We are all susceptible to distorted thinking at one time or another. When it becomes a habit, anxiety and depression could be around the corner. Since the way we think about our circumstances has the power to upset us or to soothe us, it's helpful to have some control over which thoughts grow and which ones slip through our minds like sand through a sieve. In an effort to raise awareness of the types of thinking that are linked to anxiety and depression, clients who are in Cognitive Behavioral Therapy (CBT) learn about cognitive distortions. They also learn how to change their distorted thinking. The following is a list of common cognitive distortions: All-or-nothing thinking: The person thinks in dichotomous terms, black-and-white. Either good or bad, sad or happy... Overgeneralization: The always/nevers. One setback exemplifies a person's entire life. Mindreading: A person assumes others are reacting negatively to them. We sometimes refer to this as 'taking it personally.' Fortunetelling: It only gets worse from here, folks. Discounting the positives: A person insists their accomplishments or positive qualities don't count. Shoulding all over self and others: Self and other criticism based on 'rules' that are actually preferences (Have to, must...) Labeling: Instead of seeing that he made mistake, he calls himself a failure (same for others). Mental filter: A person dwells on the negatives and ignores the positives. Magnification: A person's perception and reaction is out of proportion to the situation. Emotional reasoning: A person uses their feelings as evidence. 'I feel afraid, so it must be dangerous.' Personalization or blame: A person takes the blame when it is not (all) on them, or they lay the blame on others and do not address to their part. Here are a few scenarios. See if you can identify the cognitive distortions at play. Edward is exhausted after a long day of work. His friend Liz calls him up and asks if he would like to go to dinner. He says he is tired but he will go, and pauses. Liz doesn't immediately reply, so Edward feels awkward and quickly suggests a restaurant. On the way to the restaurant, he reviews the brief conversation to figure out what he did wrong. Why was Liz upset with him? The closer he gets to the restaurant, the more he dreads seeing Liz and sitting through the inevitable awkward silences. Tammy is going on her third first date this month. She has never agreed to go out with someone for a second date. They just don't seem to understand common courtesies. She has had to ask them to call earlier in the evenings, when any reasonable person would know that with her work schedule she would prefer earlier phone calls. And then the activities they choose for the dates...how can they not know what a woman would want to do on a date?! How many losers much she date before she finds the man of her dreams? Liz's friends tell her she's funny and creative. While she appreciates their kindness, she realizes that all people are funny and creative, and that this doesn't really make her special in any way. If there was something exceptional about her, she wouldn't be stuck in a job she hates. She has to get up so early when she's filming, worry about paparazzi, and she never knows who her real friends are. What was she thinking taking on this career? Did you notice that more than one distortion is represented in each example? The upsets created by one distortion provide fuel to the next. The next thing you know you're buried in labels and overgeneralizations. May your thinking be clear and realistic, and your upsets proportionate to the situation. And if that's often not the case, there's always CBT. Want more from the resource I consulted for this blog? See ‘Ten Ways to Untwist Your Thinking’
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Resolution: 1. A firm decision to do or not do something. 2. The act of finding a solution to a conflict or problem.
How go the resolutions? How many times last year did you put off making a change, saying to yourself or others ‘that will be my New Year’s resolution’? And now the time is here. Or maybe you have given up on making those resolutions after seeing one too many January’s come and go with no change. Change is difficult. We usually save the big ones for New Year’s resolutions. Here are a couple tips to help: Strengthen Motivation Take some time to write out a pros/cons list. What are the pros and cons of making this change? Of not making the change? Next, clarify your highest aspirations and values. Identify how the resolution connects with those. It may help to have an image in mind of how your life will look when you make the desired change. And maybe a scary image of what your life will look like if you don’t. Notice when you are slipping into the deprivation mindset, in which you view giving up a detrimental behavior as just another way in which your life is about not having or losing the things you love. Review your pros/cons list. What will you gain by making this change? Identify Replacement Behaviors Phrase goals in terms of what you will do, rather than what you won’t do. What will you do instead of smoking? Look at your pros/cons of not changing the old behavior. What were the pros of smoking? How can you achieve those ‘pros’ with healthier behaviors? For example, suppose you felt relaxed after the first drag off of a cigarette, and appreciate how quickly it would work. Can you achieve similar relaxation through meditative breathing techniques that can be done in a short amount of time? Make Process Resolutions This is similar to identifying replacement behaviors. When we set goals, we often describe a desired outcome. While it is nice to have an idea of where you are headed, there are clear steps you need to take to get there. Those steps are the process goals. The outcome goals are like the ‘firm decision to do or not so something’ and the process goals are the ‘acts of finding a solution to a conflict or problem.’ Back to the smoking example: Instead of simply stating “I resolve to quit smoking this year,’ resolve to schedule a visit with a doctor to discuss medical options, research support groups, ask family for specific help, and schedule a consultation with a certified hypnotist. The process approach is not just about outlining a plan upfront. When you come up against urges, identify ways to minimize them and make these solutions part of your resolution. For example, if you find yourself craving a cigarette when you pass a certain corner store on the way to work, choose a different route to work, or develop a plan to weaken the unconscious association between that store and buying cigarettes. Maybe you ask a family member to accompany you to that store every day for several weeks and each time you buy something you know a particular coworker would enjoy. The process approach allows us to accumulate small wins along the way, which strengthens motivation. Kyra Bobinet, MD, MPH notes that when we design a process for meeting our goals, we see challenges as opportunities for problem-solving, and we delight in each successful solution. Reinforce Progress Reward yourself for successes along the way. No doubt the old behavior was intrinsically rewarding, so the replacement behaviors have some serious competition. Be prepared with a range of rewards to apply when you resist an urge and/or utilize a replacement behavior, and apply them as immediately after the success as possible. We need an unconscious association between the new behaviors and pleasure, so rewards that light up the pleasure/reward center of the brain go a long way. Practice Once you have identified specific replacement behaviors and solutions to obstacles you face along the way, practice. Don’t wait until your urges are at their peak to practice a new behavior. Practice when you’re calm. Practice breathing techniques morning, noon, and night. Malcolm Gladwell states that it takes 10,000 hours of practice of a skill to become an expert. You’re on your way to becoming an expert at living a life aligned with your highest values and aspirations.
Most of us initially think of meditation when we hear 'mindfulness.' Maybe the word prompts a mental image similar to the picture above. Many of my clients groan when I first mention developing the skill of mindfulness. They imagine themselves sitting still in a mental tug-of-war with the litany of negative, worry thoughts that fuel the anxiety and depression that brought them into counseling to begin with. Not that I blame them. Despite the years of mindfulness practice that have brought me a sense of calm, I often experience the same initial reaction as my clients when my mindfulness reminder chimes throughout the day, prompting me to take a pause, Mindfulness is a practice and a state of being, a philosophical perspective. The practice does not always involve sitting and anchoring awareness to the breath or body sensations, or observing thoughts and images without getting caught up in them. While it is helpful to cultivate this ability in a quiet seated practice, the same skills can be practiced in day to day activities. Noticing the sensation of cold as you grab the soda can from the refrigerator, lingering with the scent of perfume as you walk through a department store, allowing the experience to unfold and close exactly as it is, without judgment (that perfume smells good/bad, get me out of here!), baking a batch of cookies with your mind on the recipe, the smell, and the taste... The human mind likes to make judgments, including how a current situation fits into our history and our preferences (I always bake great cookies!) and our future (These cookies are going to be great, everyone will love them). It is our judgment of a situation that is most often responsible for our emotional reaction to the situation, and the behavior that ensues. This isn't usually a problem, but when we are experiencing a surplus of unpleasant emotions throughout the day, developing the habit of mindfulness is a great help. Many of us are familiar with the saying: "Pain is inevitable, suffering is optional." When we judge a situation as undesirable, then reject it and make negative predictions about how the event will continue to unfold, we get antsy. Maybe the impulsive and habitual behaviors that follow improve our emotions in the short term, but create bigger problems in the long term. Similarly, when we judge a situation as desirable, we may frantically attempt to hold onto it or create more of it, paradoxically bringing the pleasant emotions of the moment to a premature end. For example, say Scott and Amy have been dating for a few weeks. Scott really likes the way he feels when he is around Amy. When he thinks about Amy, he feels happy and smiles. While at work, he remembers details of their last date, and decides to send her a text message. She usually responds right away, which makes Scott even happier. So far so good. On this day, she doesn't respond right away. Scott feels disappointed, and judges this emotion as unacceptable. Ten minutes later, he texts again. And then again. His thoughts: She should be getting back to me, if you care about someone you don't leave them hanging, I can't deal with someone who is so inconsiderate, I knew she didn't really like me...All judgments, none of which help Scott stay calm enough to re-engage in the work tasks before him and delay sending further text messages. With each unanswered text message, he gets more agitated, a feeling that is expressed in the tone of each subsequent text. When Amy gets out the staff meeting in which she learned that no one will be