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Judith S. Beck, Ph.D.

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Using Socratic Questioning to Help Social Anxiety

Posted: 10/10/10 10:00 AM ET

My client, I'll call her Alison, has social anxiety. Like many people with her problem, she holds a strong belief: "I shouldn't call attention to myself." Alison believes at heart that there is something inherently wrong with her, something that could potentially lead people to find her unappealing. Therefore, she believes she should control her behavior and not do anything that could result in criticisms from other people. I asked Alison if she was willing to do a behavioral experiment to see what would happen, for example, if she asked a question in the large office staff meeting or made conversation with a stranger in a crowded elevator. She was a bit horrified at these suggestions.

So I decided to use some self-disclosure. "Alison," I said. "Do you remember when I had to cancel our appointment a couple of weeks ago because I had to report for jury selection?" She nodded. "Well, I did something there that really called attention to myself." This got her curious and she asked what it was.

I explained. "There were 175 potential jurors in this big courtroom. They were taking 20 at a time to a different room for specific questioning. But I was number 159 and I knew I'd be in the last group and would have to wait for hours. I had a manuscript on my laptop that I was under deadline to finish. I worked on it for about an hour, then my battery went dead. So I asked the deputy where I could plug it in. He looked around and the only place was at the court reporter's desk at the front of the room. I would have to sit on a raised platform facing sideways to the rest of the courtroom. He gestured to all the people in the room, and asked if the desk would be all right. He was implying that maybe I wouldn't like having 155 people watching me while I worked. I told him it was fine.

"How could you stand people staring at you?" Alison asked. "I didn't care, "I answered." I figured most people would look at me once or twice, then get back to reading their book or chatting with the person next to them. A few might watch for longer, but I figured they'd get bored soon."

"But what if they criticized you?" she asked. "It didn't bother me," I answered. "I thought most people would only think about me for a few seconds. Some would say to themselves, 'Isn't she smart for getting special treatment.' Others might think, 'Who does she think she is, getting special treatment like that.' But I didn't think they'd dwell on me. They'd start thinking about something else a few seconds later. And even if they did have really negative thoughts about me, so what? It wouldn't mean they were right. It wouldn't mean I did anything bad or that there was anything wrong with me. It didn't really matter what they thought."

"That was really brave," Alison said. "Thanks," I replied, "but I didn't think so. I might have when I was much younger, and shyer--but I would have been wrong. It truly wasn't a big deal." I paused, to give her time to reflect on what I said. "What do you think?"

"I don't know ..." she answered slowly. "Okay," I countered. Let's say someone thought, "Look at her. She thinks she's such a big shot." Would he have been right?" "No," Alison said. "I don't think you see yourself that way." "What if he had thought, "She shouldn't have asked to sit up there." Would he have been right?" She replied in the negative. "Are you sure?" I asked. "Yeah. I guess you had the right to ask. I guess anyone could have asked. Just because it was you doesn't mean you did anything wrong."

"Can you think of any other criticisms someone might have had?" I went on. "Well, someone could always have criticized you for how you looked or what clothes you were wearing." "That's true," I reflected. "And if there had been a fashionista in the audience, for sure I would have been criticized. But so what? If someone has a critical opinion, does that necessarily reflect badly on me? Could it say more about the personality of the person doing the criticizing?"

Alison pondered that for a moment. "I'm not sure I ever thought about it like that." "Well, let's say you're in a crowded elevator and you start making conversation about the weather with someone," I said. "One person thinks, 'That's nice that she's--that is, you--are reaching out to say something." A second person thinks, 'Why is she saying that? I don't want to talk to her.' Who is right?"

Alison said, "Well, I'm not sure it's a matter of being right or wrong. One person wants to talk and the other doesn't." "Exactly," I responded. "And are you right or wrong for trying to start a conversation?" She looked puzzled. "I guess I'm right. It's a nice thing to do, even if the second person doesn't appreciate it." "And if the second person thinks negatively of you, does that say more about you or more about her?" "About her, I guess," Alison responded.

