350 TREATMENT OF SPECIFIC ANXIETY DISORDERS
Situational Exposure
Of course individuals with social phobia often find themselves in social situations that
are unavoidable and this is when anxiety will be the most intense. Both automatic and
effortful cognitive processes will be activated during exposure to the feared social situ-
ation. The central cognitive process is the automatic activation of maladaptive social
self- schemas of threat and vulnerability that result in an attentional bias for threat,
heightened focus on internal cues of anxiety, automatic inhibitory behaviors, second-
ary negative evaluation of one’s emotional state and performance, and ineffective use of
safety behaviors. Table 9.5 provides a list of key maladaptive schemas that characterize
social phobia.
The schemas that characterize social phobia are highly specific to social situations
and will not be apparent in nonsocial situations. It is anticipated or actual exposure to a
fearful social situation that will activate the maladaptive social self- schema cluster. This
cluster includes dysfunctional core self- beliefs (e.g., “I’m boring,” “I’m different from
others,” “I’m not a likeable person”), faulty conditional assumptions (e.g., “If people get
to know me, they won’t like me”; “If I blush, people will notice I am anxious and think
there is something wrong with me”), and rigid rules of social performance (e.g., “I must
not show any sign of anxiety or weakness”, “I must take control by being outgoing and
witty”) (D. M. Clark, 2001; D. M. Clark & Wells, 1995).
A number of consequences follow from automatic activation of the maladaptive
social self- schemas. The first is an automatic attentional shift for processing internal
table 9.5. maladaptive social self-schemas in social phobia
Schema content Examples
Core beliefs of helpless, weak,
or inferior social self“I’m boring”, “I’m not a friendly person”, “People don’t tend
to like me”, “I’m socially awkward”, “I don’t fit in.”
Beliefs about others “People are critical of others”, “In social situations people are
always forming evaluations of each other”, “Individuals are
constantly scrutinizing other people, looking for their flaws
and weaknesses.”
Beliefs about disapproval “It is awful when others disapprove of you”, “It would be
horrible if others thought I was weak or incompetent”, “To
embarrass yourself in front of others would be unbearable, a
personal catastrophe.”
Beliefs about social
performance standards“It is important not to show any signs of weakness or
loss of control to others”, “I must appear confident and
interpersonally competent in all my social interactions”, “I
must always sound intelligent and interesting to others.”
Beliefs about anxiety and its
effects“Anxiety is a sign of emotional weakness and loss of control”,
“It is important not to show any signs of anxiety around
others”, “If people see that I’m blushing, perspiring, have
shaking hands, etc., they will wonder what is wrong with me”,
“If I am anxious, I won’t be about to function in this social
situation”, “I can’t stand to feel anxious around others.”