Threat? Photo: massdistraction

How to improve social anxiety by training your attention

In 2009 Brad Schmidt and colleagues published a clever treatment for social anxiety disorder. Before I describe it, a short “spoiler” alert…

If, as i suspect, you are reading this looking for a self-help treatment for social anxiety, I recommend that you do not read this article, as knowing the nature of the experiment might negate its effects (or it may not; I don’t know, but it surely can’t help you so let’s stay on the safe side).

Instead, try to get hold of the computer program used in the study. The best lead I have is Richard McNally’s lab who tested an iPhone, iPad and android app of the program. There might be an ongoing study you can take part in, or you could try requesting a copy of the app for your own use.

End of spoiler alert

Hypersensitivity to threats is a feature of social anxiety disorder. Where one person sees a disgusted facial expression and ignores it to continue chit-chatting, the person with SAD will focus on this facial expression and take it as evidence that they are being poorly judged.

They are negative evaluation detectives, scanning and interpreting social situations in a way that paints them negatively. For whatever reason, an adaptive behaviour — making sure we’re not pissing off our allies — has become maladaptive, leading to anxiety.

Threat? Photo: massdistraction

A potential treatment, then, would be to re-train the attention not to focus on negative facial expressions so much. This is what the program aims to do. Here’s how it works.

Participants are presented with two pictures of people, one displaying a threatening facial expression, the other a neutral one. The pictures stay for a while and then disappear, and one picture leaves a letter in its place. Participants press a key to indicate which face left the letter behind. They are told to do this as fast as they can.

The trick is that 80% of the time the letter appears behind the non-threatening face so that over time, participants are being trained to move their attention away from threatening faces. With less attention paid to them, there’s less opportunity to infer negative judgements. The fact that participants have to press the keys quickly is important here, like a “gamification” effect to increase engagement and attention.

Participants completed eight 15-minute sessions on the program, two per week for 4 weeks. Could such a short, simple game really make real-world differences in social anxiety disorders? Well this is only one test and it needs to be repeated, but the results were impressive. After 4 weeks, 72% of participants no longer met the criteria to be diagnosed with social anxiety disorder, compared with 11% in the control group. The results remained in a follow-up four months later.

So, yes, so far it seems it can.

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