DBT for Social Anxiety
Week 01: Gain strength through
Week 02: Return to ‘now’
Introduction to mindfulness
What’s the point of mindfulness?
Mindfulness and social anxiety
The three states of mind
Mindfulness skills for social anxiety
Mindfulness ‘What’ Skills
Mindfulness ‘How’ Skills
Week 2 Action Plan
Week 03: Befriend your feelings and regain control
Introduction to emotion regulation
Aims of emotion regulation
Myths about emotions
Why do we have emotions?
Why do we have anxiety?
Emotion regulation skills for social anxiety
Understanding and naming your emotions
Checking the facts
Trick anxiety by taking the opposite action
Reducing your vulnerability to anxiety
Cope ahead and build mastery
Week 3 Action Plan
Week 04: Master the art of social interactions
Introduction to interpersonal effectiveness
Aims of interpersonal effectiveness
Things that get in the way of interpersonal effectiveness
Interpersonal myths related to social anxiety
Interpersonal effectiveness skills for social anxiety
Finding friends and getting others to like you
Being mindful of others
Week 4 Action Plan
Week 05: Hold tight and act with intention
Introduction to tolerating distress
Aims of distress tolerance
Things that get in the way of tolerating distress
Distress tolerance and social anxiety
Distress tolerance skills for social anxiety
Accepting your reality
Week 5 Action Plan
Week 06: Maintain your gains and stay well
Introduction to relapse prevention
Lapses versus relapses
Skills to improve on and maintain your gains
Learning from your lapses
Create your own staying well plan
Big changes start with small steps
Week 6 Action Plan
About This Course
Learn evidence-based DBT for social anxiety skills
This course is for people who want help managing their social anxiety.
Dr. Joseph and Dr. Sal, between them they have held positions as Psychiatrists and University Academics in several institutions across Australia. Epsychonline is their effort to bring low-cost access to mental health care globally. Lofty ambitions! If you want to get to know them, visit our YouTube Channel.
About this course
Learn evidence-based DBT for social anxiety skills
This course is for people who want help managing their social anxiety. As you complete this six-week course, you’ll learn dialectical behavioural therapy (DBT) for social anxiety skills and social anxiety treatment more broadly. We are confident that with the right skills and techniques, which we will teach you, you will be well on your way to conquering your social anxiety.
By taking this psychology course, you’ll develop a foundation or toolbox of DBT for anxiety skills. Week 1 is an introduction before we dive into more advanced topics. We will cover interpersonal skills, dealing with worry, checking the facts, surviving panic, radical acceptance, practical supports, misattributions, and so much more.
Suppose you are tired of battling your social anxiety or social phobia and want to learn about social anxiety treatment skills for real life. We can teach you DBT for social anxiety skills online. Read on to find out more.
Why we created this course
Unfortunately, social anxiety is common. It affects all genders and across all age groups. Social anxiety can cause problems at work, school, public transport, or any situation involving unfamiliar people. Social anxiety leaves people feel uncomfortable and holds them back.
For people wanting help with their social anxiety, psychology-based skills and techniques can provide the answers. DBT is a type of psychological therapy. DBT is increasingly used in clinical practice.
We have created a DBT for anxiety course. It is a six-week program of DBT skills, educational content, examples, worksheets and more to help people manage their social anxiety.
We believe DBT for anxiety skills can be taught online. With the advances in technology and our experience, we’ve created this DBT for anxiety course, which we are offering online.
How this course is different
Each week of this course is divided into five parts:
- Educational lessons at the start
- Quiz to aid self-reflection
- Aided self-reflection questions to get you thinking more
- Tailored suggestions
- Action plans and worksheets
Depending on your quiz answers, you will get specific feedback and suggestions each week. The social anxiety feedback and suggestions you get from this course will be unique to you.
If two people were to do this course, the chances of getting the same feedback and suggestion would be over 1 in 100,000.
Our team of psychologists and IT professionals have worked together to create a system that provides specific feedback and suggestions.
Why do we do this?
Everyone is unique. We want to give you answers and solutions that best suit you.
The reasons why you and someone else might want social anxiety treatment are different. The same tips and suggestions aren’t going to work for everyone, which is why we have gone to the extent of providing tailored social anxiety treatment suggestions.
