New Developments in Emotion-Focused Therapy for Social Anxiety Disorder
Abstract
:1. Introduction
2. Emotion-Focused Therapy
3. An EFT View of Etiology of Social Anxiety Disorder
4. The Process of Change in EFT for Social Anxiety
- (1)
- Initially, in the critic’s chair, the patient expresses shame anxiety (“if you say something in a meeting, it will be a disaster, everyone will see how stupid you are”). In response, in the experiencing-self chair, the patient often feels a variety of secondary emotions such as helplessness, despair, and anxiety. Although this step is initial, it often leads to some relief and symptomatic improvement because it fosters a metacognitive understanding of the social anxiety symptoms. Patients begin to understand how the anxiety is generated, and a clearer focus for treatment emerges.
- (2)
- Second, as the therapist helps the patient to express and even amplify specific and contemptuous messages in the critic’s chair, the emotional response in the experiencing-self chair is deepened and differentiated, and the patient begins to experience shame (“I feel small and worthless, and I want to shrink into the ground and hide”). The therapist helps the patient stay in this state and provides a great deal of validation for these painful feelings.
- (3)
- Embedded in shame is a fundamental need to be unconditionally accepted, to belong, and to be recognized, seen, and validated. When patients allow themselves to experience shame within the therapy session, they often gain access to these shame-based adaptive needs. Therapists help patients in this process by asking them what they need, and then by helping them to clearly articulate these needs.
- (4)
- With the help of the therapist, patients begin to express more adaptive emotions related to these needs not being met. For example, boundary-setting assertive anger toward the internal critic (“I need you to get off my back and stop monitoring everything I say”), sadness about the many losses they have experienced as a result of social anxiety (loss of relationships, career opportunities, and so on), and pride (“I have actually achieved quite a bit”). In addition, the internal critic often softens, expressing compassion toward the suffering expressed in the experiencing-self chair. Assertive anger, sadness of grieving, pride, and self-compassion are adaptive emotional experiences that help to empower the patient and to undo shame. The patient feels entitled to have these fundamental needs met, which is the opposite of feeling inadequate and undeserving.
- (5)
- Clear articulation and expression of the critic’s function is also a crucial component of this process, which further helps to activate primary adaptive emotions. Therapists help patients, when in the critic’s chair, to describe what they are doing and why (“I am watching everything you say so that you don’t say anything stupid, so that you’re not exposed”, “my job is to make sure no one finds out the real truth about you – that you are inadequate”). These messages tend to trigger primary adaptive anger and sadness in the experiencing-self-chair (“I am tired of being oppressed like that, I need my freedom to be who I am. I am not willing to take it any more”).
Key Differences between EFT and CBT for SAD
5. Efficacy of EFT for SAD
6. Conclusions and Future Directions
Funding
Acknowledgments
Conflicts of Interest
References
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Shahar, B. New Developments in Emotion-Focused Therapy for Social Anxiety Disorder. J. Clin. Med. 2020, 9, 2918. https://doi.org/10.3390/jcm9092918
Shahar B. New Developments in Emotion-Focused Therapy for Social Anxiety Disorder. Journal of Clinical Medicine. 2020; 9(9):2918. https://doi.org/10.3390/jcm9092918
Chicago/Turabian StyleShahar, Ben. 2020. "New Developments in Emotion-Focused Therapy for Social Anxiety Disorder" Journal of Clinical Medicine 9, no. 9: 2918. https://doi.org/10.3390/jcm9092918