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Yea this has happened to me before. You get pretty good and then you stop doing it for a few months. It happens. Like Neil Strauss, author of 'The Game' and Master PUA said, its just like building a muscle. If you don't do it for a while, it will be a bit harder to get back into it. As humans, we have approach anxiety hardwired into us and the best PUA gets it.
For me, if I think I start to get rusty and have lots of approach anxiety, I just do the newbie mission. Just go up to 10 woman, smile, say hi, and walk away all in one day. That's all you need to do. She can be the ugly, fat lady sitting next to you on the bus, or the 60 year old woman at the grocery store.
Another thing that I recommend and I've been doing is game all time, anywhere. Whether you are at school, a grocery store, restaurant, or anywhere there is an HB you want to approach, just approach, keeping in mind the 3 second rule (approach the target within 3 seconds). The more HBs you're around, the easier it will be to approach HBs
Lately what I have been doing to help with my inner game is listen to hypnotherapy tapes . You can find lots of recommendations in these forums.
Just remember, logic is your enemy when it comes to this game.
Hope that helps you. Good luck!
Another thing that I forgot to add is setting the frame before you approach. You could have the mindset that your target is trying to hit on you and is totally attracted to you or you can have the frame that she's a long time friend that you haven't seen in awhile. (NLP stuff btw) This will definitely change how you think of the approach when you do it.