Perhaps indications you are about to deliver a commencement speech to hundreds of impatient graduates or maybe you are before a committee defending your doctoral thesis. Most of us have experienced the intense anxiety and self-consciousness that arises from being closely watched (and potentially judged) by others. Most of us also easily interact with others on a daily basis, though some interactions (like public speaking) elicit far greater emotional reactivity. As terrible as public speaking may seem, the trauma is usually fleeting and when it is over we are allowed to retreat to our familiar anonymity. However, for individuals with Social Anxiety Disorder (SAD) even seemingly mundane social interactions like asking questions in class, talking on the telephone, or meeting new people at a party are opportunities for intense scrutiny accompanied by unpleasant psychophysiological responses. The most common treatments for SAD are Cognitive Behavioral Therapy (CBT) and medication.

I have always been interested in the efficacy of mindfulness meditation (or calm awareness of one’s moment-to-moment mental and physical experiences) in promoting general health and treating psychopathology. During the past decade, researchers have increasingly sought to test this popular, though often misunderstood, approach in a variety of settings including treatments for anxiety and mood disorders. Though I remain skeptical of the wide-eyed gusto with which some practitioners endorse meditation (often inappropriately citing its long historical tradition as justification, touting unfounded health benefits or demonstrating unscientific credulity), methodologies with some demonstrated potential for improving attention and emotional stability should be more fully investigated.

In a recent neuroimaging study published in the Journal of Cognitive Psychotherapy, researchers at Stanford University tested whether Mindfulness-Based Stress Reduction (MBSR) influences clinical outcomes and neural substrates of Self-Referential Processing (SRP) in SAD. Negative SRP, or hypercritical self-views, is a key psychological mechanism maintaining fear of judgment in social and performance situations. Prior to and following a standard 8-week MBSR treatment, patients underwent a MRI scan while completing a SRP task consisting of 25 positive and 25 negative social trait adjectives. Depending on the condition, patients responded by indicating whether or not a word was self-descriptive (experimental condition), positively valenced (control), or in uppercase letters (control).

Goldin and colleagues found MBSR resulted in a “moderate reduction” of clinical symptoms (including social anxiety, depression and rumination) and a comparison of pre- to post-MBSR responses revealed that patients had decreased negative and increased positive self-endorsement. It is not surprising that MBSR resulted in some reduction in symptoms, as many psychotherapy treatments often result in some improvement of reported symptoms (sometimes purely due to expectancy). The results are less than stellar since MBSR was not as effective when compared to studies of CBT and pharmacological interventions on social anxiety symptoms.