Table of Contents

  1. What is Cognitive Behavioural Therapy
  2. How CBT Works
  3. How does CBT work in Therapy
  4. What is Social Anxiety
  5. How does CBT for Social Anxiety work?

What is Cognitive Behavioural Therapy

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that focuses on identifying and modifying negative thoughts, beliefs, and behaviors in order to improve mental health and well-being. CBT is based on the premise that our thoughts, emotions, and behaviors are interconnected, and by changing our thoughts and behaviors, we can positively impact our emotional state. Every thought we have triggers a specific emotion as a reaction to that same thought. That emotion then triggers a certain behaviour to motivate us to get away from the situation that triggers those negative emotions.

Thoughts and emotions are connected through the neural connection between the prefrontal cortex (where thoughts come to life) and the amygdala (where emotions are processed). People may ask themselves how phobias come to life? Phobias come to life through this exact connection. The amygdala is one of the oldest parts of our brains which has not evolved as much as the prefrontal cortex. It’s main purpose is to process emotions and trigger them as a reaction to certain thoughts that represent situations to go towards to or to avoid. The problem between this neural pathway is that it mostly has one direction. What does that mean exactly? The amygdala keeps sending a warning to the prefrontal cortex that we happen to be in a dangerous situation which we should get out of based on information it gets through senses. But not all situations are truly dangerous. If we logically thought about phobias, we would not have the reaction we have. But the amygdala is not logical. It does not differentiate real life situations from thoughts. Its main purpose is to help us survive and to accomplish that the reaction has to be really fast. If the amygdala were to rely on logic, that thought process can be really slow. Slow reaction equals not being fast enough to run away.

Let’s give an example. Imagine you see a lion roaming through the streets two blocks away. The first emotion you sense is fear and your reaction is to run. This is the amygdala taking control over the prefrontal cortex. During this time, adrenaline kicks in and the prefrontal cortex shuts down so the amygdala can take over. A fast reaction is needed here. What would happen is the amydala didn’t work? Well, you would rely on your prefrontal cortex. On logic. You see the lion and then you start asking yourself questions: ‘Is that a lion? What are the odds that there is a lion roaming the city streets? Maybe I’m imagining things. Okay, it is a lion. What should I do? Should I run? Should I hide? What if the lion isn’t dangerous? Okay, I will hide just in case, but where is my safest option?..’

As you can see, relying only on logic takes time and we do not have time when it comes to survival. So now you know the amygdala’s’ purpose. You may ask yourself what does this have to do with phobias. Sometimes we react to situations that are not really dangerous when we think about it. We often feel foolish after our reaction. This is not our fault. The amygdala creates certain reactions through association and generalization. This means it reacts based on our previous experience and associates new situations through our experiences. If we had a bad experience in school in our past, we could feel negative emotions just by the thought of going to school. That’s the amygdala warning us, because it does not know the difference between reality and thoughts. No matter how much we convince ourselves that it is not logical to fear situations that have not yet happened, it often feels like we just can’t get rid of that fear through logic. ‘Why am I so afraid to get into the elevator even though I know nothing would happen to me? Okay, I can get stuck. So what? I’ll get out eventually. I am not in danger.’ Seems logical, right. So why is the fear still there? In phobias, as we mentioned earlier, the neural pathway between the prefrontal cortex and the amygdala goes only in one direction. The prefrontal cortex receives information from the amygdala, but the amygdala does not receive feedback from the prefrontal cortex. Why is that? As we mentioned earlier, the reason may be our evolutionary need to quickly react to survive. Some parts of our brains have not yet adapted to todays society, because of how quickly the world changes and evolves. Our brain can not keep up that fast. Luckily, science has found ways to deal with our brain and to help us keep up with the fast evolving world.

Let’s see how CBT works!

Thought: “I have to give a presentation at work tomorrow.”

Emotion: Anxiety and fear

Behavior: Avoidance and procrastination

In this example, the interconnectedness of thoughts, emotions, and behaviors can be observed. The thought of giving a presentation triggers anxiety and fear as the associated emotions. These emotions, in turn, influence the person’s behavior, leading to avoidance and procrastination. The individual might find excuses to delay preparing for the presentation, avoid thinking about it, or even try to delegate the task to someone else. These behaviors are driven by the desire to escape the anxiety-inducing situation. However, this avoidance and procrastination can further reinforce the negative thoughts and emotions. The person may start believing that they are incapable of giving a successful presentation, which intensifies their anxiety and fear. The cycle continues, with the thoughts, emotions, and behaviors feeding into each other.

