A simplified conceptual cognitive model is that a situation occurs which triggers automatic thoughts which we then react to. This reaction can have emotional, behavioural, and physiological components. In other words the situation / event doesn’t directly determine how we feel or react, instead our reaction is filtered by these automatic thoughts [1]. Automatic thoughts can occur rapidly, and we may not necessarily be aware of them.

Thinking about attending the university club event doesn’t directly make you depressed or anxious. It’s the automatic thoughts that lead to these feelings and actions. Automatic thoughts aren’t necessarily true. They are often distorted and irrational. By changing unhelpful or inaccurate thoughts, we can also change our emotions or behaviour.

Even in the case where an automatic thought is accurate, dwelling on it can still be unhelpful and lead to depression or anxiety. An example of such a thought would be "A whole semester has passed, and I still haven’t made a single friend at university". While this is true, dwelling on it will negatively impact our mood. Instead, it is better to focus on a plan to make friends moving forward.

Not only can unhelpful automatic thoughts prevent us from starting an activity, they can also cause us to quit an activity unnecessarily. The same situation can be interpreted differently depending on the individual. An event that most people would interpret as neutral can be interpreted as negative by a socially anxious person. Moreover, an event that most would interpret as slightly negative can be interpreted as catastrophic by a socially anxious person.

A more complex version of the cognitive model incorporates interactions and feedback between the different components. That is, the physiological or physical reaction can trigger additional automatic thoughts, and our emotions can influence our behaviour and so on. Ultimately, the key point is that our thoughts influence our emotions, behaviour, and physiological (physical) responses. It’s important to clearly distinguish between the different aspects: situation, thought, emotion, behaviour, and physiology.

Automatic thoughts come from beliefs that people have about the world around them. Some of those beliefs may be positive and others may be negative. Some are adaptive, others are dysfunctional. At times, these dysfunctional beliefs can be extreme and unrealistic and involve ideas of helplessness or worthlessness. For example, a student might believe that nobody can be trusted. By adopting beliefs that are more balanced and adaptive, ultimately future events can be interpreted in a more constructive way.

Events that occur in the physical world, as well as private mental events, can trigger automatic thoughts. Sometimes these automatic thoughts can be dysfunctional. There are a number of signs of dysfunctional automatic thoughts including:

Automatic thoughts are often (but not always) in verbal form. They can also take the form of images or memories. For instance, you might have a vivid memory of being scolded by a teacher in front of the class. We aren’t always fully aware of them, but tend to accept them as true. In reality, they might be only partially true or not true at all. By learning to identify automatic thoughts when they occur, we can evaluate them from a realistic perspective.

In order to identify automatic thoughts when you are in an anxiety-provoking situation, or even when you think about an anxiety-provoking situation, try to think about what thoughts tend to reoccur. Focus on what you are thinking when you have a strong emotional response. These thoughts may involve what you believe the other person is thinking about you, what predictions you might be making, and what you fear might happen. Case in point, a student attending a social gathering might have the following automatic thoughts:

After the gathering, they may obsess over every detail and how other attendees perceived them.

If you still have trouble identifying automatic thoughts, there are a number of questions you could ask yourself.

Don’t worry if you have trouble at first with identifying automatic thoughts. It will become easier with practice.

Moods can usually be identified with a single word. Common moods related to social anxiety that you might experience include:

But at other times you might experience moods like:

Tracking of mood changes is central to many cognitive techniques, however, we don’t explore this in detail as this chapter is only an introduction. Please consult the books in the recommended reading section for more details.

Automatic thoughts associated with anxiety provoking situations are often characterised by certain thinking errors termed cognitive distortions. By learning to identify these cognitive distortions, we can rebut certain unhelpful automatic thoughts and move to a more adaptive way of thinking.

Some automatic thoughts contain multiple distortions. Also, there is some overlap between the distortions. If you are having trouble categorising a thought, it is probably because it could fall under multiple categories. The key idea though is to look for distortions in your thinking and to recognise that our automatic thoughts are not facts.