I returned to the courtroom example. "Now, when I was in the courtroom, did my character suddenly change? Was I an 'okay' person when I first went in but suddenly a 'not okay' person when someone criticized me?" "No, that doesn't make sense," said Alison. "And how about you?" I asked. "If you do the experiment of starting conversations in the elevator, do you change from an okay person before you get in the elevator to a not okay person if the second woman criticizes you?"

"No, I guess not."

This discussion, a typical example of the Socratic questioning process in cognitive therapy, guides the client to evaluate her assumptions and modify her thinking so she can reach her goals. In the following weeks, Alison not only spoke up in elevators and staff meetings but also initiated conversations in public places such as bookstores and at social gatherings. She received mostly positive or neutral reactions from people, which helped erode the idea that there was something wrong with her. She may not be ready to voluntarily sit in front of a courtroom, but she's on her way.

 
 
 

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My client, I'll call her Alison, has social anxiety. Like many people with her problem, she holds a strong belief: "I shouldn't call attention to myself." Alison believes at heart that there is someth...
My client, I'll call her Alison, has social anxiety. Like many people with her problem, she holds a strong belief: "I shouldn't call attention to myself." Alison believes at heart that there is someth...
 
 
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01:19 PM on 10/14/2010
interesting article.
i wonder if there are more
people suffering from social
anxiety now than there
were a decade or two ago.
and why?
if yes, possibly from media over-exposure?
10:41 PM on 10/13/2010
amazing. as much as i think, i'd never thought of it like this.
07:36 PM on 10/12/2010
I enjoyed the article because I'm curious and it was interesting. I don't know many people with this problem, however. Is it common?

I did meet two people who told me they take medicine for it. This surprised me and I felt compassion for them. They didn't seem to me to be shy or lacking social skills when I talked with them individually, but I got the impression that certain situations were much more difficult than others.
HUFFPOST SUPER USER
mansterEZ
searching for secular humanist fact-based truth
02:05 PM on 10/11/2010
There was only one out of 175 that chose to make the best use of their time? Kinda reflects the direction of society these days doesn't it?
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yellowdoggie
Level 1 Baggerese Translator
04:20 AM on 10/14/2010
How can we assume the other people were not making good use of their time? Perhaps the author was the only one who needed to plug in a computer.
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mansterEZ
searching for secular humanist fact-based truth
01:59 PM on 10/11/2010
A great application of the Socratic method. Kudos.
lastpost
see biography
10:12 AM on 10/11/2010
“right or wrongâ€
In a vain attempt to exert control, an employer once asked if I didn’t care what other people thought of me. I replied that I was interested in what those whose efforts surpassed mine thought. Since their opinions would likely prove of inestimable value. But had observed that those who fitted into this category, tended not to express their observations unless prompted. Since they were already aware, of the reality of their own shortcomings.
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yellowdoggie
Level 1 Baggerese Translator
04:24 AM on 10/14/2010
Wow. I'm impressed. How did your employer respond to that?
10:06 AM on 10/11/2010
Socrates still has so many great things to offer society! Wonderful to see such classic philosophical tools being used in so many broad areas.
09:44 AM on 10/11/2010
There are simply too many critics these days. Everyone has an opinion on how you should behave, dress, and act. This applies to women more strongly than men. It takes quite a lot of guts to go out there and be yourself and take the critics. I have been outgoing for a long time but even I get tired of being criticized. But it is worth it to be yourself - it is much harder to try and fit every conformity and be someone you are not
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seventhrama
Retired health educator/Ponderer of the Universe
09:12 AM on 10/11/2010
This is the first time for me hearing about the Socratic questioning as a therapeutic tool. Posting on HuffPost is my Socratic exercise for helping me deal with own social anxiety. When I first read the initial comments, I was reminded of the feelings I had when I started adding my own comments to this thread. I am still timid with my comments and I am always mindful of how my comments might be received by others; even though, intellectually I know I have as much right to express myself as any other. However, sometimes I am overly concerned that I might be spewing my guts for the simple release it. Still I think I can run with this.
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qaan
Everything in moderation, including moderation.
10:46 AM on 10/11/2010
Interesting! When I first found HuffPost, I read a lot of articles but didn't post too much. When I did start to post, I talked about neutral things (I am a moderate, after all). I still post mostly to balance out some of the extreme views I see. But sometimes I am attacked for what I write.