Key aspects of this course
We brought key aspects of DBT to this online social anxiety treatment course. Both “what” and “how” mindfulness skills and a host of others.
In the six weeks, we will cover a social anxiety model, propose a way to measure social anxiety, and share the three states of mind DBT model. You will also learn to use opposite actions, check the facts, negotiate needs, and interpersonal effectiveness skills. These are just some parts of our six week DBT for social anxiety course.
Is that this course will help you with your social anxiety. That it forms part of your social anxiety treatment plan and is a tool alongside other professional and informal supports you get. We want to get you thinking, understanding and questioning your social anxiety. We want you to be equipped with DBT for anxiety skills that you can use in real life. Our hope is for you to experience positive change when it comes to your emotional well-being.
Good News! We have opened access to Week 1 of the learning material
Week 01: Gain strength through awareness
Topics Covered in this section
Introduction to this course
Welcome to the Epsychonline DBT for Social Anxiety Treatment Course, a six-week self-help program for people struggling with shyness and social anxiety.
Do you find social situations extremely difficult, have trouble talking to people, and worry a lot about what others think of you? Do you lack the confidence to approach people and make friends? Does your fear of social situations lead you to miss out on important opportunities, tolerate social events with great distress or avoid them altogether?
If you answered yes to any of these questions, these troubles could be stopping you from reaching your full potential and living the life you want. Don’t worry, you’ve come to the right place! Whether you suffer from mild nervousness or severe and debilitating anxiety in social situations, there are supports and effective treatment options available to you.
This course is a great place to start, and we commend you on making it this far in your journey towards self-empowerment. All you need to get started with this course are basic reading skills and access to the internet. A good dose of motivation and an open mind will also go a long way. For anyone under the age of 18 years, we suggest a trusted adult be present to guide you through the content. Some of this content might trigger distress, so it is helpful to have supports around you.
What to expect from this course?
This course will guide you through an evidence-based information and skills package each week. It will help your social anxiety treatment in different ways. The aims of this course are to help you:
- Better understand social anxiety and how it impacts you
- Set some realistic goals to help you overcome your fears
- Learn mindfulness skills to manage your social anxiety
- Learn about your emotions and why they aren’t the enemy
- Learn how to shift your emotions by changing how you think and act
- Learn what feeds social awkwardness, how to influence people and how to boost your confidence in social settings
- Learn skills to better manage distress, drop the struggle with reality and get the most out of your life
- Make a plan to maintain your gains and recover from setbacks
The course runs for 6-weeks in total, with each week broken down into three sections:
- Section 1 provides educational content and prompts to help you boost your knowledge of the topic and get you thinking about how the information applies to you. It also includes activities, or ‘action tasks’, to help you put the principles you’ve learned into practice
- Section 2 runs you through an aided self-reflection in the form of multiple-choice questions and tailored feedback, which goes a step further in helping you develop deep insight into the nature of your difficulties
Section 3 uses your responses from Section 2 to provide you with additional self-help recommendations and resources that are targeted to your unique needs.
How to get the most from this course
Having a vision for life changing improvement is great, but it is also important to have realistic expectations for this course. Learning the skills in this course will take time and practice. The more effort you put in, the more you will get out of the course. You are likely to start noticing benefits as you make changes in your own life, however, your difficulties are unlikely to be ‘cured’ completely within a short timeframe. To get long lasting benefits, you will need to continue the hard work well into the future.
When addressing emotional issues, it is not uncommon for things to get worse before they get better. Growing as a human means stepping outside your comfort zone. With that said, feeling terrible can actually be a sign of progress! We encourage you to redefine your view of success. Down the track, success might look like being able to enter any social situation with ease and confidence. But right now, success might look like simply engaging with the course content each week and making a series of small changes in the way you think and act. You may not immediately feel better, but we encourage you not to make this your aim.
On the flip side, failure does not exist in this course. Every so-called ‘failure’ provides you with useful information about yourself. Remember, knowing what doesn’t work is just as valuable as knowing what does work. So, we encourage you to reframe failures as ‘opportunities for learning’. When things don’t work out as planned, reflect on what got in the way and make the necessary changes to your approach next time. As the saying ‘you must get back on the horse’ suggests, the most important thing is that you keep trying.
So, saddle up and let’s get ready for the ride!
