Mind RELAXATION TRAINING

1. What is relaxation training?
Relaxation is the voluntary letting go of tension. This tension can be physical tension in the
muscles or it can be mental, or psychological, tension. When we physically relax, the impulses
arising in the various nerves in the muscles change the nature of the signals that are sent to the
brain. This change brings about a general feeling of calm, both physically and mentally. Muscle
relaxation has psychological benefits as well as physical. Through relaxation training you will learn
how to recognise tension and achieve deep relaxation. You will need to be an active participant,
committed to daily practice for two months or longer.
2. Importance of Relaxation Training
Muscles are designed to remain in a relaxed state until needed to perform some activity. In usual
circumstances the muscles do not remain at a high level of tension all the time but become
activated and deactivated according to a person's needs. The fight-or-flight response also results in
muscle tension. When people have been under stress for long periods of time, they may maintain
high levels of muscle tension. They may experience muscle fatigue, pain and constant
apprehension. Eventually these people may be unable to recognise tension or relax. As a result of
high levels of tension, these people may feel jumpy, irritable, nervy, or apprehensive. Tension may
appear to be almost relaxed compared with panic attacks.
When someone is in a continual high state of tension, it’s easier for a panic attack to occur because
the body is already highly activated. A minor event, such as getting stuck in traffic, can trigger
further tension, which in turn can lead to hyperventilation and panic. Constant tension makes
people over-sensitive and they respond to smaller and smaller events as though they were
threatening. By learning to relax, you can reduce general levels of arousal and tension, and gain
control over these feelings of anxiety.
Note that these responses are opposite to the fight-or-flight response.
Since some tension may be good for you, it is important to learn to discriminate between useful and
unnecessary tension. Much everyday tension is unnecessary. Only a few muscles are involved in
maintaining normal posture, e.g. sitting, standing or walking. Occasionally, an increase in tension
is extremely beneficial, for example, when you are about to receive a serve in a tennis game.
Likewise, it is probably helpful to tense up a bit before a job interview. Do not become frightened
of this type of tension. The tension is unnecessary when (a) it performs no useful alerting function,
(b) when it is too high for the activity involved, or (c) when it remains high after the activating
situation has passed.
3. Components of Relaxation Training
In order to be more in control of your anxiety, emotions, and general physical well-being it is
important to learn to relax. To do this you need to:
1. Learn to recognise tension
2. Learn to relax your body in a general, total sense
3. Learn to let tension go in specific muscles.
4. Recognising tension
Consider the following:
1. Where do you feel tension?
2. Do your muscles show characteristics of tension, such as soreness, fatigue or feeling hard?
3. Which reactions within yourself lead to an increase in tension?
(e.g. frustration, surprise, anger)
4. Which external events lead to an increase in tension?
(e.g. queues, waiting at traffic lights, work pressure)
5. Progressive Muscle Relaxation
Progressive muscle relaxation involves the muscles being relaxed in a progressive manner
gradually working through different muscle groups in the body. Both sides of the tape you have
been given have instructions for progressive muscle relaxation. Side A is a 25-minute version. Side
B is an abbreviated 15-minute version. You will be starting with Side A for the first week of the
program; your therapist will tell you when to use Side B.
Relaxation exercises should be done at least once a day to begin with. Initially, do the exercises in a
quiet room, minimising interruption, so that you can give your entire concentration to relaxation.
Explaining the exercises to those you live with, and perhaps playing the tape to them, will generally
lessen any embarrassment and minimise interruptions. Select a comfortable chair with good support
for your head and shoulders. Or cushions against a wall. Some people prefer to do the exercises
lying down, but do not use this position if you are likely to fall asleep. You cannot learn to relax
while asleep. Sleep is not the same as relaxation - consider those times when you have woken up
tense. If you want a method to put you to sleep, go over the relaxation exercises in your mind or
keep a relaxation tape specifically for that purpose. As you master the relaxation exercises, try
various postures and situations. You may use the relaxation tape as preparation for some activity
over which you anticipate difficulty. Arrange your seating appropriately, finish all you need to do
and then start the tape.
Do not practise progressive muscle relaxation while performing activities that require a high degree
of alertness, e.g., driving a car or operating a machine.
6. Getting the most out of progressive muscle relaxation
v Avoiding tensing too tightly. A maximum of 60 – 70% tension is recommended.
v Don’t tense to the point of pain or discomfort.
v Don’t worry if your mind wanders during the tape – this is often a sign of relaxation. Gently try
to focus back on the tape.
v Some people feel anxious during relaxation exercises. This usually is because they are
unfamiliar with being physically relaxed.
7. Isometric Relaxation Exercises
Isometric relaxation exercises can be done in everyday situations. Most of the exercises below do
not involve any obvious change in posture or movement. Others involve some movement. The
majority of exercises can be done quite unobtrusively, even when in company. In the early stages of
training you may have to do these exercises several times a day to counteract tension and maintain
a relaxed state, particularly when under stress. As you improve, they will take less time and become
easier. Eventually, you will find that you are doing them without thinking - that is, they may well
become a habit that you will use automatically to counter tension.
There are some important points that need to be remembered when doing the isometric exercises.
You are asked to hold your breath for 7 seconds while you hold in tension, but some people
occasionally find this too long. Try to hold it for 7 seconds if you can but this is not crucial. The
most important thing is to concentrate on putting the tension in slowly over approximately 7
seconds and releasing the tension slowing over approximately 7 seconds. The most common
mistakes that people make with isometric exercises is putting the tension in too quickly, or putting
in too much tension. These are meant to be gentle and slow exercises. The aim of the exercise is to
relax you, not get you even more tense. If circumstances do not allow you to hold the tension for 7
seconds, you can still benefit from putting in the tension slowly over some period of time and
releasing it in the same manner.
When sitting down or lying in private:
· Take a small breath and hold it for up to 7 seconds.
· At the same time straighten and stiffen your arms and legs out in front of you.
· After 7 seconds breathe out and slowly say the word "relax" to yourself.
· Let all the tension go from your muscles.
· Repeat if necessary until you feel relaxed.

