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Dr Liliya Korallo

How CBT Helps with Social Anxiety Disorder



CBT For Social Anxiety

In your daily life, you get nervous in certain situations, which is normal. In some cases, you are afraid of facing the crisis again. If it prevails, with time, the fear dominates and becomes the part of your life that is threatening. It disturbs the daily routine, work, education and personal relations resulting in bad health conditions like depression and anxiety. In such social situations, You must require social assistance from a therapist.

Cognitive Behavioral Theory (CBT) is the leading and result-oriented approach for treating psycho-patients. Research proves that CBT is a highly effective treatment for anxiety. A professional therapist helps the patient to improve his behaviour through different CBT techniques and methods. The level of fear varies from one person to the other, so not a single treatment method helps all.


What Is Social Anxiety Disorder?

When a person feels uncomfortable in social interactions where shyness, embarrassment and nervousness are apparent, he may experience a social anxiety disorder. SAD (Social Anxiety Disorder), commonly known as Social Phobia, affects approximately 13 % of the world's population, including young adults (7-20 years).

Social Anxiety Disorder is a mental disorder that is a pervasive form of anxiety. It is associated with persistent fear in certain social conditions where they are observed and may be judged by others. The subject people always feel unhappy, confused and depressed because of irrational thoughts that they are being noticed and humiliated. They stay in fear of being watched.

Below are a few examples of social situations where a person can have a social anxiety disorder.

  • On the stage for a speech or any performance

  • In front of the audience/people or guests

  • In the market, asking for the new products

  • In public places, markets, hotels or in the park

  • Meeting with new people

  • In front of the interviewer

  • Conversation on a phone call

  • Dealing with senior staff etc.

Types Of Social Anxiety Disorder

Two types of Social anxiety disorders include

  • Generalized Social Anxiety Disorder (GAD): when you feel anxious, excessively worried and fearful of most social situations.

  • Non-Generalized Social Anxiety Disorder: When you fear certain specific social situations like fear of talking to people or appearing on stage for a performance.

The common symptoms of a social anxiety disorder include nervousness, shyness, blushing, sweating, difficulty breathing, disrupted talk, lack of confidence and avoiding the situation. Signs of fear are not the same in each patient who develops GAD. You can assess if the person has GAD if he shows the following symptoms.

  • Excessively worried

  • Unrest

  • No sleep or trouble falling asleep

  • Muscle pain/fatigue

  • Stomach issues/indigestion

  • Nausea

What Are The Cause And Effects Of Social Anxiety Disorder?

Social phobia is a mental problem that starts from fear while interacting with people, leading to anxiety. Kids also develop a social phobia, and several reasons work behind the scene. Social anxiety prevails due to variable factors, including environmental, biological and cultural norms. Some of reasons a kid or adult develops social anxiety disorder may face one or a few or all of the following causes.

  • People in stressful conditions may have a great chance of developing SAD.

  • Kids having parents with SAD have more chances of developing an anxiety disorder at an early age.

  • Any bad life experience or conflict may cause anxiety.

SAD badly affects the quality of life, becomes a chronic health problem that influences daily routine and reduces the courage to perform well in every social situation. Some patients use alcohol to cope with embarrassing situations and nervousness.

Alcohol addiction and frequent use of drugs or sleeping pills may severely damage health and family relations. Anxiety, depression and suicidal thoughts bring the patient to the stage where he cannot face anyone and try to avoid every situation. He may go into isolation which again disturbs the work and job opportunities.

Therefore, it is crucial to seek treatment. You can treat it successfully via medication, social skill training, Cognitive Behavioral Therapy, and anxiety management techniques. Here we will discuss the role of CBT in social anxiety disorders.


How Does CBT Helps Social Anxiety?

Cognitive Behavioral therapy helps you identify the reasons and factors contributing to social anxiety. It aims the improvement behaviour influenced by unuseful and wrong opinions about yourself. Different skills and techniques are used to change how a particular social situation is thought.

CBT is a proven psychotherapy approach that is very old and previously used for treating depression. CBT for depression differs from CBT for social anxiety depending upon the level of fear and the patient itself.

It consists of different methods and techniques to make you understand unhealthy emotions and behaviour while interacting socially and learn how to react positively. Here are some rational thoughts, feelings and behaviour that CBT treats successfully.

  • The social events when you become nervous

  • Embarrassing thoughts on a specific bad experience

  • Guilt or anger about your abilities

  • Non-realistic thinking about yourself

  • Assertiveness and identification of the particular situation

  • Your belief that others judge you

The main goal of CBT is to learn the skills to cope with social anxiety disorder and use these skills practically in every social situation leading to anxiety. The success of CBT depends on the anxiety patent, how much he is interested, and how much he learned through CBT therapy sessions.


Common Techniques Of Cbt To Help Social Anxiety

CBT involves a wide range of techniques to treat social anxiety successfully. It identifies unfair thoughts in anxiety-causing situations and promotes skills to overcome fear and positively cope with every challenging situation.

After observing the symptoms and feared condition, the therapist decides which CBT technique is better for the social anxiety patient. Let's discuss a few CBT techniques that work amazingly for reducing fear in social anxiety.


