How to Handle Criticism With Social Anxiety Disorder

How to Handle Criticism With Social Anxiety Disorder Social Anxiety Disorder Coping Print Handling Criticism With Social Anxiety Disorder By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Medically reviewed by Medically reviewed by Steven Gans, MD on June 28, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on November 21, 2019 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Ekaterina Beznosova / EyeEm / Getty Images People with social anxiety disorder (SAD) are irrationally fearful of criticism and rejection. You may worry constantly that others are thinking negatively about you or that they do not like you.   The main focus of cognitive therapy is to convince you that your fears are unfoundedâ€"and that people are much less critical and rejecting than you expect. However, some of the time, you will experience criticism and rejection, and it is important to be able to cope. Assertive Defense of the Self In a newsletter published by the International Association for Cognitive Psychotherapy, anxiety expert Dr. Christine Padesky described a unique treatment approach for SAD. Padesky argued that the traditional focus of cognitive therapy only takes care of half of the problem for people who suffer from SAD. One of the main causes of anxiety is the overestimation of danger. For example, people with panic disorder are afraid of physical symptoms because they mean the start of a heart attack.  People with social anxiety disorder (SAD) are afraid that they will be judged negatively because of their anxiety in social situations.   Cognitive therapy shows you how your fears may be unfoundedâ€"that people are not as judgmental as you think. However, sometimes people will be judgmental. If you are not prepared to cope with judgment and rejection, then you will still be afraid that social and performance situations could end badly. Padesky describes a way to increase coping skills by exposing the person with SAD to harsh judgment during role-playing in therapy sessions. Through this process, you are able to increase your self-confidence and learn how to better cope with criticism and rejection. How to Practice Assertive Defense of the Self Padesky describes the typical steps that would be taken during therapy to increase confidence. Although this process is best done with a therapist, it is also possible to work on these steps on your own. Below is a description of how to work on this as a self-help project. Step 1. Identify automatic thoughts  you have about critical things that other people might say about you. Make a list of all of the possible things that you might hear. Step 2. Create a list of responses. This step, called the assertive defense of the self, involves coming up with a confident and assertive reaction to each of the possible criticisms. Below is an example of how this might look: Critical Thought: You are shaking. Is there something wrong with you? Assertive Response: My hands are shaking because I am anxious. Some people are afraid of heights; I get anxious when I am around people. It doesnt make me any different than anybody else. In fact, a lot of people have this fear. Its just that nobody talks about it. During therapy, Padesky would role play with the client. As the therapist, she would play a critical role, and ask her client to come back with assertive responses. She argues that this in-therapy practice is important because, in real life, actual overt criticism is few and far between. Sample Role-Playing Session In the article, she describes what the final session of role-playing might look like: Therapist: Youre shaking. Is something wrong? Client: Not really. Im just anxious, thats all. Therapist: Why are you anxious? Client: I get anxious in social situations. Therapist: YOU DO? Whats wrong? Are you crazy or something? Client: No, Im not crazy. I have social anxiety. Therapist: Social anxiety? Sounds crazy to me! Client: Maybe you arent familiar with it. But its quite common. It doesnt mean Im crazy. Therapist: You may not think so. But I think youre pretty weird if you shake like this. Client: I can understand how it might seem weird if youre not familiar with it. But Im not crazy. Therapist: I dont know. I think you must be nuts. Client: Im sorry you dont understand. But Im not nuts. When this role-play eventually takes place, the person with social anxiety usually reports feeling irritated by the critical voice rather than shamed by it. Silence Your Inner Critic One way to practice this process on your own is to argue against the critical voice that is already in your head. Do this first at home when you are not in social or performance situations until you are able to easily defend yourself against your criticisms. Then, once you feel in control, try practicing in real-life situations, imagining the critical voice of others. You might even try exaggerating your symptoms or seeking out rejection, just so that you can practice your coping skills. Padesky suggests having your hands shake in front of you while making eye contact, or deliberately asking a neighbor over for coffee who is obviously too busy to talk with you. The goal of this process is to develop a more confident and assertive way of coping with potential rejection and negative judgment. By exposing yourself to criticism and rejection, you will learn that you can cope.