Articles on changing thinking patterns & link to reduced social anxiety - Social Anxiety Forum
 
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post #1 of 6 (permalink) Old 12-18-2019, 12:20 AM Thread Starter
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Articles on changing thinking patterns & link to reduced social anxiety


Hi,

I am a mental health therapist who has experienced social anxiety since the age of 14. I wanted to post my thoughts in regards to the abundance of articles on the Effectiveness of 'Changing thinking patterns/Core beliefs' & the link to Social Anxiety Symptom Reduction. As I'm sure many of you are aware, this is generally seen/heard as the first & primary subject of treatment towards reducing social anxiety related symptoms....As a therapist who practices CBT, and is a strong believer in the profound benefits of thought awareness, challenging irrational thought(s), and/or changing core beliefs I believe this has been overblown as the way to improve social anxiety. For example, on more occasions than I can count in the past, when I have experienced anticipatory anxiety about an event, I have attempted to bring awareness to what my thoughts were having me believe. Almost every time, I am able to label my thoughts as cognitive distortions (thinking errors), and clearly recognize how irrational and exaggerated they are. I also have frequently been aware of the assumption-based 'guessing' mindset that leads to increased discomfort before the event takes place. Although I have practiced and implemented this coping method 100+ times, it has done very little to change the extreme feelings of discomfort that arise pre, during, and/or post-event although I am fully aware of how ridiculous & irrational the thoughts really are.
I feel too many therapists/authors of articles/books, etc use this as the primary way to reduce social anxiety. What they are neglecting to consider, are the sub-conscious thoughts that we are not able to tune into that also lead to stress-based thinking patterns/emotions. In my opinion, the first line of effective treatment for social anxiety should include this philosophy, but also GRADUAL exposure to situations/events that bring on the discomfort. This is the complete opposite of exposing someone to an event/situation that brings on severe levels of anxiety, which I believe to be more damaging than helpful. Instead, starting to expose self to events/situations that are MILDLY to MODERATELY uncomfortable, while tracking/writing down thoughts that bring on anxiety pre-event & most importantly, again after the event - Specifically reflecting on 'Am I glad that I attended the event'/ 'Did my pre-event thoughts come true or did something different take place'/'How do I feel after attending the event'........Tracking pre-event thoughts, as well as thoughts-feelings following the event can do a tremendous job in reducing anxiety over time. Imagine if you tracked the next 10-15 events/situations that were anxiety provoking and reviewed what you had written down pre-event vs. post-event...What one will typically begin to see quite clearly, is that the pre-event thoughts bringing on the discomfort rarely/if ever take place. In addition, one will typically see a repetitive pattern of Being satisfied about attending the event, which tends to be the case a high percentage of time. What this does is allows one to see that their pre-event thoughts bringing on the anxiety rarely take place. When someone sees this trend re-occurring time and time again, one is able to more clearly see the irrational pattern in their thinking, which leads to stress reduction and a tendency to attend more events that previously brought on more anxiety.
I become frustrated with articles/books who simply say to challenge thoughts/change core beliefs prior to events without much more direction. THE KEY TO EFFECTIVE TREATMENT IS TO DO THIS BUT IT IS ABSOLUTELY ESSENTIAL THAT YOU WRITE IT DOWN IN THIS WAY AND TRACK IT IN THIS WAY OVER A MATTER OF WEEKS/MONTHS. Doing all of this in your head tends to be extremely difficult, as we are attempting to replace irrational thoughts with more rational ones while also battling the conditioned urge to not dive back into the irrational stress-based thought(s). Hope this helps others. Thanks
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post #2 of 6 (permalink) Old 12-18-2019, 02:02 AM
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What one will typically begin to see quite clearly, is that the pre-event thoughts bringing on the discomfort rarely/if ever take place. In addition, one will typically see a repetitive pattern of Being satisfied about attending the event, which tends to be the case a high percentage of time.
I think too many therapists/self-help authors assume everyone will have the same kind of experiences.

It's all well and good to tell people to challenge their assumptions, because often they're wrong, but what about people who aren't wrong? What about people who will consistently have negative social experiences because they're notably different in a way that most people find disagreeable? They're not going to be helped by a frontal assault on their anxiety, because every attempt to overcome it will end up reinforcing it.

Those people need to be taught different kinds of coping mechanisms. How to maintain a feeling of self-worth when that worth isn't being reflected by anyone around them. How to act in the face of open hostility and ostracism. How to maintain a healthy mindset when they're living in isolation and with no one to turn to for support. Without that groundwork, they won't even try to overcome their anxiety.

