tchloeWe all have stereotypes about people with social anxiety. A lot of people falsely believe that social anxiety is the same as being shy. However, this isn’t always the case. In fact, quite often I’m asked “How can I have social anxiety when I’m such a social person?”  These are people who enjoy being the center of attention, and who have a constant stream of funny stories and interesting things to say. People like this can actually be the most socially anxious people in the room.

Here is the key to understanding this: people can have social anxiety about different things. Everyone is unique. For example, some people are very confident in job interviews and with regards to the performance at work, but are terrified at the thought of making small talk in the lunch room. On the other hand, some people are very chatty and sociable with their friends and colleagues, but experience debilitating anxiety when it comes to their work performance. Therefore, when clinicians are evaluating social anxiety, it is vital to understand the idiosyncratic differences between people, as these can have a profound impact on cognitive behavioral treatment.

The details vary from person to person, and can be complex, but social anxiety often forms through a process like this:

  1. There is a particular incident in one’s life. e.g. in childhood
  2. People read into these events, and make inferences about themselves. Normally, these inferences involve highly negative interpretations.
  3. People take precautions to try to compensate for their perceived limitation of character.
  4. In reality, the compensations are overcompensation, and over time these behaviours keep the anxiety going.

An example of an overcompensation strategy is “non-stop talking” (hence, the most bubbly person in the room). These people are uncomfortable with silence because they interpret it as “if I’m not participating in the conversation the other person might think I am boring”. It is important to keep in mind that it is not the behaviour itself that is the problem, but the motivation behind the behaviour. It is the WHY that is important. For example, non-stop talking between long lost friends is to be expected.

Other examples include:

  • always showing a lot of interest in other people’s lives (one of the recommendation in Dale Carnegie courses)
  • making excessive positive comments
  • asking a lot of questions
  • making sure everyone at a party is having a good time

Once again, these are not bad things in and of themselves. It is important to consider WHY you are doing these behaviors. If your motivation is related to how you want others to perceive you, you are probably doing it out of social anxiety

big-group-of-people-of-different

A core part of CBT treatment is to test hypotheses. For example, seeing what happens when you stop overcompensation strategies. It is likely that you find people will accept you for who you are. This is done on an experimental basis, and individuals need to see the point of these experimentation. It is easier said than done, which is probably why therapist have to truly understand the theories behind the strategies they are implementing.

This type of overcompensation strategies are known in the literature as safety behaviors or subtle avoidances. I have recently published journal articles on the topic, and I will be chairing a roundtable at the Anxiety and Depression Association of America ADAA conference in San Francisco on April 8th, 2017 titled: Harmful Safety Behavior or Helpful Coping Strategy? Understanding Client Behavior in the Face of Anxiety.

Fjola
Fjola  Helgadottir, PhD, is a registered psychologist at the Vancouver CBT Centre, who 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 and the author of Flourish: Living happily while trying to conceive. Twitter: @drfjola

ubcWe are very pleased to announce our latest collaboration, which is with Dr. Frances Chen and Dr. Chris Richardson of the University of British Columbia (UBC). We will be evaluating AI-Therapy’s cognitive behavior program within the university’s undergraduate student population.

3 years ago I wrote about blog titled: “Is diagnosis necessary for online treatment?“. My answer was no. I believe that anyone can benefit from CBT strategies, whether or not they have an official diagnosis. CBT helps people make better choices in their day to day lives, often leading to an overall improvement in happiness and confidence.

The UBC trial will provide the online social anxiety program to people who have elevated scores on social anxiety, not necessarily a social anxiety diagnosis. We are excited to see the outcome of this research.


fdh2Fjola  Helgadottir, PhD is a registered psychologist at the Vancouver CBT Centre, who has previously 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. Twitter: @drfjola

All of us at AI-Therapy wish you a very happy New Year!

Since we launched in 2012, the program has made tremendous changes to the lives of many of our users (from more than 30 countries). We always love getting feedback. Here is an email we received from one of our users in 2015 (reprinted with permission):

Dear Fjola and Ross,

Although I’ve just started the course, I feel I must write and let you know how much I’ve found it so helpful and showing an excellent and deep understanding of social anxiety. I’ve suffered for a long time. Over the last ten years I’ve had sixteen CBT sessions, a year of talk therapy and now in my second year of psychotherapy for it. In the short time of your course I’ve learnt far more from you than I have in the last ten years from any of the other therapies I’ve mentioned, let alone the number of self help books I’ve read!

I am really grateful for your expertise and wish I had come across your site much earlier. I am really enjoying your course and it is already beginning to make improvements for me. This is far more than I can say about the help I have had, which, in some cases has made me worse.

Thank you again.

It’s always a great reminder for us to get emails likes these. Let’s make 2016 the year that you tackle your social anxiety with a vengeance!

