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“Social anxiety and shyness can become so intense that they prevent people from en - joying life. This book is ideal for anyone who wants to learn to be more comfortable around other people. Drs. Antony and Swinson have taken proven treatments for social anxiety and adapted them for a non-professional audience. The s...
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anxiety and traumatic stress disorders program at the University of California, San Diego
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“This is an excellent resource written by world-renowned and skilled clinicians and researchers in the area of anxiety disorders. Drs. Antony and Swinson present the most up-to-date information about social anxiety and its treatment in a way that is clear and, most importantly, that provides step-by-step tools for ...
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— Jacqueline B. Persons, Ph.D., director of the San Francisco Bay Area Center for Cognitive Therapy and clinical professor in the department of psychology at the University of California, Berkeley
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MARTIN M. ANTONY , PH.D. RICHARD P . SWINSON, MD New Harbinger Publications, Inc.PROVEN, STEP-BY-STEP TECHNIQUES FOR OVERCOMING YOUR FEARTheShyness & Social Anxiety Workbook SECOND EDITION
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Publisher’s Note Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, ...
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Library of Congress Cataloging-in-Publication Data Antony, Martin M. The shyness and social anxiety workbook : proven, step-by-step techniques for overcoming your fear / Martin M. Antony and Richard P . Swinson. -- 2nd ed. p. cm. Rev. ed. of: The shyness & social anxiety workbook. Includes bibliographical...
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For our students. —MMA and RPS
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Contents Acknowledgments vii Introduction 1 Part 1 Understanding Your Social Anxiety Chapter 1 Shyness and Social Anxiety 5 Chapter 2 Why Do You Have These Fears? 29 Chapter 3 Getting to Know Your Social Anxiety 39 Part 2 How to Overcome Social Anxiety and Enjoy Your Life Chapter 4 Making a Plan for Chan...
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The Shyness & Social Anxiety Workbook viRecommended Readings 239 National and International Associations Providing Referrals 245 Internet Resources 249 References 251
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Acknowledgments There are many people without whom this workbook would not have been possible. First, we wish to acknowledge those who were instrumental in developing and investi - gating the treatments described in this book. Dr. Aaron T. Beck pioneered many of the cognitive strategies that are used throughout the w...
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Introduction Shyness and social anxiety are universal. From time to time, almost everyone has felt nervous speaking in front of a group or anxious when interacting with another person. We wonder if a presentation has gone well or whether we have made a good impression on a first date or a job interview. In fact, even...
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anxiety and to teach you how to evaluate the main features of your own social anxiety. Then we discuss the costs and benefits of different treatment approaches and help you to select among available treatment options. Subsequent chapters provide detailed informa - tion about particular treatment strategies including m...
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The Shyness & Social Anxiety Workbook 2fine-tuning your communication and performance skills. The final chapter of the book discusses strategies for maintaining your improvements. This book is different from other self-help books in a number of ways. Of the many books on social anxiety and shyness that you will find in ...
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This workbook is designed so that it can be used alone or coupled with regular visits to a professional therapist. In fact, a motive for writing this book was to have a good refer - ence our own clients and patients can use as they progress through therapy. This second edition has been thoroughly updated with the late...
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PART 1 Understanding Your Social Anxiety
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CHAPTER 1 Shyness and Social Anxiety Rachel was a twenty-six-year-old woman who worked as an assistant manager of a small bookstore. She was referred to our Anxiety Treatment and Research Centre to get help for intense anxiety about her upcoming wedding. Rachel wasn’t afraid of being married; in fact, she looked for...
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accepted the invitations. She had a long list of excuses to get out of socializing with other people. She was comfortable only with her family and a few longtime friends, but aside from those, she usually avoided contact with other people. After college, Rachel began working at a bookstore, and after a short time, sh...
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The Shyness & Social Anxiety Workbook 6However, she avoided eating lunch with other staff members, and she never attended any social events, including the company’s annual holiday party. Rachel lived with her social anxiety for years, despite how it interfered with her education, work, and social life. It was not unt...
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fear is controlled, in part, by an area of the brain called the limbic system. The limbic system includes some of the deepest, most primitive structures of the brain—structures shared by many less “evolved” animals. In fact, there is reason to believe that the emotion of fear is present across most, if not all, anim...
