Depression & Social Anxiety

There are many possible ways to misperceive the world, but some are special, because they have a recursive structure so they can perpetuate themselves indefinitely, despite their maladaptive effects. This self-confirmatory bias is poignantly illustrated by Barry's tale:

Barry worries about his social performance – he believes he will be unable to cope with the social challenges he expects to encounter at the Friday office party. Thinking such thoughts causes him to become more anxious, and the more anxious he becomes, the more he dreads the party, but the discomfort is just the insult. The real injury is that his expectations cause him to perform poorly in social circumstances, which validates his original belief. This recursive structure of internal states and external events continually influences Barry's social performance and his beliefs about himself - as well as the beliefs of others about his social competence. This pathogenic process - which may include worry or negative judgments of the self or future - cause Barry to create an unhappy social reality for himself and those around him. [For more about Barry and his subjective reality please click here].

Please click here to access to online treatment manual.

"It is often possible to discern a structure to people's difficulties in which internal states and external events continually create the conditions for the reoccurrence of each other."

- Paul Wachtel