Understanding and Overcoming Social Anxiety: Part Two

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In Part One of Understanding and Overcoming Social Anxiety, I discussed the basic core beliefs of people who suffer from social anxiety. To review, the core beliefs are:

1. Everyone is noticing me

2. Everyone is judging me, harshly

3. As a result of these judgments, I will be humiliated and rejected.

4. If people judge me negatively, I must suffer terribly.

I wrote about a simple behavioral experiment that challenged the first belief, that everyone is paying attention to you. How do we challenge the rest of these beliefs?

Let me digress for a moment into a bit of theory about change. In my opinion, there are two types of change, first-order change, and second order change. First-order change is change that occurs within a given mental system, without changing the system itself. Second order change is transformative, in that it changes the basic framework of the system.

A good example of this is the concept of a nightmare. Within the nightmare a person can do many things such as running away, fighting, screaming, etc. but they are still within a nightmare. Second order change means waking up from the nightmare.

In the case of social anxiety, first-order change would entail questioning the beliefs that people are judging you harshly. It might entail gathering evidence whether your beliefs about people judging you are accurate or not.

Although this approach would be useful, it’s not really transformative. Second-order change would be to change the belief that other people’s judgments matter. Not caring even if people are judging you negatively would be the ultimate second order change.

Now let’s come back to earth! How would we apply each of these types of change to social anxiety? To do first-order change you could check out your mind-reading perceptions. For instance, if you are worried that your boss was judging you negatively, you could sit down with your boss and ask for feedback. You could first start by asking for general feedback, such as “How do you think I’m doing?” Then you could narrow it down to your specific concerns. For instance, imagine that you are worried that you are not working fast enough. You could ask your boss, “Do you think I’m keeping up with the pace?”

With a friend or loved one you could use a similar strategy. You could tie nonverbal cues to your questioning. For instance, let’s imagine that your spouse furrows their brow at you. You imagine they are judging you negatively. You would then ask, “I noticed that you furrowed your brow at me just then, what were you thinking?”

This strategy would result in first-order change; that is, you would correct your beliefs that everyone is judging you negatively. But it wouldn’t change the power of those imagined or real judgments to upset you.

A second order change strategy for social anxiety would be to do some behavioral exposure tests that would help you overcome the fear of judgment. I do these with my patients frequently. For instance, we might walk around my office neighborhood wearing masks. Or we might put on two brightly colored socks that don’t match, roll up our pants so that the socks are fully visible, and walk around. Other tasks might include singing loudly (and off key) as we walk down the street. Another task might be on an elevator, announcing the floors as each passes.

The key concept behind all of these types of tasks is to overcome the fear of people noticing you and judging you. Clients quickly realize that the judgments of strangers really don’t matter.

There are literally hundreds of these types of anti-embarrassment tasks. (I’ve listed some good ones below.) One can create a laddered hierarchy of tasks ranging from relatively easy tasks to very scary tasks. Then the client can work their way up the hierarchy so that they get more and more comfortable being judged.

Another approach is to deliberately work on incurring some mildly negative judgments from people you are close to. For instance, I might ask a client to wear a shirt that their spouse disapproves of or doesn’t like. Or one could deliberately espouse an opinion that a friend would disagree with. The idea of this is to get comfortable with mildly negative judgments even from people you are close to.

A key concept regarding judgment that I try to teach clients is that if one has a clear sense of one’s self, including strengths and weaknesses, then it’s possible to be relatively independent of the judgments of others. You get to determine your own judgments of yourself, and when the judgments of others correlate with your own judgments, and then you can respond non-defensively. But when the judgments don’t correlate with your own judgments of yourself, you can gracefully ignore or dispute them. The key concept is that everyone has different opinions about almost everything, and you get to determine your own opinion about yourself.

In fact, one might view social anxiety through the lens of the sense of self. Those who suffer social anxiety usually have either a negative view of themselves which they project onto the judgments of others, or have an unstable view of themselves which depends on the judgments of others. In either case the core problem is the sense of self.

To walk around with a profoundly negative view of oneself would be even more painful if one was fully aware of the source of this negative view – one’s own thoughts. Because this is so painful, people with a negative self-concept will typically project this negative self-concept onto the world, and experience everyone around them as judging them negatively. The first step to overcoming this tendency to project and to mind-read is to make the assumption that virtually all of your beliefs about others judging you are actually a reflection of you judging yourself.  Then you can deal with the real problem – your own thoughts.

If you have an unstable view of yourself, and depend on the judgments of others to figure out who you are, then changing this is more challenging. I often give clients a variety of written tasks so that they can explore their beliefs about themselves. The challenge is to figure out who you really are, including both your strengths and weaknesses. And then accept both. Once you are okay with who you are, then the judgments of others don’t really matter very much.

Now I want to clarify an important point. Some judgments do matter. For instance, if you work in a company and your boss determines your bonuses and raises, then your boss’s judgment of you matters, at least in terms of your economic health. Other judgments that typically matter might include a graduate school thesis advisor, who can determine whether you can progress in your program or not. And in general the judgments of the people closest to you do matter, at least over the long run. If your wife or husband begins to have a generally negative judgment of you that persists, this may end up in divorce. But note that even in these close relationships, a momentary negative judgment doesn’t really matter. If my hair gets too long, and starts to look funny for a week or two until I get it cut, my sweetheart won’t reject me. (Of course, she may drop subtle hints about haircuts!)

So, to summarize:

1. Social anxiety is at its core a disorder of the self. People with a strong and confident sense of self don’t suffer social anxiety. One might conceptualize social anxiety as a frantic attempt to accurately determine one’s self by polling others.

2. There is first-order and second-order change regarding social anxiety. First-order change involves making more accurate determinations of the judgments of others towards you. First-order change involves challenging mind reading beliefs and testing whether others are even paying attention to your behavior.

Second-order change is more profound and more radical. It involves learning not to care, even when others judge you negatively. It also involves bringing back your attention from the outside world and the judgments of others to the inside world and your own judgments of yourself.

3. Almost everyone can benefit from tuning into their inside judgments of themselves. As Oscar Wilde once said, “To love oneself is the beginning of a life-long romance.” We are stuck with ourselves, flaws and all, and learning to love and truly accept ourselves is really the beginning and the end of internal comfort in life.

 

 

 

Appendix: Some Examples of Anti-Embarrassment Tasks

In an elevator, open your briefcase or handbag, and look inside, and ask “Got enough air in there?”

Say “Ding” at every floor.

On a bus or subway, stand up and announce each stop.

On the street, ask for directions to a store you are standing right in front of.

 

Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

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