Anxiety and Panic Disorder

Patient Treatment Manual

This manual is both a guide to treatment and a workbook for persons who suffer
from Anxiety and Panic Disorder. During treatment, it is a workbook in which
individuals can record their own experience of their disorder, together with the
additional advice for their particular case given by their clinician. After treatment
has concluded, this manual will serve as a self‐help resource enabling those who
have recovered, but who encounter further stressors or difficulties, to read the
appropriate section and, by putting the content into action, stay well.
1. Panic Attacks, Panic Disorder & Agoraphobia
A Panic Attack is a sudden spell or attack when you felt frightened, anxious or very uneasy in a
situation when most people would not feel afraid. During one of these attacks the following
symptoms may occur:
shortness of breath trembling or shaking
pounding heart hot or cold flushes
dizzy or light headed things around you feel unreal
tingling fingers or feet dry mouth
tightness or pain in the chest nausea or butterflies
a choking or smothering feeling "jelly legs"
feeling faint blurred vision
sweating muscle tension
feeling you can’t get your thoughts together or speak
fear you might die, lose control or act in a crazy way
Panic Disorder is the name given to the condition in which people have unexpected panic attacks,
worry about what panic attacks might do or mean, and change their behaviour as a result of having
panic attacks. Individuals with panic disorder will have experienced a number of these symptoms
during a panic attack. Different people will find different symptoms more frightening or unpleasant
than others.
When the panic becomes severe most people try to get out of the particular situation, hoping the
panic will stop. Alternatively, they get help because of fears they might collapse, have a heart
attack, or go crazy. Occasionally, some people want to be alone so that they don't embarrass
themselves in some way. When individuals start associating panic attacks with certain situations,
they often try to minimise the panic attacks by avoiding the same or similar situations. For
example, some people who have their first panic attack on a train may start to avoid trains and
buses in the future. When this avoidance is widespread and severe, the condition is called
Agoraphobia.
Situations that are avoided by people with agoraphobia (or endured with anxiety or discomfort) can
usually be understood as situations from which escape might be difficult (physically or socially) or
in which it might be difficult to obtain help if a panic attack occurs. An underground train is an
example of a situation from which it is physically difficult to escape, whereas a dinner party is an
example of a situation from which leaving might be socially awkward. Being alone at home or
alternatively, a long way from home, are examples of situations in which it might be difficult to
obtain help. There are, of course, situations that combine elements of these: being on a peak-hour
train could be seen to involve difficulty escaping as well as difficulty obtaining help.

