Online Treatment for Social Anxiety Disorder via Skype
Mindfulness Therapy for Social Anxiety Disorder
In order to overcome social anxiety disorder you need to develop a more conscious and non-reactive relationship to your anxiety reactions themselves. The real problem for most anxiety sufferers is that you become totally identified with the anxiety when it gets triggered, you become consumed by it and overwhelmed by it. This process is called Reactive Identification, the process through which we lose our identity and become the emotion itself. During mindfulness training you will learn how to prevent reactive identification and develop a conscious relationship with your anxiety and thoughts as the Observer of the emotions instead of becoming the object (emotion, thought, perception, etc). The Observer is fundamentally free, it is not the anxiety, it is not the object that is observed, and this is the essential key to overcoming anxiety and depression and all forms of emotional suffering caused by blind reactive identification with the contents of our mind. When you stop reactive identification you also stop feeding the anxiety and this makes healing and resolution of the anxiety possible.
Watch this video about the mindfulness therapy approach for social anxiety disorder:
Welcome. My name is Peter Strong. I’m a professional online therapist specializing in mindfulness therapy and I offer online treatment for social anxiety disorder. So during the online therapy sessions, what I’ll be teaching you is how to work with those anxiety reactions that you experience in the presence of other people or situations where you feel that people are looking at you or that you’re on the spot.
We need to find a way of breaking free from the process of what is called Emotional Contraction that happens when these habitual anxiety reactions are triggered in the mind, and best way to do that is to actually meditate on the situation that triggered that social anxiety. So during this very focused meditation we try to identify the triggers and we identify the emotional reactions. We then develop mindfulness around the emotional reactions. So in effect isolating them and preventing them igniting further reactivity that intensifies the social anxiety.
We learn to change our relationship to these emotions and help to resolve the emotions by developing our conscious relationship with them and developing compassion towards them. So this is quite easy to do. It takes a bit of learning and a bit of guidance, but basically the rule is that the more you can identify those emotional reactions the better, and the more that you can develop friendliness towards those emotions the better, and the more that you’re able to stay conscious with those emotions without reacting further the better it will be. This is what creates the right internal conditions that will lead to the healing and resolution of that social anxiety.
It’s similar in many ways to exposure therapy, which is highly recommended for social anxiety, but we’re doing this in our minds. We’re running through the situation in our minds, finding the emotional reaction and then changing our relationship to it so that we don’t get caught up blindly in that emotional reaction. We learn instead to develop a friendly and compassionate relationship to that part of us that is scared, and this is what is essential for the part of us to heal and to change.
So this is what I’ll be teaching you during our online therapy sessions. I will teach you how to work with your social anxiety and how to overcome those patterns of automatic, blind emotional reactivity that feeds the anxiety.
If you’d like to learn more about the mindfulness methods for overcoming social anxiety, do please go to my website, learn some more about the online treatment for social anxiety disorder, and then e-mail me and let’s schedule a trial Skype therapy session to work on your social anxiety disorder. Most people find the mindfulness approach very effective indeed and you can expect to see significant changes after the first three to four sessions. So if you would like to learn more about online treatment for social anxiety disorder, go to my website and let’s set up a Skype therapy session to help you learn how to apply mindfulness for overcoming social anxiety disorder.
Tips to Help You with Your Social Anxiety
There are many things that you can do to start changing things around, and be assured that it is possible to break free from the terrifying grip of social anxiety, shyness and other forms of anxiety disorder.
Anxiety, like all other forms of emotional reactivity is habitual in nature – based on learned habitual reactions that form through the interaction of Unawareness and Compulsion, the two principal factors that underlies all emotional reactions.
As you know, what you do not see is what has greatest power over you. So, the first principle to develop is awareness of your habitual reactions. You have to become an expert on how they work, their structure and the initial symptoms of when they arise. The more you see, the more power you will gain over the habitual force of the anxiety reactions.