Some common cognitive distortions include:

All-or-nothing thinking. Situations are viewed as only falling into two categories such as complete success or complete failure, or perfect or awful. (e.g., "I didn’t do a good job making small talk with other students at the halls of residence. Now EVERYONE thinks I’m a weirdo"). This is also called black-and-white thinking. All-or-nothing thinking is associated with unrealistic standards.

Catastrophising (fortune-telling). Consistently making negative predictions about the future, usually based on flimsy evidence (e.g., "I didn’t make any friends during the first week at university. Now I’ll never make any friends"). If the word never occurs in an automatic thought, it is often an indicator of catastrophising. A closely related cognitive distortion is catastrophic thinking, this assumes that if a negative prediction did come true, it would be terrible beyond belief.

Disqualifying or discounting the positive. Positive experiences, actions, or qualities are dismissed as not counting for various reasons. Instead, the individual focuses only on the negative (e.g., "The students at the club meeting were nice to me, but that’s only because they took pity on me. I can tell nobody likes me").

Emotional Reasoning. Because you "feel" something is true, you start to believe that it must be true. Evidence to the contrary is ignored (e.g., "I felt depressed after going to a party. That means nobody liked me"). This distortion is also called confusing feelings with facts.

Labelling. This refers to labelling yourself or others without considering evidence that might support other conclusions. Being unhappy about some specific aspect is generalised to a complete judgement about something (e.g., "I failed a test at university that means I’m a loser").

Magnification / minimisation. Negative evaluations are magnified and positive ones are minimised. You worked hard on a group project and your group got a high mark (e.g., "I didn’t do anything. A few smart people in the group deserve all the credit").

Mental Filter. This refers to filtering out positive details and focusing on one or several negative details.

Mind Reading. Making assumptions about what other people are thinking. The person you are interacting with might be thinking positive or neutral thoughts about you, but you leap to the conclusion that they are thinking negative thoughts (e.g., "In a tutorial we had to work in a group. I just know the other group members thought I was an idiot"). If the automatic thought contains the words "they think", or "they are going to think" that is often indicative of mind reading.

Overgeneralisation. This refers to making extremely broad and unjustified conclusions based on the current situation (e.g., "Two weeks have already passed at university and I haven’t made any friends. Now I’ll never make any friends").

Personalisation. The belief that others behave in a certain way due to something that you did, rather than consider other explanations or all possible factors. (e.g., "I asked the lecturer for some guidance on an assignment, but they refused saying it should be obvious. The lecturer must hate me").

Should and must statements. This refers to having fixed and inflexible ideas about how you and other people should behave. Often it involves setting standards that are so high that nobody can live up to them. If the automatic thought contains "should", "have to", "must" etc then it is probably an example of this (e.g., "I must never accidentally say the wrong thing. If I do, I’m a terrible person").

Tunnel vision. Looking at a situation solely from a negative perspective.

Unhelpful thought. Although this isn’t necessarily a distortion, we include it in our list, so we know to identify automatic thoughts that occur repeatedly that are unhelpful. (e.g., "I failed the whole semester").

Automatic thoughts are not facts, rather they are simply mental constructs about the way the world is. Careful examination of these constructs can reveal how accurate or inaccurate they are. Remember that social anxiety can lead us to pay attention only to information that confirms our negative thoughts. Automatic thoughts can become so familiar to us, that we never think to ask whether they make sense. Therefore, it is useful to get into the habit of questioning these automatic thoughts. Consider alternative beliefs, predictions, and interpretations. What is the evidence for the original thoughts and what is the evidence for the alternative thoughts?

