Social anxiety disorder

[buddy28]

Re: Re: Re: Re: Re: Re: Social anxiety disorder

I'm unclear how this differs from reading a self-help book and practicing exercises at home alone. I am very mistrustful of any therapeutic modality that doesn't involve more than the individual and his thoughts. Is it worth noting the irony that you're talking about treating SAD without another person present? Is your lens also your symptom?

I should have been more clear. The therapy I’m practising for social anxiety strongly suggests participation in a behavioural group consisting of other social anxiety sufferers, towards the latter half of treatment. The preliminary cognitive portion is intended to reorient individual thinking towards more rational thought, stop constant negative ruminations, and introduce disorder specific cognitive strategies which help reduce the severity of social anxiety.

For instance, many social anxiety sufferers tend to unconsciously fight or hold on to physical anxiety instead of learning to accept it. Fighting physical anxiety usually intensifies nervousness experienced, thereby exacerbating conditions associated with the presence of anxiety.

The cognitive therapy I’m working on that addresses physical anxiety consists of short statements suggesting the *acceptance* of anxiety and the benefits derived from it, instead of fighting anxiety. The cognitive material is intended to be read aloud, daily in something called 'slow talk', until the individual can feel the therapy working.

The psychological principle underlying the effectiveness of repetitive cognitive therapy is gradual cognitive reprogramming through gentle reiteration of rational phrases.

I do acknowledge that in some ways, cognitive therapy can represent a form of indirect behaviour modification. But the analogy of the drowning man and life buoy comes to mind. And to be honest, I have no problem with the ethical implications of behavioural modification since some behaviours and thoughts can be extremely self defeating.

Well that's interesting. One of the growing critiques of psychodynamic practice is that the recollection and catharsis of "trauma" actually re-traumatizes the client, and entrenches his disorder. (The NYT Magazine did a lengthy article on this a few weeks back.) The argument, cognitive based, is that clients should learn to "repress" their memories. I find this to be more true than not, having done considerable primal work. I met people who have been laying in safe rooms, shouting at their mommies, for years. However, a psychodynamic approach does not require reiterative catharsis.

I’m familiar with this argument too. I doubt all cognitive approaches would advocate total repression of traumatic past events. However, I recognize that most don’t encourage continued, reiterative cathartic expression of those same events. Its really difficult to pigeon hole one therapeutic modal as encompassing a rigidly defined set of therapeutic techniques and criteria for their application, when most psychologists describe themselves as eclectic in their treatment strategy.

From my own perspective, one intended effect of the cognitive behavioural therapy I’m practising for Social Anxiety is to free the individual from paralysing negative rumination sufficiently to enable unimpeded exploration of issues having personal consequence. In my opinion, there’s no real set of 'official' criteria clinicians who employ cognitive techniques use to determine what existential related issues can be contemplated by their clients and whom patients should discuss those issues with. But I do think cognitive therapeutic philosophy does elude to the appropriate timing of when such contemplation should occur and recommends restricting it until the cessation of severe symptoms. On the surface, this suggests cognitive thought asserts existential exploration has little to do with complete patient recovery. But I think this is erroneous logic. I believe cognitive philosphey prioritizes, in applicable circumstances, the expeditious normalization of patient functioning to reduce mental confusion and anguish experienced. After that, any topic is fair game.

Then again, if the life buoy is perforated, he might want something more secure to hold onto: like meaning in his life. And that might be something more than clining to a method.

I suppose its a matter of individual perspective.



I'

ve referred plenty of people to cognitive work. My experience is that the techniques start to slip when the underlying gestalt, undressed, begins to assert itself. I consider this a demonstration of the fact that the psyche operates as more than a cognitive linguistic machine.

I agree. There’s certainly allot more to healthy operation of the human psyche than purely cognitive thought. However, that doesn’t diminish the significance cognitive thought has in 'normalized' emotive experience.

I'

Your assumption about clients doing psychodynamic work is not accurate. Most are very unstable emotionally. In analytical-based work there is often a presumption that the individual is fundamentally stable and wishes, by exploring his memories, fantasies, dreams, experiences, to discern meaning and purpose in existence. This is very far from an abstract experience. In fact, it almost always stresses the involvement of the body and, in my view, bears more in common with aesthetics than science.

interesting.