What is social anxiety
Before we jump into the social anxiety treatment skills content for this course, we must first define what we mean by social anxiety. Social anxiety is a term that’s thrown around a lot, so just take a moment to think about your own understanding of what it means.
As its name suggests, social anxiety is anxiety that occurs in response to social situations. The anxiety can be felt in the lead up to, during, and after a social event or interaction. People with social anxiety fear being judged, negatively evaluated, or humiliated by others. They often worry that others will think they are stupid, boring, incompetent, or weird. Even when the appraisal from others is positive, people with social anxiety often hate being the center of attention. They also fear that others will notice and judge them for showing signs of anxiety, such as sweating, blushing, or stumbling over their words.
Social anxiety can occur simply as a result of being with others. People will differ regarding the types of social situations they fear and the amount of anxiety they experience in each setting. Some examples of situations in which social anxiety commonly occurs are:
- Performing in front of others (e.g., public speaking, oral exams, being watched while doing something as simple as writing or eating)
- Being the focus of attention (e.g., sitting at the hairdresser, walking into a function late, or being asked a question)
- One on one conversations (e.g., initiating or maintaining a discussion, talking about yourself, speaking your mind, asking questions, or making phone calls)
- Being in groups or crowds (e.g., shopping, meetings, social events/parties, public transport, or standing in lines)
- Interacting with the opposite sex (e.g., dating or meeting new people)
For people with social anxiety, the above situations often cause a great degree of distress. People overestimate the amount of threat and underestimate their capacity to cope. As such, they either endure the social situation with intense anxiety and discomfort, sometimes to the point of panic, or they avoid it altogether. Other times, they will become reliant on unhealthy ‘safety behaviors’ (e.g., substance use, needing a support person present), which keep the cycle of anxiety going. We will discuss safety behaviours in more depth later in this course.
In either case, social anxiety gets in the way of life, big time! If you’re reading this, you’re probably already aware that enjoyment in life is reduced when we live with constant worry about how we come across or what others might think of us. Opportunities are missed and many of life’s pleasures lose their shine. That is why social anxiety and depression often go hand in hand. Estimates suggest that between 35 and 70% of people with social anxiety disorder also meet criteria for a diagnosis of depression. Therefore social anxiety treatment becomes even more important.
Shyness, social anxiety, and social anxiety disorder (SAD) – what’s the difference?
A certain amount of anxiety in social situations is normal. In fact, most of us feel nervous or shy in certain social situations from time to time. It is quite common for people to dread things like speaking in public or interviewing for a job. So, what separates normal nerves and shyness from severe anxiety in social settings?
We can think of shyness, social anxiety, and social anxiety disorder (SAD) on a spectrum of severity, ranging from mild to severe. They all share the same symptoms but differ in terms of their level of impact on a person’s life. Shyness is the mildest form and is often likened to feelings of discomfort, self-consciousness, and timidness when around others. Shyness can feel uncomfortable but is unlikely to interfere with a person’s life in extreme ways. Shy people often take a while to warm up in social situations, but they tend to outgrow these feelings with age.
Social anxiety, the next step along the continuum, is a more severe form of shyness. It involves intense worry and fear of social situations, often with a whole host of physical symptoms (increased heart rate, nausea, breathlessness, muscle tension, sweating, etc.), and avoidance of common social situations. For social anxiety to be called a ‘disorder’, aka SAD, it must meet the specific criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5; American Psychiatric Association 2013). For SAD, the DSM-5 states that the anxiety must:
- Almost always be present in at least one or more social situations
- Be out of proportion to the actual threat (that is, be ‘excessive’)
- Cause the person to avoid the feared situation or endure it with severe discomfort
- Significantly impact how the person functions in different areas of life
- Be persistent, typically lasting for 6+ months, and
- Not be caused by substances or another mental or physical condition.
The lives of people with SAD are often greatly restricted by their social fears. Worry about certain social situations and events can build up over months and is unlikely to settle or disappear during or after the event. The expectation and fear of negative evaluation is ever present and significantly impacts on functioning in relationships, work and school, and leisure pursuits. Over time, people can lose confidence in themselves and begin to feel down and defeated as a result.
