Overcoming Social Anxiety: Effective CBT Strategies and Insights

Problems for practicing Cognitive Behavioral Therapy (CBT) for overcoming social anxiety include: 1. Identifying Negative Thought Patterns: Difficulty

Doctor, I am suffering from social anxiety disorder.
I have been trying to reduce my anxiety by practicing Cognitive Behavioral Therapy (CBT).
The content for CBT states that people suffer from social anxiety due to irrational thoughts, including negative statements, so changing these thoughts can be helpful.
I have been trying to practice changing my thoughts for a long time, but it doesn’t seem to work.
I want to know why.
As a professional in psychology, you may know the details or steps I might be lacking.

Can you tell me how to analyze automatic thoughts? How can I identify core beliefs? How can I use dynamic psychology to find core conflictual relationship themes related to social anxiety? How can I effectively change negative thoughts and overcome resistance to beliefs? What are the steps for effectively changing thoughts?
What is the connection between social anxiety and narcissistic complex? If I also combine the CCRT’s (Core Conflictual Relationship Theme) RE’s observation model in my treatment, how can I analyze wishes and responses from others and from myself to identify negative thoughts? I hope you can provide me with advice that may help me recover from this condition.

Sincerely,
Kun Jay Chain

Jian, 10~19 year old female. Ask Date: 2006/07/13

Dr. Song Chengxian reply Psychiatry

Dear Mr.
Jian,
I apologize for the delayed response.
I have just returned to the country.
Regarding your two questions, I found it somewhat challenging to fully understand them as they were described in English.
Essentially, the cognitive-behavioral therapy and social skills training for social anxiety disorder or Asperger's syndrome can be helpful, but it may not be feasible to implement them on your own.
I recommend seeking assistance from a nearby professional psychiatrist, who can conduct the necessary diagnostic evaluations and arrange an appropriate and effective treatment plan.
Sincerely,
Cheng-Hsien Song

Reply Date: 2006/07/13

More Info

Overcoming social anxiety disorder (SAD) can be a challenging journey, but Cognitive Behavioral Therapy (CBT) has proven to be one of the most effective treatments available. Your experience with CBT, particularly in trying to change irrational thoughts, is a common struggle for many individuals dealing with social anxiety. Let's delve into some effective strategies and insights that may help you in your recovery process.

Understanding Automatic Thoughts
Automatic thoughts are spontaneous, often negative thoughts that arise in response to specific situations. To analyze these thoughts, start by keeping a thought diary. Whenever you feel anxious, jot down the situation, your emotional response, and the thoughts that crossed your mind. This practice helps you identify patterns in your thinking and recognize the irrational beliefs that fuel your anxiety.

Identifying Core Beliefs
Core beliefs are deeply held beliefs about yourself, others, and the world. They often stem from past experiences and can significantly influence your thoughts and behaviors. To uncover these beliefs, reflect on the following questions:
1. What do I believe about myself in social situations?
2. What do I believe others think of me?
3. What do I fear will happen if I engage socially?
Once you identify these core beliefs, you can begin to challenge and reframe them. For instance, if you believe "I will embarrass myself if I speak up," you can counter this with evidence from past experiences where you communicated successfully.

Utilizing Dynamic Psychology
Dynamic psychology, particularly the concept of Core Conflictual Relationship Theme (CCRT), can be beneficial in understanding interpersonal dynamics that contribute to social anxiety. CCRT focuses on identifying patterns in relationships that may lead to anxiety. To apply this, consider your interactions with others:
1. Wish: What do you want from others in social situations? (e.g., acceptance, validation)
2. Response: How do you perceive others respond to your needs? (e.g., rejection, indifference)
3. Self-Response: How do you feel about yourself in light of these interactions? (e.g., unworthy, anxious)
By analyzing these elements, you can gain insight into the underlying conflicts that may be perpetuating your social anxiety.

Changing Negative Thoughts
To effectively change negative thoughts, consider the following steps:
1. Identify the Thought: Recognize the negative thought as it arises.

2. Challenge the Thought: Ask yourself if the thought is based on facts or assumptions. What evidence do you have to support or refute it?
3. Reframe the Thought: Replace the negative thought with a more balanced perspective. For example, instead of thinking "Everyone will judge me," try "Some people may judge me, but many will be supportive."
4. Practice: Use exposure therapy by gradually facing social situations that trigger your anxiety. Start small and build up to more challenging scenarios.

Addressing Resistance to Change
Resistance to changing beliefs can stem from fear of the unknown or discomfort with new perspectives. To overcome this, remind yourself of the benefits of change. Engage in self-compassion and acknowledge that change takes time. Consider working with a therapist who can guide you through this process and provide support.

Connection Between Social Anxiety and Narcissistic Complex
There can be a connection between social anxiety and narcissistic traits, particularly in how individuals perceive themselves in relation to others. Those with social anxiety may fear negative evaluation, which can sometimes overlap with narcissistic tendencies, such as a heightened sensitivity to criticism. Understanding this connection can help you navigate your feelings and responses in social situations.

Combining CCRT with RE’s Observation Model
If you choose to incorporate RE’s observation model, focus on how your wishes and responses from others shape your negative thoughts. Reflect on how your desires for acceptance influence your perceptions of others' reactions. This reflection can help you identify cognitive distortions and work towards more realistic interpretations of social interactions.

Conclusion
Overcoming social anxiety is a multifaceted process that requires patience and persistence. By utilizing CBT techniques, analyzing automatic thoughts, identifying core beliefs, and understanding interpersonal dynamics, you can make significant strides in managing your anxiety. Remember, seeking support from a qualified mental health professional can provide you with tailored strategies and encouragement on your journey to recovery.

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