# Thought Challenging as Part of CBT



## Black_Widow (May 23, 2008)

After having been to some CBT sessions, and having tried this a few times, I felt sure that once I returned to work that this would greatly reduce my anxiety in the types of situations which set off my panic attacks. But unfortunately this hasn't turned out to be the case. :-( I've been finding that even though it's easy enough to convince myself that the alternative thoughts I think up are true when I'm not at work - and in a calmer state - that it's not such a simple matter once I'm actually back in the situation again. My old thoughts just seem to take right back over again, and then I find I'm back to square one with my anxiety symptoms. 

Just wondered if anyone else had experienced the same kind of difficulty with this, and how they tackled it if they chose to continue persisting with it anyway.

Many thanks for reading


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## yeah_yeah_yeah (Mar 27, 2007)

Hi Black

Firstly well done for applying what you have learned. It must be very frsutrating to feel that your efforts are not paying off and if I were you I would be beginning to have doubts about whether it can help me. This is totally ok, because its what you are feeling inside. Always let your therapist know how you feel - its ok to give him / her negative feedback and helps them do their job 

The problem with some approaches of CBT to SA as that you will be told that just changing your thoughts is enough. This is totally inaccurate. Changing core beliefs that drive anxiety take an awful lot more than that.

The best option right now would be for you to buy a copy of Overcoming Social Anxiety and Shyness by Gillian Butler. The process of using CBT for SA is as follows:

1) Education about how thoughts affect feelings
2) Education about how to actually identify the thoughts hidden at the root of the feelings
3) Learning to *start to make cracks *in the thoughts and beliefs by using thought challenging methods. The thinking part only starts you off - a bit like finding the end of the sticky tape on a roll!!

4) Establishing a hierarchy of situations you find difficult from easy to terrifying.
5) Identify your safety behaviours - the things you subconsciously do automatically to "keep you safe" but which actually maintain the fear.
6) Learn to change your attentional focus. Maintaining internal focus maintains anxious feelings throughout real world siutations.
7) Construct behavioural experiments based on the *thoughts and rules * (not core beliefs yet) coming from yor your anxiety ladder and the cognitive work you have done. The 'thinking' makes the start, the real experiments begin to reinfirce it, but if you start too hard or high up your ladder, it will be more diffcult to make progress.
8 ) Use belief change sheets to identify the *core beliefs* that maintain your anxiety and use experiments to attack them.
9) If you have a 'mental picture' of yourself that you look stupid, or blushing, having the therapist use video feedback to challenge this thought.
10) If you are too anxious to do the experiments, having "role plays" set up in clinic to simulate it.

If you are getting 'traditional CBT' with none of these elements then I am sorry to say but it will be more difficult to make changes. The above is the latest approach to SA based on the latest research and also embodied (apart from the video feedback and role play) by the Gillian Butler book.


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## Black_Widow (May 23, 2008)

Hey there Yeah Yeah  

Many thanks for all your feedback, much appreciated!

Unfortunately I'm no longer seeing my therapist, as was only allocated a limited number of sessions. I've since had to go back to work, so am now trying to help myself on my own. 

However, as it happens, I do have that book by Gillian Butler. I've not read through all of it properly yet, but certainly will ensure I do so and that I bear all that advice in mind. I suspected that the reason I've been having the trouble I have, is because I also need to work at tackling my deep rooted negative beliefs - but it's very helpful to have that clarified by somebody else and be given pointers on how to approach this. Many thanks again!


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## yeah_yeah_yeah (Mar 27, 2007)

Whee!! Cool, I admire your positive spirit! That will really help to carry you, especially at the times where it may feel like you have fallen back.

CBT should be at least 6 months in length, maybe more. If you have the book, read it, read it, and re-read it. Take notes!! Then, go back and apply everything it says for a good long chunk of time. In 2 months you will feel definite changes. At 6 months ytou will be flying!! 

Keep posting at SAS so we can lift you up at those times when its starting to feel too hard alone, and to celebrate with you when it goes well!! Thats what we're here for, ya hear??

YAy!! :banana


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## Black_Widow (May 23, 2008)

I'll definitely bear all of that in mind and will do. Many thanks!


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## tiberius (Feb 9, 2007)

Black_Widow said:


> I felt sure that once I returned to work that this would greatly reduce my anxiety


I have experienced the same thing. It's easy to imagine in your mind how you can be calm in any situation when you are alone in the comfort of your living room. But when you're actually there at that job meeting/interview/presentation you get those old feelings of anxiety back. That's just part of the healing process. It's two steps forward one step back.

*Remember, you can't have a setback unless you've already made some progress!*

So, a setback is a proof that you have made *some* progress. Be rational about. Don't expect that you will suddenly feel 100% OK in any situation. But say to yourself "Ok, I still feel a little anxious in this situation. But I have made some progress. I feel slightly better now than I did a month ago."

You've had SA probably for years (as we all have). It would be irrational to assume that a few therapy sessions would erase all previous anxious thoughts and beliefs. It's about taking one day at a time and gradually changing your thoughts, beliefs and behavior. It is important to notice even the smallest progress you make so that you can pat yourself on the back and keep pushing forward!


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## yeah_yeah_yeah (Mar 27, 2007)

:agree

And nice hat dude  You look like a jazz musician and thats a cool thing where I live


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## Black_Widow (May 23, 2008)

tiberius said:


> Black_Widow said:
> 
> 
> > I felt sure that once I returned to work that this would greatly reduce my anxiety
> ...


That all makes perfect sense. I'm definitely guilty of having expected too much out of myself too soon like that. And I have been putting extra pressure on myself by worrying lots about the future, when - as you've mentioned - just taking things one day at a time and appreciating small changes would have been alot more helpful.

I will also bear this all in mind. Many thanks to you as well for your comments.


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## griff (Apr 18, 2008)

Just seen this thread - I'd also recommend 'Feel the fear and do it anyway' by Susan Jeffers - prob not exactly for SA but tackles how to get past some seemingly insurmountable everyday interaction obstacles - it may help someone - you can read a bit about it if you look it up on Amazon books.


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## CopadoMexicano (Aug 21, 2004)

griff said:


> Just seen this thread - I'd also recommend 'Feel the fear and do it anyway' by Susan Jeffers - prob not exactly for SA but tackles how to get past some seemingly insurmountable everyday interaction obstacles - it may help someone - you can read a bit about it if you look it up on Amazon books.


I agree its a good self help tool in general for overcoming fear but sa is more complex.


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## griff (Apr 18, 2008)

Yep I agree with you - but sometimes it helps to come at things from different perspectives because everyone's different.


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## Black_Widow (May 23, 2008)

griff said:


> Just seen this thread - I'd also recommend 'Feel the fear and do it anyway' by Susan Jeffers - prob not exactly for SA but tackles how to get past some seemingly insurmountable everyday interaction obstacles - it may help someone - you can read a bit about it if you look it up on Amazon books.


I heard about this book before. I'll certainly consider picking it up, and will look it up. Thx


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