Detached Mindfulness in Social Anxiety

Copyright (c) Donald Robertson, 2011.  All rights reserved.

See the previous article on Detached Mindfulness for information on the general strategy before reading this.

For some problems, such as social anxiety, it’s particularly important to face your fears by repeatedly entering distressing or anxiety-provoking situations.  Psychologists call this “exposure therapy”, and it’s often considered to be the most reliable component of modern behaviour therapy or CBT.  One way of using Detached Mindfulness is to enter situations that would normally evoke anxiety or be avoided while being mindful of your automatic thoughts.  The trick is to remain in the situation while observing your thoughts and treating them as mere hypotheses, and tolerating your feelings as harmless and transient.

Prof. Adrian Wells, the founder of Metacognitive Therapy (MCT), advises clients to metaphorically “look through”, or look beyond, their thoughts while focusing attention on the outside world, discovering whether the thoughts are accurate or not in the process.  He describes this as asking yourself, in the situation that you fear, whether you’re living by your thoughts or by “what your eyes reveal” about real events around you (Wells, 2008, pp. 80-81).  One way of imagining this might be to write or draw your thoughts on a pane of glass and then look through it, beyond the thought.  This can serve as a kind of metaphor for what it’s like to respond to thoughts with Detached Mindfulness in a specific situation, while looking beyond them to see what’s happening in the external world, in reality.

Wells co-authored, with David Clark, the most influential CBT treatment protocol for social anxiety, which centres on the advice to overcome self-consciousness by focusing instead on the external situation, e.g., the faces of the people with whom you’re interacting.  Combining Detached Mindfulness with this CBT approach for social anxiety might mean focusing on the external situation, while being aware of automatic thoughts, but looking through them at the outside world to see how they compare to reality, rather than simply responding to them as if they were facts.  For example, someone who has the thought “They’re going to think I’m an idiot”, might continue to be aware of having this thought, mindful of it, while remaining in a social situation and looking at people’s faces to see what they reveal and responding to that external situation rather than the thought.  Indeed, social anxiety is typically understood in terms of three phases: before, during, and after a social encounter.  The Cognitive-Attentional Syndrome (CAS) and its opposite, Detached Mindfulness, might be seen in relation to these stages as follows,

1. Before.  Anticipatory anxiety and worry about social catastrophes in the near future.  Excessive preparation or avoidance (safety behaviour).  Alternatively, automatic thoughts about anticipated social situations are accepted as mere thoughts (hypotheses) to be tested out later, and observed in a detached way, until they naturally fade from the mind (Detached Mindfulness).
2. During.  Heightened self-focused attention (self-consciousness), in relation to anxious feelings and bodily sensations and automatic thoughts and images about how you “come across” to others (threat monitoring) and worry about their possible negative reactions.  Subtle avoidance of eye-contact, etc., speaking quickly to try to escape, trying to avoid being noticed (safety behaviour).  Alternatively, attention is focused externally on other people’s faces and their reactions while automatic thoughts and images are accepted in a detached way, as you remain in the situation and look beyond them, responding to other people’s behaviour rather than to your thoughts (Detached Mindfulness).
3. After.  The “post-mortem” or retrospective analysis of “what went wrong” or “what it all means” (rumination), often leading to feelings of shame or depression.  Avoidance of uncomfortable memories of the event and negative emotions by using alcohol or distraction (safety behaviour).  Alternatively, intrusive memories of the event are acknowledged but rumination and analysis is postponed until a later date or banned completely, and nothing is done in response, allowing the memory to remain in mind and fade naturally in its own time without interference.

Fears about what other people might think of you can be viewed with Detached Mindfulness in the same way as your own thoughts.  A good way to illustrate this is to imagine what you fear others might think (e.g., “You’re an incompetent idiot!”) is written clearly on a sticky post-it note attached to their forehead.  This can make it easier to view the thought as a mere hypothesis, in a detached manner, without falling into the trap of trying to avoid or suppress awareness of it.  Accepting the presence of the thought in a detached manner, while paying attention more fully to the external environment, allows you to observe the faces and reactions of other people naturally without excessive self-focus or absorption in internal experiences and worry.