Take a moment to think about where you might lie on the continuum. Do you identify more with having shyness, social anxiety, or full-blown SAD? What factors led you to your conclusion here (e.g., the severity of your anxiety, the degree of impact it has on your life)? Regardless of where you sit on the continuum, the skills taught in this course will likely be of benefit to you.
Causes of social anxiety
As with all mental health problems, there is no one cause for social anxiety. The most widely accepted theory is that several biological, psychological, and social factors interact to contribute to this problem. Below, we discuss some of the factors that are commonly thought to increase a person’s risk of developing social anxiety:
- Genetic vulnerability
- Family history of mental illness, including anxiety or depression
- A shy, timid, or inhibited temperament as a child
- Imbalances in brain chemistry (in particular, a chemical called ‘serotonin’) and altered nervous system functioning
- Certain personality traits, including introversion, hypersensitivity, and proneness to worry
- Low self-esteem
- The presence of generalised anxiety and depressive symptoms
- External locus of control or the belief that what happens to us is determined by external, rather than internal, things.
- Growing up in an overprotective or controlling environment
- Experiencing neglect, insensitivity, and invalidation as a child (e.g., being criticised often, having your flaws pointed out)
- Adverse life events, including exposure to stress, trauma, and abuse (e.g., parental separation, financial stress, and sexual abuse)
- Social adversity, including being a victim of bullying, social humiliation, or racism
- Being rejected by peers
Do any of the above factors ring true for you? Can you trace your social anxiety back to a specific event or point in time? Often, people can link the origins of their social anxiety to aspects of their childhood or teenage years. Take a moment to think about when social anxiety first became an issue for you and ask yourself what was going on for you at the time (or in the years prior).
A model of social anxiety
Have you ever been afraid of something, only to learn more about it and realise it isn’t as scary as you first thought? Social anxiety is no different. Once we understand how something works, we are in a much better position to do something about it. Here, we discuss one model of social anxiety, which explains how social anxiety is triggered and maintained. As you’ll see, by helping us to understand the vicious cycle that occurs, this model gives us plenty of ideas for intervening to break this cycle and put a stop to social anxiety.
The Social Anxiety Model:
Key to interpret the model:
1= Trigger situation
2= Unhelpful thoughts and beliefs
4= Anxiety symptoms & avoidance
Let us walk you through the model step by step.
We often start with a specific situation or event that triggers or ‘sets off’ our anxiety. This might be a social interaction, oral presentation, a simple comment made by a friend, or going on a date. The triggering situation can also be internal, such as reflecting on a past event or noticing some physical discomfort in the body (e.g., feeling hot or sweaty).
Unhelpful thoughts and beliefs
The triggering situation leads to an unhelpful (aka ‘negative’) thought, or often a chain of unhelpful thoughts, about ourselves and others. Some examples are:
- “That was so embarrassing, everyone thinks I’m a total loser”
- “I’m bound to mess up and make a fool of myself!”
- “No one will talk to me”
- “Other people are saying bad things about me behind my back”
- “If I go bright red I won’t cope, I might even pass out”
Our unhelpful thoughts often stem from the deeper beliefs we hold about ourselves, for example, ‘I’m not good enough’, ‘I’m unworthy’, ‘I’m unlikeable’, or ‘I’m incompetent’.
Our unhelpful thoughts are often catastrophic, that is, they tend to overestimate social threat/danger and underestimate our capacity to cope. As such, we assign negative meaning to the situation and ourselves, and end up feeling anxious and overwhelmed.
Self-consciousness and self-focused attention
Once social anxiety is triggered, we tend to look inward and focus on our discomfort. We might scan for and focus on our physical symptoms of anxiety (such as a flushed face, racing heart and sweaty palms), instead of paying attention to what is going on around us. We think that others are also paying attention to our symptoms and judging us for them. All of this just works to increase our anxiety. We become self-conscious, worry about how others see us, fear embarrassment, and personalize things that happen around us.
When we personalize, we misinterpret situations and believe that others’ words and actions are somehow about us. For example, say you built up the courage to present an important proposal at work. However, whilst you were presenting, several of your colleagues left the room. Afterwards, you might personalize this situation by thinking “they left because my talk was terrible, I’m such a failure”. In reality, these colleagues may have been enjoying your presentation, but had to leave to attend a mandatory meeting. By personalising, we feel worse in the moment and set ourselves up to be even more anxious next time.
