Emma Watson did a wonderful speech for the UN recently, and if you haven’t seen it yet you should really check it out:

She launched a campaign called “HeForShe”, where men around the world are asked to join the gender equality agenda. The speech has gone viral (when I opened my Facebook this morning it seemed like half of my friends were raving about it). I came across some coverage of it with the headline “Her Voice Might Tremble, But Emma Watson’s Message Is Strong and Clear.” In my opinion, I found her voice to be very human and down to earth. I think her message was stronger because of this touch of tremble, which highlighted the fact that the speech wasn’t easy for her. Remember, this is a famous actress whose career is performing. She was nervous because nobody feels confident all of the time, and stepping outside of our comfort zone is when we grow.

This made me think of social anxiety and how we treat it. Cognitive behavior therapy (CBT) for social anxiety challenges people by moving them out of their comfort zones. We learn the most when we “put ourselves out there”. It is about experimenting with your thoughts and behaviors, and helping you live your life without fears.

I think a lot of social anxiety behavior in women is linked to gender equality. Sometimes we fear that by speaking our mind we will be labelled as “bossy”, whereas a man in the same situation could be called a “leader”. This is something we need to move past. For women, overcoming social anxiety can have a fantastic impact on their careers and self-confidence.

Fjola Helgadottir, PhD, CPsychol, is a clinical psychologist, who has trained all over the world. She has worked in Australia and at the University of Oxford in the United Kingdom. She is AI-Therapy’s director and co-creator of AI-Therapy’s Overcome Social Anxiety program.

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.

BABCP Conference

On July 22nd I am will be speaking at the British CBT conference, which is being held in Birmingham this year. The topic of my symposium is one of my favorite subjects, and a common theme on this blog: safety behaviors. My co-speakers are Brynjar Halldorson, Kate Muse and Clare Mein, and we are very lucky to have two of world’s leading experts on the subject as a discussant and chair: Paul Salkovskis and Freda MacManus.

Real-time audience responses

As part of our talk, we will be asking our audience questions to get their opinions on certain subjects. For example, here is a question that I will pose to the clinicans in the audience:

Our hope was that the audience would vote using their smartphones or tablets, and we would display the results in real-time as the votes are submitted. I spent some time searching for existing solutions, but everything I could find was either too difficult to use, too expensive, or required special software to be installed. Therefore, we decided to build our own polling service the way wanted it. It is simple and easy to use, and without any fancy bells and whistles. It is a great tool so we have decided to make it available to everyone for free.

Polls are a great way to spice up lectures or presentations. You can give it a try here:

http://www.ai-therapy.com/poll/

Let us know what you think, and feel free to share the link with anyone who is looking for a real-time audience response system.

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, 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

I recently came across an article on the failure of the Alcoholics Anonymous (AA) treatment model. It makes a strong case, and is well worth a read (the full article is here).

If AA works for you that’s great, but you are in the minority.

I’ve been skeptical of AA for years now. On one hand, I personally know several people who have successfully used the program, and I’m sincerely happy that they have found a way to deal with their alcohol problems. However, I have treated many more people in my professional practice for whom AA has simply not worked.

I have serious objections to the way AA is run. In particular, their reluctance to publish information on success rates is unacceptable. The article claims that AA fails for up to 90%-95% of attendees. Until AA shows a willingness to become more transparent and adopt evidence-based treatments, there is little hope that the program’s efficacy will improve.

It is not always about the alcohol.

One flaw in AA’s treatment strategy is the assertion that alcohol is the root cause of all problems in an alcoholic’s life. In many cases this is not true, as alcohol is often used to cope with other issues. For example, let’s consider how social anxiety might cause someone to abuse alcohol, as I’ve come across this many times.

People usually feel more confident and have fewer inhibitions while drinking. This can be appealing for those with social anxiety, and can even appear to be effective in the short term. However, using this as coping mechanism has several disadvantages. For one thing, after the effects of alcohol have subsided many people find themselves in a cycle of rumination that increases feelings of anxiety. Furthermore, if you need to drink in order to deal with social situations, this can lead to a dependency or addiction.

Any treatment that focuses purely on abstaining from alcohol (as AA does) is bound to have limited success.

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 AI-Therapy Blog

The upcoming BABCP Conference and AI-Therapy’s free real-time audience polling service

BABCP Conference

Real-time audience responses

“You need help” should be a positive gesture!