Lets start with CBT ! The acronym stands for "Cognitive Behavioral Therapy"
This style of therapy has gotten a lot of support based on the research that has been done in the field of psychotherapy.
CBT was developed under several different names by frustrated psychoanalysts who could not seem to help their depressed patients much with psychoanalysis. They found that it is possible to go at the problem of depression or anxiety in a very direct manner. CBT teaches you to self-monitor depressing or anxious thoughts and learn to stop them at their source.
It is possible to use your thoughts to "bridle" your runaway emotions.I use the word bridle because emotions can feel uncontrollable like a wild horse. We all know, though, how much control of that wild horse can be gained with a bridle and training. Brains are very similar but you must do the work. Pills are quick and easy skills take a little time. Pills and skills both show about the same effectiveness, but CBT skill development functions like a vaccination against depression. These techniques even change brain chemistry.
Many persons with depression and anxiety feel victimized by the world and they also feel like there is nothing they can do about feeling victimized and they also tend to believe that this issue will probably continue to torment them in the future.
So people who are clinically depressed or anxious often have toxic views of themselves, their world and their future or past. There is a famous guru who used to say, "What...at this moment...is missing ?" Most often the answer is 'nothing' or 'not much actually'. It is our rumination about the past and/or catastrophizing about our future that wrecks an otherwise good moment of NOW. This last little paragraph is the whole CBT conceptual universe in a single nugget.
A good first technique to try is "thought stopping" . Whenever you find your self 1) ruminating about the past or 2) catastrophizing about the future, say "STOP !!" Then RE-SET your mind onto the now.
Try this...if you want to reflect on the past or plan for the future, do this ON PAPER so that you accomplish something other than merely punishing yourself with negative criticism. Otherwise, if you are depressed or anxious, assume you should get better daily at THOUGHT STOPPING.
Hint: If you need a little something extra to put the brakes on your brain, wear a big wide rubber band on your wrist and pull it back and give your wrist a strong POP if your mind doesn't want to cooperate with THOUGHT STOPPING. Refuse to let your brain get away with these "automatic" thoughts. After you pop your wrist, RE-SET your thinking onto something positive. Don't quit...don't give up. It takes a while to train a wild horse so that it rides nicely. When you are depressed your brain will say. "Aw whats the use...this ain't gonna help anyway!" That is the depression talking. Take this statement and put it in your three column exercise below if this is what your brain tries to pull on you.
3 Columns simulated by ///
///a bunch of words can't help////emotional reasoning, jumping to conclusions///this stuff wouldn't sell books if it didn't work-it worked for people I know, I should try it
Then you do the Behavioral part of the Cognitive Behavioral Therapy system. Like for example getting a pencil and paper for the 3 Column Technique would be Behavioral. On a large scale, you have to go forth and act out your new resolution with initially small goals in mind. Make them small enough to be easy. Don't give up, but rather be as intense and repetitive as you need to be to get your brain to start breaking this habit of negative thought and emotional stuckness.
The next level of the "Behavioral" is simply to STOP reading after this short paragraph and TAKE the time and effort to find a stupid pencil and stupid piece of paper and do the stupid exercise. (Aha, I quickly realize that throwing in "stupid" is a labeling that only burdens me further) Other behaviors would be setting goals, posting them, posting progress toward sub-goals and generally breaking down the goal directed behavior of changing depressing thoughts and behaviors until I have a clear idea of WHAT the next logical, positive and helpful BEHAVIOR would logically be. (even if it is to meditate or take a nap ;-)
COGNITIVE DISTORTIONS
These are thought patterns that get us down and keep us down that need to change in order to heal depression.
