Does CBT help with Social Anxiety Disorder?

In this blog, we will help you understand and answer the question,” Does CBT help with Social Anxiety Disorder? and also explore its techniques and strategies

Does CBT help with Social Anxiety Disorder?

Social anxiety disorder is one of the most prevalent anxiety disorders. Research has proved the efficacy and effectiveness of CBT (Cognitive Behavioral Therapy) with anxiety disorders and various studies have discovered that it is especially useful for the treatment of social anxiety disorder.

What is Social Anxiety?

Social Anxiety Disorder is one of the most common anxiety disorders. People feel dread or severe anxiety in social situations and this greatly hampers their life. The social situations could be anything, eg. making new friends or even eating in a restaurant or even giving a presentation. 

CBT (Cognitive Behavioral Disorder) is not just the most effective therapy but also one of the most reliable treatment options for Social Anxiety. Numerous researches have shown and proved that social anxiety disorder is best handled with the help of CBT.

The Development Of Social Anxiety

Being anxious in social situations is very normal if a person is experiencing it for the first time or if they are out of their comfort zone. But if being anxious in social situations becomes a norm and interferes with the individual’s development, daily routine, or lifestyle then it can be considered a grave problem.

Some people are predisposed to develop SAD. They have shy personalities and find it difficult to open up in front of strangers or find it uncomfortable to step out of their comfort zones. On the other hand, some people might have a traumatic experience that leads to the development of SAD.

Following is the list of some causes that contribute to the development of Social Anxiety Disorder

• Inherent Personality
• Childhood Traumatic Event (Eg., An Embarrassing moment in Social Situations)
• Bullying and Teasing
• Parenting
• Neglect
• Hereditary
• Abuse Etc.

These are just some of the many causes that lead to the development of Social Anxiety Disorder.

The onset of SAD is usually during preteens to late adolescence but in some cases, it has been found to start early as well. 

What are the tools used to assess Social Anxiety?

There are tools developed to assess whether a person is suffering from social anxiety disorder and the severity of that disorder. Some of these scales are either administered by a clinician and some are self-report assessments.

• Liebowitz Social Anxiety Scale (LSAS)
• Brief Social Phobia Scale (BSPS)
• Social Phobia and Anxiety Inventory (SPAI)
• The Social Phobia Scale and the Social Interaction Anxiety Scale (SPS and SIAS)
• Social Phobia Inventory (SPIN) and Mini-SPIN
• Social Avoidance and Distress Scale (SAD)
• Fear Questionnaire Social Phobia Subscale (FQ-Social)
• Cognitive Self-Report Measures

Cognitive Restructuring of Core beliefs

Every human being possesses a set of Core beliefs that influences their attitudes. Core beliefs are beliefs we have about ourselves as an individual, the people we are surrounded by, and even the environment. These core beliefs are of dual nature. Some of them are positive, reinforcing whereas the rest are negative, and discouraging. Both these sets of core beliefs maintain a balance. But when this status quo is disturbed it affects our attitudes and thought processes.

As we discussed there are two types of core beliefs. Positive core beliefs are, “I am strong”, “I am worthy” whereas negative core beliefs are,” I am worthless, “I am unlovable”. These beliefs play an integral part in the formation of our cognitive thought processes and attitudes. 

When our negative core beliefs overpower our positive beliefs it tends to create a ripple in our psyche. We get overly influenced by adverse thoughts and ultimately our behavior is affected as well. To overcome this issue it is imperative to restructure those thoughts and turn them into positive and uplifting thoughts. This process is known as cognitive restructuring.

Core beliefs of Social Anxiety

Our core beliefs are formed through our interaction with the outside world. We derive meaning about ourselves through the actions, behaviors, and attitudes of the people around us, so naturally, the core beliefs of a person suffering SAD are greatly influenced by our experiences and interactions.

 If someone experiences bullying in their childhood and later on develops SAD due to this traumatic event then their core beliefs would be something like,” I am unlovable”, or ”I am undeserving” etc. Some common core beliefs held by people suffering from SAD are as follows

• Everybody hates me
• I cannot trust anyone
• I am ugly
• I can never do anything right
• I can never be as good as the others.
• Everybody else is better than me
• I will fail.
• I am always wrong
• Everybody will judge me

Cognitive Restructuring Or Challenging the Core Beliefs

As explained in this blog earlier, turning negative thoughts into positive thoughts is called cognitive restructuring. It is achieved by challenging those thoughts. Once we develop our negative core beliefs we start considering them as truths disregarding the fact that these beliefs are a product of our reasoning. We tend to forget that we could have flawed reasoning and the beliefs we hold are not universal truths.

Challenging these unhelpful beliefs could be an emotionally draining process that could adversely affect the person’s emotional state. This is one of the toughest parts of CBT. This process follows a systematic approach and analyzes these thoughts to disapprove them. 

The cognitive restructuring is accomplished by undertaking the following measures:

Evidence Testing

The person suffering from SAD is asked to provide evidence to support claims and beliefs.

A question like, “What makes you think you are undeserving or unlovable can make the person think and question their own beliefs and reasoning behind them. Evidence testing is just a way for the therapist to make the client understand that there is very little evidence or truth associated with their beliefs. 

