A psychologist treated a patient with a pronounced social anxiety disorder using the iceberg model as a guide. First, he and the patient identified the visible symptoms: severe anxiety in social situations, withdrawal, and physical stress reactions. Then they worked on the hidden causes below the surface. It turned out that the patient had deeply internalized negative beliefs about himself – particularly from bullying experiences in school (e.g. the unconscious belief: “I embarrass myself when I speak in front of people”). These unconscious beliefs formed the “hidden iceberg” of his fear. With cognitive restructuring, the therapist helped the patient to question these assumptions and replace them step by step with more realistic, positive affirmations. At the same time, they used exposure therapy: in small, controlled steps, the patient faced the dreaded social situations – first in role-playing games during therapy sessions, and later in real life, for example by speaking to strangers in the group. These new, positive experiences allowed him to reevaluate the situations he had previously avoided.
Gradually, the patient noticed that his old, hidden fears were losing their power: he now understood where his social fears came from and recognized the previously unconscious triggers in everyday life. With this understanding and the new experiences, he was able to significantly reduce his anxiety reactions. At the end of therapy, the results were impressive: the symptoms of social anxiety decreased drastically, the patient was able to attend meetings again, speak freely in front of others and even formed new friendships – something that seemed impossible to him before therapy. His newfound confidence in social contacts increased his quality of life enormously. The case study demonstrates how effective the combination of uncovering hidden beliefs and exposure can be: By working on the “underwater” part - the unconscious causes of anxiety - the visible symptoms of anxiety also disappeared.