Mindfulness is defined as paying attention in the present moment. We investigate the hypothesis that mindfulness training may alter or enhance specific aspects of attention. We examined three functionally and neuroanatomically distinct but overlapping attentional subsystems: alerting, orienting, and conflict monitoring. Functioning of each subsystem was indexed by performance on the Attention. Mindfulness-based cognitive therapy (MBCT) incorporates elements of cognitive-behavioural therapy with mindfulness-based stress reduction into an 8-session group program. Initially conceived as an intervention for relapse prevention in people with recurrent depression, it has since been applied to various psychiatric conditions.
Upsetting Social Anxiety Thoughts
–I don’t know what to say. What do I say next?
–I might say something stupid / offensive.
–S/he’ll think I’m boring / stupid / unattractive / socially inept, and will dislike me.
–What I have to say isn’t good enough. No one will be interested.
–They can tell I’m anxious and will think I’m weird or weak.
–I might embarrass myself.
These are just a few of the many distressing and distracting hot thoughtsthat make us feel socially anxious. If only we could silence them!
If only. Have you ever tried to push an annoying thought out of your mind? Typically that effort backfires and ends up strengthening and prolonging the thought. Try this experiment: tell yourself that you must stop thinking about a pink elephant. Or, when you have a melody in your mind, try very hard to stop thinking about that tune. Most people find that trying to stop thinking about a thought paradoxically leads us to think about it even more! That’s because our efforts to stop thoughts are really telling our brains that these thoughts are very important.
What is Mindfulness for Social Anxiety?
Cognitive-behavioral therapy (CBT) teaches that it is more helpful to train our brains to treat these hot thoughts as unrealistic and unhelpful than it is to try to get rid of them. One strategy to do this is called MINDFULNESS: paying attention to the present moment with interest, rather than judgment.
I have the impression that most people think mindfulness means meditation. Even many therapists who teach mindfulness training are really just teaching meditation. That’s especially unfortunate because meditation, despite it’s many benefits for other concerns (eg. stress management, pain management, spiritual development), has been demonstrated to be a very ineffective strategy to overcome social anxiety. Meditation is certainly one place to practice mindfulness. But for dealing with social anxiety, it is much more useful to practice mindful focus during conversations and other situations around people in which we are uncomfortable.
Curiosity Training: Practicing Mindfulness for Social Anxiety
I call this type of mindfulness practice while we are interacting with others—or even while we are simply around others--curiosity training. We are learning to get out of our heads and into the moment. Instead of focusing our attention on ourselves—criticizing our performance or appearance, trying to guess what others are thinking of us, struggling to script out what to say—we learn to treat all those thoughts asbackground noise—something we’re aware of but not paying attention to—and instead return our attention to taking interest in the situation, the person, and the conversation.
We’re not trying to stop or silence any distressing thoughts. Remember, doing so tends to backfire and strengthen the thoughts and increase our distraction. We are instead learning to gently put those thoughts into the background—like we do with noise—and refocus our attention on taking interest in what is happening outside of ourselves. Some people find it helpful to silently say something very short and non-critical—eg. “mindful,” “present,” “focus”—to briefly interrupt our thoughts and then refocus our attention on the conversation, persons or situation in the moment.
Curiosity training takes frequent, ideally daily practice. It’s easiest to start practicing in situations in which you are calm, and working your way up to more anxiety-provoking situations as you get better at it. An additional tool that some people find helpful in learning mindful focus when anxious is the Attention Training Technique, a 10-minute recording created by Adrian Wells, PhD, in which you practice focusing on one sound while putting several other sounds into the background. (Email me and I’ll send you a copy: [email protected].)
Cognitive Restructuring for Social Anxiety
But what if my hot thoughts are too distressing to treat like background noise? Worse yet, what if they are true, or at least partly true? I can’t just ignore them then, can I? Fortunately, there is another strategy used by cognitive-behavioral therapy (CBT) to deal with distressing thoughts called COGNITIVE RESTRUCTURING. In contrast to mindfulness, which helps us change our relationship with our thoughts, cognitive restructuring helps us learn how to test our thoughts against real world evidence, and change their content so that they are more realistic and helpful. I will describe how to do cognitive restructuring in my next blog post. In the mean time, I suggest reading Mind Over Mood by NSAC Newport Beach / Orange County director, Dennis Greenberger, PhD, for an excellent description of how to do cognitive restructuring to help with anxiety and depression.
Larry Cohen, LICSW
Cofounder, National Social Anxiety Center; Director, NSAC District of Columbia
[email protected]; 202-244-0903
How to Get Help for Social Anxiety
The National Social Anxiety Center is a national association of regional clinics with certified cognitive therapists specializing in social anxiety and anxiety-related problems. We have compassionate therapists who can help you to reduce social anxiety. Currently, we have regional clinics in San Francisco, District of Columbia, Los Angeles, Pittsburgh, New York City, Chicago, Newport Beach / Orange County, Houston / Sugar Land, St. Louis, Phoenix, South Florida, Silicon Valley, Dallas, Des Moines, San Diego, Baltimore, Louisville and Philadelphia. Contact our national headquarters at (202) 656-8566 or visit our Regional Clinics contact page to find help in your local area.
