Cognitive Educational Therapy

Is Cognitive Behavioral Therapy very effective in treating Social anxiety?

Im HIGHLY self-conscious and have an obcession with how other people view and percieve me. I talked to a few people and they said CBT and hypnotherapy can clear this problem up in a relatively short amount of time.

Yes definetly
What is CBT?
It is a way of talking about:
How you think about yourself, the world and other people
How what you do affects your thoughts and feelings.
CBT can help you to change how you think (“Cognitive”) and what you do (“Behaviour)”. These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the “here and now” problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.
It has been found to be helpful in:
Anxiety
Depression
Panic
Agoraphobia and other phobias
Social phobia
Bulimia
Obsessive compulsive disorder
Post traumatic stress disorder
Schizophrenia

How does it work?
CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

A Situation – a problem, event or difficult situation
From this can follow:
Thoughts
Emotions
Physical feelings
Actions
Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it.
An example
There are helpful and unhelpful ways of reacting to most situations, depending on how you think about them:
Situation: You’ve had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you.
Unhelpful Helpful
Thoughts: He/she ignored me – they don’t like me He/she looks a bit wrapped up in themselves – I wonder if there’s something wrong?

Emotional:
Feelings Low, sad and rejected Concerned for the other person
Physical: Stomach cramps, low energy, feel sick None – feel comfortable

Action: Go home and avoid them Get in touch to make sure they’re OK

The same situation has led to two very different results, depending on how you thought about the situation. How you think has affected how you felt and what you did.

In the example in the left hand column, you’ve jumped to a conclusion without very much evidence for it – and this matters, because it’s led to:

a number of uncomfortable feelings
an unhelpful behaviour.

If you go home feeling depressed, you’ll probably brood on what has happened and feel worse. If you get in touch with the other person, there’s a good chance you’ll feel better about yourself. If you don’t, you won’t have the chance to correct any misunderstandings about what they think of you – and you will probably feel worse.

This is a simplified way of looking at what happens. The whole sequence, and parts of it, can also feedback like this:

This “vicious circle” can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.

CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them – and so change the way you feel. CBT aims to get you to a point where you can “do it yourself”, and work out your own ways of tackling these problems.

“Five areas” Assessment
This is another way of connecting all the 5 areas mentioned above. It builds in our relationships with other people and helps us to see how these can make us feel better or worse. Other issues such as debt, job and housing difficulties are also important. If you improve one area, you are likely to improve other parts of your life as well. “5 areas” diagram.

What does CBT involve?
The sessions
CBT can be done individually or with a group of people. It can also be done from a self-help book or computer programme. In England and Wales two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks, Beating the Blues is for
people with mild to moderate depression.

If you have individual therapy:

You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly, sessions. Each session will last between 30 and 60 minutes.

In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.

The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.

You decide what you want to deal with in the short, medium and long term.

You and the therapist will usually start by agreeing on what to discuss that day.

The work
With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

Together you will look at your thoughts, feelings and behaviours to work out:
- if they are unrealistic or unhelpful
- how they affect each other, and you.

The therapist will then help you to work out how to change unhelpful thoughts and behaviours

It’s easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend “homework” – you practise these changes in your everyday life. Depending on the situation, you might start to:

Question a self-critical or upsetting thought and replace it with a positive (and more realistic) one that you have developed in CBT

recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

At each meeting you discuss how you’ve got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don’t seem to be helping.

They will not ask you to do things you don’t want to do – you decide the pace of the treatment and what you will and won’t try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

How effective is CBT?
It is one of the most effective treatments for conditions where anxiety or depression is the main problem
It is the most effective psychological treatment for moderate and severe depression
It is as effective as antidepressants for many types of depression

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