Why Cognitive-Behavioral Therapy (CBT)
Is The Most Effective Way
to Overcome Social Anxiety The word "cognitive" refers to learning, so this leads us back to the brain, since the brain processes information (i.e., consciousness, remembering, etc.) and enables us to "learn" new things.
It would be nice if we could take a pill or get an injection and have all this "learning" added to our brain all at once. But that is not how the human brain works. The brain must learn new information and this takes time because to really learn something well, a lot of repetition is involved. The more you do something, or the more you study something, the better you will become and the more you will know about that thing.
There is no short-cut to learning.
If we are discussing what will WORK in helping us overcome social anxiety, then there is no process other than learning what is rational and then acting on it (thus, CBT).
Today, many scientific communities, including psychiatry, as well as the new areas of brain science -- usually termed "cognitive neuroscience" -- are built on the foundation of what we in psychology call "cognitive-behavioral" therapy.
CBT is generally credited to Drs. Aaron Beck and Albert Ellis, who worked independently and challenged prevalent Freudian psychoanalytic theory in the 1950's for the majority of people with mental health problems.
In the sixties and seventies, growing amounts of research began to show that cognitive-behavioral therapy was indeed the therapy of choice for many conditions.
In the 1980s, this research on CBT was solidified, and more importantly for us, "social anxiety" was discovered and found its way into the psychiatric definition book, called the DSM.
The massive body of research we have today, beginning in the 1990s, was supported by the National Institutes of Mental Health, and was under the direction of Drs. Richard A. Heimberg and M. R. Liebowitz, currently of Temple University. These are the original "gold standard" studies on social anxiety and its treatment.
Cognitive-behavioral therapy has been the only type of therapy to prove effective in permanently alleviating anxiety disorders and depression.
What we have done at SAI is to expand on these initial studies, increase awareness of the necessity of repetition, reinforcement, and rationality, and provide enough time for both the cognitive and behavioral therapy to work.
Our programs at SAI are much more detailed, contain many more strategies (or solutions), and provide essential social opportunities that typical research ignores. We have found that a comprehensive approach to helping people overcome social anxiety is most successful.
In the psychiatric journal, Psychiatric Annals, Volume 30, Number 11, November 2000, the editor-in-chief, Jon Fawcett, M.D., wrote a lead editorial titled, "Psychiatrists Should Be Proficient in Cognitive Therapy".
In the article, Dr. Fawcett points out that "a mass of studies demonstrating the efficacy of cognitive behavioral therapies has built up following the dogged persistence of Aaron Beck, M.D., in developing cognitive-behavioral therapies for depression and anxiety disorders..."
For a short and simple explanation of cognitive-behavioral therapy visit
http://www.anxietynetwork.com/hcbt.html
We have published an article that explains how cognitive-behavioral therapy works for social anxiety, and why cognitive-behavioral therapy must be specific to the problem being addressed. That is, CBT for social anxiety consists of different therapy elements than for other problems or disorders. This article may be found at:
http://www.socialanxietyinstitute.org/ccbtherapy.html
Many adjunct and pseudo-therapies also exist. Some may be helpful as additions to CBT, and others are get-rich-quick schemes. Relaxation methods, some forms of hypnotherapy, massage, meditation, and acupuncture have been shown to be helpful sometimes in relieving symptoms of social anxiety. They are only adjuncts, however, as they do not help people to make permanent progress against social anxiety. Appropriate medications are helpful too, but they only temporarily address the problem.
Only a change in the brain's neural pathways (this is what "learning" is) can cause permanent changes to occur so that we can change irrational thinking into rational thinking and then act on it. This is the heart of cognitive and behavior therapy.
This is the way the human brain works. As we have discovered more about the human brain, it has helped us develop and design therapies that cause the brain to change, and allow solutions to problems like social anxiety.
As many of us have found, if, in the past, we have learned irrational thoughts and beliefs, then, today, we can more easily learn rational thinking patterns and belief systems. Cognitive and behavior therapy must go together in treatment for social anxiety. One without the other is not going to provide us an acceptable solution.