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Shyness and Social Anxiety 7There is no question that when anxiety is too intense it can interfere with perfor - mance; however, mild to moderate amounts of anxiety are actually helpful. If you never became even slightly anxious under any circumstances, you probably wouldn’t bother doing the things that must be done....
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any obvious trigger. Panic attacks are discussed in more detail later in this chapter. To summarize, fear is an emotional reaction to an immediate danger, whereas anxiety is a state of apprehension about some future threat. For example, worrying about giving a presentation that is a week away is a reflection of anxiet...
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The Shyness & Social Anxiety Workbook 8as interpersonal situations ) or situations in which you are the focus of attention or might be noticed by others (these are often called performance situations ). Examples of interpersonal situations and performance situations that may be feared by people with high levels of s...
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Shyness and Social Anxiety 9UÊActing on a stage UÊReading out loud in front of others UÊEating or drinking in front of others UÊUsing public bathrooms with others in the room UÊWriting with others watching (for example, completing a form in public) UÊMaking a mistake in public (for example, falling down, dropping your ...
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speaking), whereas for others, the social anxiety occurs in almost all social situations. The experience of social anxiety is related to a number of common personality styles and traits including shyness , introversion , and perfectionism . People who are shy often feel uncomfortable in certain social situations, par...
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The Shyness & Social Anxiety Workbook 10will notice their “flaws” and judge them negatively. Perfectionism is discussed again later in this chapter. HOW COMMON IS SOCIAL ANXIETY? It is difficult to obtain accurate estimates of the prevalence of social anxiety because different studies have tended to define social anxiet...
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12 percent of people reported having the necessary symptoms to receive a diagnosis of social anxiety disorder at some point in their lives. In fact, social anxiety disorder was found to be the fourth most prevalent psychological problem in this study, after depres - sion, alcohol abuse, and specific phobias (for examp...
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Shyness and Social Anxiety 11There also may be differences in the types of social situations that men and women fear. One study found that men with social anxiety disorder were more fearful than women of urinating in public bathrooms and returning items to stores, whereas women with social anxiety disorder were more...
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In this section, we will discuss how a person’s social anxiety can affect relationships, work and school, and other day-to-day activities. After reading each section, take a few moments to consider how your social anxiety affects each of these areas of your life, and then describe this in the space provided. Relatio...
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The Shyness & Social Anxiety Workbook 12may be completely out of the question. Social anxiety may be more manageable around more familiar people, such as close friends and family—but not always. For some people, anxiety may actually increase as a relationship becomes more intimate. Also, social anxiety can interfere...
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finishing high school, he kept in touch with his closest friends. However, because of his anxiety, he often dreaded returning their calls and almost never accepted their invitations to get together. Eventually, his friends stopped calling him. UÊAlison’s roommate consistently plays loud music after midnight, making i...
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Shyness and Social Anxiety 13Education and Career Significant social anxiety can have an impact on a person’s education and career. It can affect the types of courses you take in school and the types of jobs you might accept. It can also affect job performance as well as your enjoyment of school or work. Consider the...
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view is completely overwhelming. On several occasions she has arranged for job interviews and then failed to show up because of her social anxiety. UÊPeople at work think that Jason is a snob. He tends to be very serious, and he speaks very little to others. Even when someone asks him a question, he tends to answer ...
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The Shyness & Social Anxiety Workbook 14Other Day-to-Day Activities Just about any activity that involves contact with other people can be affected by social anxiety. The following examples illustrate the range of situations and activities that are often difficult for people who are socially anxious. UÊSita avoids goi...
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anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association 2000). The DSM-IV-TR is the guide used by mental health practitioners to identify and diagnose various types of psychological problems. DSM-IV-TR diagnose...
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Shyness and Social Anxiety 15Although there is strong evidence that some of the DSM-IV-TR disorders (for example, schizophrenia, Alzheimer’s disease) are associated with a biological dysfunc - tion, the evidence is much less clear for other disorders. The problems listed in the DSM-IV-TR range from severe mental illn...
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anxiety disorder if he or she had a strong fear of public speaking but didn’t need to speak in front of groups and didn’t care about having the fear. On the other hand, a person who fears public speaking and needs to speak in front of groups (for example, a school - teacher) might be considered to have social anxiety...
