CBT Can Help Beat the Blues and Anxiety

In the UK, there is a fairly broad consensus among general practitioners that the best treatment for non-manic mental disorders such as depression and anxiety is counselling backed up by medication when immediate relief or improvement to such conditions is required.

And, the counselling which tends to be employed in the UK more often than not is cognitive behavioural therapy (cbt) due to empirical research proving its efficacy. Using social anxiety disorder as an example, cbt aims to challenge though processes which provoke certain feelings or emotions while also using exposure therapy to change behaviours which exacerbate underlying feelings.

Counsellors find with social anxiety disorder that sufferers tend to have unrealistic social goals, for example, thoughts of needing to be perfect, such as performing the best in a social situation, whether that is being the funniest person or most popular.

Cbt aims to strip away and challenge such though processes enabling patients to try to self correct their thinking in such situations by asking simple questions, such as is it realistic to always expect yourself to be popular with everyone? Why is it important to be liked by everyone? Is is fair to yourself to put pressure like this upon yourself?

Over time, this rational, cognitive based approach aims to broker change by helping the social anxiety sufferer to have more realistic goals in social situations, such as' I can only be myself and some people may like me or not'. They also challenge a key aspect of social anxiety disorder thinking, which is the aspect of 'mind-reading'.

Most sufferers tend to think they may have performed badly or be unpopular based not on what anyone has said or done but on their perceptions. These perceptions are examples of faulty thinking, as they cannot possibly read minds.

This is a key aspect of cbt, not to get the patient to think positively but more realistically. In addition, to realise that projected negative thoughts from others is simply a projection of their own negative thoughts about ourselves.

A behavioural challenge to social anxiety sufferers is to use mirror tests or audio and video tests, as social anxiety sufferers tend to perceive themselves more negatively when looking in the mirror or when seeing pictures of themselves or hearing or watching themselves think.

The challenge cbt gives to social anxiety suffers is not only to exchange unrealistic social goals for objective verification goals, but also to challenge 'catastrophic thinking'.

This is when the social anxiety sufferer overplays the consequences of perceived poor performance in social situations.

Rather than the extremes of rejection and humiliation that may results from blushing, or forgetting trains of though in presentations, nothing really that catastrophic happens. Again, cbt practitioners try to probe with questions that challenge faulty thinking, such as ' when this happened in the social situation: did you lose your job, or were you publicly ridiculed, or did nothing really change apart from what you felt?'

This challenge to faulty thinking will be bolstered by behavioural challenges, such as asking the patient to go into a shop, ask for something and then say , 'sorry, I've forgotten my wallet'. Typically, this is at the extreme end of what sufferers fear so by completing such a task and seeing no terrible consequences, it will help understanding that their fears were part of false thoughts.

This illustration of how cbt works with social anxiety is a cursory and slight example of how cbt operates, but helps to demonstrate how challenging beliefs and assumptions, which form the basis of many thoughts, helps to undermine the hold of many minor mental disorders on patients.