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I’ve just come back from the British Association for Behavioral and Cognitive Psychotherapies (BABCP) conference, which was held in Birmingham last week. The conference was excellent. One of my favorite talks was by my colleague Dr Clare Mein of Oxford University. She was presenting her PhD from the University of Western Australia, where she also trained as a clinical psychologist.

Dr Mein demonstrated in series of experiments how social anxiety can affect social situations. In particular, she found that people with social anxiety interact differently during conversations. For example, think about the last time you got lost in a conversation with someone who you are not anxious around (best friend, partner, etc). You got lost in the moment, and the conversation went smoothly. However, it’s very different when you feel socially anxious, isn’t it? When we are anxious there are many thoughts going through our head unrelated to the conversation itself. These are often related to impression management. Here is an example:

The research showed that these thoughts are one reason why people with social anxiety don’t get “lost in the moment”. Unfortunately, it also showed that the conversational partner typically notices this, making the overall experience worse for both people.

Dr Mein conducted an experiment with people who have low scores on social anxiety measures. She asked these participants to count the number of words starting with the letter ‘T’ while having a conversation. The results showed that the when the participants were distracted by the counting they weren’t fully engaged in the conversation. Furthermore, the conversation partners felt less connected. In the same way, people with social anxiety are often focused on something else (i.e. how they present themselves), having a negative impact on the conversation.

People with social anxiety often have a collection of impression management strategies that they’ve acquired over the years. One goal of treatment, such a with a therapist or an online programs like AI-Therapy, is to identify and let go of these behaviors. This frees you to focus on the conversation. The good news is that if you successfully overcome social anxiety you’ll be able to enjoy high quality social interactions with everyone, not just your friends and family.

Fjola Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy, a developer of online CBT treatment programs.

Stop mental health stigma, and start seeking help

A recent study has shown that living with an untreated mental illness lowers life expectancy. Therefore, not only do suffers get less enjoyment from their day to day life, but their lives are shorter. Why is it that people continue to suffer in silence?

Perhaps the main reason that people do not seek treatment is the stigma surrounding mental health. Sadly, this is widespread in today’s society, and there are several reasons for it. For example, we’ve all seen movies where someone commits a horrific crime, and the text at the end tells us that the person is now seeking therapy. This creates an association between anti-social behavior and therapy. This is outrageous, as the vast majority of people who seek therapy are normal, kind and caring people. Some people are genetically predisposed to having mental health problems, while others struggle with negative life experiences. In both cases, seeking help can be a life changing experience, and in neither case should it be something to be ashamed of.

I think it is time to start thinking about mental health problems in the same way as medical problems. If you had a friend or family member who was physically unwell, telling them that “you need help” would be kind and supportive advice. Why doesn’t the same hold for encouraging someone to see a psychologist?

Fjola

Fjola Helgadottir, PhD, CPsychol, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

A lot has been written about the use of smartphones in social situations – it is the pet peeve of many. People often find it irritating to have a conversation (or eat a meal, watch a film, etc.) with someone who is constantly tapping away at their phone. In this blog I will look at the issue from a slightly different perspective. For those with social anxiety, smartphone use may actually be maintaining their problem.

A safety behavior is an action taken to manage one’s anxiety by exerting (perceived) control over a social situation. It is a behavior or action that is taken in order to prevent the core fear – being negatively judged by other people. Checking your smartphone is a perfect example that seems to be becoming increasingly common. People may do it to avoid something they fear: uncomfortable conversations, meeting new people, awkward silences, etc. In many cases they are worried that they won’t be able to “perform” in the social situation. In other cases, they may want to look important by being online and connected 24/7.

The problem with safety behaviors is that they tend to make the problem worse. On one hand, since it is an avoidance behavior, anxiety is maintained since it is never challenged. Sometimes uncomfortable conversations turn into interesting ones, sometimes awkward silences are followed by deep and meaningful comments, and sometimes when you meet new people you find a friend for life. Being on a smartphone can take away these opportunities. Also, if the social situation goes well despite being on a smartphone, one might wrongly attribute the positive outcome to the smartphone!

To illustrate another point, consider the following scenario:

Alice goes to a party where she doesn’t know many people. She is very anxious, and is worried that the other people at the party will not like her. She spends a lot of time sending text messages, as she hopes this will demonstrate that she is a social person with a wide group of friends. The other people at the party make no effort to engage with Alice, as it looks to them like she has no interest in being there.

As you can see, the safety behavior (checking the phone) is the very reason why people are judging Alice negatively.

I should note that not all smartphone use in social situations is a safety behavior, as it depends on the reason why people are using their phone. There are many other reasons why someone may use their phone, such as bad habit or addiction (I will save that for another blog).