One way to get a different perspective is to think about what would you tell a close friend who came to you with those thoughts following a situation they found challenging? Your friend might tell you about a party they went to and how "everybody thought they were weird and noticed that they were very anxious", you would console them and say, "I’m sure most people didn’t think you were weird. Your anxiety probably wasn’t that noticeable. Even if a few people noticed, they probably didn’t care". You might also say something like "I also feel anxious at parties, especially when I have to talk with people I don’t know. But my anxiety decreases, and then I start to enjoy myself".

In addition, consider the costs and benefits of those thoughts. If those thoughts aren’t helpful, then it is time to let them go.

By correcting dysfunctional thoughts and beliefs, we experience less anxiety, less avoidance, and free up mental resources to focus on the situation at hand.

It’s useful to keep a record of your dysfunctional thoughts and more rational responses. A tool we can use for this is the social anxiety thought record. One approach is to have one thought record for each unique situation. If this is a situation we are facing for the first time, we would start a new form. It could also be a situation we have faced before, in which case we can add new material to an existing form.

It’s useful to review the record when we anticipate that a situation will reoccur, or after it has reoccurred. That way we can refresh our minds regarding how to rebut these specific negative thoughts. Although it might be difficult to develop rational responses at first, it will become easier over time.

It’s important to remember that the goal of these cognitive techniques is to replace distorted negative thoughts with more balanced and realistic thoughts. It’s likely that these more balanced and rationale thoughts are more positive than the original negative thought, but the goal isn’t just to replace a negative thought with a positive thought. A positive thought that is not supported by evidence could be difficult to accept and hence is unlikely to lead to a change in behaviour and emotion.

Sometimes you might find that the automatic negative thought is supported by evidence. For example, you might have an automatic negative thought that "I’m always anxious because of my part-time job". In reality, there is a lot of evidence for this because the manager is always yelling at workers and blames them unreasonably for business problems. In this case, a better approach is for the individual to come up with a plan to quit the job and find another one, rather than try to change the automatic negative thought. Not all automatic thoughts are distorted and some are best dealt with by developing an action plan.

Socially anxious people can sometimes retreat from the world and spend all their spare time watching television, playing video games, or surfing the internet. This can sap energy and cause more negative thoughts, resulting in a downward spiral of more inactivity. Therefore, it is important to take action, however small. In order not to get overwhelmed, set small goals that aren’t too difficult to achieve. Increased activity can lead to more confidence and positive thoughts which in turn then leads to more activity creating a positive feedback loop.

Plan several activities that involve socialising every week. The way to improve is to make small changes in behaviour and thinking every week. Over time, these small changes build into big changes.

Students will already typically have a plan for the week that incorporates things like scheduled lectures and tutorials. Social activities can be added to this same schedule.

Sometimes unhelpful thoughts can block intended activities. For example, negative predictions like "None of my classmates will be friendly if I try to strike up a conversation with them". When your mood is bad, or you are engaging in unhelpful behaviours, monitor your automatic thoughts and make note of them. Remind yourself that the automatic thoughts may be false or only partly true.

As previously mentioned, the goal of cognitive therapy isn’t relentless positivity, but rather realistic and helpful thinking. Sometimes anxiety might suddenly flare up in a situation, and it isn’t practical to go through the process of completely analysing and rebutting automatic negative thoughts and creating a rational response. In this scenario, it is useful to have some coping statements on standby. These are short statements used to reassure ourselves in a difficult situation. A given coping statement is often applicable to multiple situations.

A characteristic of social anxiety is maladaptive automatic thoughts that distort reality. This distortion, in turn, lead to disproportionate emotions, physical responses like shaking and sweating, and unhelpful behaviour, such as having to leave the situation. By analysing these automatic thoughts, we can identify particular distortions and develop a rational response. These rational responses aren’t necessarily relentlessly positive, rather they are about adopting a more balanced and objective perspective. Having an objective perspective can in turn help reduce some of the extreme emotions and "fight or flight" type response that are experienced.

As well as addressing the cognitive aspects of social anxiety, another important strategy is graduated exposure to the anxiety-provoking situation. This is covered in the next chapter.