Psychoeducation

It is a process of informing and educating people about psychiatric methods who need a reliable service to remove mental illness. A therapist informs his client about the type of mental illness, the method or technique he will be using, the reasons behind the mental issue, the effectiveness of the treatment and the improvement in social behaviour.

Here are a few ways the client gets information through psychoeducation.

  • Verbally educate the clients in therapy sessions.

  • Psychology tools like written materials, brochures, cards or signs are used to inform clients how therapy works for social anxiety.

  • Physical exercises and practical home tasks encourage the clients to sort out their problems and the best way to treat them.

Relaxation Training

CBT also introduces relaxation training to motivate the client to cope with the anxiety disorder. Grounding and breathing exercises work well to release stress immediately in a particular situation. When clients take a deep breath in a fearful case, their inner body relaxes, and calmness empowers their thoughts to tackle the challenging environment very well.

It is a simple and old technique to release fear and anxiety symptoms. A skilled therapist helps his client with different relaxing methods which they can follow in every tricky situation to avoid anxiety disorder. They practice the breathing technique in therapy sessions and are advised to practice it at home to overcome anxiety.


ABC Model

It is a basic Cognitive Behavioural Technique to work on unnatural, unhelpful, unrealistic beliefs about a social situation and your adverse response to that event. A psychologist, Dr Albert Ellis, developed this module to treat mental illness.

  • A: Stands for activating events, whether they are internal or external

  • B: The beliefs about yourself or others, whether rational or irrational, to a particular situation.

  • C: these are the consequences of that event due to your beliefs.

The therapist helps the patient to identify their thoughts and reshape their thinking for positive outcomes and healthy life through the ABC model.


SMART Goal Setting

It is another technique CBT uses to identify goals and how to achieve them positively. Your therapist helps you set all the plans and makes you skilful in setting your desired goals in time. It can be possible through mutual discussion in different sessions of therapy. The SMART stands for

  • S for specific goals

  • M for measurable

  • A is for Achievable goals

  • R is for Relative to your desired plans

  • T is for a timely approach.

Exposure Therapy

You can treat social anxiety disorder effectively with exposure therapy, a technique CBT uses to reduce the symptoms of fear in social phobia. With the help of a therapist, the client is exposed to a fearful situation in real or imagination to develop tolerance against that social situation. The therapist adopts different exposure therapy strategies, including the following:

  • Direct exposure to the activity or In vivo exposure Therapy

  • Imaginary or visualising exposure therapy

  • Technology-based exposure therapy or virtual reality exposure

People struggling with social anxiety disorder usually avoid situations where they feel uncomfortable, which is not suitable for their everyday life. A therapist can help his client by exposing him to a situation he feels terrible about or fear so that the level of anxiety starts diminishing after a few sessions.


Cognitive Restructuring

Another effective technique CBT uses to treat social phobia is cognitive restructuring. A professional therapist helps you to understand, challenge and reframe your negative thoughts and beliefs that disturb your routine and cause anxiety. It helps to improve negative thinking into realistic and healthy ideas to eradicate social phobia.

A therapist decide which method is efficient for identifying distorted beliefs and appropriately restructuring them. Depending upon the level of social phobia and the condition of the anxiety patient, a CBT expert follows a few or all the following steps.

  • Identification of inaccurate or automatic beliefs

  • Identifying cognitive distortions: the client's thoughts and labels himself in social anxiety.

  • Understanding the reasons behind disputed thoughts. It can be possible only when your therapist is experienced and observe the situation.

  • Reframing unhelpful thoughts to alternative and productive thoughts.

Benefits Of Cbt For Social Anxiety

The leading psychotherapeutic approach discovers the unrealistic thinking pattern leading to social anxiety. A professional therapist helps the person struggling with social anxiety disorder, making him strong to think, feel and react positively. CBT helps social anxiety a lot by adopting different strategies, and given below are a few benefits of CBT for social anxiety.

  • It promotes self-esteem, confidence and courage among people struggling with social anxiety.

  • CBT successfully eradicates unhelpful and destructive thinking about themselves and improves their abilities to deal with a previously tricky social situation.

  • Through mind-relaxing exercises, CBT helps discover the reasons behind people with anxiety symptoms and introduces strategies to deal with unacceptable and worrying situations.

  • The affectees start living an everyday life after having CBT. Thinking patterns and behaviours are improved.

  • They can appropriately manage every unusual and unacceptable situation and live a strong and healthy life.

Effectiveness Of CBT For Social Anxiety

It depends on the willpower and acceptance of the affectees; how they react, treat and understand the situation. CBT is an effective way of treating social anxiety with its methods and techniques. After completing the CBT sessions, people can manage the problem because they learn the skills to discover the factors that trigger the cause of social anxiety.

In most cases, CBT completely recovers the affectees, while at extreme levels, it might need medication or another psychotherapeutic approach. After discussing the treatment plan with them, A therapist decides which treatment plan is best for the affected. This result-oriented approach proves the high success rate worldwide while treating social anxiety.


Final Thoughts

Hence, Cognitive Behavioral Therapy (CBT) is an approved and leading psychotherapeutic approach to dealing with social anxiety problems. It can reduce the signs of fear, and nervousness, and also CBT helps with cognitive distortions by using different methods and techniques alone or in combination. Depending on the severity of anxiety and the client's willingness, an experienced therapist decides on the CBT method to dismiss negative thoughts and replace them with positive ones.



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