Anxiety symptoms and avoidance behaviours
When social anxiety is triggered, we experience all the common symptoms of anxiety. In addition to feeling anxious, nervous, or tense, symptoms include things like increased heart rate, rapid breathing, tightness in the chest, sweating, shaking, difficulty thinking/concentrating, muscle tension, gastrointestinal problems, and poor sleep. People may also have a sense of impending danger, panic or doom and a strong urge to escape or avoid the anxiety provoking situation. This is our ‘fight, flight, freeze’ system kicking into action to prepare us for the perceived danger.
Social anxiety is also associated with ‘avoidance behaviours’, which involve things people do or don’t do to reduce their anxiety. There are three different types of avoidance behaviours:
- True avoidance – complete avoidance of the feared social situation (e.g., not attending an event, failing to turn up for a job interview, or withdrawing from a course when you find out it involves group work)
- Escape – leaving or escaping from a feared situation when you are already in that situation (e.g., leaving a party early, walking out on a date, or leaving the cinema before the movie finishes)
3. Safety behaviours (partial avoidance) – aim to reduce your anxiety in a situation when true avoidance and escape are not possible. Safety behaviours involve attempts to control the situation and feel less anxious when having to remain in the situation (e.g., avoiding eye contact, taking a support person to speak on your behalf, taking medication or drinking alcohol before an event).
Safety behaviours often become a way of life and can be especially hard to identify. People find false security in safety behaviours because they provide temporary relief from anxiety. The problem with safety behaviours, and all avoidance behaviours for that matter, is that they maintain (and even worsen) anxiety in the long run. Safety behaviours may help you ‘survive’ a social situation, but they don’t allow you to truly overcome your fears.
Factors that maintain social anxiety
So far, we have talked about some common factors that can cause social anxiety. Whilst these factors are important to think about, many of them can’t be changed. For example, we can’t choose our genetics or go back and undo our childhood experiences. To overcome social anxiety, it is therefore helpful to consider the things that maintain it in the present. We touched on a few of these things in the above section, but we will cover them in more depth below.
When simplified, social anxiety boils down to a misrepresentation of threat/danger (we overestimate it) and our ability to cope (we underestimate it). There are a few things that keep this pattern going, including:
When you’re feeling anxious about a social situation, where do you tend to focus your attention? Do you pay attention to the topic of conversation and your surroundings, or do you tend to focus more on your discomfort? Most people with social anxiety have an ‘attentional bias’, which means they focus on things that make their anxiety worse. This includes things about themselves (physical symptoms and negative thoughts) and their environment that might signal social danger (e.g., a person looking at them strangely or laughing).
Oftentimes, this information is misinterpreted (i.e., the person was actually laughing at a joke someone had told them) and used to confirm underlying unhelpful thoughts and beliefs (e.g., people can see I’m anxious, they must think I’m strange). The effects of this are increased anxiety and self-consciousness and decreased social performance. After all, how can you perform a task (e.g., make a speech, play a sport) or be fully present in a conversation with someone if you are focused on danger and discomfort, rather than on the task at hand.
Unhelpful thoughts and beliefs
We touched on this topic briefly when we introduced the model of social anxiety. You have probably noticed that you start to feel anxious when you have anxious thoughts about a social situation, or any situation for that matter. There is a lot of evidence to support the idea that our thoughts play a significant role in how we feel. Thoughts can come in the form of words (e.g., telling yourself you’ll make a fool of yourself) or images (e.g., memories or images of a situation playing out badly). The problem with our thoughts in social anxiety treatment is that they are biased towards the negative and therefore create a lot of discomfort for no good reason!
An important aspect of thinking that influences social anxiety treatment is your perception of how you come across to others. When we trace it back, the feeling of being uncomfortable in front of others often originates from thoughts about looking bad, appearing highly anxious or performing poorly. You might think you sound ‘stupid’ or that your physical symptoms (e.g., flushed face, sweating, trembling) are blatantly obvious. The reality is that you probably come across far better than you think, and most of the time, people are generally unaware of the things you’re stressing about. Nevertheless, this way of thinking works to increase your sense of social danger, further heighten your stress response, and keep your anxiety going.
