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Customer Review

on 3 May 2004
I've seen this book mentioned many times as a good self-help guide on two online SA communities ([...] and [...]) and on reading it I would recommend it to any SA sufferer. In particular, I think it would be really helpful for someone new to the topic of Social Anxiety, perhaps not sure whether or not they have it, and unclear about how they could use techniques from self-help CBT. There's lots of information here I am familiar with through learning from several web sites, but this book is a real timesaver - it might not have all you need to know about SA, but more than enough to understand your problem and begin to think of possible solutions. The book makes liberal use of lists of key points in bullet-point format, and has many boxes with examples of the terms being discussed, so it's quite understandable too. Rather than just use a jargon term such as "avoidance behaviour" it gives practical examples which you can then see if they apply to you.
For someone new to the subject just being able to recognise "Yes, that's what I've got" can be really helpful. Getting out of denial is the first step to tackling a problem you might have allowed to grow unchecked for years. SA has many signs and symptoms, affecting multiple areas - how you think, how you behave, on your body and emotions. This book helps you understand how these areas are interrelated, how they affect each other, and hence the things that need to be done to tackle the problem. It shows how many "vicious circles" are maintained - an example of a cycle would be
Avoid conversations with people -> Dread conversations -> Tend to blush when they happen -> Avoid the next conversation
Breaking out of these cycles of thinking/ feeling/ acting forms a major part of the book, which is divided into:-
• Changing thinking patterns
• Doing things differently
• Reducing self-consciousness
• Building up confidence (this can also occur through non-social activities)
These four sets of activities all complement each other, and can create a "virtuous circle" where even a small amount of time regularly spent can produce dramatic improvement. Examples are given of CBT-type exercises you can complete (I'd recommend buying a workbook or jotter to complete these in one place, rather than using scrap paper) such as a Thought Record, simply a table where you fill out each of the following categories:-
• Specific situation (think of a situation in which you use a safety behaviour)
• Prediction (what will happen if you do not keep yourself safe? How will you know if it happens?)
• Experiment (How will you find out? What will you do differently?)
• What actually happened? (What did you observe? Stick to the facts.)
• Conclusions (What does this mean?)
After the event you can then re-think your original belief - e.g. asking yourself how much you believe it now (from 0-100 per cent).
The book gives many examples of how our thinking can be faulty (all or nothing thinking, assuming the worst etc) and also how we can substitute better thoughts for the faulty ones (e.g. by thinking what a helpful friend or parent would say to you, or what you would say to a friend who had the same problem). Changing our perspective in this way can be really helpful, and I think it's similar to the idea of "self-parenting" where we come up with our own solutions and more positive ways of thinking about something.
A good idea the book gives is to create "flashcards" with a belief, assumption or negative thought on one side of the small card and a more healthy perspective in response on the other side. I think this would be really helpful for someone wanting to do something they found anxiety provoking (going to a family occasion, meeting someone of the opposite sex). As we all know, in the middle of a stressful situation the negative thoughts and feelings flow easily and thinking up a positive replacement can be much more difficult - having some "Blue Peter" examples which you prepared earlier could be really helpful.
The book is thoroughly grounded in good research and filled with practical advice - there wasn't anything I read that jarred with me or I viewed as author bias. At the same time the book was a little dry to read, not especially motivational for me, and I had the same feeling about completing the CBT exercise as I would about regularly eating oat bran - no doubt good for me but not especially fun. However the more I got into the book the more the tasks required seemed manageable, and believable, and I can see myself applying them in the coming months. If I spent even 30 minutes a day, five times a week, for two months I'm convinced I would progress a lot, so I'm "sold" on the concept of CBT in that sense.
I would say if someone was feeling very depressed they would probably be better off getting treatment for the depression before tackling CBT, and equally if someone felt able to do positive things (such as attending an SA meet or going out and doing something with friends) they'd be better off doing that than staying at home completing CBT exercises. For people in between, however, I think the exercises would be tremendously helpful. If you're not in a position to do anything social at the moment this book is excellent preparation for taking those first steps. If you are feeling a little better, are getting out a bit more, and feeling a bit brighter in general, I think this book will really complement and reinforce what you are doing. No hesitation in recommending this book for anyone with SA, or for anyone wanting to understand and help an SA friend or relative.
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