The past few months have been slow on the AI-Therapy blog, but rest assured that we’ve been very busy. We have reached some major milestones.

Science Magazine

The synthetic therapist

In July we were featured in a Science Magazine special issue on Artificial Intelligence. The article is called “The synthetic therapist”, and gives an overview of the current state of the art for administering evidence based clinical psychology via computerized therapy. The article describes an Overcome Social Anxiety user’s experience with the  program:

[…] the program assumed the role of full-fledged therapist, guiding her through a regimen of real-world exercises for taking control. It sounds like a typical success story for clinical psychology. But no human psychologist was involved.

There is an open access podcast where the author, John Bohannon, shares his thoughts on the field (a link can be found on this page). The article itself is behind a paywall, but can be downloaded here for those with institutional access (note the article refers to AI-Therapy as CBTpsych, which is its original name).

Granville Youth Health Centre, Vancouver Canada

ICYlogo
AI-Therapy is excited to announce that we have received a grant from St. Paul’s Hospital Foundation’s Enhanced Patient Care Fund. The Inner City Youth Program provides care for at-risk youth in Vancouver’s inner-city area. We will be working with ICY to develop an online social anxiety treatment specifically targeted towards this population. Stay tuned for more updates on this.

Can sauerkraut cure social anxiety? Yesterday an article was published in the Huffington Post with the title “Sauerkraut Could Be The Secret To Curing Social Anxiety“. The timing of this article is interesting, as only a few weeks ago John Bohannon conducted a fantastic experiment that demonstrates why you should be skeptical of health new stories. I highly recommend you read the full article. In brief, he conducted a bogus study that appears to demonstrate that eating chocolate helps people lose weight (wouldn’t that be great!?). Pretty soon his results were being reported by media outlets around the world. This exposed several weak links in the way scientific studies are conducted and distributed:

  • Statistics: There are many ways that statistics can lead a scientific study astray. One of the most common is a process known as data dredging, which involves testing a large number of hypotheses until one is found that appears to be statistically significant. However, effects found in this manner are usually due to random chance. Data dredging is often done unconsciously by scientists who are under pressure to publish results.
  • Effect size: Even when an effect is real, it is important to know how strong the effect is. In some cases it will be so weak that its impact is negligible.
  • Peer review: Peer review is one of the strongest tools we have to prevent the publication of poor quality work. However, even this system is flawed. As John Bohannon discovered in another expose, there are many so-called “academic journals” that claim to conduct peer review but will actually publish anything if a fee is paid.
  • Lack of fact checking: Often a journalist will lift a story directly from a press release without doing any background research about the publication or its authors.
  • Stories that sell: In order to increase sales, stories are usually given a “spin” to make them more exciting. This often involves catchy, but misleading, headlines, or twisting and oversimplifying the results.

All of these factors contribute to the poor state of health science reporting. It is not uncommon to see completely contradicty stories that are published within weeks of each other.

med_news

When you see a headline like “Sauerkraut Could Be The Secret To Curing Social Anxiety” you should resist the temptation to run to your local German deli and stock up on fermented cabbage. Rather, you should base your decisions on research that has stood the test of time, with multiple independent studies showing the same outcome. If you are serious about tackling social anxiety you should use a technique like cognitive behavior therapy (CBT), which has been demonstrated to be effective in hundreds of studies.

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who 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 and the author of Flourish: Living happily while trying to conceive. Twitter: @drfjola

It can be very hard to understand the impact that anxiety problems have on those who suffer from them. For example, people with social anxiety are often told to simply “get over it” by the people in their lives. This attitude usually doesn’t stem from a lack of compassion, but rather a lack of understanding. In reality, you can’t “just get over” anxiety problems any more than you can “just get over” a broken leg. Effective treatments for both conditions exist, but recovery can be a lengthy and a challenging process.

I came across an excellent cartoon series where an artist illustrates the role of anxiety in her life. Click below to see the whole post:

Anxiety cartoon

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who 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 and the creator of Flourish: Living happily while trying to conceive. Twitter: @drfjola

In this video I explain one of the core concepts behind social anxiety: safety behaviors. Safety behaviors maintain social anxiety, because when we engage in them we are missing opportunities to learn from our success. Therefore, we continue to feel anxious and lose confidence.

In a recent testimonial, a user of our Overcome Social Anxiety program describes how stopping safety behavior has made major changes to his life! Our program creates a personalized formulation for each user. This includes identifying safety behaviors, and learning techniques for stopping them. You can learn more about the program here.

Fjola

Fjola  Helgadottir, PhD, CPsychol, is a clinical psychologist, who 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 and the creator of Flourish: Living happily while trying to conceive. Twitter: @drfjola