CBT for Social Anxiety Disorder: Using downward arrow and thought challenging techniques

Summary

In this reflective dialogue, an individual grapples with a deep-seated belief of being unworthy of friendship, stemming from school experiences and continuing into the workplace. Through a CBT exercise of thought challenging, they weigh evidence for and against this belief, realizing that while they have faced social exclusion, they also have close relationships and are a supportive friend. This exercise helps to reduce the intensity of their negative belief, suggesting that their social worth is more a matter of choice than inherent unworthiness.

Takeaways

• 🤔 Concern about saying something stupid at work stems from fear of being perceived as weird.
• 😔 Belief that being seen as weird would lead to social isolation at work.
• 🗣 Worry about not having anyone to talk to at work, leading to feelings of loneliness.
• 🫤 Spending a lot of time alone has led to feelings of unworthiness of friendship.
• 📉 Strong belief (95 out of 100) in not being worth friends, rooted in school experiences.
• 🏫 School experiences of exclusion, like not being invited to parties or being last picked for teams, contribute to negative self-belief.
• 🤷 Similar feelings of exclusion at work, such as not being invited for drinks.
• 👪 Positive evidence against negative belief includes close relationships with family and friends.
• 👫 Efforts made for friends, like organizing events and making presents, show qualities of a good friend.
• 📊 Exercise of weighing evidence for and against the negative belief leads to realization of personal choice in social engagement.
• 💡 Conclusion of exercise reduces belief in unworthiness from 95 to 40, acknowledging both progress and ongoing struggle.

Q & A

What is the primary concern of the person speaking in the transcript?

The primary concern is the fear of saying something stupid at work and the belief that they are not worth being friends with, which stems from past experiences at school and current social situations at work.

What negative belief does the speaker have about themselves?

The speaker has a deeply ingrained negative belief that they are not worth being friends with, which they rate at about 95 out of 100 in terms of belief strength.

When did the speaker start believing that they were not worth being friends with?

The belief started during their school years, where they experienced social exclusion and were often the last one picked for teams.

How does the speaker's current work situation relate to their past school experiences?

The speaker feels a similar sense of exclusion at work, often not being invited to social events after work or feeling left out of groups, which mirrors their school experiences.

What evidence does the speaker provide that contradicts their negative belief about being a friend?

The speaker mentions having close relationships with family and friends, making efforts for friends' birthdays, and organizing events, which shows they are a good friend.

What is the concept of 'thought challenging' as mentioned in the transcript?

'Thought challenging' is a cognitive-behavioral therapy (CBT) technique where negative thoughts are scrutinized by weighing the evidence for and against them, similar to putting the thought on trial.

How does the speaker's avoidance of large social gatherings contribute to their belief?

The speaker's avoidance of large parties and events due to anxiety reinforces their belief that they are not worth being friends with, as they choose not to engage with people.

What is the significance of the speaker's friends and family in challenging their negative belief?

The support and affirmation from friends and family serve as evidence against the negative belief, showing that the speaker is valued and considered a good friend by those close to them.

How does the speaker's attitude towards their friends indicate their worth as a friend?

The speaker's willingness to prioritize friends' needs, even when it causes anxiety, demonstrates their commitment and care, which are qualities of a good friend.

What change occurs in the speaker's belief after the thought challenging exercise?

After the exercise, the speaker's belief in being not worth being friends with decreases to about 40 out of 100, indicating a shift in their perspective.

What does the speaker realize about their social situation after analyzing the evidence?

The speaker realizes that their social situation is not entirely out of their control and that they have the power to choose to engage more with others, which challenges their initial belief.