This development of awareness of what is happening in your mind and body during an anxiety reaction is central, and the specific form of awareness that has most benefit is called mindfulness. This is not the same as knowing about your habits or talking about them, which is second-hand knowledge, but the direct seeing of the reaction and thought processes in real-time. Mindfulness is all about “living in the present” and this means being directly aware of emotions and thoughts, positive or negative, as they arise now.
So, you can begin changing habits by developing mindfulness of them. The more you see, the freer you become.
You are Not Your Thoughts
The Buddha taught this 2500 years ago, and this is one of the most important lessons to learn if you want to break free from the habit of anxiety.
Whenever you catch yourself thinking, “I am feeling so anxious right now,” or “They are going to think that I am weird,” change this to, “I notice that the feeling of anxiety has arisen in me,” and “I notice that an uncomfortable feeling has arisen in me.”
The objective here is to stop yourself identifying with these negative thoughts. Taking them to be true, to be who we are, is our habit and our major problem, because when you identify with your emotional reactions you lose yourself and become the emotion. This is the origin of our suffering – the loss of True Self and then becoming a slave to the thoughts and emotions.
Exposure or Challenge Therapy
This is central to all good therapy, especially CBT Cognitive Therapy and Mindfulness Therapy. You take the initiative here and actually construct specific and measured challenges – such as talking to a girl at work or visiting a supermarket.
However, the purpose of Exposure Therapy is not to simply relive the anxiety according to our habit, but to test out how well we have prepared ourselves to manage the challenge ahead of time through our Mindfulness Practice.
Imaginal Exposure Therapy
Using mindfulness we can begin to change our habitual anxiety reactions by confronting them in our imagination and investigating the sensory structure of the way that we see things in our mind’s eye. Emotion has a structure in the form of inner imagery. When we see this, which is the whole point of mindfulness therapy, then we can see what needs to change. Change the imagery and you can change the emotional reaction itself.
Through imaginal exposure therapy way we can learn better ways of managing our anxiety and we can rehearse how we want to respond in specific situations that challenge us – and then we can go out and test ourselves!
You will probably benefit from expert guidance in this aspect of working with your emotions, but you will be surprised how much you can achieve by yourself without the guidance from a therapist.
Posture and Body-centered Approaches for Anxiety
Besides inner mindfulness work, which is designed to change the mental structure of habitual anxiety reactions, we can also change the external bodily structure of anxiety. Just think about it. What posture do you take when afraid? Chances are it will be one of withdrawal, of closing up, of contracting and cowering. Now, what Mindfulness Psychology teaches us is that this bodily structure – in posture, movement and tightening of specific muscle groups – is actually required to maintain the emotion of fear or anxiety. This is the physical habitual reactivity of anxiety.
When we train ourselves to become aware of the physical structure of our anxiety reaction through mindful awareness, we can experiment in making specific changes, opening our posture, expanding our physical presence, massaging and relaxing tight muscles, etc. Again, by changing the physical structure of our anxiety reaction we can directly change the emotion itself.
There is so much more you can learn!
There are dozens of simple mindfulness-based tools that you can learn and that prove very effective for fundamentally changing the underlying process that creates your social anxiety. You might benefit from reading more of the pages on this website, or if you feel ready, you can schedule a few Skype sessions with me. Most of my clients see big changes after 3-4 sessions of Mindfulness Therapy.
How Do I Get Online Therapy for my Social Anxiety Disorder?
If you are really interested in changing and breaking free from the grip of anxiety around people, then simply email me and email me. Ask your questions and schedule your first Skype session. There are no upfront payments and satisfaction is guaranteed.
ONLINE COUNSELING SERVICE WITH AN ONLINE THERAPIST
TELL ME ABOUT YOURSELF
ASK YOUR QUESTIONS
SCHEDULE A SKYPE THERAPY SESSION
Here is a useful article about Social Anxiety Disorder Treatment:
Social Anxiety Disorder — also known as social phobia — is commonly treated by either psychotherapy or certain types of psychiatric medications. Social phobia is characterized by a persistent fear of social situations or performance situations (such as public speaking) where embarrassment might occur.
While both psychotherapy and medications have been shown to be effective in the treatment of social anxiety disorder, a combination approach to treatment — utilizing both at the same time — may be the most timely and beneficial.