Anxiety and Phobias

A phobia is a particular type of fear. Just as people fear many things, there is a large range of
things that can become a phobic concern. However, a phobia is different from a fear for three
reasons. The first of these is that the fear is intense and includes many of the following
sensations:
BODILY SENSATIONS
· Heart racing
· Sweating
· Trembling
· Rapid breathing
· Breathlessness or shortness of breath
· Muscular tension
· "Butterflies" in the stomach
· Nausea
· Weakness in muscles
· Tingling in hands and feet
· Hot and cold flushes
· Chest tight or sore
ACTIONS
· Feeling like fleeing or doing so
· Feeling frozen to the spot
· Crying or screaming
THOUGHTS
· Fear
· Worry "what if . . ."
· Embarrassed or irritated
· Shame
· Confused thinking
· "Something might happen"
· "This is dangerous" or "I might act in a dangerous way"
All of these actions, thoughts, and feelings are indications of fear and anxiety. It is important to
note that while they are unpleasant to experience, on their own they are not dangerous or lifethreatening.
We will discuss later why these experiences occur, but before we do, the second
feature of a phobia needs to be described.
Phobias involve avoidance of what is feared (or, at the very least, the object or situation is
endured with distress). Because anxiety is unpleasant and people worry what might happen when
they confront what they fear, people with phobias avoid the objects or
situations that make them afraid. This avoidance may take many different and subtle forms, such
as:
· Not going near the feared object or situation
· Escaping the situation
· Making excuses for not doing what scares you
· Imagining yourself somewhere else
· Thinking about something else
· Looking the other way
· Drinking alcohol or taking other drugs
· Taking antianxiety medications
· Seeking the presence of others
· Talking to the people you are with about anything
Many of the ways in which people with phobias avoid what they fear are subtle and this, in part,
may be due to the final important characteristic of a phobia, its "irrationality." As you may have
found, people who do not have phobias have difficulty understanding those who do; they may
say that the fears are silly, childish, and nonsensical. And while you also know that the situation
does not represent a real danger, at another level you may believe that it may do so. You may
even be able to agree with your family and friends and say that "I know that nothing will
happen" but it doesn't help. There is still this other part of you that is afraid a nagging doubt
that says "what if . . ."
To summarize what we have covered so far, phobias are characterized by three things. First,
there is an intense fear and anxiety about some object or situation. Second, there is an avoidance
of the feared object or it is endured with great difficulty. Finally, there is a conflict between
the knowledge that the situation is relatively safe and the belief that it may not be.
1.1 Rationale the Program
The program will focus on the three aspects of the phobia and you will be given skills that
specifically target each of them. As such, the treatment is like a tripod. It requires all three legs to
be present to stand firmly. This means that you will need to learn, practice, and keep using all of
the techniques to control your anxiety. The three strategies that this program covers are
techniques designed (1) to control your physical sensations, (2) to help you face more
comfortably the things that you currently fear and avoid, and (3) to modify what you say to
yourself. A further module will cover skills that have specific relevance to controlling
the fainting in the presence of blood and injury.
It is important to realize that achieving control of anxiety is a skill that has to be learned. To be
effective, these skills must be practiced regularly. The more you put in, the more you will get out
of the program. It is not the severity of your fear or avoidance, how long you have had your
phobia, or how old you are that predicts the success of the program. Rather, it is your motivation
to change your reactions. Using all three techniques, you will be able to master your fear.