When I first got someone who started hurling insults at me, I actually got pretty mad about it. It took me a while to calm down and write an unemotional response to their post. After getting a few people doing this to me, I finally realized that these people had some anger issues. Maybe they had a bad day. Maybe they lost their job. Maybe they blamed their entire life situation on Obama. Whatever the cause, I think they were posting provocative statements to either make themselves feel better, start a heated argument (misery loves company), or defend the concepts that comprise their own reality bubble from the friction caused by the inconsistencies they constantly run into because of the conflicting information that true reality constantly throws at them.

There's no need to be concerned about "spewing your guts" on HuffPost. Everyone does it. Don't limit yourself to just saying what you think. Like life, you have to express how you feel to make real connections. If someone doesn't like it, they can ignore you and you can ignore them. They will find some new target to yell at after a few posts.
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seventhrama
Retired health educator/Ponderer of the Universe
12:57 PM on 10/11/2010
"qaan",

Thanks for your incredibly thoughtful replied to my post. I have printed and posted it above my computer monitor for continuous motivation. Like you, I try to understand where people are coming from when they respond to my posts, as well as, to those who seem to vent for the sake of venting. On my bad days, I only have two brain cells working and they are not talking to each other, so glancing at some of the posts can be a bit tedious. The Internet like any form of human endeavor can be use for good or bad and all points in-between. My motto is - there are no single-sided coins in the universe. Peace!
09:04 AM on 10/11/2010
Your method is fine if you don't believe you have come upon a cure for Social Anxiety, Because knowing something intellectually will not necessarily allow a patient to feel the anguish that is embedded strongly in them. I have social anxiety that is different from Alison's, I am uncomfortable at parties sometimes making phone calls to people I don't know. People uncomfortable with certain people although they are nice people. I'm not afraid I will do something that will make me look bad, I have nothing to say my mind blanks out except for the thought I have nothing to say and how do I get out of here. I am fully aware of the intellectual reasons why I am wrong but that doesn't stop the incessant thoughts which then turn into bad feelings. I could go to a baliff and ask him where the plug is and would have no issue with being in front of the crowd. When I have a specific reason to talk to a person live, it's easier. But that doesn't cure me of my social anxiety, Good for Alison if it worked but don't start thinking it's the way to treat all social anxiety. You are not thinking of your patients well being if you do. It's a start but not a cure.
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moonflowerjewelry
Buy American made, no excuses.
03:22 PM on 10/11/2010
x2
It can be a function of recurrent depression or bipolar disorder - days I can work my farmer's market and sell and talk and have a fabulous time, followed by days where eye contact with others is virtually impossible.
06:05 AM on 10/11/2010
Your question as to whether or not you entered the courtroom as an okay person and then changed to a not-okay person through your actions didn't actually address that Alison already sees herself as a not-okay person.
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Libby123
Where are we going? Why are we in this handbasket?
09:51 AM on 10/11/2010
True, but it was the series of questions from beginning to end which led Alison through a logical course of looking at the situation differently. Her vision of herself as a not-okay person is not logical, but the first step for her to change her views is for her to see, in small logical bites, how illogical it is. Once she can begin to see that, then she can try such an experiment for herself. Once she gets accustomed to experimenting in social settings in which the criticism she imagines she has coming does not come, she has a chance to start seeing herself in a better light. She can stop viewing herself as deserving of criticism and stop viewing others as harsh critics waiting to pounce on her. She's not only judging herself unfairly, but is also making unfair judgements of others, assuming that they are so unkind as to criticize her when in fact, they haven't given her that much thought. How much better is it that she frees herself of two unfair assumptions?
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MagicManDoneIt
When facts are lacking. Just say...
03:49 AM on 10/11/2010
As Dr. House would say: "Socratic Method, the best way to teach anything except juggling chainsaws..."
02:45 AM on 10/11/2010
You just lucked out by sitting on your high pedestal because none of the other potential jurors was persistent enough. One or more of them could have actually taken action and complained to an officer that it was unfair for only one person to be given that kind of treatment. He could have protested and gotten support from a few others to join force and could have convinced the officer (through Socratic way of rationalizing) that in fact it was WRONG for you and only you to be sitting up there and doing your own personal work when in fact you could have been reading about the trial you may end up being a juror on, or you could have been conversing with others regarding the trial and so on. The officer would then have had to ask you to go back and sit with others and if you had refused then he would have had to resort to force.
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UnreasonableExpectations
08:27 AM on 10/11/2010
The thing about this, in the 'adult' world, no-one has any reason to be jealous short of jealous of reason. I bet more than a few people sitting in the crowd for hours were thinking...why the hell didn't I bring my laptop...or Gee, I wonder if Jim updated his status since the party last weekend... My point is, short of some near psychosis--anyone would not have had any reason to speak up. In the personality dynamics, even bullies would recognize the so-called 'special treatment' she was getting and possibly want to join her somewhere away from the rest of the group.