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The Shyness & Social Anxiety Workbook 16Diagnosing social anxiety disorder is a complicated task. The information outlined in this section gives you an idea of how mental health professionals distinguish different types of problems from social anxiety disorder. However, this overview will probably not be enough for ...
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the cognitive aspects of social anxiety (anxious thoughts, expectations, predictions), and the behavioral aspects of social anxiety (for example, avoidance of social situations). Cognitive behavioral treatments for social anxiety encourage people to think of their social anxiety in terms of these three components. In...
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Shyness and Social Anxiety 17UÊRacing or pounding heart UÊBreathlessness or smothering feelings UÊDizziness or lightheadedness UÊDifficulty swallowing, choking feelings, or a “lump” in the throat UÊQuivering or shakiness (for example, in the hands, knees, lips, or whole body) UÊBlushing UÊNausea, diarrhea, or “butterfli...
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socially anxious, their symptoms are much less noticeable than they think. For example, a study by Mulkens, de Jong, Dobbelaar, and Bögels (1999) found that when socially anxious individuals are exposed to a stressful social situation, they are more likely than nonanxious individuals to believe that they are blushi...
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The Shyness & Social Anxiety Workbook 18that there were no differences between socially anxious and nonanxious people with respect to the actual intensity of blushing. Although in most cases people’s anxiety symptoms are less noticeable than they think, there is no question that a small number of individuals have a t...
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Strictly speaking, people don’t react emotionally to the situations and events in their lives. Rather, they react to their beliefs and interpretations concerning these events and situations. In other words, given an identical situation, different people might have com - pletely different emotional responses, dependin...
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Shyness and Social Anxiety 19UÊThe other person is not interested in the topic of the conversation but still likes you as an individual. UÊThe other person is hungry. UÊThe other person is in a hurry (for example, he or she is late for an appointment). UÊThe other person is tired. UÊThe other person is feeling sick o...
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UÊPeople should always be interested in what I am saying. UÊPeople should never have a disapproving or bored look on their face when I am talking. UÊPeople should never talk about me behind my back. UÊIf I make a mistake at work, I’ll get fired.
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The Shyness & Social Anxiety Workbook 20UÊPeople will be angry with me if I make a mistake. UÊI’ll make a fool of myself if I give a presentation. UÊPeople can tell when I’m nervous. UÊPeople find me unattractive, boring, stupid, lazy, incompetent, weird, weak, and so on. UÊPeople are untrustworthy, judgmental, and nas...
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the feared situation: UÊTurning down an invitation to a party UÊMaking an excuse not to have dinner with a friend UÊNever answering questions in class UÊAlways arriving late for meetings and leaving early in order to avoid making small talk
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Shyness and Social Anxiety 21UÊOffering to help with the dishes at a party in order to avoid talking to the guests UÊMaking an excuse to get off the telephone with a friend or coworker UÊDistracting yourself from your anxious thoughts UÊHaving the room dark during your presentation in order to keep the audi - ence foc...
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Alternatively, the cycle may begin with the cognitive component. For example, before giving a presentation, you may tell yourself that you are going to lose your train of thought and that others will notice how uncomfortable you are. You imagine that the others will interpret your discomfort as a sign of weakness (c...
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The Shyness & Social Anxiety Workbook 22Finally, the cycle may start with the behavioral component, namely avoidance and safety behaviors. By putting off getting together with friends for a long time (behavioral component), you are more likely to experience anxious thoughts (cognitive component) about what might hap...
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a sample completed form is included. OTHER PROBLEMS AND FEATURES Social anxiety is often associated with other problems. These may include panic attacks in social situations, excessively high standards and perfectionism, depressed mood, a negative body image, substance abuse, or difficulty trusting others. We will no...
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Shyness and Social Anxiety 23minutes, although it usually peaks immediately or within a few seconds. Also, to meet the full criteria for a panic attack, there must be at least four symptoms from a list of thirteen, including racing heart, chest discomfort, dizziness, breathlessness, shaking, stomach discomfort, swea...
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In social anxiety, people tend to place too much importance on making a perfect impression on others. If they are not guaranteed to be approved of by others, they may feel very anxious in social situations or avoid socializing altogether. Perfectionism is different from simply having high standards. High standards a...