How CBT works in Therapy

Cognitive Behavioral Therapy (CBT) aims to break this cycle by identifying and challenging the negative thoughts, replacing them with more realistic and adaptive ones. By doing so, it can help individuals manage their emotions effectively and engage in behaviors that are more constructive and aligned with their goals. For example, through CBT, the person may learn strategies to reframe their thoughts about the presentation, develop relaxation techniques to manage their anxiety, and practice effective presentation skills to build confidence. These changes in thoughts, emotions, and behaviors work together to promote a more positive and adaptive response to the situation.

In CBT, a therapist works collaboratively with the individual to identify and challenge unhelpful or distorted thoughts and beliefs that may contribute to emotional distress or problematic behaviors. The therapy aims to replace these negative patterns with more realistic and adaptive ways of thinking, ultimately leading to healthier emotions and behaviors. CBT has been extensively researched and has shown effectiveness in treating a wide range of mental health conditions, including anxiety disorders, depression, phobias, post-traumatic stress disorder (PTSD), eating disorders, and substance abuse, among others.

What is Social Anxiety?

Social anxiety is a common mental health condition characterized by an intense and persistent fear of social situations or performance situations. People with social anxiety often experience significant distress and anxiety in social interactions, leading to avoidance of such situations. Individuals with social anxiety may fear being embarrassed, judged, or scrutinized by others. They may worry excessively about being negatively evaluated or humiliated in social settings. Common situations that trigger social anxiety include public speaking, meeting new people, participating in group activities, attending parties or social events, or even everyday interactions like making phone calls or eating in public.

The symptoms of social anxiety can vary from person to person but often include:

Physical symptoms: Rapid heartbeat, sweating, trembling or shaking, blushing, shortness of breath, dizziness, stomach discomfort, or nausea.

Emotional symptoms: Intense fear or anxiety, feeling self-conscious, excessive worry, fear of being the center of attention, or fear of being judged.

Behavioral symptoms: Avoidance of social situations, difficulty initiating or maintaining conversations, staying silent or speaking very softly, or relying on safety behaviors (e.g., avoiding eye contact, hiding behind objects, or using alcohol or drugs to cope).

Social anxiety can significantly impact an individual’s daily life, relationships, and overall well-being. However, effective treatments are available, including therapy (such as cognitive-behavioral therapy, as mentioned earlier) and, in some cases, medication. These approaches can help individuals manage their anxiety, challenge negative thoughts and beliefs, improve social skills, and gradually face and overcome their fears in social situations.

CBT for Social Anxiety

Cognitive Behavioral Therapy (CBT) is one of the most effective therapeutic approaches for treating social anxiety. CBT for social anxiety typically involves the following components:

Cognitive Restructuring

This component focuses on identifying and challenging negative thoughts and beliefs associated with social situations. Individuals with social anxiety often have distorted or exaggerated beliefs about how they are perceived by others or the potential negative outcomes of social interactions. Through CBT, they learn to recognize these irrational thoughts and replace them with more realistic and balanced thinking patterns.

Exposure Therapy

Exposure is a fundamental aspect of CBT for social anxiety. It involves gradually and systematically exposing individuals to feared social situations in a controlled and supportive manner. Through exposure, individuals confront their fears and anxieties, allowing them to learn that their feared outcomes are unlikely to occur or that they can effectively cope with them. Exposure therapy is typically done incrementally, starting with less challenging situations and progressing to more anxiety-provoking ones.

Social Skills Training

Social anxiety can be associated with deficits in social skills and confidence. CBT may include specific training in social skills, such as effective communication, assertiveness, and problem-solving. Individuals learn practical strategies for initiating and maintaining conversations, managing social interactions, and addressing social challenges. This training helps build confidence and enhances their ability to navigate social situations successfully.

Relaxation and Stress Management Techniques

CBT often incorporates relaxation and stress management techniques to help individuals cope with anxiety symptoms. These may include deep breathing exercises, progressive muscle relaxation, mindfulness techniques, and other relaxation strategies. By practicing these techniques, individuals can reduce their overall anxiety levels and manage anxiety symptoms during social situations.

Throughout the therapy process, individuals with social anxiety work closely with a therapist who guides and supports them in applying these strategies. The therapist helps individuals identify their specific triggers, develop personalized coping mechanisms, and provide feedback and encouragement. CBT for social anxiety is a collaborative and goal-oriented therapy that aims to help individuals change their thoughts, behaviors, and emotional responses related to social situations. With practice and persistence, individuals can gain confidence, challenge their fears, and gradually overcome social anxiety.

If you have any further questions about CBT or social anxiety, we encourage you to reach out to us, or if there’s any other way we can be of help to you. We appreciate your interest in our services and value the opportunity to work with you. We understand the importance of finding the right support and assistance for your needs and will find the therapist that would be suitable for you. Please know that we are committed to your well-being and want to ensure you receive the assistance you require.

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