Laura L.C. Johnson, MBA, MA, LMFT, LPCC, is the Director and Founder of the Cognitive Behavior Therapy Center of Silicon Valley in Saratoga, CA ...Read More
Did you know that by practicing cognitive behavioral therapy (CBT) and mindfulness, you can create new circuits in your brain? You can actually change your brain so it’s more flexible, focused and compassionate.
We’ve known for a while that CBT and mindfulness work for many problems especially stress, anxiety and depression. New research is emerging from Stanford University and elsewhere indicating that CBT and mindfulness are effective for social anxiety.
If you have social anxiety, you know that some key problems include negative thinking about yourself, doubt about whether others like or respect you and whether you fit in, and excessive worry and anxiety before, during and after social situations. The model of social anxiety below shows how social anxiety is triggered and maintained. We experience a social or interpersonal situation that activates negative beliefs and assumptions about ourselves or others. Once triggered, we feel anxious because of the negative meaning we’ve given to the situation. We may use “safety behaviors,” or do things that make us feel less anxiety in the moment, but end up making us feel hopeless and discouraged because we don’t learn that we can tolerate anxiety and nothing really bad or scary generally happens. (The exception would be if you are being emotionally, verbally or physically abused or intentionally hurt in some way.) Once social anxiety is triggered, we become self-conscious, worry about what others are thinking, fear being embarrassed, humiliated or looked down on and our self-consciousness causes us to look inward.
An example might be thinking about going to your high school reunion. You tell yourself, ” No one will remember me. I was such a nerd in high school. The other kids used to make fun of my thick glasses. I really don’t want to go and make a fool of myself again.” You perceive the social danger as rejection. You become self-conscious and focus on yourself and your anxiety reactions. You might predict, “I will end up standing in a corner by myself and no one will talk to me. I’ll make a fool of myself. I’ll feel anxious and won’t be able to stand it.” So you don’t go (safety behavior) and stay home alone with a bottle of wine and ice cream, feeling sad and discouraged.
Imagine, alternatively, if you believed the following: “In high school I was very studious and a few of the jocks made fun of my glasses. I’ve changed now. I’ve grown up, have a good job and people tell me I’m attractive. Even though I didn’t have a lot of friends in high school, I did have a few close friends who may end up going. I would really like to see them. Yes, I might feel anxious in the first half hour or so but I know it’ll pass as I start talking to my friends and having fun.” How might the model of social anxiety change if you had these beliefs instead?
CBT helps you learn more flexible and accurate thinking as well as effective behaviors and coping skills. CBT does not discount the negative but helps you put it into perspective and see what information you might be missing that could help you develop more helpful thoughts and beliefs. Mindfulness can complement CBT by increasing your ability to direct your attention to more productive thoughts and activities and reduce anticipatory anxiety and obsessive rumination.