything can be used, such as reading, pleasurable daydreaming or filling in a crossword. Your goal is to become so absorbed that your symptoms will reduce considerably. Practice these techniques daily so they will work when you need them to.

Step 3: Often our dread of speaking in public is related to our apprehension of authority figures. We are also susceptible to being caught up in the myth of perfection. Remind yourself that perfection is unrealistic and that you can only do your best. Forgive yourself any errors and reassure yourself that this is not a life or death situation.

Step 4: If you can, confide in someone you trust when you start to feel distressed while socialising. They can reassure you that your symptoms will pass if you pay attention to your breath and distract yourself. Finally, piling on self-criticism when you are already feeling vulnerable will not help – be gentle with yourself.