Posted by: Dr. Jennifer Fee | October 29, 2010

Can Psychotherapy Help People with Social Anxiety Disorder?

Social Anxiety Disorder (S.A.D.) is painful, isolating, and destructive to people’s lives.  The person who made this video is obviously deeply familiar with what it’s like to suffer from S.A.D.:

How can psychotherapy help someone who is suffering in this intensely?  Here’s three ways therapy can help:

1.  Therapy helps address Fears, Worries and Negative Beliefs:  This person talked about being afraid of being judged and talked about behind his/her back.  If these are your thoughts, doesn’t it make sense that you would avoid people?  Who wants to be judged!  I don’t!  And, if you avoid social situations all or a lot of the time, there’s little to no opportunity to challenge those thoughts and belief systems….hence staying stuck in the problem.

Therapy can help challenge those thoughts a little bit at a time, by helping you to consider alternatives. However,  it’s not nearly as simple as “Don’t think that,” or “That’s not true,” or “Here, think this other, more positive thought.”

Instead, therapy can be a bit like putting some of your beliefs on trial in a courtroom.  There’s a “prosecuting attorney” presenting all of the evidence that your belief is not true.  Then there’s a “defense attorney” presenting all of the evidence  that the belief is true!  Interestingly the belief is often not found to be “true” or “untrue,” but rather that’s there often a morsel of truth mixed in with a whole lot of untruth.  The two sides reach a “settlement” or middle ground and come up with an “alternative” or more “balanced” belief.

2. Help with Taking Risks:  The person in the video mentioned that he/she tries to take risks, but that he/she “can’t handle the pressure.”  Risk taking is extremely important with all forms of anxiety, because the only way to conquer fears is to eventually face them.  However, going at that alone without help can be very overwhelming.  Many people who I’ve talked to who try to take risks on their own make some very key mistakes such as:  taking too large a risk, taking risks with “unsafe” people, and take risks before addressing their negative beliefs, so the results are evaluated through that grid.  All of these mistakes can make for a “no-win” situation.

So–a therapist can be somewhat like a coach, preparing you in every way possible to achieve success.  To explain, a therapist can help you plan out risks or “experiments,” in a safe, slow, and manageable manner.  Your therapist can help you identify your beliefs before you take a risk, and point out how you might be filtering the results of your risk through that grid. If a risk or an “experiment” doesn’t go well, a therapist can help you to figure out why, and what adjustments to make.

3.  Relationship with the Therapist:  Your relationship with your therapist is a key, important social “situation.”   Your therapist is going to be concerned about building a safe, trusting relationship with you.  When you have a good relationship with a therapist, then you can allow your fears to arise within the safety of that relationship, and you can take risks to address some of those fears.  I’ll give you an example:

Some of the people who I work with who have Social Anxiety Disorder are afraid of writing in front of other people.  Therefore, these clients always have their checks ready before coming into session so that they don’t have to write in front of me.  So–it’s a big deal when a person with this fear sits in front of me and writes out their check!  It might be a healing moment, or it might be a chance for us to process in the “here and now,” what it’s like to take that risk with me.

You can probably guess that therapy is a lot of hard work, and it certainly is.  However, the payoff can be tremendous.

Thanks for reading!  –Dr. Jennifer Fee

©2010. You may repost if you include the entire post with byline. This blog is for educational purposes a substitute for professional diagnosis and treatment.


  1. Great post! I especially like your first point. I suffer from social anxiety, and in therapy, my therapist and I go back and forth on my irrational beliefs. I don’t think it’s about taking irrational beliefs and forcing them to be rational; it’s more of a synthesis. I like to think of it as a dialectical process. I present a theory (my irrational belief) and my therapist refutes it (with a rational belief) and then synthesis occurs slowly, as I go about testing out my new beliefs.

    • Thanks for your comment, Mike. I think that the testing out of the new belief is the most critical part….I’m going to write about that soon.

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