While some people may find relief from some social anxiety symptoms through trying simple self-help techniques, most people with a diagnosed social phobia condition will need professional treatment in order to overcome it.
Psychotherapy for Social Anxiety
Psychotherapy is a very effective method of treatment for social anxiety disorder. Specifically, cognitive behavioral treatments — which include techniques such as exposure therapy, cognitive restructuring without exposure, exposure therapy with cognitive restructuring, and social skills training — appear to be highly effective in treatment social anxiety, in a time-limited manner. Most cognitive-behavioral therapy (CBT) can be administered within 16 sessions (usually one session per week). At the end of treatment, a person’s anxiety symptoms are greatly reduced or even disappear in some cases.
In addition to CBT, other psychological treatments have also been found effective in the treatment of social anxiety. These include cognitive therapy (a form of CBT), social skills training alone, relaxation exercises, exposure therapy alone, behavioral therapy, and some other types of less-practiced forms of psychotherapy.
Exposure therapy is often a primary component of psychotherapy treatment of social anxiety disorder. Exposure therapy involves a person learning to understand the irrational basis for their fears (cognitive restructuring), teaching simple relaxation skills to practice while in the moment, and gradually being “exposed” to the situation which causes the anxiety. The exposure is done first in the safety of the psychotherapy office, imagining the scenario and walking through it with the therapist. As the patient’s confidence grows, he or she will begin to apply the skills they’ve learned in the therapy session to outside world events and environments.
Psychotherapy treatments have been shown to be highly effective in treating social anxiety disorder (Acarturk et al., 2009; Powers et al., 2008). Most people who try psychotherapy with a therapist who has experience in treating social anxiety disorder will find relief from their symptoms.
Medications for Social Anxiety
The primary class of drugs used to treat social anxiety are called selective serotonin reuptake inhibitors (SSRIs). This class of drugs was first developed to treat depression and so are often referred to as antidepressants. Since then, however, they have been found to be effective in the treatment of a wider range of disorders. Common SSRIs include Paxil (paroxetine), Zoloft (sertraline), Prozac (fluoxetine), and Luvox (fluvoxamine).
Another type of antidepressant called Effexor (venlafaxine) may also be prescribed to help with the symptoms of social phobia.
These kinds of medications generally take 6 to 8 weeks in order to start feeling the full therapeutic effects of them. While it may be frustrating to wait during that time and feel little relief, always take all medications as prescribed by your doctor. If you experience any distressing side effects, talk to your doctor immediately.
There is little specific reason to prescribe one antidepressant over another for the treatment of this disorder. Your doctor may choose your medication based upon their own experience in prescribing it, or based upon the typical side effects most people who take it experience. If you are not experiencing relief in 6 to 8 weeks from the first medication prescribed, talk to your doctor. He or she may decide to either up your dose or try a different medication altogether.
Other Medications for social anxiety disorder
In addition to SSRIs, others kinds of medications are occasionally prescribed in the treatment of social anxiety disorder.
Anti-anxiety medications called benzodiazepines are rarely prescribed for social anxiety disorder, because they are extremely habit-forming and act as a sedative. However, because they act quickly in the short-term, they may be prescribed when a specific situation warrants their use — such as an unexpected public speaking engagement that can’t be avoided.
A class of drugs called beta blockers may also be used for relieving social anxiety. Beta blockers work by blocking the flow of epinephrine (more commonly known as adrenaline) that occurs when you’re anxious. This means they can help to control and block the physical symptoms that often accompany social anxiety — at least for a short while. They are primarily used for short-term situations, such as when you need to give a speech. However, like benzodiazepines, they are not generally recommended for the treatment of social anxiety and are rarely prescribed for it.
Self-Help Techniques for Social Anxiety
A number of self-help techniques may be tried to help control social anxiety symptoms. These are techniques adopted from cognitive behavioral therapy (CBT), but can also be used outside of formal psychotherapy.