Not everyone who tries to overcome their anxiety with CBT is going to succeed, because not everyone is going to have more positive than negative experiences interacting with other people. It's the assumption that a person's negative predictions are unfounded that is conventional therapy's greatest weakness, and it's why all kinds of people end up in places like this. Betrayed by therapists who failed to understand the seriousness and complexity of their problems. And instead of asking themselves why their patients are failing, the therapists blame the patients. "You just weren't trying hard enough. You have to want to get better." Etc.

I say this as a person who believes in the value and utility of CBT. I use it both on myself, and when I'm trying to help other people. Our beliefs have a profound impact on our behaviors and actions. But it's important to approach each person as an individual and deal with the full range of their problems in a sensible way. And for many people, a CBT approach to combating anxiety, on its own, is worse than useless. A significant amount of other preparatory work has to be done for those people. And ime, most therapists have neither the time nor inclination to do that work.

But welcome to the forum. I hope that doesn't scare you off.

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post #3 of 6 (permalink) Old 12-18-2019, 01:24 PM Thread Starter
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No...Doesn't scare me off at all. I agree with everything you stated. As a therapist, I am blown away every week hearing my client's past experiences with therapists and their complete lack of effort and/or basics to what is most important for effective treatment to take place. 85% of effective treatment is solely on the therapeutic relationship. One of the biggest factors in the relationship is understanding & being non-judgmental.
At the same time, I don't feel your points speak as much to the ineffectiveness of these techniques, and more so in the therapist someone is seeing. A therapist should NEVER say things like: 'you aren't working hard enough'. That's a complete lack of knowledge on the debilitating symptoms anxiety and/or depression bring in. One concern is most clients will get scared off of seeing ANY therapist once they experience one that is just a bad therapist. As a result, All therapists are viewed as bad and/or a belief sets in that therapy is ineffective. Instead, they should recognize that there are bad therapists and good therapists out there. If they experience judgment from one, do not go back and continue to search for someone that has the most basic (and most crucial) set of traits in place: Supportive/Understanding/Non-Judgmental/Patient/Flexible. This is pretty easy to spot...If you are not seeing those traits in them, they are not a good fit for probably anybody.
Too much emphasis has been placed on the specific models therapists implement and the type of therapy they 'specialize' in. Find someone who can relate or understands that the lack of progress is more so due to the debilitating symptoms that surface when significant stress arises.
At the same time, those that seek therapy do need to realize that the true work takes place in between sessions. The session itself is more like a piano lesson. Getting good at the piano requires practice in between performances/lessons/etc.
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post #4 of 6 (permalink) Old 12-18-2019, 01:31 PM Thread Starter
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The most effective methods to reduce stress are to reduce stagnancy. When we are stagnant we think more. When we are stressed we think about things that leads to feeling even more stress. It can be very difficult to increase activity when you are depressed and/or anxious. That's why I believe it's so important to start with mildly uncomfortable situations rather than ones that bring on more significant discomfort. I recommend reading 'The Depression Cure'. I initially read the title and was deterred by the word cure. But after reading the text everything made sense. The book includes the 7 most important steps to reducing depressive symptoms. It is also easy to read & understand. Great book.
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post #5 of 6 (permalink) Old 12-18-2019, 05:30 PM
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Originally Posted by SjS2424 View Post
The most effective methods to reduce stress are to reduce stagnancy. When we are stagnant we think more. When we are stressed we think about things that leads to feeling even more stress. It can be very difficult to increase activity when you are depressed and/or anxious. That's why I believe it's so important to start with mildly uncomfortable situations rather than ones that bring on more significant discomfort. I recommend reading 'The Depression Cure'. I initially read the title and was deterred by the word cure. But after reading the text everything made sense. The book includes the 7 most important steps to reducing depressive symptoms. It is also easy to read & understand. Great book.
Hi, I'm curious as to what you'd suggest for someone almost completely socially isolated. One of the steps in that book is about the usefulness of social support. Your first post in this thread is based on a person who has events that cause them some sort of anxiety on a regular basis. What approach would you take with a patient who has neither of these things?

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post #6 of 6 (permalink) Old 12-23-2019, 10:31 PM
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For social anxiety I think of irrational thoughts as pre-warnings for upcoming encounterments with people in the environment.

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