getting raises this year and sees the ten text messages from Scott, each one with an angrier tone than the last, she feels annoyed. She decides to ignore Scott and isn't sure she wants to continue dating someone who is so demanding of her attention. (Perhaps a reasonable assessment of his behavior, but she frames it as a judgment of him). Suppose Scott had observed the situation, his thoughts, and his feelings without judging them, and without getting caught up in them? He notes that he is disappointed that she hasn't texted back, but makes no judgments about her or the feeling of being disappointed. Amy gets out of her meeting, sees the one text from Scott, and feels a little better, and texts Scott back. Disappointment is difficult enough without all of the judgments, the negative predictions, the reflections on self-worth fueled by the unpleasant emotion. Scott moved from the inevitable pain of disappointment, which will rise and fall on its own, to the optional suffering that resulted from rejecting the situation and the emotion. If this is a pattern for Scott, he would greatly benefit from a daily seated mindfulness practice. In order to change these behavioral patterns, he will need to develop tolerance to unpleasant emotions like disappointment, rather than react to them and frantically attempt to alter their normal course. Repeated observation of/exposure to his emotions in a controlled setting such as a counseling sessions or daily mindfulness practices will offer him the reassurance that emotions do indeed rise and fall on their own without any conscious intervention on our part, and will increase his ability to tolerate and accept these emotions. In a nutshell, mindfulness is observing, objectively describing, and participating in what is happening right now, rather than judging the moment, predicting the future, or ruminating on the past. What a peaceful existence! We need to be patient with ourselves and with the process when we begin to practice mindfulness. Set specific 'process' goals (mindfully eat 1 meal/day, do one 10+ minute mindfulness mediation/day) rather than outcome goals (feel calmer). The guide in one of my favorite mindfulness meditations suggests that we compare the mind to a puppy in training. When we train a puppy to 'stay,' we tell him to stay, he walks away, we pick him up and bring him back, tell him to stay...we don't yell at the puppy, kick the puppy. We acknowledge it is difficult for an energetic puppy to 'stay.' It is with this attitude that we gain the most from a mindfulness practice. What drives our behavior? Why do we pretend that we like our new acquaintance's favorite sport, when indeed it bores us? What keeps us up late into the night finishing that school or work slide-show presentation? What precipitated the web search that landed me on this blog?
What drives our behavior? Why do we pretend to like our new acquaintance's favorite sport, when indeed it bores us? What keeps us up late into the night finishing that school or work slide-show presentation? What precipitated the web search that landed you on this blog?
There are numerous theories of psychology that address these questions. In 1943, Abraham Maslow introduced the 'Hierarchy of Needs' model. The first four 'basic' or 'deficiency' needs are what we think of as human necessities: physiological, safety, belonging/love needs, and esteem needs. When we detect a deficiency in those areas we are driven to remove it. Maslow posited that deficiencies at one level must be corrected before one can move to the next level. For example, it's not likely that I will look into joining a meetup.com group (love, belonging) when I am being evicted from my apartment (physiological/shelter, safety/security).** The remaining needs are 'growth' needs. These are driven by a positive desire for growth, not by the urge to eliminate a deficiency; our deficiency needs must be met before our focus turns to the growth needs. Perhaps your desire to better understand yourself and human behavior in general landed you on this blog (cognitive/need to know). Maybe your esteem needs have been satisfied, and it is actually a desire for symmetry and order (aesthetic need) that keeps you up at night finishing that slide-show presentation.. While it is common enough to seek help when deficiency needs are not met, we are often driven to counseling by the need to 'self-actualize' -- to realize our full potential. While working on self-actualization, we may come to the conclusion that the perpetual focus on self leaves something to desire regarding our development, and we turn to self-transcendence (to connect to something beyond us, helping others find fulfillment and to meet their own potential). Many times I have witnessed a client to come into counseling and commence work on a deficiency need, such an 'intimacy issues' with a spouse (love and belonging), and as that deficiency is corrected, begin to explore personal talents and abilities as yet undeveloped. The fulfillment that comes from self-actualization work, as well as the type of potential uncovered, prompts the client to commit to value-driven living. Counseling offers the opportunity to identify what deficiency need is driving compulsive and/or self-sabotaging behavior. We can learn how to get these needs met, either by effectively requesting help from others, or providing ourselves with the needed object, experience, or feeling. Beyond the deficiency needs, counseling offers a dedicated space to explore self-actualization and self-transcendence; a means to participate in the full experience of being human. **The 'progression' of needs can be shaped by cultural norms and socio-economic conditions. |
AuthorColleen Ann McDonald, at your service. Archives
February 2016
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