Specific Anxieties in Social Phobia

The predominant emotion in social phobia is anxiety. As we have seen, anxiety occurs in response
to a perceived threat through activation of the flight or fight response. Whilst this response
developed in animals as an emergency response to physical danger, in humans it can also be
triggered by the threat of some type of loss. It may be that a fear of losing our social standing with
others may trigger the anxiety of social phobia. It may also relate to some deep seated need to be
accepted by others which could date from prehistoric times when an individual’s survival in a harsh
and dangerous environment depended on acceptance by the tribe. In any case, it is now clear that
the anxiety in social phobia is triggered by a fear of being negatively evaluated. Underlying this is
an excessive concern about the opinions of others.
You can compare your degree of concern about what others may think of you with the general
population by completing the following questionnaire, developed by Watson and Friend.
FNE SCALES
In each case indicate whether or not the statement applies to you by writing either T for true or F for false.
Please be sure to answer all the statements.
1. ___ I rarely worry about seeming foolish to others.
2. ___ I worry about what people will think of me even when I know it doesn't make any difference.
3. ___ I become tense and jittery if I know someone is sizing me up.
4. ___ I am unconcerned even if I know people are forming an unfavorable impression of me.
5. ___ I feel very upset when I commit some social error.
6. ___ The opinions that important people have of me cause me little concern.
7. ___ I am often afraid that I may look ridiculous or make a fool of myself.
8. ___ I react very little when other people disapprove of me.
9. ___ I am frequently afraid of other people noticing my shortcomings.
10. ___ The disapproval of others would have little effect on me.
11. ___ If someone is evaluating me, I tend to expect the worst.
12. ___ I rarely worry about what kind of impression I am making on someone.
13. ___ I am afraid that others will not approve of me.
14. ___ I am afraid that people will find fault with me.
15. ___ Other people's opinions of me do not bother me.
16. ___ I am not necessarily upset if I do not please someone.
17. ___ When I am talking to someone, I worry about what they may be thinking about me.
18. ___ I feel that you can't help making social errors sometimes, so why worry about it.
19. ___ I am usually worried about what kind of impression I make.
20. ___ I worry a lot about what my superiors think of me.
21. ___ If I know someone is judging me, it has little effect on me.
22. ___ I worry that others will think I am not worthwhile.
23. ___ I worry very little about what others may think of me.
24. ___ Sometimes I think I am too concerned with what other people think of me.
25. ___ I often worry that I will say or do the wrong things.
26. ___ I am often indifferent to the opinion others have of me.
27. ___ I am usually confident that others will have a favorable impression of me.
28. ___ I often worry that people who are important to me won't think very much of me.
29. ___ I brood about the opinions my friends have about me.
30. ___ I become tense and jittery if I know I am being judged by my superiors.
Score this questionnaire by giving yourself 1 point if you said “True” to numbers 2,3,5,7,9,11,
13,14,17,19,20,22,24,25,28,29,10. Score 1 point if you said “False” to
1,4,6,8,10,12,15,16,18,21,23,26,27. Your score gives an indication of how concerned you are to get
the approval of others in your life. Approximately 75% of people in the general population score
less than 19 on this scale. Scores higher than this indicate a level of over concern about others’
opinions of you that is likely to cause distress – and result in anxiety in social situations.
That’s not to say that others don’t get any social anxiety. They do. Everyone would like to think
that they are accepted and approved of by others they come in contact with. We all know the
feeling of embarrassment when we make a silly mistake, say something inappropriate or draw
attention to ourselves in an unflattering, and usually accidental, way. However, there are several
differences between normal social anxiety and social phobia.
Normal social anxiety Social phobia
Moderate desire for approval Strong desire for approval
Expectation of approval Expectation of disapproval
Reasonable tolerance for disapproval Extremely distressed by disapproval
Easily forgets about faux pas Dwells on faux pas, very upset by them
When in doubt interprets response as positive When in doubt interprets reaction as critical
So, it is the fear of negative evaluation that is the core of the problem, but it is compounded by
unrealistic beliefs about:
· How bad you think negative evaluation is, and what you believe the consequences will be for
you
· How likely you think it is that you will be evaluated negatively
This explains why some people that show the apparent signs of anxiety that worry you - who blush
or tremble, sweat or shake, appear lost for words or stumble over what they are saying – do not
appear to worry about it. Indeed, many of the people we have treated in the past have commented
that they have encountered people who did what they themselves feared without worrying about it,
for example, the person who shook when writing, yet seemed unconcerned,

