Social Anxiety Intervention

Attentional Focus Shift Training

Since self-monitoring is a key maintenance factor, the treatment trains the patient to externalize his attention.

He is taught to direct his senses outward: listening attentively to what the interlocutor is saying, observing the colors of the room or the details of others' clothing.

The goal is to collect objective data from reality rather than subjective data from his own fears.

By ceasing to look at oneself ("Am I turning red?"), the person can see that others are not scrutinizing him or her with a magnifying glass, thus breaking the illusion of being the negative center of attention.

Restructuring of Standards and Fear of Criticism.

People with social anxiety often operate under unattainable standards of perfection ("I must never falter," "I must always be resourceful").

Cognitive intervention seeks to relax these rigid rules by questioning the perceived catastrophe of making a social mistake.

Socratic questioning is used to reassess the cost of disapproval: "Is it really the end of the world if someone doesn't like you?", "Do you judge others so harshly when they make a mistake?".

The goal is to normalize human error and reduce the weight given to the opinion of others.

Behavioral Experiments and "Shame Attacks".

To dismantle negative predictions, behavioral experiments are designed to test reality.

If the patient believes "If I ask a dumb question, everyone will make fun," he or she is encouraged to walk into a store and ask something obvious (e.g., "Where are the shoes?" while standing in front of them).

By deliberately performing the feared action, the patient discovers that the anticipated catastrophic consequences (mass ridicule, rejection) rarely occur; generally, people are indifferent or polite.

These exercises, sometimes called "shame attacks," serve to desensitize the patient to social judgment.

Summary

The treatment trains the shift of attentional focus outward. The patient is taught to observe the environment and others in order to break the illusion of being observed.

Cognitive restructuring relaxes rigid standards of perfection. The seriousness of making social mistakes is questioned and the paralyzing fear of criticism or disapproval is reduced.

Behavioral experiments test negative predictions in reality. By deliberately executing feared actions, the patient discovers that anticipated catastrophic consequences rarely occur.