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Free Online Cognitive Behavioral Therapy
Techniques Workbook
Techniques Workbook
If you’ve found this page, you’ve probably already heard that CBT is the scientific, research-supported treatment for psychological problems and disorders. Once known only to a just few inquisitive therapists, cognitive behavioral therapy (commonly referred to as CBT) is nowadays frequently in the news, with most contemporary research studies focused on CBT and CBT interventions. Cognitive behavioral therapy is the culmination of years of scientific research into the mind and what makes us feel better. Unlike traditional talk-therapy, CBT interventionsmake use of a number of exercises and skills to reduce anxiety, depression, and many other psychological problems. These exercises have been the subject of much study and testing, and have proven effective in the real world. All of the exercises included below are among those validated by decades of clinical research and testing. Click here to compare CBT results compared to traditional therapy and medication.
How Does CBT Work?
CBT interventions provide a simple ways of understanding challenging situations and problematic reactions to them. Cognitive behavioral therapy emphasizes three main components implicated in psychological problems: thoughts, emotions, and behaviors. By breaking down difficult feelings into these component parts, it becomes very clear where and how to intervene when an issue arises. If a particular negative thought seems to be causing a chain reaction of negative emotion and behavior, the best solution may be to reexamine that thought. If a behavioral pattern seems responsible, it’s likely a new behavioral response to the situation would be helpful.
Often, all three components are interwoven throughout difficult problems and feelings. Cognitive behavioral therapy exercises are designed to intervene on all three components simultaneously. For instance, when uncontrollable worry is the problem, CBT exercises can help people to identify more effective and grounded thoughts, which lessens anxiety. In turn, reduced anxiety makes it easier to engage in skillful behavior to actively address the triggering problematic situation.
Below is a list of cognitive behavioral therapy exercises common to a number of different CBT treatments:
Cognitive Restructuring:Cognitive restructuring (also referred to as cognitive reappraisal) is a cognitive behavioral therapy exercise designed to help people examine unhelpful thinking patterns and devise new ways of reacting to problematic situations. Cognitive restructuring often involves keeping a thought record, which is a way of tracking dysfunctional automatic thoughts, and devising adaptive alternative responses.
CBT Techniques for Depression: Activity Scheduling: Activity scheduling is a CBT technique for depression that helps people engage in behaviors they ordinarily would avoid, due to depression, anxiety, or other obstacles. This CBT intervention involves identifying a rewarding low-frequency behavior, and finding time throughout the week to schedule the behavior to increase its frequency. It is used in treatment for depression as a way of re-introducing rewarding behaviors into people’s routines. While seemingly simple, it is a core component of Behavioral Activation, the most effective empirically-supported treatment for clinical depression.
Cognitive Behavioral Therapy Exercises: Activity Scheduling
Cognitive Behavioral Therapy Exercises:
Cognitive Restructuring
Cognitive Restructuring
- Overgeneralizing or Overgeneralization
Graded Exposure: Exposure is a cognitive behavioral therapy exercise designed to reduce anxiety and fear through repeated contact with what is feared. This has been to shown to be among the most effective treatments that exists for any psychological problem. The underlying theory is that avoidance of things we fear results in increased fear and anxiety. By systematically approaching what you might normally avoid, a significant and lasting reduction in anxiety takes place.
Successive Approximation: Successive approximation is a cognitive behavioral therapy exercise that helps people tackle difficult or overwhelming goals. By systematically breaking large tasks into smaller steps, or by performing a task similar to the goal, but less difficult, people are able to gain mastery over the skills needed to achieve the larger goal. One way of practicing this skill is to Act as if.
Mindfulness Meditation:Mindfulness meditation is a cognitive behavioral therapy exercise that helps people disengage from harmful ruminating or obsessing, learning to connect to the present moment. Mindfulness originally comes from Buddhist meditation and is the subject of a significant amount of new research on effective treatments for psychological problems. Mindfulness has been shown to improve attention, pain management, and emotion regulation.
Cognitive Behavioral Therapy Exercises: Mindfulness Meditation
Dialectical Behavioral Therapy Workbook Pdf
- Half-Smile Practice
- Mindfulness STOP Skill or STOP Acronym
- Mindfulness Exercises for Chronic Pain
Skills Training: Skills Training is a cognitive behavioral therapy exercise designed to remedy skills deficits, and works through modeling, direct instruction, and role-plays. The most common subjects of skills training are social skills training, assertiveness training, and communication training. Skills training can also occur during problem-solving therapy.
Cognitive Behavioral Therapy Exercises: Social Skills Training
Validating Difficult People
Problem Solving:Problem Solving is a cognitive behavioral therapy exercise to help people take an active role in finding solutions to problems. Chronic mood problems or repeated disappointment can result in people taking a passive role when difficult situations arise. By teaching people effective problem solving strategies, they are able to regain control and make the best of difficult situations.
Relaxation Breathing Training:Relaxation training is a cognitive behavioral therapy exercise designed to help people reduce physiological symptoms of anxiety, such as shortness of breath, rapid heart rate, dizziness, etc. By reducing the body’s anxious arousal, people are able to think more clearly, thus increasing feelings of comfort and further decreasing anxiety symptoms.
Cognitive Behavioral Therapy Exercises: Relaxation Training
Dialectical Behavioral Therapy Pdf
For more information about each of these interventions, visit our CBT books list for recommended reading about CBT.
Mindfulness Pdf Linksdialectical Behavioral Training Program
Cognitive Behvaioral Therapy Los Angeles is a therapy practice of expert psychologists with the highest level of training and experience in providing evidence-based treatment. To ask a question or schedule a consultation to determine whether CBT is right for you, click the button below.