This post hits close to home as I too struggle with social anxiety at times. The feelings of going into a group setting and having feelings of tightness in the chest, sweating and the heart beating fast. For those of us that struggle with this issue, there can be different reasons, some of us are bothered by loud noise and are are sensitive to how our senses respond to stimuli. Some of us also are afraid of how we are going to be judged. Will someone ask me a question about me, will they approve of the way I dress, will they think that my interests are exciting versus being dull? I recently completed a Diploma in Rational Emotive Behavioural Therapy and I found that working with our states of mind being irrational versus rational has been very beneficial for myself but also for how I deal with this topic in sessions. When we look at ourselves as dull, boring, not worthy and many other negative traits, we are looking at ourselves in this light as a whole, the reality is that pieces of us may have these traits but the key word is (pieces). When we look at a client's thoughts about themselves and remind them that catastrophising thoughts lead us to believe that we are more than 100% of any trait and this is just not possible. A client needs to understand that they may think they are worthless but the worthlessness only makes up a small (piece) of themselves and that realistic and rational states would place them between 1-99% worthless; and this is where the work can begin. The irrational mind tells us that we are in a state of no turning back and that our badness, awfulness and worthlessness make up us as a whole when in reality these are small parts of us that can be treated and worked through. Once the client can grasp that their concerns are treatable and that they are not wholly worthless and there is a possibility they may be able to handle social situations, this is where we can work with interventions that point out our irrational state in these circumstances. The following sessions will focus on the client's commitment to understanding that their thoughts are irrational and how they can proceed in a more rational way.
One of the key elements of REBT will be to remember that nothing causes us to think or feel the way we do. These thoughts and feelings come from within us. I don't agree with this statement as a whole and therefore use basic REBT to integrate into my practice. Telling a person that no circumstance or person can have an effect on their thoughts or feelings does not benefit them as I believe it is our role to work with what the client brings to the session and try to create an alternate reality to what the client is presenting to their therapist.
I will work with the client around taking baby steps to take risks that may help them to achieving their goal of feeling more comfortable in social situations. Some of the risk taking, depending on the level of anxiety the client is feeling, can include going to a café alone one week, followed by going to the same café with a close friend. The client can then start to create further risk taking activities that may help them to achieve a more comfortable state in a social environment.
During sessions we can also visit the client's past and determine if this fear of interaction with others came from a specific situation or environment. Things like being home schooled, being made fun of in school and a rough upbringing can have an effect with how we engage with others
The client will need to make commitments to work on the situation and reminded that change will not happen if they don't change current thoughts, beliefs or challenge themselves to interact with others despite how uncomfortable it may seem.
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