Avoidance and safety behaviours
It is understandable to want to avoid feeling anxious, after all, it’s a difficult emotion to sit with. In order to get rid of anxiety, many people with social anxiety try to avoid or escape social situations to prevent their fears from eventuating. However, as we touched on above, avoidance, escape and safety behaviours only work to maintain the symptoms of social anxiety. Whilst they can provide some temporary relief in the short term, these behaviours are life limiting and prevent people from gathering evidence to challenge their beliefs.
Let’s take an example. Say that you fear public speaking because you believe you’ll show signs of anxiety, freeze up and embarrass yourself. You predict people will laugh and make fun of you afterwards. So, you do everything within your power to avoid public speaking. You call in sick for work, skip class, and come up with every excuse under the sun to avoid speaking in front of people. In one instance, you worked up the courage to start presenting, but left for the restroom after a few minutes and didn’t return (escape behaviour). Each time you avoid or escape public speaking, you reinforce your belief that it is unsafe and that you wouldn’t have coped or survived.
But what if you do go ahead with all the presentations, yet your intense fear of public speaking remains? It is likely that you’re engaging in some form of partial avoidance, or what we call ‘safety behaviour’. Safety behaviours are things you do within social situations to try and prevent your fears from coming true. For example, you might try to avoid eye contact, talk very quickly, deflect questions, or take anti-anxiety medication prior to the presentation. While you may feel that these things helped you to ‘survive’ the situation, they actually prevented you from learning that the situation was safe, and that you could have coped without them.
Lack of opportunity to develop social skills
As we have learned, people with social anxiety often avoid social situations as a way to manage their anxiety. This means they have less exposure to social situations and, therefore, less opportunity to develop their social skills. If avoidance isn’t possible, safety behaviours such as staying quiet, making excuses to leave, or asking a lot of questions to avoid having to talk about personal information are often used. These behaviours make us less engaged in the situation and can send the message to others that we are disinterested in them. This can also limit opportunities for ongoing social interactions.
Without repeat exposure to a range of different social situations, it is harder to develop skills like assertiveness, social confidence, and the ability to get others to like you. The more you avoid, the more you may begin to see yourself as socially inept, and vice versa. Furthermore, many people with social anxiety have had negative past experiences ranging from social embarrassment to bullying and trauma. By avoiding social situations, people limit their chances of having more positive social interactions and what therapists call ‘corrective experiences’.
So, there you have it. Hopefully by now you have a better understanding of social anxiety and the key factors that keep it alive. As we mentioned above, knowledge really is power here. Now that you know what is keeping you stuck, you can take action to change these things. In the weeks to come, you will learn skills that aim to target (and reverse) each of the factors that currently keep your social anxiety going.
Understanding social anxiety in your own life
We have talked a lot about social anxiety in general terms. In this section, we want you to apply what you’ve learned so far to yourself. Take a moment to think about how social anxiety rears its head in your own life. Below are some questions to get you started:
When I feel socially anxious:
- Where am I usually? What types of situations/social groups/occasions does it show up in?
- What is my mind telling me? What am I predicting will happen?
- How do I feel? What do I notice in my body?
- What do I typically do? Do I do anything to try and avoid the anxiety?
Great job on getting this far– we have covered a lot about social anxiety, and you’ve done well to stick with us! In the next section, we briefly discuss DBT for anxiety, which forms the foundation for the remainder of this course.
What is DBT
Dialectical Behaviour Therapy (DBT) is an evidence-based therapy approach, which was developed by Marsha Linehan in the early 1990’s. DBT is effective at helping people live more in the present, better manage difficult emotions, and build healthy, lasting relationships. Whilst DBT was originally designed to treat a condition known as Borderline Personality Disorder, it is increasingly being adapted and applied across several other mental health conditions, including anxiety disorders. With that said, you don’t need to have any diagnosis to benefit from DBT.
The ultimate aim of DBT for anxiety is to help you end destructive behaviour patterns and build the life you want to live. In social anxiety treatment, this may look like ending avoidance, stepping into your authentic self, and pursuing opportunities with confidence. To get you there, DBT for anxiety teaches skills across four broad areas, including 1) being in the present moment, 2) tolerating distress, 3) regulating emotions, and 4) building interpersonal skills. We will learn more about each of these skill sets and how they can benefit you in the weeks to come.