Anxiety Management

The previous section discussed the nature of anxiety and panic, and the situational and lifestyle
factors which can contribute to generally heightened levels of stress and anxiety. By paying
attention to these factors you can help reduce your level of arousal - the degree of tension and
alertness you feel – when this is excessive for your needs and your health.
Specific anxiety management strategies include:
· Hyperventilation control - the slow breathing technique covered in Section 2
· Relaxation Training
Slow-Breathing Technique
It is known that even a slightly elevated rate of depth of breathing beyond what is required in the
circumstances can contribute to feelings of anxiety. Many individuals will not have obvious
hyperventilation, and currently it is not felt to play a major role in the anxiety experienced by most
people with social phobia. It is more likely to be of importance if you noted an elevated breathing
rate in the exercise above, or if you do actually suffer panic attacks.
The slow breathing technique can be used as the foundation of your anxiety management strategies,
helping to calm you down so that you can think more clearly and apply the “straight thinking’
strategies you will learn in the next part of the program. It can also be useful strategy to shift your
focus away from your anxious concerns, and many people over the years have found the technique
helpful for these reasons. The best approach is to use the technique at the first signs of anxiety.
The slow breathing technique will give you a breathing rate of 10 breaths per minute. It is best to
use a watch in practice sessions initially to make sure that you get the feel for the right timing –
when we feel anxious there is a tendency for us to feel a bit “speedy” and want to do everything too
fast! Concentrate on making your breaths smooth and light. Breathe through your nose to help limit
the amount of air you take in and thus prevent overbreathing. It should feel as though the air is just
drifting lightly past your nostrils. Relax your stomach muscles. The movement is so light that it is
unnoticeable from normal breathing to anyone who may be watching. Ready? Now do the
following:
SLOW BREATHING TECHNIQUE
1. Take a medium sized breath in, hold it and count to 6 (timing 6 seconds with your watch).
2. When you get to 6, think “relax” and breathe out. Try and feel as though you are releasing
tension as you breathe out.
3. Next breathe in for three seconds and out for three seconds, in a smooth and light way.
4. At the end of each minute (after 10 breaths) hold your breath again for 6 seconds, think “relax”,
breathe out, and then continue breathing in the six-second cycle for another minute.

What is a panic attack?

