Internally-focused attention is one of the most frequent and self-defeating safety-seeking behaviors relied on by persons with social anxiety disorder. When experiencing social anxiety, most persons are engaged in mental behaviors such as: self-monitoring anxious symptoms; self-critiquing performance; scripting what to say next; trying to read the other persons’ judgments of them; worrying ahead of time about how the interaction will go; and ruminating afterwards about negative aspects of how it went. Although intended to improve the way they come across to others, these self-defeating safety-seeking behaviors have the opposite effect: increasing anxiety and distraction, and hurting social performance.
Traditional exposure-therapy approaches to social anxiety have generally neglected the problem of self-focus, and have instead targeted eliminating observable external safety-seeking behaviors. Third wave cognitive-behavioral therapies have indeed emphasized training in mindfulness for social anxiety, but have generally limited this training to internally-focused mindfulness practice such as meditation. Research demonstrates that the most effective cognitive-behavioral strategies emphasize training in externally-focused attention: CURIOSITY TRAINING.
This seminar discusses various strategies to help socially anxious persons understand the impact of internally-focused attention, and practice externally-focused attention with an attitude of curiosity. I also examine how to combine external mindfulness with behavioral experiments (exposures) aimed at testing hot thoughts, underlying assumptions and core beliefs, as well as achieving personal therapy goals. I highlight how external mindfulness complements rather than replaces cognitive restructuring in social anxiety treatment.
Note: although curiosity training is a core component in cognitive-behavioral therapy for social anxiety, it is not a stand-alone strategy. It is meant to be combined with behavioral experiments to test and modify socially anxious automatic thoughts and underlying beliefs. If you need training on all aspects of CBT for social anxiety, please watch our recorded seminar on Cognitive-Behavioral Therapies for Social Anxiety Disorder: An Integrative Strategy.
Larry Cohen, LICSW, A-CBT: cochair and cofounder, National Social Anxiety Center (NSAC); director and psychotherapist, NSAC District of Columbia (Social Anxiety Help).
(This workshop was a Master Clinician Session presented on March 18, 2021 at the Anxiety and Depression Association of America online conference.)
Our workshops and webinars are offered as an educational resource for
mental health professionals who are already familiar with cognitive and behavioral therapies.
These resources alone do not suffice as adequate training
to conduct cognitive and behavioral therapies
for those with social anxiety and related problems.