How to use cbt to treat social anxiety

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Social Anxiety... How it Affects People and How CBT Can Help Treat it

Step By Step Guide 1. HIGH SELFCONSCIOUSNESS SYMPTOMS • People with social anxiety find it very difficult or impossible to relax around others. They may feel certain other people are judging them or observing them. Sufferers are often worried they will make mistakes and embarrass themselves or be shown up in front of other people.

TREATMENT • A CBT technique to work with self­ consciousness is to challenge the assumption that the person is always observed. The person might be asked to consider whether they pay a lot of attention to others or talk about how little attention people pay to other individuals.

2. AVOIDANCE OF SOCIAL SITUATIONS SYMPTOMS People with social anxiety often prefer to avoid social situations to prevent this anxiety, missing out on various experiences they may want to engage in. People with social anxiety may want to engage more, but feel they can't do it. Social anxiety may make them avoid fun events or gatherings.

TREATMENT To overcome avoidance with CBT, a person is asked to think about social situations where they might feel social anxiety and rate those situations from 1 to 10. Then, the person is asked to gradually enter situations, starting with those that give them the least anxiety.

"CBT can help social anxiety symptoms..."


3. ACADEMIC DIFFICULTIES SYMPTOMS Social anxiety can make it difficult to speak in public, give presentations, or interact with people during group projects or in the classroom. People with social anxiety can have a hard time participating, so all of this can hinder their academic performance or prevent them attending college.

TREATMENT With CBT the person learns techniques that involve controlling one's breathing to reduce anxiety and help with being more able to relax in difficult situations, like exams and evaluations or presentations, which are often a source of increased anxiety, along with changing beliefs.

4. DEBILITATING PANIC ATTACKS SYMPTOMS All sorts of social situations and interactions with others can be a source of increased anxiety, which can make individuals so nervous and overwhelmed that it leads to a panic attack. Fear of losing control and having a panic attack can cause social anxiety sufferers to avoid situations more.

TREATMENT The person learns relaxation techniques that help to to reduce physical symptoms, and being more able to relax in difficult situations. CBT challenges the panic by looking at evidence from previous situations, how they coped and how the fear of a panic attack rarely manifests.

5. DIFFICULTIES AT WORK SYMPTOMS People with social anxiety might struggle if their roles require them to do presentations or even to engage with co­workers, customers in person or in phone conversations. Networking and training opportunities might also be difficult. This can limit career advancement or cause them to remain unemployed.

TREATMENT CBT works with cognitive distortions (such as thinking in black and white) to reduce them or eliminate them altogether. These distortions help the person feel more comfortable doing things required for the job. For example, they feel more at ease making mistakes rather than too upset over it to think straight.

"CBT can help to develop new skills..." 6. PROBLEMS WITH JOB INTERVIEWS SYMPTOMS To land a job or a scholarship or succeed in beginning any number of things, an interview, assessment or a similar setup is often a requirement. For people with social anxiety, this can be difficult to overcome. They may feel judged and on display in such situations, and worry they will look bad. They may become tongue­tied or stammer, or worry that their mind might go blank. They might also connect the outcome of an interview with a measure of self­worth.

TREATMENT CBT teaches various relaxation techniques. The person can practise progressive muscular relaxation the person when they want to avoid appearing too tense or nervous. Role­ playing helps to prepare for interviews. CBT also challenges negative assumptions about what an interview really is, and encourages thoughts, such as: there is nothing to lose by trying or thinking of it as people just having a chat.


7. DATING AND RELATIONSHIP ISSUES SYMPTOMS Dating means meeting new people, a daunting prospect from the perspective of social anxiety. People might feel too self­ conscious to approach new people romantically. Social anxiety can produce symptoms such as sweating, facial redness, diarrhoea and nausea, all of which can feel impossible in a romantic scenario.

TREATMENT CBT offers support in the form of structured exposure situations in which a person might approach someone they are attracted to and ask a question or for direction, to experience the anxiety and see that it wasn't as bad as they were expecting. Simple, self­regulated exercises can facilitate dating later on.

8. DIFFICULTIES WITH FRIENDSHIPS SYMPTOMS Platonic relationships may be affected, as people might feel unwilling to go out and even meet with existing friends, potentially jeopardising the bond between them. It helps to have friends that really understand and who can support the sufferer with gradual exposure to social settings.

TREATMENT Social skills training is offered as part of a CBT treatment regime. The person can learn to better engage with others by gradually challenging themselves to social situations, and practising communicating in more effective ways, thereby helping their relationships.

9. RELUCTANCE TO TRY NEW THINGS SYMPTOMS People with social anxiety might avoid any situations where they feel judged, including courses or workshops for things that interest them, any kind of group situation, or any kind of situation where they might begin to feel panicky or where they have reduced control over circumstances.

TREATMENT CBT encourages the person is to experiment and branch out. They might be given homework that involves new activities, or explore new things in practical ways during a therapy session, learning new skills that can help them be prepared for and open to new possibilities.

10. EVERYDAY STRESS SYMPTOMS Social anxiety can lead to stress in simple day to day situations that involve interacting with other people, such as phone conversations, going shopping, etc. – all necessary parts of daily life. Even the thought of these kind of activities can bring on a great deal of anxiety for the sufferer.

TREATMENT CBT works to reduce the physical symptoms of anxiety, helping reduce the stress the person is feeling. They are also encouraged to break down goals and daily life challenges into manageable segments and to be mindful of stress levels and thoughts that overwhelm.

"CBT can help create lasting change..." For more information, or to book a CBT session with chartered psychologist Dr Vanessa Ruspoli, visit www.dr­ruspoli.com or call +44 (0)7747­ 777361.


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