July '25 - Brainspotting for Social Anxiety

Social Anxiety Disorder (SAD) affects approximately 7% of the U.S. population each year (NIMH). Over a lifetime, nearly 12% of Americans will experience social anxiety. It typically begins in early to mid-adolescence, with most individuals reporting symptoms before age 18.

SAD often co-occurs with other mental health conditions:

• It is comorbid with depression in up to 70% of cases.
• It significantly increases the risk of substance use disorders and other anxiety disorders.
• Individuals with SAD frequently struggle with:

1. Lower academic achievement
2. Difficulty securing or maintaining employment
3. Strained or limited social relationships

Over the past 25 years, I have treated many adolescents and adults suffering from Social Anxiety. It can be deeply distressing and debilitating. I’ve found that a combination of Brainspotting, social skills training, and in some cases, medication (e.g., SSRIs, SNRI’s or Beta Blockers) can be very effective. I also help them find a focus outside of themselves, and their anxiety for social situations

Let me share a story.

One of my clients, whom I’ll call Nick, was in his late 40s. He was painfully shy and overwhelmed by social settings. After his divorce, he wanted to meet someone new, but couldn’t tolerate being in social environments. Though he loved to dance, he once left a singles dance just five minutes after arriving.

I introduced him to concepts from Dale Carnegie’s classic How to Win Friends and Influence People (linked HERE), especially the idea of encouraging others to talk about themselves. I realized Nick had a huge heart and loved helping people—so I gave him an assignment.

At the next singles dance, I challenged Nick to shift his focus outward. Instead of dwelling on his anxiety, I asked him to invite every single woman, who hadn't yet been asked, to join him for a dance. His mission was to stay until he had danced with all of them.

At the end of the night, a kind woman approached him. She had noticed his thoughtful gestures and found him handsome. They danced - and eventually fell in love. Today, they are happily married.

Here’s what I did with Nick:

• Brainspotting using the Double Spotting Social Anxiety Frame (see below).
• Social skills training from Dale Carnegie’s book (linked HERE). We practiced:

1. Asking open-ended questions
2. Making eye contact
3. Engaging in small talk
4. Active listening

• Medication support: I sent a letter to his doctor recommending an SSRI, SNRI, or beta blocker.
• Exposure therapy with a purpose: I encouraged him to engage in social situations with a clear purpose, helping him build confidence gradually.