What we have done at SAI is to find, develop, and use specific strategies and solutions for social anxiety.
The therapy we do here at SAI, and the therapy contained on the audio therapy tape series, is constructed specifically for overcoming social anxiety. It is cognitive-behavioral therapy designed to help overcome social anxiety in the quickest and most effective (permanent) way.
Don't worry about ups and downs and setbacks, just continue along with the therapy. There are thousands and thousands of people now, including me, who have overcome fairly severe cases of social anxiety.
The GREAT thing is that if you move forward, and do not give up, you will continue to make progress and you WILL learn to overcome this dreaded way of life.
--Thomas A. Richards, Ph.D.
Psychologist/Director, SAI
Social Anxiety, Chemical Imbalances in the Brain,
and Brain Neural Pathways and Associations:
What Does It All Mean?
Thomas A. Richards, Ph.D.
Psychologist/Director, SAI
Most people misunderstand the meaning of "chemical imbalances" in the brain. This phrase has become the buzzword to use today to explain mental health problems, including social anxiety.
We receive several letters a day concerning this subject, and the comprehensive audio therapy series "Overcoming Social Anxiety: Step by Step" explains more thoroughly than an article can what is happening in the brain as people with social anxiety learn to progress and conquer social anxiety.
Understanding completely how this works is important to progress and recovery, so this is discussed thoroughly on the audio series relative to recovery from social anxiety disorder.
What follows is a simplified version of these mechanisms, because brain processes and mechanisms are not fully understood and the explanations that we do have would fill several large textbooks.
We can say that no one is "born" with social anxiety. You may remember circumstances and events from very early in life, but there is no "gene" that codes for social anxiety, and there is not an immutable set of genes that cause social anxiety to occur.
At best, we can say that some people have a predisposition toward anxiety in general. From what we know, this is not a predisposition to social anxiety per se, it is a predisposition to be anxious in general.
Why you develop social anxiety has more to do with environment than it has to do with genetics. However, there may be combinations occurring.
People do not generally understand that even if something is genetically influenced, this does not mean it is genetically caused. Social anxiety can not occur unless events, situations, and circumstances in the persons' environment "push" or "lead" the person to develop it.
Because we develop social anxiety over time (although some people feel it hits them all at once), the brain is learning all the time -- this is cognitive structuring -- how to be socially anxious. The brain is learning how and what to be afraid of.
The brain is literally creating new neural pathways and associations that feed and fuel our fears and anxieties in social situations.
This is quite normal because everything we learn becomes part of our neural associations or pathways.
When you learn things about your family, it becomes a part of your brain's neural pathways and associations. Remembering your mother brings back many memories because they are all tied together or bundled together by these neural pathways or associations in the brain.
Anything you learn, regardless of what it is, becomes a part of the vast neuronal associations in the brain, which contain over one billion nerve cells.
When you learn that Alexander the Great tried to conquer the world, as did Napoleon, your brain ties these people together into a neural association in your brain concerning history, historical events, and leaders who lived in the past.
When you learn to tie your shoes, ride a bicycle, drive a car, use a computer keyboard, or learn a musical instrument, your brain gradually develops the neural pathways to make your "practicing" become automatic.
The more you practice, and the more quality time you put into your practice, the more that your brain pathways change. Fairly soon, you know how to tie your shoes and you don't think about it anymore. This practice you did has made tying your shoes become automatic.
Learning a musical instrument works the same way. At first, it is difficult and hard, but the more you practice, the better you get. As you take one step at a time, and practice thirty minutes a day on your instrument, you continue to improve and get better.
What is happening? Your brain is arranging a new neural pathway or association for learning to play that instrument. As your brain develops this new pathway (it grows the more you practice and learn), you get better and better at playing your instrument.
It is exactly the same way with cognitive (learning) therapy for social anxiety.
As you learn, and then practice, the cognitive methods, strategies, and concepts, a new neural pathway begins to form. The more you practice, the more this new neural pathway or association grows.