Reshaping into positive thoughts.

Once the person has undergone evidence testing and realized the futility of their beliefs it is time to shape those thoughts into alternative positive thoughts. 

Thoughts like, “I don’t fit in”, could be changed to ” I might not have much in common with others but that doesn’t mean we can’t be friends”. 

The individual must realize the toxicity of their previous beliefs and venture to reshape them into positive thoughts. 

Exposure and Conquering Fears

When fear overtakes our reasoning it becomes difficult to rationalize and reason. It is necessary to face them and learn to overcome them gradually. 

Research has suggested that gradual, consistent exposure to our fears or events, objects, and circumstances associated with our fears can reduce their intensity. 

As an exercise, the therapist might ask their client to put themselves into situations that induce dread in them. Though doing this exercise is a very tough task and most of the time clients try to avoid it.

To understand this with the help of an example let’s consider a hypothetical scenario. A girl is socially awkward and suffers from SAD. Any kind of social situation that involves interaction or even being in the presence of people causes her to feel dread.

In such cases, even common daily life activities like eating in a restaurant or ordering food can induce severe anxiety. For such a client the therapist would purposely make the girl engage in these activities.

While initially, it might seem cruel to put a person through a situation that they are uncomfortable with and scared of. Hence this has to be done properly while keeping the emotional well-being of the client in mind.

So the girl could start with easy tasks such as placing an order on the phone. Here, she is in charge and can disconnect whenever she wishes which might help her feel in control of her surroundings. 

Gradually she can move on to harder tasks. The purpose of these tasks is to make the girl realize that these situations can be overcome. 

Becoming Self Reliant. 

The purpose of CBT is to make the client capable of handling their problems. Towards the end of the therapy, the therapist ensures that client can handle their issues on their own even in the absence of the therapist. 

Also, it is imperative to make the person suffering from SAD understand that they might encounter embarrassing situations in the future as well. They might end up embarrassing themselves in front of people. But such situations are unavoidable. They cannot be controlled. 

Though they can control the way they decide to perceive it. Additionally, they need to accept that such situations do not define them as a person and they can overcome the embarrassment. 

To achieve this the client is taught assertiveness. “I can overcome this”, “This is not the end of the world.” The person must learn to assert these powerful thoughts and imbibe them into their thoughts and attitude. 

Relaxation Techniques

Social anxiety disorder causes a lot of emotional distress which also manifests into physical symptoms. Some of them are:

• Hyperventilation
• Panic Attacks
• Heart palpitations
• Fatigue
• Dizziness
• Body aches etc

To alleviate these symptoms caused by anxiety some relaxation techniques are proven to be very effective.

• Calm breathing exercises
• Progressive Muscle relaxation
• Visual imagery

While social anxiety is a debilitating disorder that can have serious implications in a person’s life it is important to remember that it can be overcome with the right approach and mindset. Cbt is a treatment that has proved its efficiency in treating Social Anxiety disorder. At present, it is the most utilized and reliable treatment method for anxiety. 

Conclusion

We explored all the methods and treatments involved in CBT when helping to cope with social anxiety and also discovered the effectiveness of CBT in dealing with social anxiety disorder.

Frequently Asked Questions By People. 

Does Cbt work for social Anxiety?

Yes, CBT works very well for Social Anxiety. Various studies have shown that CBT is one of the most efficient and leading methods of treatment for SAD.

What are some CBT strategies for anxiety?

There are many strategies employed by therapists to treat SAD. They are:

• Cognitive Restructuring/Reshaping the thought Process
• Guided Discovery
• Facing the fears/ Systematic desensitization
• Making a Record of Emotions and feelings/Journaling
• Making a schedule for activities and events
• Behavioral Experiments
• Relaxation Exercise
• Role-Playing 
• Breaking Down the tasks into easy steps

Does social anxiety go away?

People often confuse social anxiety with shyness. But social anxiety is a disorder that affects the day-to-day activities of the person suffering from it. Social anxiety cannot go away on its own if left untreated. 

Does social anxiety get worse with age?

While social anxiety does not necessarily get worse with age, people are more susceptible to it as they age. This could be because of various factors such as changes occurring in the brain and body, environmental factors, etc. 

What happens if social anxiety is left untreated?

It can lead to severe consequences if social anxiety is left untreated. It is a mental disorder that affects the daily activities of life, relationships, and confidence of a person. If left untreated it could lead to severe impairment. Also, it can lead to the development of other types of mental disorders such as depression, panic attacks, agoraphobia, etc. 

References

Gillihan, S. J. (2016b). Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety (1st ed.). Althea Press.

How Cognitive Behavioral Therapy Can Treat Social Anxiety Disorder. (2021, September 1). Verywell Mind. https://www.verywellmind.com/how-is-cbt-used-to-treat-sad-3024945

Letamendi, A. M., Chavira, D. A., & Stein, M. B. (2009). Issues in the assessment of social phobia: a review. The Israel journal of psychiatry and related sciences, 46(1), 13–24.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925842/

National Social Anxiety Center. (2021, September 24). CBT STRATEGIES TO OVERCOME SOCIAL ANXIETY. https://nationalsocialanxietycenter.com/cognitive-behavioral-therapy/social-anxiety-strategies/