DBT is traditionally delivered in structured, face to face settings, and often includes a combination of group and individual work. This is where most of the research has been done, however, access to this kind of therapy is not always convenient or available to everyone. Our online courses aim to make support more available to those who need it, however, they are not intended to be a substitute for therapy with a qualified health practitioner. This course offers an introduction to the foundational DBT for anxiety skills, which many of you will likely benefit from. Some of you will, however, need to seek professional support on top of this work.
DBT is based on several key principles or assumptions, each of which are important to know and remember throughout this course. These principles can help you give yourself more encouragement and compassion when things get hard.
DBT assumes that:
- You are doing your best
- You want to improve (and are capable of doing so!)
- You need to commit to hard work to achieve the improvement you are capable of
- You must practice new skills across all contexts for them to ‘stick’ and be effective
- You are responsible for your own life
- Your thoughts, feelings and behaviours are always caused by something
- Working out and altering the cause of your actions always trumps judgement and blame
How can DBT help with social anxiety treatment?
As we have seen, there are several factors to social anxiety treatment. DBT for anxiety offers a range of skills that can address each of these factors and help you break free from social anxiety.
These skills include:
- Harnessing the power of now (mindfulness)
- Sitting with discomfort and distress
- Regulating your emotions
- Building strong interpersonal skills
As you may have experienced first-hand, social anxiety can make your world shrink.
You react more to your thoughts than the world around you, which can be utterly debilitating. This is where mindfulness skills come in – they help give you the tools to refocus your attention, jump out of your anxious mind and body, and enjoy the world around you.
Learning how to sit with your discomfort and distress can give you a sense of empowerment and help you overcome the avoidance and safety behaviours that are currently keeping you stuck. Emotion regulation skills help you challenge the negative beliefs that keep you paralysed in fear and doubt, whilst strengthening your interpersonal skills can give you the confidence you need to start approaching social situations in a healthier way.
Making a commitment to change
Change is hard. As outlined above, DBT assumes that people must commit to change if they are to achieve real improvement. This section is about helping you do just that.
To give yourself the best chance of success in this course, you will need to make sure your motivation levels stay high. One way to maintain your motivation for change is to be clear on the reasons why you want to change. These reasons are a good reference point to come back to when things get tough.
Exercise: Reasons for change
Take a moment to think about your reasons for change. We have provided you with some examples to get you started. We also encourage you to come up with your own reasons.
For example, I want to:
- Feel better about myself/improve my self-esteem
- Improve my mood and general wellbeing
- Feel more confident when talking to others
- Be able to relax and enjoy social events
- Be free to pursue opportunities as they arise
- Improve my performance & reach my potential at work, school, in sport etc.)
- Gain a sense of freedom in my life
Exercise: Pros and cons of change
Hopefully, you have had a think about your reasons for change. We now encourage you to think about the potential benefits and costs of social anxiety treatment in your life. Use the downloadable form to record the pros and cons of trying the skills you’ll learn here versus not trying the skills and staying the same. Once you have done this, weigh the list of pros and cons and ask yourself which option will get you to your goals in the long run.
Exercise: Self-contract and goal setting
If you’ve decided to commit to change, well done! Let’s formalise (and celebrate) this commitment by making a contract with yourself.
We encourage you to complete the downloadable self-contract, which prompts you to set a goal or goals, consider the steps you’ll need to take to achieve this goal, and set a reward for following through. You may also want to enlist the support of friends and family on this journey, as they can help keep you accountable and on track towards success.
Week 1 Action Plan
- Complete the exercises set out in the ‘making a commitment to change’ section. You can use the worksheet to help you record your:
- Reasons for change
- Pros and cons of change, and
- Self-contract and goal setting
- Over the coming week, use the Social Anxiety Diary to take note of the following when you feel anxious:
- Trigger situations
- Unhelpful thoughts
- Physical sensations
Big changes start with small steps
Often, we have a vision of what we want to achieve, and we expect ourselves to get there in one big leap. This is not only unrealistic, but it is simply unfair! Throughout this course, we encourage you to acknowledge the small steps you take towards your goals each day, no matter how insignificant they may seem. This is a tough journey, so be kind to yourself along the way.
Start right now by congratulating yourself on getting to the end of the Week 1 educational content. We think this is an accomplishment in itself that is worth celebrating, so see if you can set aside some time to reward yourself for your efforts.
See you next week!