Understanding Social Anxiety - Cognitive Processes

The Alena app uses neuroscience-based assessments and cognitive behavioral therapy to identify and shift the four core cognitive processes (or mental patterns) that contribute to our social anxiety.

Here, we talk to Dr. Mona Garvert, Lead Research Scientist at Alena, about these cognitive processes – what they are, how do we define them, and how Alena therapy uses them to help you improve your social anxiety.

Dr Garvert brings over a decade of experience studying the human brain at renowned institutions such as UCL, Oxford and the Max Planck Society.

What do we mean by cognitive processes?

Cognitive processes are the mental functions underlying our perception, thinking and behavior. The brain takes the huge wealth of information that we capture through our senses (vision, sound, touch, taste and smell), and interprets them to guide our behavior.

Our brain makes sense of the information coming in through our senses and informs us about how we should act in order to keep ourselves safe. We learn from previous behavior about what works, and what doesn’t, and we use that to know how to make the right decisions, and how to act in future.

In a crowded place or situation, your brain automatically processes which things you need to focus on. It tries to pick and choose the relevant information to you at that moment. That attention influences our thinking, our perception of ourselves and the world, and our memories of how interactions happened and the outcomes of these.

How do these cognitive processes impact social anxiety?

We have good evidence from Clark and Wells that four cognitive processes are associated with high social anxiety - Beliefs, Attention, Rumination and Avoidance. People who score highly for social anxiety also tend to have different levels of these cognitive processes compared to people who don’t experience social anxiety.

How were these cognitive processes first identified?

Beliefs, Attention, Avoidance, and Rumination were all identified as part of the cognitive behavioral therapy model by Clark and Wells. They were found to be common thought processes that people with social anxiety experienced, and by tackling these and changing them, their social anxiety also improved.

When people have high levels of social anxiety, they also tend to have specific negative beliefs about themselves. Evidence showed that by targeting beliefs alongside attention, rumination and avoidance, it helped improve social anxiety levels.

Let’s go deeper into these cognitive processes. Please can you explain what you mean by Beliefs?

Beliefs are the way that we see ourselves, and how we believe that others see us too. We have seen that people with high social anxiety tend to have negative beliefs about themselves.

Beliefs can be conditional and unconditional. Conditional beliefs are situational, based around how you perceive yourself in a specific scenario - for example, when at work, or on a video call, you might think “when people see I’m anxious, they will think that I’m weak”. These are the easiest beliefs to target with your therapy.

Unconditional beliefs are not situationally specific - they are about you as a person. If you have social anxiety these might be that you are a timid person, or boring, or clumsy. These are harder to change, but not impossible with the right treatment.

The second cognitive process is Attention, what does this mean?

Attention is a hugely important factor in how we interact with and learn about the world, and also influences our mental health. Where we focus our attention has an impact on our interpretation of scenarios and interactions.

Often, we see that people who experience social anxiety tend to focus a lot of their attention on themselves, which unfortunately means that they aren’t absorbing cues from the environment and people around them. They can leave a situation believing that it’s been a negative experience, where in reality because they have been solely fixating on themselves they haven’t seen the positive interactions and responses that actually occurred.

Thirdly, we have Rumination – what impact does this have on social anxiety?

Past experience helps us make decisions in the present, based on how things happened previously – so it’s useful to be able to remember what happened in the past and how to behave appropriately now.

However, people who experience social anxiety tend to show a strong bias in what they remember and constantly rehearse negative social interactions again in their mind. This reinforces this negative impression that they had before.

The final cognitive process is Avoidance – can you explain more about this?

Very often, people with social anxiety tend to be afraid of a social situation, so they will create safety behaviors. An example of this could be clinging to a glass whilst out – thinking that holding this glass will prevent your hands from visibly shaking; or wearing a thick jumper to prevent you from having visible sweat patches.

Both of these safety behaviors prevent you from learning that social situations can be a positive experience – such as that you won’t sweat if you don’t wear a thick jumper, or that you will be fine if you aren’t holding a glass in public.

If you can’t learn more neutral, positive things, then you will always resort back to the safety behaviors thinking that you can’t cope without them.

How does the Alena app identify your personal cognitive processes?

Alena uses game-like assessments to simulate scenarios that would trigger these cognitive processes and then analyzes your responses using our computational neuroscience models to create your social anxiety profile.

This profile informs you which areas you need to focus on in order to improve your social anxiety. This kind of clarity is the first step in helping someone break free from social anxiety.

Find out more about the science behind Alena

How does the therapy target these cognitive processes?

Based on the user’s unique scores, they will receive a personalized treatment plan that will vary in terms of dosage of the therapy, recommended exercises and type of additional support they receive.

For example, if you’re in the Optimal zone for a given pattern, your treatment would focus on maintaining this level, whilst if your level is Elevated, your treatment would focus on shifting the pattern to a healthy level.

Find out more about our therapy and how it works.