Social anxiety:
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The central concept in cognitive behavioural therapy CBT is:
what you think = what you feel (and do).
If you think negative thoughts, you get negative feelings (and generally, you do negative things)
If you think positive thoughts, you get positive feelings (and generally, you do positive things)
This central concept to cognitive behavioural therapy CBT explains how social anxiety disorder develops in the first place, and how it is treated.
This means, you have social anxiety because you think in a certain way. These patterns of thought cause certain feelings and actions. And if you can change these patterns of thinking, you can change the way you feel and act.
I would agree with that.
But what if it was the other way around? What if it was the feelings that came first, which then caused the negative thoughts?
And who really knows whether it was the thought or the feeling that came first? It appears logical that it would be the thought that came first. But is this really the case? Could a child not just experience a negative feeling, perhaps because they somehow connect with a negative feeling in someone close to them, like a parent. And then because this child experienced this negative feeling and they didn’t know why, they then developed thoughts and beliefs to explain why they had this negative feeling.
We use an adult way of logic and intellect to explain how social anxiety develops. But could this be wrong? Children think differently to adults. Social anxiety develops in childhood. Could there be something missing because we are using an adult viewpoint to explain a problem that develops in childhood?
I don’t know the answer to these questions.
And it is a bit like the chicken and egg question. Which came first, the egg or the chicken? Well, does it really matter?
But one area I do think cognitive behavioural therapy CBT does struggle in – the treatment of social anxiety disorder when the emotions involved are very highly charged.
When you are in the grip of high levels of fear or anxiety, it is hard to think positive thoughts, or to challenge beliefs that fuel these emotional reactions, even though you logically know the thoughts and beliefs are false.
But what if there was a way of reducing or eliminating the negative feelings first? Could you then develop positive thoughts and beliefs to maintain that? And would it be a lot easier to do it this way round?
I personally believe that the vital first step is to reduce or eliminate the emotional meaning of an event or memory. Once you have done this, it then becomes a lot, lot easier to use cognitive behavioural techniques, and other techniques like neurolinguistic programming, goal setting, and coaching, to overcome social anxiety disorder.
Summary
The main concept in cognitive behavioural therapy CBT is that what you think, affects how you feel and what you do. It is the thought that comes first. But what if it was the other way around? What if it was the feeling that came first, and then thoughts developed to explain it? This is an unusual way of looking at the problem. However, in my experience, if you are able to reduce or eliminate the negative feelings first, it becomes a lot easier to develop positive thoughts and beliefs that help you.
Take care,
Paul