Panic means a sudden spell or attack of feeling frightened, anxious or very uneasy. Typically
symptoms come on suddenly and escalate in severity over the next 5-10 minutes. A panic attack is
essentially a severe flight or fight reaction.
During a panic attack the following symptoms may occur:
· feeling short of breath
· pounding heart
· sweating
· trembling or shaking
· blushing
· trembling or croaking voice
· nausea or a fear of vomiting
· dizziness or light-headedness
· tingling fingers or feet
· tightness or pain in the chest
· a choking or smothering feeling
· hot or cold flushes
· feelings of unreality
· a feeling that you cannot get your thoughts together or speak
· an urge to flee
· a fear that you might die
· a fear that you might act in a crazy way.
You can see from the list of changes that occur during the flight or fight response how at least some
of these symptoms arise. Any or all of these symptoms may occur. Not every one with social
phobia gets panic attacks. Each individual tends to have their own pattern of symptoms in response
to anxiety, and to find some symptoms more distressing or unpleasant than others. In social phobia,
blushing, sweating and shaking are often seen as the most troubling symptoms.
When anxiety becomes severe, most people try to escape the situation in order to prevent the feared
consequences (the “flight” aspect of the flight or fight response). In other words, if an individual
fears that their anxiety will cause them to look odd, or say something inappropriate they will try to
escape the situation before this can happen. Once out of the situation the anxiety usually settles
quickly.
Most people rapidly learn to predict the situations in which the anxiety or panic is likely to occur.
Some people quickly begin to avoid such situations altogether. Anticipatory anxiety can be a severe
problem. Sometimes an individual really intends to go through with a social outing or performance
situation but avoids it at the last minute because their anxiety has escalated to the point where they
feel totally unable to manage the situation. Avoiding situations that cause anxiety may seem the
only alternative to the negative evaluation that it is feared may result if social performance is
adversely affected by anxiety.
But what if your performance wasn’t as badly affected as you thought? You would lose the
opportunity to learn this. Your anxiety would probably start spreading to other types of social
situations. Meanwhile, your level of confidence and self esteem would drop as you found yourself
more and more restricted in what you felt you could cope with. Hence, you would become even
more anxious about the situations you feared. When social phobia has been present for a long time
the individual often structures his or her life around the need to avoid certain situations or expends
considerable effort and anxiety planning what to do in case a panic should occur.
This program will teach you how to control your anxiety and panic and how to cope with situations
in which anxiety is likely to occur.
EXERCISE: MAKE A LIST OF SITUATIONS IN WHICH YOU WOULD FEEL VERY ANXIOUS
1. __________________________________________________________________________________
2. __________________________________________________________________________________
3. __________________________________________________________________________________
4. __________________________________________________________________________________
5. __________________________________________________________________________________
The Role of Hyperventilation
We now turn our attention to one particular aspect of the flight or fight response, namely, the
increase in rate of respiration, or overbreathing.
Efficient control of the body's energy reactions depends on the maintenance of a specific balance
between oxygen and carbon dioxide. This balance can be maintained through an appropriate rate
and depth of breathing. The flight or fight response triggers an increase in the rate of breathing in
preparation for taking flight. When this response is triggered by a social situation, you are unlikely
to respond by running away, at least, not literally! The increase in oxygen intake is not matched by
an increase in carbon dioxide production and an imbalance results.
Hyperventilation is defined as a rate and depth of breathing that is too much for the body's needs at
a particular point in time. The imbalance which results causes many physical symptoms, including:
· dizziness
· light-headedness
· confusion
· breathlessness
· blurred vision

How Does Social Phobia Differ from Shyness and Normal Social Anxiety?

