CBTpsych.comFjóla Dögg

Helgadóttir

What is CBT?• Cognitive Behavior Therapy• Evidence based approach for treating anxiety• Only one RCT has been published so far using

CBT for anxiety in AWS.

Do AWS benefit from CBT?• Prevalence of Social Phobia diagnosis

may be as high as 60% in AWS

• In 200 AWS, 94% sought speech treatment vs. 0% sought Ψ treatment

• Ψ = psychology

Speaking is one of the core fears in social phobia …

• public speaking (21.2%)

• speaking in a meeting or class (19.5%).

Why do AWS not receive CBT?• Lack of time?

• Lack of awareness of social phobia?

• Stigma associated with Ψ treatments?

• Exclusion criteria in the DSM?

The nature of social anxiety• 3rd most common of the Ψ disorders

• Most people never seek treatment• Reason: shame & embarrassment

True or false?-I rarely worry about seeming foolish to others.

-I worry about what people will think of me even when I know it doesn't make any difference.

-I feel very upset when I commit some social error

-I am frequently afraid of other people noticing my shortcomings.

-The disapproval of others would have little effect on me

Free feedback on http//www.fjola.com.aupassword: clinic2008

What can CBT do for AWS?

• Improve quality of life

• Decrease anxiety, anger, sadness

• With or without stutter

CBTpsych.com

• My PhD invovled using modern technology to deliver CBT to AWS over the internet (therefore robot theme)

Demo 1

Questions?

Anger and frustration

• Tyranny of the shoulds

• Rules of for living

50 Great Myths of Popular Psychology

• Myth #1 Blowing our Tops Defuses Anger

Resource:Scientific American

Resource:Scientific American

Common should statements• Everyone should treat me nicely• I shouldn't stutter• I should have grown up in a "perfect" family environment• I should always say "yes" to requests from others• I should always look good in other people's eyes

Everyone should treat me nicely

Benefit CostI will be happy when I am treated nicely.

A major disadvantage of this 'should' is that it is simply unrealistic. Some people are rude and inconsiderate. If I think that people should treat me nicely, I will become infuriated every single time it doesn't happen. I will experience anger and frustration regularly. My happiness is at stake here. This 'should' is damaging.

I shouldn’t stutter

Benefit CostI will work hard to be fluent. I will be happy whenever I am fluent.

I DO stutter from time to time. Therefore, insisting that I shouldn’t stutter will make me feel anxious, frustrated and sad. I will end up feeling ashamed and guilty, as if I am letting myself down. Furthermore, the anxiety that I create by insisting that I must remain fluent will increase the likelihood that I will stutter.

I should have grown up in a "perfect" family environment

Benefit CostAt times when I think that I have come from a "perfect" family I will feel very content

If I see any signs of my family being imperfect, I will feel unhappy. I might feel anger toward my parents for failing to provide me with the 'perfect' upbringing. Since there is no such thing as a 'perfect' family, I will often be able to find flaws in my childhood experience. I will blame my childhood for my current difficulties, and I can't change the past.

I should always say "yes" to requests from others

Benefit CostI will get lots of opportunities in the workplace to take on extra tasks.

I will probably be taken advantage of in my personal and professional relationships. I will end up doing lots of things that I really would prefer to avoid. I will end up feeling overburdened. I will end up resentful of the demands of others.

Final note!As you can see, there are lots of serious disadvantages to this SHOULD. It is setting the person up for failure, shame and frustration. Consider the following syllogism:

(A) Human adults with a history of stuttering tend to be dysfluent from time to time(B) I’m a human adult with a history of stuttering(C) Therefore, I SHOULD stutter from time to time

If you did a Cost-Benefit analysis on this SHOULD you would see its merits!

Safety behaviours

• Function to maintain anxiety

• Definition remain in its function

• Heightened self-focus

• Prevention of disconfirmation

• Contamination of the social situation

• Drawing attention to herself

Your safety behaviours

• What are are you doing to eliminate social threat?

↓↓Quality of life means more:• Frequent emotional turbulance

• Anxiety

• Anger

• Sadness

• Lack of motivation to engage in life

↑↑ Quality of life means more:• Attention to the postive things in life,

such as: the nice weather in Sydney, the beautiful beach, great food, great nightlife, opportunity to meet new people, interesting things to do with friends, travelling, learning about new cultures, languages, doing your favorite exercise, listening to great music, engaging in hobbies of interest, great outdoors hiking, good sense of humour, interesting documentaries etc.

Do you have many causal thoughts?

• The best way to know that you are having one, is that you are feeling anxious, sad, or angry!

The End

• Thanks for your time!

• Any questions – ask me now, or email me on fjola@fjolad.com