Anxiety and Metacognition

Anxiety is one of the most common disorders in clinical practice; therefore, many scientists, doctors, and psychologists attempt to understand the causes of anxiety and the possible relationships between anxiety and metacognition. For example, individuals suffering from social anxiety disorder generally have a high fear of being negatively evaluated by others in social situations (e.g., an oral exam).

This fear can stem from certain metacognitive beliefs of the individual.

Beliefs of the type: “I’m terrible at public speaking,” “I always mess up when my friends watch me take a penalty kick,” “I’m terrible at free throws,” and so on. All of these statements are metacognitive beliefs about their own abilities to perform tasks successfully in front of people. Social metacognition is an internal evaluative system of beliefs that synthesizes thousands of evaluations the individual makes about themselves and their experiences.

After any social interaction, we try to evaluate our social relationships positively or negatively. People with social anxiety tend to view any social exposure situation as a source of stress, and therefore, they try to avoid them or endure them as best they can (often with dysfunctional coping mechanisms).



Shame or shyness do not necessarily have to be considered social anxiety disorders. The level of comfort we feel in different social contexts often varies, and such changes in social well-being can be considered normal. The social discomfort reactions we experience in each situation can depend on diverse factors, such as your personality (extroverted or introverted), your current mental energy level, or the quality of your previous night’s REM sleep (if you slept well).

Another important factor is the degree of familiarity of the people present in the social context. For example, yesterday I was invited to a dinner where a neurosurgeon, an internationally renowned pianist, etc., were present, and my level of social comfort was quite low. But that doesn’t mean I suffer from social anxiety. It simply means that certain people command my respect. Even when I’m stopped by the police to check if my car has a valid inspection, I don’t know, a person with a gun also commands my respect. All of these are social stress situations.

Unlike everyday social stress, social anxiety disorder involves intense fear or high anxiety in different social situations to the point where these egodystonic emotions interfere with your life, routine, and work. People with social anxiety often experience symptoms such as palpitations, cold sweats, trembling hands, shortness of breath, nausea, and even a feeling of losing control during oral exams or other social exposure situations.

Social anxiety disorder often begins with such mundane ideas or emotions as the fear of others thinking poorly of you (for example, many patients explain how difficult it is for them when they are asked to go to the chalkboard in front of their classmates). But ideas that you are bad at something or that you won’t be liked by new classmates can play a decisive role in the onset of social phobia. Social anxiety can start in childhood but usually intensifies during adolescence.

Emotional and Behavioral Symptoms of Social Anxiety

The signs and symptoms of social anxiety disorder include some of the following items:
– Fear or anxiety in social situations.
– Fear of being examined or scrutinized by strangers.
– Fear of having conversations with strangers.
– Fear of attending meetings where you don’t know anyone.
– Fear of being watched while eating, drinking, or walking on the street.
– Fear of blushing during an oral exam or when giving a presentation.
– Fear that all the above symptoms will make people think negatively of you or reject you in class or at work.
– Systematic avoidance of oral presentations or tasks due to intense fear.
– Systematic avoidance of oral exams due to fear of blanking.
– The social anxiety you feel is usually disproportionate to the stimulus (meeting up with other families) that triggers it.
– Social fears typically last for more than 6 months, and almost all the strategies you use to overcome them fail.
– You often need to smoke, do something with your hands, move around, stand up, or take pills to face social situations that stress you out.


Adrian Wells’ metacognitive therapy is a cognitive therapy. Cognitive therapies focus on ideas and beliefs about yourself or your fears and anxieties. The key is that if you can understand what you truly think about a topic, you are likely to stop being afraid of it. However, metacognitive therapy emphasizes the person’s metacognitions, not just their ideas. It explores to what extent a person is capable of observing their stream of thoughts from the outside, as an impartial observer, rather than getting trapped in the situation or the physical and mental reactions that fear provokes.

When studying the interaction between social anxiety and metacognition, certain variables become important, such as self-awareness or social self-beliefs (a crucial step for successful treatment based on cognitive restructuring), and so-called metacognitive beliefs (Gkika, Wittkowski, & Wells, 2017).

Social beliefs fall into three types:

1. High self-demand:

High self-demand doesn’t have to be bad. Self-demand is the process of setting high standards of behavior and performance for oneself. Self-demand can be positive if it is an energy that helps you achieve your goals, but it can also be negative if you are too strict or inflexible because it can cause stress or dissatisfaction. It’s challenging to find a middle ground between self-demand and self-acceptance. The problem is that many children and adolescents try to please their parents and meet their expectations. When these expectations are unrealistic, a sense of constant failure sets in. Moreover, the child often feels guilty for not measuring up. This guilt can lead to feelings of sadness and even depression.

2. Conditional beliefs:

“it depends on what I do, whether people will like me or not”.

3. Unconditional beliefs:

“the rest of the world thinks I’m inferior”.