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The Shyness & Social Anxiety Workbook 24People who are depressed are often embarrassed about feeling down, may assume that others don’t want to be around them, and may avoid being around other people. Social anxiety and depression are associated with similar thought patterns as well— specifically, negative thoughts ab...
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alcohol or other drugs to feel more comfortable in social situations, it may be important to address this issue at the same time that you are working on your social anxiety. Anger and Mistrust of Others In addition to fearing negative judgment from others, some people with high levels of social anxiety may also have ...
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Shyness and Social Anxiety 25OVERCOMING SOCIAL ANXIETY Two general approaches have been shown to be useful for overcoming social anxiety: psychological strategies and medications. We’ll discuss each of these briefly. Psychological Strategies Although there are many different types of psychotherapy practiced by mental ...
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The Shyness & Social Anxiety Workbook 26 Three Components of Social Anxiety Monitoring Form Place/Situation/TimeFear (0–00)Physical Feelings Anxiety-Provoking Thoughts Anxious Behaviors
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Shyness and Social Anxiety 27Three Components of Social Anxiety Monitoring Form—Completed Sample Place/Situation/TimeFear (0–100)Physical Feelings Anxiety-Provoking Thoughts Anxious Behaviors At a party on Tuesday night; I said to Mike, “It’s been ages since I saw you last,” and he responded by reminding me that I...
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CHAPTER 2 Why Do You Have These Fears? BIOLOGICAL FACTORS As with any emotion or personality trait, our biology affects the tendency to experience anxiety in social situations (Mathew and Ho 2006). Biological processes such as natural selection or evolution, genetics, brain activity, and alterations in the levels o...
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The Shyness & Social Anxiety Workbook 30have developed according to the same laws of natural selection that are thought to have guided the more “positive” aspects of human evolution (Moalem and Prince 2007; Nesse and Williams 1994). For example, in their book, Why We Get Sick: The New Science of Darwinian Medicine , ...
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very much dependent on those around us. None of us could survive without the help of others. As infants and children, we are completely dependent on our parents for food, shelter, comfort, and education. As we grow up, we continue to depend on other people. We depend on our employers to provide us with money for foo...
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errors at work or school. In addition, socially anxious people often avoid taking social risks and may therefore find it difficult to make friends or to find work. Whereas mild to moderate levels of social anxiety are completely normal and potentially helpful, extreme social anxiety can interfere with a person’s functi...
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Why Do You Have These Fears? 31So, from an evolutionary perspective, people with social anxiety disorder do not have an illness, per se. Rather, they have too much of a good thing . Social anxiety is helpful in small doses, but when it is too intense, it can make life more difficult. Genetics and Social Anxiety Socia...
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rial). Because twin pairs tend to be raised in similar environments regardless of whether they are identical twins or fraternal twins, a higher social anxiety concordance rate in identical twins than in fraternal twins is thought to be evidence that genetics may have played a larger role in the development of the s...
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The Shyness & Social Anxiety Workbook 32make up human DNA. This work has made it possible for scientists to study particular genes that may be involved in the development of social anxiety disorder and many other conditions, using research methods known as linkage studies and association studies . So, what do we kn...
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focused and socially withdrawn. Not surprisingly, shyness and social anxiety tend to be associated with both of these personality styles (Briggs 1988). Recently, researchers have started to use molecular genetics studies to identify specific genes that may contribute to traits such as introversion (Stein, Schork, and...
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Why Do You Have These Fears? 33Effects of the Brain and Neurotransmitters Compared with other psychological problems, including other anxiety disorders, studies examining the biological factors underlying social anxiety often have failed to obtain significant findings. For example, research examining hormonal factors, ...
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that is involved in the experience of basic emotions, including fear), and the hippocampus (a part of the limbic system that controls memory and spatial abilities). Furthermore, treatment of social anxiety with either cognitive behavioral therapy or medication leads to reductions in activity in the amygdala and hi...
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The Shyness & Social Anxiety Workbook 34How Learning Contributes to Social Anxiety A large number of studies suggests that learning plays an important role in the development of fear. We learn to fear objects and situations through three main routes (Rachman 1976). First, directly experiencing a trauma or some negati...