Progress is slow at first, just like it is when you learn any new skill, but if you continue to practice, you continue to get better. If you practice enough, the habit becomes more and more automatic over time.
What you learn changes the neural associations in your brain. What is in those neural pathways or associations becomes permanent.
Now, how do brain chemicals, neurochemistry, and "imbalances" of brain chemistry fit here?
Your neural pathways and associations influence and decide which neurochemicals, and at what "strength" pass through the synapse (i.e., synaptic gap). Your neurochemistry is determined by your neural pathways and associations, not the other way around.
Medication or pills can change your brain chemistry temporarily. But, medications has no power to change neural pathways or associations. There is no cure for social anxiety in medication. There is a temporary, chemical change in your brain brought about by the medication. But it lasts only as long as the medication is synthesized to last, from four hours to longer periods. But it is never permanent. You always need to take another pill.
The only permanent solution is to change your neural pathways and associations. This can only be done by learning new strategies, rational concepts, and new methods to extinguish social anxiety. Then, these new strategies and methods must be practiced and practiced. This is why we always talk about repetition.
Without repetition, neural pathways and associations cannot change. To have a permanent solution for social anxiety, our neural pathways and associations MUST change.
When our neural pathways and associations change, our brain chemistry also changes. This is a permanent change, because you have practiced the new methods and concepts (i.e., the cognitive therapy) into your brain repetitiously, thus creating new neural associations. The more dense these neural associations are, the more you have recovered from social anxiety.
Everything in life works like this. Whatever you really learn causes new neural pathways in the brain, and, over time, with repetition, you gradually become better and better at something.
Cognitive therapy is nothing more than learning the appropriate strategies, methods, and concepts so that our brains can change. Our new neural pathways continue to grow and our new feelings, beliefs, and thoughts changed automatically, too.
The human brain is not limited in terms of learning. You can learn all you want, and keep learning until the day you die.
Cognitive therapy, if used correctly, creates permanent changes in your brain neurology, and these changes then affect your brain chemistry.
Everyone, barring brain diseases, can learn to overcome social anxiety. The cognitive therapy necessary is nothing more than a learning process... that must be repeated, repeated, and repeated .... so that our neural pathways and associations can gradually change.
This is a simplified version of what occurs in the brain, but it is an accurate portrayal of what happens as we learn to overcome social anxiety.
Some people have done a little cognitive therapy -- without the practice and the repetition -- and then said, "cognitive therapy didn't work for me".
That, of course, is not true. They did not know, or were not told, that cognitive therapy for social anxiety works in the same way that learning anything new works (e.g., learning to play a musical instrument).
It does work, but it takes persistence, practice, and repetition. The brain's neural pathways must change so that your beliefs, thoughts, and perceptions become more rational. This can only occur if you change your neural pathways by practicing repetitiously the new methods and concepts learned in cognitive therapy.
Cognitive therapy is nothing more than "learning" the appropriate methods, strategies, and concepts to help your brain develop new neural pathways that are more rational than the old anxiety-ridden pathways.
This is more fully explained in the audio therapy series, "Overcoming Social Anxiety: Step By Step" and the cognitive therapy provided throughout this series directly relates to overcoming social anxiety altogether.
This, as you can see, takes practice, persistence, and repetition. But, it works. It has to work because, as you continue, your mind really does change. You are developing new neural pathways and associations as you learn (and continue to learn and reinforce) appropriate cognitive strategies.
People can and do overcome social anxiety.
The solution is in the practice, repetition, and constant reinforcement. Progress can be made relatively quickly, faster than most people expect, but there is no substitute for practice and repetition. This does take time and patience, but every three weeks or so, if you practice each day, you will find you have made some major progress.
Continuing forward until social anxiety disorder is a thing of the past is the right choice to make.
Source : Social anxiety institute
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It'd be great if that didn't involve readily telling another human being your thoughts and feelings and what you feel triggers them. 
