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Changes in picturing of ‘self’ in social anxiety disorder: a case report

Published online by Cambridge University Press:  23 February 2015

Yasuko Tanaka ,
Osamu Kobori  and
Michko Nakazato
Yasuko Tanaka*
Affiliation:
Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba University, Chiba, Japan Minami Fujisawa Clinic, Fujisawa, Japan
Osamu Kobori
Affiliation:
Department of Psychology, Swansea University, Swansea, UK
Michko Nakazato
Affiliation:
Research Center for Child Mental Development Chiba University Graduate School of Medicine, Chiba University, Japan
*
*Author for correspondence: Y. Tanaka, Department of Cognitive Behavioral Physiology, PO Box 260-8670, Chiba University Graduate School of Medicine 1-8-1 Inohana Chuouku, Chiba, Japan (email: tanakayasuko_2005@msn.com).
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Abstract

Social anxiety disorder (SAD) is characterized by significant distress regarding social performance situations. Patients experience strong embarrassment about how they are perceived by others due to increased self-focused attention. This case report presents two cases of SAD and the effects of cognitive behavioural therapy (CBT) on ‘picturing of self’ (e.g. self-picturing and self-projection). The goal was to demonstrate the changes in ‘picturing of self’ using brief video feedback (VF) as a treatment and projective drawing as an assessment method of CBT, especially with SAD. The CBT consisted of psychoeducation and case formulation, cognitive restructuring, and behavioural experiments. In one case VF was used to provide additional means by showing the patient's own actual moving figure, the self-picture. For the other case, the patient was instructed to ‘draw a person’ and the changes in drawing style were assessed. Through the course of CBT, Liebowitz Social Anxiety Scale scores reduced significantly in both cases. ‘Picturing of self’ changed as a result of the use of CBT. Brief VF and projective drawing would be useful for individuals to see the change in themselves.

Keywords

Cognitive behavioural therapyself-picturingsocial anxiety disorder
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e1
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Recommended follow-up reading

Clark, DM, Wells, A (1995). A cognitive model of social phobia. In: Social Phobia: Diagnosis, Assessment, and Treatment (ed. Heimberg, R. G., Liebowitz, M. R., Hope, D. A., Schneier, F. R.), pp. 41–66. New York: Guilford Press.Google Scholar
Machover, K (1949). Personality Projection: In the Drawing of a Human Figure. Springfield, IL: Charles C. Thomas Publisher.Google Scholar