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anxiety. Examples of Negative or “Traumatic” Experiences That May Have Contributed to My Social Anxiety
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Why Do You Have These Fears? 35LEARNING BY OBSERVING OTHERS Observation is a powerful way of learning to fear specific objects and situations. This form of learning (also called vicarious learning ) includes developing a fear by observing role models who themselves are anxious in social situations. Another form of ob...
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The Shyness & Social Anxiety Workbook 36In the space below, list examples of informational learning experiences that may have contributed to, or helped to maintain, your social anxiety. Examples of Indirect or Informational Learning Experiences That May Have Contributed to My Social Anxiety Why Only Some People Devel...
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chances of developing social anxiety. You have probably heard that the best thing to do after falling off a horse is to get back on as soon as possible to avoid developing a fear of horses. The same is true of social anxiety. If you avoid a social situation following a trau - matic experience, you may increase your c...
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Why Do You Have These Fears? 37HOW BELIEFS CONTRIBUTE TO SOCIAL ANXIETY As discussed in chapters 1 and 6, people with elevated social anxiety tend to think about social situations in a more negative way than do those people who are less anxious. Anxiety-provoking thoughts, interpretations, and predictions can lead ...
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assume that others will interpret their physical symptoms as normal (perhaps a sign of feeling hot, being hungry, and so on). UÊWhen presented with an ambiguous social situation (for example, a stare from someone else or a phone call that isn’t returned), people with ele - vated social anxiety have a heightened tende...
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The Shyness & Social Anxiety Workbook 38that are related to social anxiety (words such as “blush” or “party”) than do those who are less anxious. UÊSocial anxiety is associated with a tendency to have a better memory and recognition for other people’s faces, particularly if the expression on the face appears to be n...
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to know. See chapters 7 through 9 for a discussion of strategies for confronting feared situations instead of avoiding them and for stopping the safety behaviors that help to maintain your fear over time. And, in chapter 10, we’ll discuss strategies for improving communication and social skills.
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CHAPTER 3 Getting to Know Your Social Anxiety WHY CONDUCT A SELF-ASSESSMENT? The initial step that a psychologist, psychiatrist, or other mental health professional takes in beginning to help an individual with a particular problem is a period of evalua - tion and assessment. This evaluation process involves collect...
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The Shyness & Social Anxiety Workbook 40In the same way, a detailed self-assessment will help you to understand and address your difficulties with social anxiety. We strongly recommend that, before you begin working on changing your own social anxiety, you carry out a careful self-assessment. This assessment process ...
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social situations. A comprehensive self-assessment will help you to decide which fears to work on first. First, it will be important to identify which situations you fear and avoid. Next, you will need to identify your priorities—that is, which aspects of the problem you want to begin to address first. When choosing y...
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Getting to Know Your Social Anxiety 41UÊTry to work on fears that interfere the most with your day-to-day life. Being able to confront the most disabling fears will have a much bigger impact on your life than working on fears that are less important to you. UÊIf one of your treatment aims is very important to you but...
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you to decide whether to spend time working on the skills involved in asser - tiveness, public speaking, dating, or general communication. (See chapter 10 for strategies for improving various types of social and communication skills.) UÊIf you decide to take medications for your social anxiety, the choice of which m...
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The Shyness & Social Anxiety Workbook 42MEASURING YOUR IMPROVEMENT Assessment is not only for the initial phase of your treatment. Rather, the process of assessment should continue throughout treatment and even after treatment has ended. Continuing the assessment process throughout treatment will provide you with a w...
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Behavioral Assessment A behavioral assessment involves directly observing a person’s behavior or asking the person to perform a specific behavior and then measuring the thoughts and feelings that arise in that situation. The most common types of behavioral assessment for social
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Getting to Know Your Social Anxiety 43anxiety are the behavioral approach test and behavioral role-play . These involve having a person enter a feared social situation (behavioral approach test) or act out a feared situation in a role-play (behavioral role-play) and having the person report his or her fear level, a...
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that you need to work on most. At the beginning of chapter 4, we will suggest additional questions that will help you to develop a treatment plan. WHICH SOCIAL SITUATIONS DO YOU FEAR AND AVOID? For each of the following situations (divided into interpersonal situations and per - formance situations, as defined in chapt...
