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ACT for social anxiety

Many of us feel nervous or self-conscious at times, for example when giving a speech or being interviewed for a job. However, for some people the anxiety they experience in social interactions is more than just occasional nerves or shyness. Rather, these people may feel intense fear, especially in situations that are unfamiliar, or situations in which they feel they are being watched or negatively judged by others. This kind of social anxiety can lead to feelings of inadequacy, embarrassment and depression, and merely thinking about social situations can cause feelings of intense anxiety.

Anxiety can lead to avoidance

 

A significant outcome of social anxiety is very often what we can call avoidance behaviour – that is, a person with this kind of anxiety may avoid social situations that they fear will trigger anxiety, or which have triggered anxiety in the past. This avoidance is a way of managing the anxiety, but unfortunately it usually comes at a significant cost. For example, a person may miss out on social bonds because of avoiding social gatherings of

various kinds, he or she may miss out on promotions or other opportunities at work through always attempting to avoid meetings and presentations, the avoidance may cause loneliness, sadness and perhaps regrets, and so on. In other words, attempts to control the anxiety by avoiding situations that trigger it may place some very significant limits on a person’s life. Life is restricted and a sense of freedom may be lost.

Acceptance and Commitment Therapy ACT can help

Is there an alternative, then, to avoiding the anxiety and the situations that trigger it? Yes, there is! Acceptance and Commitment Therapy, or ACT for short, has a range of strategies that provide a different way to relate to the difficult thoughts and feelings that show up for some people in social situations. Instead of having to miss out on meaningful and worthwhile interpersonal situations through avoidance, ACT teaches ways to allow these thoughts and feelings to be present, while getting on with “what matters”. Being clear about “what matters” is therefore very important in ACT, as this will provide the direction in which we want to move our lives, and helps us cultivate a willingness to make room for unpleasant thoughts and feelings in order to create a meaningful life.

 

In ACT we use the term Values to refer to “what matters”. In his well-known book The Happiness Trap, Australian ACT therapist and trainer Russ Harris explains values as follows: “Values are our heart’s deepest desires for the way we want to interact with the world, other people and ourselves. They’re what we want to stand for in life, how we want to behave, what sort of person we want to be, what sorts of strengths and qualities we want to develop”. During ACT sessions the therapist helps the client identify his or her values across various domains of life, such as family relationships, health, career and so on. Having identified values, the next step is to set specific behavioural goals that are guided by the values, rather than by the perceived need to avoid anxiety.

 

An example is helpful here.  Matthew hates going to parties. He feels extremely anxious before and during any kind of party or gathering, and has thoughts such as “no one will talk to me”, and “I am going to say something stupid for sure”. His face goes red whenever he speaks with someone he doesn’t know well, and he has the constant sensation of butterflies in his stomach. He is invited to the eightieth birthday party of his girlfriend’s grandmother.  Matthew’s usual response to invitations like this is to think up an excuse of some kind, so that he doesn’t have to go to the party and experience the unpleasant thoughts and feelings that show up for him.  However, Matthew knows how much his girlfriend loves her grandmother, and the role the grandmother plays in her family. He recalls his belief that it is important to value and respect older members of the community, and he thinks about the kind of partner he would like to be in the relationship with his girlfriend. He also thinks about his wish to have close relationships with other members of his partner’s family, and his desire to develop his own capacity to have relaxed and comfortable relationships with people. Here Matthew is thinking about his values in a range of different domains of life; intimate relationships, family relationships, community, and personal growth. He decides to go to the party, despite knowing that unpleasant thoughts and feelings are likely to show up. He is willing to make room for those thoughts and feelings in order to take a committed action that will move his life in a valued direction across a number of domains.

 

One of the main goals of ACT is to help people do what Matthew did in our example – move their life in a valued direction, while allowing, rather than avoiding, any difficult thoughts and feelings that may arise. During ACT sessions clients learn processes by which they can do just that.

 

If you experience anxiety in social situations, please consider making an appointment with me so that we can discuss whether ACT would be an appropriate treatment for you. I also invite you to refer to my article About Acceptance and Commitment Therapy ACT