Cognitive Behavioral Therapy (CBT) is widely used to treat a number of anxiety disorders, including social anxiety disorder (SAD). It's a form of treatment that focuses on the sources of your anxiety, which are your thoughts. By teaching you how to first identify negative thought patterns, then how to replace them with more positive thoughts, it's possible to stop or at least lessen worrisome thoughts so you can feel more comfortable when you're in social situations.

Therapy vs. Medication for Anxiety

Should you give CBT a try to treat your social anxiety or is medication a better option? The answer is that both of them have their places in an overall treatment plan for SAD. Taking medication is a good way to deal with the physical sensations associated with social anxiety, such as:
  • Confusion
  • Difficulty catching your breath
  • Dizziness or lightheaded
  • Muscle tension
  • Nausea
  • Rapid heartbeat
They can make you feel more comfortable when you need to be in situations where you would otherwise experience these types of sensations. However, the medication does not help you get to the root of your anxiety and attack it at its source, no matter how well it treats the symptoms.

Therapy, when used in combination with medication, can be a very effective treatment to help people learn how to reduce their anxiety symptoms or even achieve relief from them. Once the medication gets the physical symptoms under better control, you can start working with a therapist on doing the same with your thoughts. It is a two-pronged method of approaching your healing from SAD.

Two Parts to Cognitive Behavioral Therapy

CBT can be broken down into two segments. The first one, the cognitive portion, has to do with either addressing the way that your thoughts contribute to the anxious feelings you're having when you are in or even thinking about, social situations. The behavioral part of the therapy looks at your actions (how you behave and react) in the situations that trigger your anxiety.

The basic concept of CBT is that your thoughts determine how you feel. A particular situation itself does not determine your emotions, but your perception of it has an impact on how you feel and how you react to it. When you change your feelings, you change the way you behave in similar situations going forward.

Identifying and Challenging Negative Thoughts

With the help of a therapist, you'll be directed to identify your negative thoughts about social situations. This can take some practice, since thoughts tend to be very fast. There may be several thoughts that jump into your head when you think about going to a place where you'll be with people or talking to people at an event. for instance.

Your therapist may direct you to picture going to a party and write down all the thoughts you have associated with that event. Here are a few examples of the thoughts you may have:
  • "I really don't like parties. I'd rather go to a movie instead so I don't have to talk to people."
  • "I never know how to dress for a party. What if I'm over/under-dressed for the occasion? I'll feel foolish."
  • "There won't be anyone there I know and I'll spend the whole night sitting by myself."
  • "I don't know how to make small talk. I know I'll blurt out something stupid."
Next, you determine which thought was the one that made you feel most anxious about the situation. When you find the one that was the most anxiety provoking, you challenge that thought.
Here are several examples on how to challenge such thoughts:
  • Ask yourself whether the thought is based on current events or something from your past that you need to deal with.
  • Are you predicting something that will happen? You're not a fortune teller.
  • Are you trying to guess how others will respond to you? You're not a mind reader.
  • Is your thought accurate? Using the example of the party, have there been times when you've been able to make small talk, have dressed appropriately and interacted with people you just met?
  • Try turning the thought around: What advice would you have to a friend who came to you with the same problem?

Replace Negative Thoughts with More Realistic Thoughts

Once you've gone through a list, your therapist will help you start replacing your anxious thoughts with more positive ones. You can start making plans for dealing with social situations and then carry them out.

CBT will give you several tools you can use when you are feeling anxious - tools you can apply in any situation where you're feeling uncomfortable. Over time, you'll start to identify your own negative thoughts and know how to switch them to more positive thoughts on your own - ultimately benefiting greatly from the results.