A cognitive model of social anxiety and its application to stammering
Presenter: Jane Fry, The Michael Palin Centre for Stammering Children
By Carolyn Allen, North Glasgow NHS

There are many different kinds of anxiety, but social anxiety may have particular relevance to stammering. Previous research has shown that adults who stammer show more social anxiety than people who do not; that is, people who stammer may be more likely to be anxious that others will evaluate or judge them negatively.

Cognitions - memories, images and predictions for example - heavily influence our response to events. We use these to assess future events for levels of potential comfort or discomfort and attempt to predict the possible outcomes. Our interpretations of events can be accurate but equally they can sometimes be unhelpful, biased or, as Jane nicely put it: "sometimes we're just barking up the wrong tree".

Cognitive models and cognitive behavioural therapy address the anxiety that comes from thoughts which have induced negative responses such as: embarrassment or anger (feelings), sweating or hot flushes (physical responses) or avoidance of particular situations (behavioural responses and safety behaviours).

Cognitive therapy acknowledges that social anxiety is not based on thoughts which are in any way irrational. Instead, it helps clients understand their fears and challenge them so that avoidance of situations can be reduced and confidence in speaking increased.

For me, cognitive models make much sense and I like the fact that they do not judge whether thoughts are right or wrong. Predictions and interpretations may seem to be unhelpful but cognitive behavioural therapy shows there is a very logical process behind all conclusions that we make as individuals. I feel this quote really encapsulates the ethos behind cognitive work:

People are disturbed not so much by the events themselves as by what they make of them.
(Beck, 1989)

Having had a taster of cognitive therapy a while ago, this workshop was a great refresher and I hope that I will be able to use this approach more in my work.

From the Winter 2005 edition of Speaking Out