Self-focused attention can make people less likely to see their social performance in a positive light, and contributes to social anxiety. This exercise is designed to help your clients experiment with directing their attention outwards.

When people struggle to control the focus of their attention, they find it much harder to interrupt cycles of worry, rumination, and other forms of self-focused attention. The Attention Training Practice Record helps clients learn to direct their attention, using a series of listening exercises which they can practice to reinforce the learning.

Full of exercises and practical recommendations, the Managing Social Anxiety: Workbook (Third Edition) is written by Debra A. Hope, Richard G. Heimberg, and Cynthia L. Turk, and provides therapists with essential tools to deliver effective, evidence-based psychological treatment for social anxiety.

This month also sees the release of two of our psychoeducation guides published in Spanish. The Evaluating Unhelpful Automatic Thoughts and Trauma and Dissociation guides are now available to download in Spanish for all Advanced and Complete members.

Trauma and Dissociation ᐅ

Cell Reports Medicine have published a fascinating basic study into the effects of breathwork on mood & respiratory function from Andrew Huberman, David Spiegel & colleagues. This randomized controlled trial of 111 participants compared the effects of a 5-minute daily mindfulness practice with 5-minutes of breathwork exercises (cyclic sighing, which emphasizes prolonged exhalations; box breathing, with equal duration of inhalations, breath retentions, and exhalations; and cyclic hyperventilation with retention, with longer inhalations and shorter exhalations).

While all four groups showed significant improvement in positive affect and reduction in anxiety and negative affect, the cyclic sighing group showed greater increases in positive affect than the mindfulness group. Overall, the breathwork group showed a lower respiratory rate than the mindfulness group by the end of the study, indicating a lowering in sympathetic tone.

Guilt is a hybrid of negative thoughts and emotions that arises when people blame themselves for all or part of the negative outcome of an event (e.g., “I did something bad”). Shame is when one judges not just their actions but their entire self negatively (e.g., “I am bad”). For people with PTSD, trauma-related guilt is one of the symptoms likely to linger, even after successful PTSD treatment. Building upon Edward Kubany’s excellent work on guilt, Sonya Norman and her team have developed a 6-session individual manualized intervention for working with guiilt and shame which includes elements of psychoeducation, addressing cognitions common in guilt and shame, and working with values (and values violations).

Two recent publications address TrIGR. The first is a review of the research program published in Current Treatment Options in Psychiatry, and the second is a randomized trial comparing TrIGR with supportive care in a group of 145 veterans. The latter study indicates that targeting guilt using the protocol effectively reduces symptoms of PTSD.

TrIGR – Overview [PDF] ᐅ