Call me anti-social, but honestly, being around that many people in any setting is sure interesting at least, but horrifyingly rage-inducing when everyone isn't a grown up about it..myself included. Ever go to Wal-Mart at 9pm, when there seems to be one isle open, and 22 employees standing around, while 50 people wait in line to check out. I like to start acting like I have tourettes and randomly swearing and cursing to my friends; or talking about something very awkward in front of that many people. The more people I can make fidget and look uncomfortable is a bonus.

The best experience of this was one night we went to wal-mart around midnight to get beer and something to BBQ with, just so happened Twilight was released on DVD...
10:05 AM on 10/11/2010
That is a bizarre reaction to this story.
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yellowdoggie
Level 1 Baggerese Translator
04:27 AM on 10/14/2010
I was thinking the same thing. What if? What if? And then what if? Geez. That poster must be absolutely paralyzed.
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01:49 AM on 10/11/2010
At college I audited a class in the socratic dialogues. It was very enjoyable and enlightening.
There was another class which was not required, but which I sought out, in basic arithmetic logic. If one gets the basics wrong, it is easy to make errors in judgment with more complicated problems.

If I may go astray here, I would venture to say that the problem with right wing propagandists such as Beck, and what qualifies right wing pundits as propagandists, is the lack of logic in their thinking. The logical inconsistencies in their ideology may be what makes it appealing to their base of the poorly educated, but it is also what prevents their ideology from appealing to those trained in thinking skills.
To paraphrase Karl Rove, the more education a person has, the more likely that they will vote Democratic.
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UnreasonableExpectations
08:52 AM on 10/11/2010
If life was based upon algorithimical logic, the cause and effect mentality already used in folly by people on both sides would be even worse.

If Gay;
then,
(some wild action here)
else,
6pack+6pack=goodtime
}

Could you imagine? Some people are already robots..cylons perhaps?
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qaan
Everything in moderation, including moderation.
10:59 AM on 10/11/2010
Some people are brainwashed from birth to believe that there are only two choices for any life situation. Yes/no, right/wrong, good/evil, present/absent, all/nothing, etc. I call this binary thinking, and it's the way children think. It's used to great effect in many religions and in politics.

Use the ignorance of the audience to weave a story using your own version of the facts until you can present the issue in a way that shows the audience that there are only two possible choices they can make. If the audience believes you, they will feel that you are so knowledgeable they should trust whatever choice you tell them to make. This is what Glenn Beck does on a daily basis.

The key to this is to keep the audience ignorant of any other perspective. Watch how many of these people get angry at you if you try to give them a greater perspective on issues. They start feeling like you are telling them that they are stupid for not seeing the bigger picture. And that, to me, is where the Teabagger outrage comes from.
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HUFFPOST COMMUNITY MODERATOR
yellowdoggie
Level 1 Baggerese Translator
04:29 AM on 10/14/2010
Did he really say that? I have seen that paraphrase here tonight somewhere else. I cannot believe he was honest enough or perceptive enough to actually say that out loud. LOL
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DouglasEby
Talent Development Resource
01:38 AM on 10/11/2010
Thanks for such a helpful and articulate explanation of some of the belief process underlying anxiety. For many of us who are highly sensitive, I think our emotional "alarm" in reaction to attention is often enough to incite so much stress in some social environments that we may choose to retreat from the painful feelings without exploring the beliefs we could change. And both feelings and beliefs are, after all, fluid - and not always "the truth" of a situation.