Psychotherapy, CBT & Counselling in London Marylebone

CBT for Social Anxiety in London

CBT for Social Anxiety in London - Cognitive Behavioural Therapy for Social Anxiety

CBT for Social Anxiety in London

If you have a social anxiety (also known as social phobia) it means that you have a constant preoccupation with being evaluated negatively by others. For example, you are constantly worried that people will negatively evaluate you, or they will reject you in their social judgements. You may also be always worried about how you look, how you laugh, how you sit, etc.

The adaptive side of social anxiety is that it can motivate individuals to perform well. In addition, social anxiety may help to maintain socially appropriate behaviour. As a result, social anxiety may motivate you to prepare for presentations or to express your opinions politely within conversation. However, this can become problematic if the preoccupation is to such an extent as to prevent you from socialising with others.

Are you struggling with Social Anxiety?

People may start to avoid social occasions for fear that other people may judge you. This can include fear of eating in social contexts, fear of saying the wrong thing or fear of meeting new people. For example, you may overanalyse the comments or behaviours of others and interpret these as negative evaluations of your own behaviour. That is to say, your focus tends to be on analysing the behaviour of others in an attempt to mind read if others view your actions as acceptable or unacceptable.

Some people may be more vulnerable than others to developing these difficulties.

How can CBT for Social Anxiety in London help?

CBT surely helps in dealing with social anxiety by identifying the underlying thoughts and complexes leading to this behaviour. For example, cognitive restructuring helps to overcome these thoughts. Also, mindfulness is useful to make you confident and present in the moment. Finally, you are taught problem-solving to sort out your thought patterns.

CBT can help overcome social anxiety in an individual very effectively according to NICE. It helps the individual to overcome their fear of rejection and face the world with courage.

When is the right time to seek CBT for Social Anxiety?

If you are showing these symptoms for more than a few weeks, it is time to seek professional help:

  • Fear of judgement.
  • Worrying about humiliation.
  • Avoiding crowd.
  • Avoiding the situations where you are the centre of attention.
  • Expecting the worst consequences of everything.

In conclusion, in order to meet formal diagnostic criteria for a social anxiety diagnosis, this must cause social or occupational impairment, significant distress and be present for a minimum of 6 months. The fear must be out of proportion to the sociocultural context and threat present.

How long does CBT for Social Anxiety in London usually last for?

When CBT techniques like mindfulness, reconstructing, and flooding are used, the treatment hardly needs more than 16 sessions. It is a brief treatment with long-lasting effects.

How does a person develop Social Anxiety?

Predisposing factors

Factors that may increase the likelihood that social phobia will develop may include: Biological vulnerabilities (behavioural inhibition and fear of negative evaluation). Poorly defined social goals. Socially anxious modelling by parents or a perception that others hold high social standards for you. For example, fearing that you will not live up to expectations if you have previously performed well.

Parenting Styles

Parenting styles may also play a part, including overprotective parenting. This parenting style leads the child to avoid experiences they perceive as difficult. It may also contribute to a lack confidence in their abilities to cope. Likewise, anxious attachment styles may also lead to a difficulty interpreting the actions and intentions of others. People with anxious attachment tend to be over cautious within social situations. They may perceive cues of danger when these are not present.

Core Beliefs

Core beliefs may include the belief that you are unable to perform in social situations and belief that others hold high social standards for you. Specifically, you may believe that others will perceive you as weak or stupid, others will notice your anxiety symptoms. This includes the belief that others are monitoring your actions closely and will negatively evaluate you.

Precipitating factors

Factors associated with the definitive onset of social anxiety may include: stress, unfamiliar social situations, loss of relationships, and anticipation of social embarrassment or lifecycle transitions.

Perpetuating factors

Factors that maintain the problem once it has become established may include: Dysfunctional thought patterns and safety behaviours, such as heightened focus on self including monitoring your own behaviours such as conversation or gestures. Negative self-perception. Perceived poor social skills. Low perceived motivation control. High estimated social cost.

Safety Behaviours

Coping behavior used to reduce anxiety and fear when you feel threatened may include: Avoiding unfamiliar situations or situations where a negative evaluation is possible and post-event rumination. You may analyse their behaviour after an event in an attempt to check if they have acted socially appropriately.

Protective factors

Factors that are strengths of the person and reduce the severity of problems, promoting healthy and adaptive functioning may include: Interests in engaging in activities. Support from friends or family and a willingness to challenge your core beliefs.

What is CBT for Social Anxiety in London? A case example.

Cara is meeting her partner’s friends for a dinner date. Cara has never met these particular friends previously but has heard a lot about them from her partner, Joel. Joel reassures Cara that these friends are looking forward to meeting her. Cara is familiar with the restaurant, as she has eaten there often. When Cara arrives to the restaurant she starts to feel anxious. Her hands start to shake as she approaches the table. Cara worries that Joel’s friends will notice this. Cara believes that her voice is noticeably shaky as she introduces herself. She excuses herself to go to the bathroom. Cara wonders if she should feign feeling unwell and go home as she does not want to embarrass herself. She fears that Joel’s friends will dislike her and tell Joel this. She worries what they will think about her leaving abruptly to go to the bathroom.

This can be understood within a Cognitive Behavioural Therapy framework as follows:

Predisposing factors

Factors that may increase the likelihood that social anxiety will develop: Meeting new people (Joel’s friends). Attention is self-focused. Unclear if Cara has had parental modeling of anxiety or the type of attachment style she has.

Precipitating factors

Factors associated with the definitive onset of social anxiety: The stress Cara experienced upon entering the restaurant led to her hands starting to shake. She became more anxious as a result. Cara’s attention is self-focused as she is vigilant to her experience of anxiety and shaky hands and voice.

Perpetuating factors

Factors that maintain the problem once it has become established: Cara is analyzing and monitoring her own physical sensations and behaviours. She then perceives others to have paid as much attention to these as her and to have given her a negative evaluation based on this. Cara has left the situation to avoid this discomfort, removing the possibility of challenging if these beliefs are true.

Protective factors

This cycle could be improved if Cara were to challenge some of her beliefs, including the belief that Joel’s friends are judging her. If she returns to the table she may find that she feels less anxious as the conversation continues and may find evidence that contradicts the belief that they dislike her. For example, they may tell her that they have had a nice time when the evening ends. If Cara returns to the table she will also be preventing herself from the safety behaviour of avoiding unfamiliar situations, which may give her confidence in future situations.

Factors that are strengths of the person and reduce the severity of problems, promoting healthy and adaptive functioning: Cara is familiar with this restaurant. Call us for CBT for Social Anxiety in London.

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