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The Shyness & Social Anxiety Workbook 44Fear Scale 0 10 20 30 40 50 60 70 80 90 100 None Mild Moderate Extreme Very Extreme Avoidance Scale 0 10 20 30 40 50 60 70 80 90 100 Never AvoidRarely AvoidSometimes AvoidOften AvoidAlways Avoid Feared Social Situations Worksheet Interpersonal Situations (interacting w...
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Getting to Know Your Social Anxiety 45Performance Situations (being observed by others) Fear Avoidance Item Giving a presentation at work Making a toast at a party or family gathering Speaking in meetings at work or school Playing sports or participating in aerobics in front of others Standing in a wedding p...
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extent to which the variable listed affects your level of fear or discomfort in the types of social situations that you fear. For example, if you are much more anxious when talking to a woman than when talking to a man, you might rate the effect of the other person’s sex on your anxiety at about a 75 or 80. Use the ...
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The Shyness & Social Anxiety Workbook 46Effect on Your Discomfort Scale 0 10 20 30 40 50 60 70 80 90 100 No EffectSmall EffectModerate EffectLarge EffectVery Large Effect Your Anxiety Variables Aspects of the Other Person and their Effect on Your Discomfort Effect on Your DiscomfortItem Age (whether the o...
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Getting to Know Your Social Anxiety 47My Relationship with the Other Person and Its Effect on Your Discomfort Effect on Your DiscomfortItem How well you know the other person (family member, close friend, acquaintance, stranger, and so on) How intimate and close you are to the other person Whether there is a hist...
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The Shyness & Social Anxiety Workbook 48Aspects of the Situation and Their Effect on Your Discomfort Effect on Your DiscomfortItem Lighting (for instance, the light level is so high that you feel that any sign of anxiety will be visible) How formal the situation is (for example, eating at a wedding reception vs. ...
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that you are extremely fearful of experiencing the sensation in front of others. Intensity of the Physical Sensations Scale 0 10 20 30 40 50 60 70 80 90 100 Not at AllMild Moderate Extreme Very Extreme
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Getting to Know Your Social Anxiety 49Fear of Having the Physical Sensations in Front of Others Scale 0 10 20 30 40 50 60 70 80 90 100 No FearMild FearModerate FearExtreme FearVery Extreme Fear Intensity of SensationYour Fear of SensationSensation Racing or pounding heart Breathlessness or smothering f...
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The Shyness & Social Anxiety Workbook 50 WHAT ARE YOUR ANXIETY-PROVOKING BELIEFS, PREDICTIONS, AND EXPECTATIONS? As discussed in chapter 1, your beliefs have a big impact on how you feel in social situations. For example, if you expect that others will think you are stupid, weak, or unattractive, you are very likely...
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notice my hands shaking.” To identify your own anxiety-provoking thoughts, we recommend the following steps. First, review some of the examples of anxiety-provoking thoughts listed in chapter 1. These will give you an idea of the types of thoughts that are often associated with social anxiety. Next, think of social ...
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Getting to Know Your Social Anxiety 51Your Anxiety-Provoking Beliefs What am I afraid will happen in the situation? What might people think about me in the situation? Is it almost always important that I make a good impression? Why? How will I react in the situation (what symptoms will I exhibit)? What if my expectatio...
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The Shyness & Social Anxiety Workbook 52WHAT ARE YOUR ANXIOUS BEHAVIORS? Anxiety and fear are usually accompanied by a strong urge to do something to reduce these uncomfortable feelings. Are there behaviors that you use to reduce your anxiety? Here are some examples. Avoidance of social situations. Are there situati...
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you’re anxious? Each of these is an example of how people sometimes overcompensate to cover up what they perceive to be flaws. If you can think of examples of times when you have overcompensated in social situations for what you thought were flaws or faults, list them below. Excessive checking and reassurance seeking....
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Getting to Know Your Social Anxiety 53your hair is perfect and continually asking your friends to reassure you that you are interesting or smart. Although it is helpful to seek reassurance from time to time, constant reassurance seeking can have a negative impact by helping to maintain your fear. By asking for reas -...
shyness_social.pdf