Improve Social Anxiety with Mindfulness
By John M. de Castro, Ph.D.
“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.” – Larry Cohen
It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.
Anxiety disorders have generally been treated with drugs. But, there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD). Mindfulness-Based Cognitive Therapy (MBCT) was developed to treat depression but has been found to also be effective for other mood disorders. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate mood disorders. MBCT has been found to help relieve anxiety and to be effective for social anxiety.
In today’s Research News article “A Pilot Study of the Effects of Mindfulness-Based Cognitive Therapy on Positive Affect and Social Anxiety Symptoms.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00866/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_662896_69_Psycho_20180605_arts_A ), Strege and colleagues recruited adults with social anxiety disorder or generalized anxiety disorder and provided them with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). Training occurred once a week for 2 hours with daily work at home. Participants completed measurements before and after treatment ofr social anxiety, positive and negative emotions, worry, and mindfulness.
They found that, as has been previously reported, after MBCT training there was a significant reduction in social anxiety symptoms. The amount of reduction in social anxiety symptoms was predicted by the amount of increase in positive emotions following MBCT training but not by the reduction in negative emotions. Also, the amount of increase in positive emotions following MBCT was associated with the amount of increase in mindfulness.
These are interesting results whose interpretation has to be tempered with the recognition that there wasn’t a control comparison condition. So, these results must be viewed as preliminary pilot findings that suggest that a more highly controlled randomized trial should be performed. Nevertheless, these results suggest that MBCT training improves positive feelings and this in turn produces improvements in social anxiety. This suggests that elevating mood, rather than eliminating sour mood, is the crucial change produced by MBCT. In addition, it appears that the increased positive emotions are a product of increased mindfulness. All of this results in a tentative hypothesis that MBCT training increases mindfulness that, in turn, improves positive feelings and this then produces improvements in social anxiety.
So, improve social anxiety with mindfulness.
“Using mindfulness, we can begin to notice what happens in the body when anxiety is present and develop strategies to empower clients to “signal safety” to their nervous system.” – Jeena Cho
CMCS – Center for Mindfulness and Contemplative Studies
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Strege MV, Swain D, Bochicchio L, Valdespino A and Richey JA (2018) A Pilot Study of the Effects of Mindfulness-Based Cognitive Therapy on Positive Affect and Social Anxiety Symptoms. Front. Psychol. 9:866. doi: 10.3389/fpsyg.2018.00866
Randomized controlled trials have demonstrated that mindfulness-based cognitive therapy (MBCT) is efficacious in reducing residual depressive symptoms and preventing future depressive episodes (Kuyken et al., 2016). One potential treatment effect of MBCT may be improvement of positive affect (PA), due to improved awareness of daily positive events (Geschwind et al., 2011). Considering social anxiety disorder (SAD) is characterized by diminished PA (Brown et al., 1998; Kashdan, 2007), we sought to determine whether MBCT would reduce social anxiety symptoms, and whether this reduction would be associated with improvement of PA deficits. Adults (N = 22) who met criteria for varied anxiety disorders participated in a small, open-label trial of an 8-week manualized MBCT intervention. Most participants presented with either a diagnosis (primary, secondary, or tertiary) of generalized anxiety disorder (GAD) (N = 15) and/or SAD (N = 14) prior to treatment, with eight individuals meeting diagnostic criteria for both GAD and SAD. We hypothesized participants would demonstrate improvements in social anxiety symptoms, which would be predicted by improvements in PA, not reductions in negative affect (NA). Results of several hierarchical linear regression analyses (completed in both full and disorder-specific samples) indicated that improvements in PA but not reductions in NA predicted social anxiety improvement. This effect was not observed for symptoms of worry, which were instead predicted by decreased NA for individuals diagnosed with GAD and both decreased NA and increased PA in the entire sample. Results suggest that MBCT may be efficacious in mitigating social anxiety symptoms, and this therapeutic effect may be linked to improvements in PA. However, further work is necessary considering the small, heterogeneous sample, uncontrolled study design, and exploratory nature of the study.