Many people describe themselves as shy, although there is no clear definition of what this means!
Shyness with others, or increased self-consciousness, occurs in phases through childhood. It is
common in the teenage years as an individual starts to think about how others might see them. For
most people, this type of social anxiety decreases with age.
Some social situations continue to cause a degree of anxiety for most people. Good examples are
public speaking, or arriving alone at a social gathering of unfamiliar people. Normal social anxiety
is not disabling, it settles quickly during or after the event, and it does not begin weeks before the
event. There is no expectation of negative evaluation. Things are different for the person with
social phobia. They tend to start worrying a long way in advance, the discomfort may well get
worse as they stay in the situation, and next time they may be even more worried. Afterwards they
may go over and over aspects of their performance with which they were unhappy. The reasons for
this will be discussed in detail in a later section of the manual. Severe shyness that causes
significant avoidance of social interaction or distressing anxiety in social situations is probably
social phobia.
What is Avoidant Personality Disorder?
Individuals with avoidant personality disorder are anxious in almost all types of social interaction.
They fear, and expect, not only negative evaluation, but also rejection or humiliation. There is often
a sense of inferiority to others, low self esteem, and considerable avoidance of social interaction.
Interestingly, looking anxious is often not the greatest concern of those with the avoidant
personality style. These individuals may be far more anxious about how they are relating to others,
and fearful that in some way they will be found inadequate or worthless and be rejected. The
problem has usually been present since early childhood, and involves deeply ingrained patterns of
thinking. Estimates vary greatly as to how common this problem is, but at least a quarter of those
with social phobia will also have the avoidant personality style. Avoidant personality styles can be
helped by the social phobia program because there is so much overlap between the two disorders.
If you have an avoidant personality, you must be prepared for the fact that it will probably take
some time to overcome your problems to a satisfactory degree because they have been present for
so long, and to such an extent. In many cases, you will find it helpful to seek ongoing help with
your problems after this program finishes. You can discuss this matter further with your therapist.
How Common is Social Phobia?
Social phobia has been documented across a range of cultures. It is estimated that between 1.5-
4.5% of the population has social phobia at any time. Slightly more women are affected than men.
However, probably more men are affected by avoidant personality disorder. Social phobia usually
starts in the teenage years and tends to be a chronic disorder that does not go away spontaneously.
Studies consistently indicate that most people have suffered with social phobia for many years
before they seek or find appropriate treatment.
What Causes Social Phobia?
We still don’t know for sure what causes social phobia. It seems that the most important factor
related to the development of social phobia is a genetic vulnerability to anxiety in general. This is
probably largely due to greater sensitivity and reactivity of the nervous system. Some people tend
to react more, often with anxiety or nervousness, when faced with any type of external event. These
people seem to be more vulnerable to developing anxiety problems. There is also an increased risk
of developing social phobia if a close relative has the disorder. It is unusual for social phobia to
develop from a specific incident, although this may happen more often in “circumscribed” social
phobia (where only one or a few situations cause anxiety). Aspects of the family environment do
not appear to be very important causative factors.
The Effect of Personality
Personality refers to habitual ways of thinking about ourselves, our relationships with others and
our environment, and the coping strategies we use in these situations. Individuals with social
phobia tend to describe themselves as sensitive, emotional and prone to worry. As we have seen,
this does tend to run in families. People who are very sensitive to criticism, or overly concerned
about creating a good impression may be more susceptible to social phobia. Some of these attitudes
are learned in childhood, but genetic and temperamental factors also influence personality
development in ways we do not fully understand.
Hypersensitivity, emotionality, and proneness to worry can be a handicap. You can’t radically alter
your personality – but nor should you want to! There are advantages to being sensitive: Sensitive
individuals care about others and can empathise readily, which are valuable characteristics. We can
teach people to be less sensitive but it is very hard to teach someone to be more sensitive! Those
with social phobia are “people people”. What you can change about your personality is the degree
to which you show various traits. This course aims to help you to learn to be less sensitive and less
worried about what others think.
Treatment of Social Phobia
Cognitive behaviour therapy has been shown to result in long term improvement. Cognitive
behaviour therapy is based on the principle that how we feel about a situation is determined by
how we think about it. It is based on the work of Aaron Beck and Albert Ellis. These principles
will be discussed in detail later in the program. The components of a cognitive behavioural
program for social phobia include:
· Knowledge about anxiety and social phobia
· Control of anxiety and panic
· Changing unhelpful thinking patterns
· Involvement in social interaction
Drug treatments are also available in social phobia but many people will not need medication.
When medication is necessary, it is still important to learn cognitive behavioural techniques for
managing social phobia, since this appears to give the best long term result. Your doctor can give
you more information.
The Aims of this Program
What you can expect by the end of this program is for your symptoms to have shown a noticeable
degree of improvement. You should have a good understanding of what is required to treat social
phobia and be confident that you can continue to apply the principles you have learned with a good
expectation of further success. Your therapist can discuss this with you in more detail.