In addition, social beliefs also have two types of characteristics:
– Ego-syntonic: Beliefs that align with our self or worldview, related to the development of generalized anxiety disorder.
– Ego-dystonic: Thoughts felt as distressing, repugnant, or directly inconsistent with one’s self-concept, which tend to generate more specific phobias.

Ego-syntonic symptoms are experienced as acceptable and consistent because they align with a person’s perception and values/beliefs. Therefore, these symptoms do not cause stress or conflict. For example, if a person always enjoys winning, the excitement generated by competition can be considered ego-syntonic. This emotion motivates and excites them before a competition.

In the same study, the authors found a direct correlation between the degree of social anxiety and the existence of self-demanding and conditional beliefs, depending on the specific cognitive process encountered at any given moment.

As for metacognitive beliefs, they can be divided into different types:

1. Positive beliefs about worrying.
2. Beliefs about the uncontrollability and danger of thoughts.
3. Cognitive confidence.
4. Cognitive self-confidence.
5. Beliefs about the need for control.

In the same study mentioned earlier, the presence of these beliefs did not correlate with the occurrence of social anxiety disorder in clinical samples. In other studies conducted with non-clinical samples, measuring a situation that is typically stressful for many people (giving a public speech), they found that the magnitude of these beliefs correlated with a decrease in anxiety levels before giving the speech.



Would you be interested in this TED TALK: thinking about thinking


Workbook for children to improve Metacognition

Metacognición - Dr.Guilera









Dr. Jaume Guilera

About the blog:

This blog has been created by Dr. Jaume Guilera, a physician working in the field of learning disorders, with the intention of making an effort to disseminate information about the most common cognitive disorders in children and adolescents. I approach learning disorders in children and adolescents from a cognitive-behavioral perspective. My work is carried out in collaboration with other professionals, from a multidisciplinary perspective (psychologists, educators, and doctors). The working philosophy is to address each case individually according to its needs. I mainly work with learning disorders (Dyslexia, Dyscalculia, Reading Comprehension) and neurodevelopmental disorders (ADHD, Autism).


Allen, J. G., & Fonagy, P. (Eds.). (2006). The handbook of mentalization-based treatment. John Wiley & Sons 

Amador, X. F., Strauss, D. H., Yale, S. A., Flaum, M. M., Endicott, J., & Gorman, J. M. (1993). Assessment of insight in psychosis. American journal of Psychiatry, 150, 873-879. 

Alvarez-Bueno, C., Pesce, C., Cavero-Redondo, I., Sanchez-Lopez, M., Martínez-Hortelano, J. A., & Martinez-Vizcaino, V. (2017). The effect of physical activity interventions on children’s cognition and metacognition: A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry56(9), 729-738.

Baror, S., & Bar, M. (2022). Increased associative interference under high cognitive load. Scientific reports12(1), 1-13..

Buck, B., Gagen, E. C., Luther, L., Kukla, M., & Lysaker, P. H. (2020). Dynamic relationships between emotional distress, persecutory ideation, and metacognition in schizophrenia. Journal of Clinical Psychology, 76(4), 716-724.

Chiao, J. Y., Harada, T., Komeda, H., Li, Z., Mano, Y., Saito, D., Parrish, T. H., & Iidaka, T. (2010). Dynamic cultural influences on neural representations of the self. Journal of cognitive neuroscience22(1), 1-11.

Diamond, A. B. (2015). The cognitive benefits of exercise in youth. Current sports medicine reports, 14(4), 320-326.

Heyes, C., Bang, D., Shea, N., Frith, C. D., & Fleming, S. M. (2020). Knowing ourselves together: The cultural origins of metacognition. Trends in Cognitive Sciences24(5), 349-362.

Flavell, J. H. (1979). Metacognition and cognitive monitoring: A new area of cognitive–developmental inquiry. American psychologist34(10), 906.

Gkika, S., Wittkowski, A., & Wells, A. (2018). Social cognition and metacognition in social anxiety: a systematic review. Clinical Psychology & Psychotherapy, 25(1), 10-30.

Lavie, N. (2010). Attention, distraction, and cognitive control under load. Current directions in psychological science19(3), 143-148.

Leonhardt, B. L., Vohs, J. L., Bartolomeo, L. A., Visco, A., Hetrick, W. P., Bolbecker, A. R., Breier, A., Lysaker, P., & O’Donnell, B. F. (2020). Relationship of metacognition and insight to neural synchronization and cognitive function in early phase psychosis. Clinical EEG and Neuroscience, 51(4), 259-266.

Lysaker, P. H., Buck, K. D., Salvatore, G., Popolo, R., & Dimaggio, G. (2009). Lack of awareness of illness in schizophrenia: conceptualizations, correlates and treatment approaches. Expert review of neurotherapeutics9(7), 1035-1043.

Lysaker, P. H., & Lysaker, J. T. (2017). Metacognition, selfexperience and the prospect of enhancing selfmanagement in schizophrenia spectrum disorders. Philosophy, Psychiatry, & Psychology, 24(2), 169-178.


If you have any more specific questions or need further assistance with any of the provided information, please feel free to ask.

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