Today we interview our beloved Jill Levitt, PhD who will be
joining me in teaching the upcoming social anxiety workshop on
October 2nd. Jill is the co-leader of my weekly
psychotherapy training group at Stanford, and is the co-founder and
Director of Training at the Feeling Good Institute in Mountain
Social anxiety was one of the most frequent problems that
patients sought help for when I was in private practice in
Philadelphia. Because of my own severe and persistent social
anxiety since childhood, it’s my favorite problem, too. Whatever
you’ve had, I can tell you that I’ve had the exact same thing, too,
and know how sucky it can be. I can show you the path to freedom
from that affliction, and what a joy that will be!
According to the DSM5, there are at least five types of social
Public Speaking Anxiety
Performance Anxiety. This a broad category that can include
athletic or musical performance, or any time you have to
demonstrate your skills in front of people who might judge you. For
example, I had a severe camera phobia since I was a child, and only
got over it a couple years ago!
Shy Bladder / Bowel Syndrome
In addition, other negative feelings typically go hand-in-hand
with social anxiety, such as shame and loneliness, as well as
depression and feelings of inferiority and even hopelessness.
This workshop will focus on therapists looking for training.
However, the general public are also included, since you will get
the chance to practice and work on your own fears during the
workshop. I (David) have noticed that feelings of social anxiety,
especially performance anxiety, are almost universal among
therapists, at least judging from those who attend our weekly
TEAM-CBT training group at Stanford.
So, come to heal yourself AND to learn how to heal your
patients and loved ones.
We will be covering not one, but four treatment models for
social anxiety in the workshop:
1. The motivational model: Nearly all anxious
individuals resist exposure, which is a crucial part of the
Most therapists also resist exposure for a variety of reasons,
thinking the patient is too fragile, or the technique will be too
dangerous or upsetting for their patients. This is unfortunate,
since this pretty much dooms the treatment to failure, especially
if you are aiming for a “cure” rather than endless talk and
2. The Cognitive Model. Although usually not
completely curative, the Daily Mood Log is essential to treatment,
so you can find out exactly what patient are thinking and feeling
at one specific moment when they were feeling anxious. I present
the case of Jason, a young man feeling shy and anxious while
standing in line to check his groceries one Saturday morning at the
local grocery store.
Many cognitive techniques are incredibly important and useful
in the treatment of social anxiety, including Explain the
Distortions, the three types of Downward Arrow (uncovering)
Techniques, the Double Standard Technique, Externalization of
Voices, the Feared Fantasy, and more. Although these methods are
helpful and illuminating, they will rarely or never be quite enough
for a complete cure. For that you will need:
3. The Exposure Model. In the workshop, we
will be teaching:
Smile and Hello Practice: In today’s podcast Jill discussed the
purpose of this technique, how to introduce this technique to your
patients, and how to implement it. This is an example of the many
techniques we will teach on October 2. David provided a dramatic
example of how this humble technique changed the life of a young
man from India.
Talk Show Host
Feared Fantasy: We role-played how I used this humor-based
technique in my work with Jason
We will also explain how to use several techniques crucial to
the reduction of the patient’s resistance:
Dangling the Carrot
Sitting with Open Hands
However, many therapists have intense resistance to making
patient accountable with these techniques that are absolutely
central to TEAM-CBT, thinking they are cruel or crude or
narcissistic, or some such thing. In the podcast, Jill illustrates
a beautiful and gentle but firm way of introducing these techniques
to patients, and emphasizes that they are actually ethical,
therapeutic, and necessary for a good outcome.
She also emphasizes, and I totally agree, the importance of
going with the patient into the real world to do the Exposure
Techniques. I have used extreme exposure techniques on hundreds of
occasions when treating anxious colleagues on Sunday hikes for
example, urging them to stop hikers we meet and disclose their own
shyness, for example.
The advantages of doing this type of thing in the real world
include the ability to coach the “patient” with the best examples
of how to use whatever technique you’re advocating, and to be there
to support the patient during and after the experience.
4. The Hidden Emotion Model. This technique is
often extremely helpful in the treatment of any form of anxiety,
but is perhaps less often used in the treatment of social anxiety.
I can think of one example when it was extremely helpful. This was
a woman whose boss kept pressuring her to give presentations about
their company locally and to groups in other locations as
She opted out because of her social anxiety. But lurking behind
her symptoms were her feelings of resentment about being asked to
do too much. Once she brought these feelings to conscious
awareness, she decided to discuss his expectations, her feelings,
and her compensation with her boss. This worked well, and her
public speaking anxiety magically disappeared.
Although this pattern is not common, it is always worth
consideration in your treatment plan, because family and friends
often pressure people with social anxiety to confront their fears,
and this typically does trigger feelings of resentment and
We also discussed two Self-Defeating Beliefs that are nearly
universal in individuals with social anxiety: the Spotlight and
In the podcast, I give examples of several techniques that were
life-changing for patients. Jill emphasizes that one of the
underlying treatment themes is how to “wake up” from your trance so
you can learn not to take yourself so seriously and begin to have
fun and enjoy yourself and others way more. Improvement is not the
goal of treatment.
The goal of treatment is word that many mental health
professionals fear and resent: CURE! In the podcast, I describe the
difference between a 100% cure for any form of anxiety, and a 200%
Do you know the difference? I give an example of my own fear of
heights when I was in high school. Of course, that’s a phobia, and
not a form of social anxiety, but you can also have a 200% cure for
social anxiety, too!
In a 100% cure your fears go to zero. You are no longer
particularly anxious about talking to strangers, or public
speaking, for example. In a 200% cure, you come to LOVE the very
thing that terrified you in the past.
Rhonda, Jill and I think this will be a powerful one day
experience. We will focus on a common problem that is usually
treatable fairly quickly, and often with fabulous and life-changing
results. We hope you can join us!
For registration information, please go to:
Jill, Rhonda, and David
About the Podcast
This podcast features David D. Burns MD, author of "Feeling Good, The New Mood Therapy," describing powerful new techniques to overcome depression and anxiety and develop greater joy and self-esteem. For therapists and the general public alike!