1. Practice deep breathing exercises.
We often identify the physical symptoms of anxiety more readily than the psychological symptoms — so they are often the easiest to change. One of those prominent physical symptoms is breathing. We feel a shortness of breath when anxious, like we can’t breathe normally or can’t catch our breath.
A simple breathing exercise you can practice at home can help alleviate this feeling of shortness of breath.
- In a comfortable chair, sit with your back straight but your shoulders relaxed. Put one hand on your stomach and the other hand on your chest, so that you can feel how you breathe while practicing the exercise.
- Close your mouth, and inhale slowly and deeply through your nose while counting slowly up to 10. You may not make it to 10 when you first try this exercise, so you can start with a smaller number like 5 first.
- As you count, notice the sensations of your body while inhaling. Your hand on your chest shouldn’t move, but you should notice your hand on your stomach rising.
- When you reach 10 (or 5), hold your breath for 1 second.
- Then, exhale slowly through your mouth while counting out 10 seconds (or 5 if you’re just starting). Feel the air pushing out of your mouth, and the hand on your stomach moving in.
- Continue the exercise, breathing in through your nose and out through your mouth. Focus on keeping a slow and steady breathing pattern. Practice at least 10 times in a row.
The more you do this, the more you learn to control your breathing — which you thought was uncontrollable — on your own.
2. Take baby steps forward.
Baby steps are such an important of any treatment, but they can also be helpful for self-help exercises. After all, you didn’t get this way overnight. So changing it isn’t going to happen in one try either.
For social anxiety disorder, this can mean learning relaxation exercises (such as the deep breathing exercise above), and practicing them until they become second nature and easily done in any situation, at any time.
People fear the very idea of “exposure therapy,” so it’s important to understand what it does not mean. It doesn’t mean going into your most-feared social situation tomorrow without little help or techniques under your belt. It also doesn’t mean having to face your worst fears in order to overcome them.
Exposure therapy simply refers to being exposed, very gradually, to social situations that would normally be anxiety-provoking. But your exposure to them is in lock-step with your learning relaxation and coping techniques that help you deal with anxiety as it arises.
You can try this out in a smaller form on your own, with the help of a close friend or anxiety buddy. For instance, if you fear the social requirements of a dinner party, try going out with a smaller, more trusted group of friends first. Try and recognize what you’re feeling throughout the night, and when you feel little spikes of anxiety. What happened just before them? How did you keep them from turning into something bigger?
3. Listen to your self-talk or inner voice.
We often tell ourselves things in our heads that may or may not be true. Psychologists call this sort of thing “self-talk,” while others call it their inner voice. Some of this self-talk is positive and can help bolster our self-esteem. Other times, this self-talk can be negative and destructive to our happiness.
When this latter thing happens, psychologists call it a “cognitive distortion” — that is, our thoughts are distorted and irrational. We all engage in these automatic thoughts or cognitive distortions, many times throughout the day. They lead us to make assumptions about our own and other people’s thoughts, feelings and behaviors which are often untrue.
The key is to identify the automatic thoughts as they occur, and then answer them back so you don’t let them get the better of you.
Social anxiety disorder is a fairly common concern which can be treated with a combination of psychotherapy, medications and self-help techniques. But the first step to any treatment is acknowledging the problem, and then seeking out help from a trained mental health professional, such as a psychologist.
Acarturk, C.; Cuijpers, P.; van Straten, A.; de Graaf, R. (2009). Psychological treatment of social anxiety disorder: A meta-analysis. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 39, 241-254.
Powers, Mark B.; Sigmarsson, Snorri R.; Emmelkamp, Paul M. G. (2008). A meta-analytic review of psychological treatments for social anxiety disorder. International Journal of Cognitive Therapy, 1, 94-113.
Roy-Byrne, Peter P.; Cowley, Deborah S. (2007). Pharmacological treatments for panic disorder, generalized anxiety disorder, specific phobia, and social anxiety disorder. In: A guide to treatments that work (3rd ed.). Nathan, Peter E. (Ed.); Gorman, Jack M. (Ed.); New York, NY, US: Oxford University Press, 395-430.