- Best Results1-3 months
- Treatment RecoveryNA
- Procedure Time45 minutes
- Skin SpecialistPsychologist
- Duration of ResultsLong-term
- Back to WorkNA
CBT for Excessive Sweating
Excessive sweating may be a symptom of social anxiety. Excessive sweating is a troubling and embarrassing anxiety symptom for some social phobia sufferers. If you find that you do not have a problem with excessive sweating whilst alone, and that your hyperhidrosis appears to be triggered by exposure to the possibility of negative evaluation by others, you probably have social phobia. Working with an experienced psychologist in the field of sweating disorders can help manage excessive sweating.
FactsFacts On CBT for Excessive Sweating
- Hyperhidrosis can be a symptom of social anxiety
- A psychologist can assist in reducing social anxiety
- Psychologists can implement methods such as attention training and confrontational training to control your sweating
- Cognitive behaviour therapy (CBT) can empower you to control your sweating and your thoughts
- Most patients can learn to reduce anxiety over a few sessions
- Behavioural therapy can be covered under Medicare
How to tell if anxiety plays a role in sweating?
When people get nervous, they may find they are sweating on their face, they have sweaty palms or large wet patches under their armpits. Excessive sweating may be visible to others. Facial sweating may be particularly distressing for women who like to wear makeup, as sweat can make foundation run.
Sweaty palms may be problematic for people who are required to regularly shake hands. People with excessive sweating believe their perspiration is shameful and that they will be negatively judged and evaluated for sweating.
Hyperhidrosis sufferers believe other people will think they are ill, devious, nervous, or weak and will not want to socialise with them or do business with them. Fear of sweating can lead to people avoiding some social situations altogether or developing subtle avoidance behaviours such as:
- Favouring clothes which they think are less likely to reveal sweat (favoured colours are white and black)
- Avoiding clothes which fit tightly under the arms
- Avoiding wearing fabrics such as lycra and nylon
- Changing clothes multiple times a day
- Avoiding shaking or holding hands because their palms are sweaty
- Underdressing for the climatic conditions
- Wiping their hands and face in social situations
Such efforts to hide and control the excessive sweating problem only maintain and exacerbate the condition.
Once someone has sweated excessively once or twice in social situations (and perhaps someone passed comment on their sweating) the hyperhidrosis sufferer may anticipate they will sweat in a particular social situation. This anticipatory anxiety aggravates the sweating problem.
What is CBT or cognitive behavioural therapy?
Cognitive behavioural therapy (CBT) challenges the sufferer’s beliefs as to how other people view sweating. For example, CBT may challenge the sufferer’s beliefs about how visible the sweating is. For instance, sweating often feels worse than it looks. Your psychologist may be able to provide you with video feedback of how you appear in feared social/performance situations.
CBT would also involve getting you to confront the situations where you fear sweating, instead of avoiding them. Your psychologist would help you to develop a graded hierarchy of situations where you fear sweating, and you would start by exposing yourself to situations where you experienced only a mild degree of fear. After repeated, prolonged, massed exposure to the mildly anxiety/sweat provoking situation had led to a decrease in anxiety and sweating, you would expose yourself to another social scenario where your fear of sweating was more intense and repeat the procedure until you had worked your way through your hierarchy.
If your anxiety about excessive sweating decreases, so will the sweating.
Attention training may also be part of your treatment. If you can focus your attention better on what is going on around you, rather than being self-focussed on your physical symptoms, negative thoughts and behaviour, you may sweat less. Psychological treatment may also involve learning relaxation techniques.
What are the advantages of CBT?
- CBT is a natural treatment for excessive sweating (no medication, no surgical procedures etc)
- CBT has no unpleasant side effects unlike medication or surgical procedures.
- CBT empowers you to help yourself manage your sweating issue.
- CBT treatment is a short-term cost, not an ongoing expense. Most people can learn how to deal with their anxiety in a limited number of sessions, e.g.,10 sessions
- Treatment is under Medicare if your doctor considers you are eligible for a mental health care plan.
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Why do a minority of patients fail anti-sweating injections?
Botox can markedly reduce sweating in well over 90% of patients. This injection works rapidly & efficiently to reduce neurotransmission. This prevents the sweat gland from activating. Treatments are safe, effective & in the large part predictable. Why is it that a minority of patients still experience sweating, even if the units of Botox are doubled?
The answer is that psychological input overrides the benefits of Botox injections. If this molecule blocks 95% of sweat glands, the 5% that remain active are susceptible to emotional input (stress). These glands can increase output twenty-fold, hence the perception of efficacy is cancelled out. In this group of patients, CBT can be invaluable.
Is CBT covered under Medicare?
You can also discuss with your doctor whether you are eligible for a mental health treatment plan and if that is the case you can get a Medicare rebate for up to 10 sessions of individual therapy per year. You can also ask your doctor to refer you to a psychologist experienced in the treatment for excessive sweating.
Who performs CBT?
In Brisbane, I refer to Tammy White, or the OCD Clinic in Bulimba.
Catherine Madigan (B.A. Hons., M.A. Clinical Psychology) is a clinical psychologist based in Melbourne who specializes in the treatment of anxiety disorders, including social anxiety (e.g., fear of blushing and sweating). She provides cognitive behavioural therapy (CBT) to her clients.
Catherine studied psychology at the University of Melbourne. Catherine currently works in her private practice in Richmond, Victoria. She has two websites www.socialanxietyassist.com.au & www.anxietyaustralia.com.au and offers bulk billing to health care card holders.
Davin’s Viewpoint on CBT & Excessive Sweating
Botox anti-sweat injections have an efficacy rate of over 96%. The 4% that fail injections usually have an element of psychological input, namely anxiety that contributes to the sweat stress cycle. This is where working with a psychologist can be beneficial. Once this thought-sweat cycle is broken the prognosis is excellent.
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