In the mid-90s, a study highlighted the nuances of exposure therapy in the context of social phobia, shedding light on the concept of “safety behaviors.” These behaviors act as crutches, allowing individuals to engage in exposure while mitigating excessive anxiety. Take, for instance, someone with a fear of conversing with strangers; they might opt to remain tight-lipped during social interactions. However, such behaviors impede the efficacy of exposure, preventing the genuine testing and exposure of their fears for validation.
Internal Perceptions: Self-Judgment vs. External Evaluation
Notably, a prior study analyzing thought data collected from interviews with socially anxious patients reveals that they tend to report higher negative self-evaluative thoughts than the evaluations others hold of them. In essence, they project their self-perceived judgments onto external perceptions. This self-imposed lens perpetuates their anxiety and shapes their behavior.
Continuing with the above example, if the individual avoids participating in the conversation, they remain shielded from confronting their fears of ridicule or ostracization. This nullifies the potential benefits of subjecting themselves to the feared situation. It’s akin to not taking any action at all, counteractively undermining progress.
The Paradox of Frequent Social Exposure
Despite individuals with social phobia frequently subjecting themselves to social situations, their anxiety levels often remain unaffected. This phenomenon is attributed to the employment of safety behaviors, subtle or generalized avoidance mechanisms. These behaviors manifest as efforts to conceal blushing with makeup, pre-planned conversational topics to avert awkward silence, or gripping objects to hide physical tremors. Regrettably, while these behaviors might create a subjective illusion of protection against perceived threats, they inadvertently reinforce negative beliefs.
The challenge lies in the fact that safety behaviors undermine the essence of exposure therapy by hindering the disconfirmation of negative cognitions related to feared social threats. These behaviors prevent the individual from truly facing their fears and testing their validity, as they serve as psychological shields.
Defying Anxiety: Breaking Free from Safety Behaviors
By contrast, research shows that individuals with social phobia who are specifically directed to abandon safety behaviors experience a marked reduction in anxiety levels. This group demonstrates significant improvements in their phobias compared to those who do not receive such instructions. This suggests that shedding safety behaviors can indeed pave the way for progress, allowing individuals to genuinely confront their fears, challenge their beliefs, and potentially find relief from the grip of social anxiety.
References:
Morgan, H., & Raffle, C. (1999). Does reducing safety behaviors improve treatment response in patients with social phobia? Australian and New Zealand Journal of Psychiatry, 33(4), 503–510. https://doi.org/10.1046/j.1440-1614.1999.00599.x
Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (2016). Social Phobia: The Role of In-Situation Safety Behaviors in Maintaining Anxiety and Negative Beliefs – Republished Article. Behav Ther, 47(5), 669-674. doi:10.1016/j.beth.2016.08.010