Our social anxiety treatment program can help you identify and challenge maladaptive safety behaviors. I encourage you to think about your actions, and try turning your smartphone off next time you are at a party. Not only are you less likely to be perceived as uninterested in the social situation, I guarantee you will have a richer experience, and you are a lot more likely to make a good impression on other people!

The shame and embarrassment that lie at the heart of social phobia are two of the reasons why those who struggle with social anxiety never seek treatment. In fact, studies have shown that a social anxiety diagnosis is usually missed in primary care since people are reluctant to report their symptoms to their GP. Furthermore, a 2008 study found that the more severe the social anxiety, the less likely individuals are to seek treatment. Finally, studies have shown that once a diagnosis has been made, the average length of time before initiating treatment is 17 years. Think about this for a minute.

17 years. Think about all the minutes, seconds, hours and years wasted. Consider the time spent worrying about what you said, worried that someone is upset with you, not asking people to meet up, not catching up with old friends, tormenting yourself after social events about something you feel you said or did wrong. All of these are symptoms of social anxiety, and since there are effective treatments available, there is absolutely no reason to loose 17 years of your life. I urge you to take action today. Contact a qualified clinical psychologist, or try an online solution like AI-Therapy’s Overcome Social Anxiety.

The relationship between salaries and social anxiety

It is a known fact that one area where social anxiety has a big impact on people’s lives is in the workplace. In particular, studies have found that people with social anxiety are less likely to be promoted and have, on average, lower salaries.

When was the last time you asked your boss for a raise?

Lack of assertiveness is one cause of this problem. For some people, being assertive is “too risky” since they have a strong fear of negative judgement – particularly by authority figures. For example, you might be worried about annoying or upsetting your boss, so you convince yourself that “now is not a good time to ask”. Unfortunately, the “right time” never seems to present itself.

In the past, psychologists and counselors would teach you techniques about how to present yourself. For example, common advice would be “make eye contact” and “stand tall with a straight back”. However, if you learn techniques like these without tackling the underlying social anxiety or the fear of negative evaluation, you’ll probably still struggle to gather the courage to ask for a raise.

Facing your fears (with CBT) can be a life changing experience.

One of the most effective ways to tackle anxiety is with a technique called cognitive behavior therapy (CBT). This is a long term solution, since it helps people evaluate and challenge their thoughts and behaviors, making them more likely to engage in activities they previously avoided.

In our AI-Therapy program, we use CBT to identify and target the thoughts and behaviors underlying the user’s social anxiety. Not only do our user report fewer social anxiety symptoms after completing the program, but also an increase in happiness and overall quality of life. Who knows – maybe it will give you the courage to ask for that promotion in 2014?

It seems like every time I open Facebook or LinkedIn I see some tips from celebrities or entrepreneurs how to be more confident or successful. In reality, a little talent, a lot of hard work, and some lucky breaks are the key ingredients to success. Yet, successful people have a tendency to attribute their trajectories to a handful of tricks people “must do” in order to succeed. Unfortunately, these tips aren’t always as helpful as they seem. In fact, they can even lead to safety behaviors. If social anxiety is a problem for you, it is important to learn about the role of safety behaviors, and see if you are using them to “play it safe” socially.

This blog post is the first in a series where I will give some common tips, and explain why they are actually counterproductive.

Tip 1. Pretend to be interested in other people

The self-improvement writer Dale Carnegie recommends that people pretend to be interested in what others are saying during conversation. While this may sound reasonable when we are trying to impress someone, it can actually backfire. First, the other person might sense a lack of genuine interest in the topic, and find it uncomfortable that the listener is pretending to be interested. Second, if the social interaction results in a positive response, the pretender is likely to attribute the success to their pretense of being interested, not that they were liked for who they are. Third, this sort of behavior can maintain unhelpful thoughts people have about themselves, such as “I’m so plain and boring”. Every social interaction is an opportunity for people to disconfirm these types of unhelpful thoughts. However, every time safety behaviors are used, an opportunity is missed.

Tip 2. Read over your emails at least 5 times

Many of us overemphasize the importance of wording in our emails. Whilst this may seem reasonable, it simply isn’t always helpful. In fact, some of the most successful people I have corresponded with send me emails full of spelling mistakes (probably due to auto spelling) and no formal structure. Life is too short to read emails more than a couple of times. Try sending emails without proofing them: it’s difficult at first, but then it becomes liberating. It becomes easier to respond from your phone or tablet, and can save you from thinking about the emails when you are doing something else!

In other news, I just had a peer reviewed paper on safety behaviors accepted in the Journal of Speech, Language and Hearing Research. Once it is in press, I will blog about this as well!

Fjola Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

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“You need help” should be a positive gesture!