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Question

Social Anxiety

A client goes to a psychotherapist seeking help for incapacitating social anxiety.  Describe what the therapeutic approach might be like if the therapist is a:

  • psychoanalyst
  • behavior therapist
  • Gestalt therapist
  • cognitive therapist

Answer

THERAPEUTIC APPROACHES ON SOCIAL ANXIETY

Approach by a psychoanalyst

A psychoanalyst will most probably rely on the psychodynamic model when dealing with an incapacitating social anxiety problem. Psychoanalysts view social anxiety as a disorder that emerges during childhood. As such, they relate social anxiety to early childhood experiences which have a perverse and profound impact on the behavior of individuals in later years. The psychodynamic model establishes four key sources of social anxiety among individuals. These include: expectation of shame or humiliation that results from harsh or critical parents, conflict between goal attainment and fear or success, conflict between need for gaining independence from parents and the fear of rejection by the parents, and fear resulting from need to make perfect impression (Leichsenring et al., 2013).

The main goal of a psychoanalyst is to uncover potential conflicts and childhood experiences that lead to social anxiety (Leichsenring et al., 2013). Psychoanalysis is well suited to individuals having underlying issues that result to social anxiety. The classical psychoanalytic theory focuses on treatment of mental problems by identifying repressed unconscious desires resulting from early childhood experiences. Treatment focuses on helping individuals identify causes of their anxiety. Individuals are encouraged to talk freely about any issues they may have and to overpower internal conflicts. As individuals understand themselves better, their level of anxiety or fear diminishes.

Therapeutic approach by behavior therapist

Behavior therapists hold the view that social anxiety arises due to faulty thinking patterns among individuals (Hope, Heimberg, & Turk, 2010). Cognitive-behavioral therapy as a science emerged in the 1980s and became more popular in the 1990s with the publication of numerous researches on anxiety disorders. Over the years, the main goal of behavior therapists has remained the same – to establish irrational beliefs and thinking patterns and to replace them with realistic ones among individuals with social anxiety disorder. The relationship between a behavior therapist and the patient is more like one between teachers and students. The behavior therapist aims at teaching new methods or changing patterns of thought among patients.

Related: Biological Foundations of Behavior

Behavior therapists examines the behavior of individuals in particular situations. They may also examine the cognitive aspects related to social anxiety such as negative thoughts and emotions. Behavioral therapists posits that thoughts mainly influence individual’s emotions rather than external events (Hope, Heimberg, & Turk, 2010). During treatment, behavior therapists group together individuals suffering from social anxiety. They are then exposed to practical activities that may cause mild anxiety. The behavior therapist then works to help individuals reduce the degree of anxiety felt from these situations through repetition. The behavior therapist can introduce a series of situations that cause anxiety. Participants increase their confidence regarding their personal capabilities and thus reduce social anxiety.

Therapeutic approach by gestalt therapist

A gestalt therapist is guided by the assertions of the gestalt school of thought which emerged in the later 1940s. Gestalt school of thought is hinged on the premise of relational theory principle that takes individuals as whole in terms of their body, mind and soul (Nevis, 2014). In addition, the principle asserts that individuals can best be understood as per their current situation and as they experience it. A gestalt therapist aims at establishing self-awareness and non-judgmental tendencies among individuals suffering from social anxiety. In this way, an individual is able to acquire a new perspective on life.

Gestalt therapists focuses on an individual as a whole in terms of body, mind, and spirit and the present state of events (Nevis, 2014). It not only focuses on self-awareness but also on the present events in the life of an individual as they happen from one moment to another. The approach in gestalt therapy asserts that self-awareness may at times become clouded by negative thought patterns leading to feelings of dissatisfaction and sadness. A gestalt therapist focuses on what an individual feels in the present, and anything else that which can be observed. In gestalt therapy, feelings and perceptions are critical in interpreting existing attitudes.

Related: Personality Characteristics and Criminal Behavior

Therapeutic approach by a cognitive therapist

Cognitive therapy revolves around the thinking processes.  A cognitive therapist concentrates on teaching new methods that leads to behavior change. Cognitive therapists believe that individuals suffering from social anxiety can train or condition their minds to respond in a different and rational manner than in the past (Hope, Heimberg, & Turk, 2010). Cognitive therapists believe that the human mind can be reconditioned to think in a rational manner and thus reducing social anxiety. Cognitive therapists may use a variety of methods in treating social anxiety such as teaching patients to relax, acceptance paradox, focusing techniques and how to curtail negative thoughts. Some techniques such as focusing enable individuals to develop a rational view of things.

Cognitive therapy largely involves learning new skills or new ways of coping with stressful events (Hope, Heimberg, & Turk, 2010). Cognitive therapists teach individuals suffering from social anxiety skills to cope with it. The person being taught must practice the skills taught at home. Through repetition, learning occurs as the learned skill becomes a habitual or automatic thing. Cognitive therapy is similar to school learning where new information is taught to students who then internalize it through repetition or practicing the skills learned.

References

Hope, D. A., Heimberg, R. G., & Turk, C. L. (2010). Managing social anxiety: A cognitive-          behavioral therapy approach: therapist guide. New York: Oxford University Press.

Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., & Hoyer, J. et al.             (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety            disorder: a multicenter randomized controlled trial. American Journal of Psychiatry,   170(7):759–767. doi: 10.1176/appi.ajp.2013.12081125.

Nevis, E. C. (2014). Gestalt Therapy: Perspectives and Applications. CRC Press.nd citations.

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