References

Anderson HH, Anderson GL (eds) (1951). An Introduction to Projective Techniques. New York: Prentice Hall.Google Scholar
APA (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. DSM-III. Washington, DC: American Psychiatric Association.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Text rev. DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
Boschen, MJ, Curtis, S (2008). Investigating a critical evaluation tendency in social anxiety. Journal of Behavior Therapy & Experimental Psychiatry 39, 489–496.Google Scholar
Clark, DM (2005) A cognitive perspective on social phobia. In: International Handbook of Social Anxiety: Concepts, Research and Interventions Relating to the Self and Shyness (ed. Crozier, W. and Alden, L. E.), pp. 405–430. Chichester: John Wiley & Sons.Google Scholar
Clark, DM, Wells, A (1995). A cognitive model of social phobia. In: Social Phobia: Diagnosis, Assessment, and Treatment (ed. Heimberg, R. G., Liebowitz, M. R., Hope, D. A., Schneier, F. R.), pp. 41–66. New York: Guilford Press.Google Scholar
Connor, KM, Davidson, JRT, Churchill, E, Sherwood, A, Foa, E, Weisler, RH (2000). Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry 176, 379–386.CrossRefGoogle ScholarPubMed
Draguns JG, Tanaka-Matsumi J (2003). Assessment of psychopathology across and within cultures: issues and findings. Behaviour Research and Therapy 41, 755–776.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I disorders (SCID I). New York: Biometric Research Department.Google Scholar
Gillespie, J (1994). The Projective Use of Mother-and-child Drawings: a Manual for Clinicians. New York: Brunner/Mazel.Google Scholar
Goodenough-Harris, F (1926). Measurement of Intelligence by Drawings. Yonkers-on-Hudson, New York: World Book Co. Google Scholar
Harris, DB (1963). Children's Drawings as Measures of Intellectual Maturity: A Revision and Extension of the Goodenough Draw-a-man-test. New York: Harcourt, Brace & World, Inc. Google Scholar
Heimberg RG, Mueller GP, Holt CS, Hope DA, Liebowitz MR (1992). Assessment of anxiety in social interaction and being observed by others: the Social Interaction Anxiety Scale and the Social Phobia Scale. Behavior Therapy 23, 53–73.Google Scholar
Hirsch, C, Meynen, T, Clark, DM (2004). Negative self-imagery in social anxiety contaminates social interactions. Memory 12, 496–506.CrossRefGoogle ScholarPubMed
Iwai, H (1984). Diagnostic drawing of children's mind seeing abnormal and normal [in Japanese]. Tokyo: Nihon Bunkagausha.Google Scholar
Kessler, R, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry 62, 593–602.Google Scholar
Kingdon, DG, Turkington, D (1994). Cognitive-behavioural Therapy of Schizophrenia. New York: Guilford.Google Scholar
Kobori, O, Nakazato, M, Yoshinaga, N, Shiraishi, T, Takaoka, K, Nakagawa, A, Iyo, M, Shimizu, E (2014). Transporting Cognitive Behavioural Therapy (CBT) and Improving Access to Psychological Therapies (IAPT) Project to Japan: preliminary observations and service evaluation in Chiba. Journal of Mental Health Training, Education and Practice 9, 155–166.Google Scholar
Koppitz, EM (1968). Psychological Evaluation of Children's Human Figure. New York: Grune & Stratton.Google Scholar
Liebowitz, MR (1987). Social phobia. Modern Problems of Pharmocopsychiatry 22, 141–173.Google Scholar
Liebowitz, MR, Gorman, JM, Fyer, AJ, Klein, DF (1985). Social phobia. Review of a neglected anxiety disorder. Archives of General Psychiatry 42, 729–736.Google Scholar
Machover, K (1949). Personality Projection: In the Drawing of a Human Figure. Springfield, IL: Charles C. Thomas Publisher.CrossRefGoogle Scholar
NICE (2011). NICE guideline for common mental health disorders. National Institute for Health and Clinical Excellence (NICE).Google Scholar
Oster, GD, Gould, P (1987). Using Drawings in Assessment and Therapy: A Guide for Mental Health Professionals. New York: Brunner/Mazel Inc. Google Scholar
Rapee, RM, Heimberg, RG (1997). A cognitive-behavioral model of anxiety in social phobia. Behavior Research and Therapy 35, 741–756.CrossRefGoogle ScholarPubMed
Reisberg, S, Pearson, DG, Kosslyn, SM (2003). Intuitions and introspections about imagery: the role of imagery experience in shaping an investigator's theoretical views. Applied Cognitive Psychology 17, 147–160.Google Scholar
Sahaku, T (1991). Images and drawings: discussion from the cognitive psychology [in Japanese]. In: Rinshou Byouga Kennkyu, Annex 3, pp. 38–57.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neurposychiatiric Interview (M.I.N.I): the development and validation of structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 22–33.Google Scholar
Spitzer, RL, Kroenke, K, Williams, JB, Lowe, B (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine 166, 1092–1097.Google Scholar
Spitzer, RL, Kroenke, K, Williams, JB, the Patient Health Questionnaire Primary Care Study Group (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Journal of the American Medical Association 282, 1737–1744.Google Scholar
Turner SM, Beidel DC, Dancu CV, Stanley MA (1989). An empirically derived inventory to measure social fears and anxiety: the Social Phobia and Anxiety Inventory. Psychological Assessment 1, 35–40.CrossRefGoogle Scholar
Zimbardo, PG., Haney, C, Banks, WC, Jaffe, D (1974). The psychology of imprisonment: privation, power and pathology. In: Doing Unto Others: Explorations in Social Behavior (ed. Rubin, Z.), pp. 61–73. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
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