1. Dichotomous reasoning ....is All or nothing thinking...seeing everything as black or white
2. Discounting...eg the good stuff was just luck or..."that wasn't nothin' "
3. Mental filter...focusing on the bad stuff instead...often a judgmental need to see the negative too often
4. Mindreading... AKA jumping to conclusions...assuming
5. Personalizing...like fault finding...their fault, my fault...or "They did it to me"... and ongoing hurt feelings
6. Overgeneralizing... "always"..."never"..."totally"...watch out for charged up words that are secretly toxic
7. Labeling... ie self name calling... or cubbyholing ...stereotyping
8. Magnification... ie making mountains from molehills...blowing things out of proportion...catastrophizing
9, Emotional Reasoning...trying to use hunches and feelings for your logic...justifying feelings as your ultimate proof
10. Automatic Injunctions...Should statements also oughts, musts, have to's...
This is the general list of "depressogenic assumptions". Get it ?...things you automatically assume you should believe and continue to do that get you...and keep you...DEPRESSED ! Perhaps you will find a new depressogenic assumption of your own that is not on the list. If you do, feel free to email me and if it is ubiquitous, I would want to add your newly discovered one to this traditional list. One famous salesman used to say, "I'm doing a checkup from the neckup to get rid of stinkin' thinkin'."
The Remedy
(by the numbers)
1. Think in shades of gray. So many people are actually "proud" of their tendendcy "of thinking in black and white". Its quite problematic.
2. Take credit where credit is due. Get a consult from a friend. Think about what you would say to your friend in that situation.
3. You just don't HAVE to think negatively. Reframe problems as opportunities. Chose optimistic perspectives. Problems bring gifts.
4. Be data oriented. Ask questions to ensure your view is accurate, Look before you leap to a conclusion.
5. Don't fall for the blame game. Don't blame others or yourself. Just do what you can to better the situation.
6. Avoid infinity words. Use often instead of always. Seldom instead of never. And don't see one event as an indication that things can't change.
7. Use less emotional wording. Don't call yourself names, It doesn't help you.
8. You could move a mountain if you go at it one shovel at a time. Don't blow your situation up needlessly.
9. Use the correct tool. Emotions are not meant for logical analysis. Put things on paper to check yourself.
10. As Al Ellis said, "Don't go shoulding all over yourself." Catch "should" "must" ought" and nip them in the bud.
(This is all about gaining control of your INTERNAL DIALOGUE !! Many times we are secretly wanting to keep on wearing the "cruel shoes" cause "that's the way I've always been...and my father was black and white before me and his father...my situation is chronic...nobody knows the trouble I seen..." etc etc)
Think of COST/BENEFIT ANALYSIS: What does my beloved/ "justified" depressive internal dialogue gain me ? What burdens is it putting on me ? Have I ever TRULY tried to take this bull(^%#) by the horns ? If I didn't mentally say negative things to myself would my emotional state be worse or better.
OK LETS DO IT !!! (that's your behavioral primer phrase...get ready to do a behavior:
GET THAT PEN AND PAPER NOW...(or else quit reading...ok?)
Make a 3 column chart on paper. Just draw a line from top to bottom on the paper dividing the page into thirds. Put DEPRESSING THOUGHT at the top of the first column, DISTORTION in second column and REMEDY in third column. Write down a negative thought and put it through the process. If you can't find one of your own to use, do someone else's or make up an easy one for practice.
In column one I would put eg, "I'll never get out of debt". In column two I put "all or nothing","emotional reasoning" and any other distortion I notice. In column three I write, "I need to stay positive. Others have done it, I can do it too. One small step at a time. I need to reinforce and reward my small steps."
This is not a thorough example but perhaps you get the idea. Start now and write down your negative thought, Identify the cognitive distortion and try to correct it with some healthier statements in column three. Just doing the actual writing brings the thought into the concrete world. Lasso that cognitive trouble maker ! Then the next behavioral part is often taking this new perspective "to the street" and applying it with your behavioral choices. Or perhaps the main thing is just constantly reminding your internal dialogue of your new correction. If you start to "dis" your cognitive correction...seriously...put the "dis" in column one and work it thru to 3. Do this WHENEVER it happens and until the "dis" ing stops. (For the less modern dis is short for disrespect)
You are probably wasting your current reading time if you are not NOW ready to try this. Get a piece of paper and draw three up and down lines dividing the paper into thirds. Get busy. Do it now. There is never any other time than NOW. You will find that its not perfect but it DOES work and you will begin to feel better. The more you do this, the better you get at it. It is far more useful to start now and forgive yourself for a lackluster effort than to just read the rest and not go thru the motions. Sure it feels like an inept excercise...but isn't that also the depression talking ?
OK...here's a better example: "This will never work. I am seriously depressed. What difference is writing a few things on paper gonna make. I am a basket case."
Jot that down in column one. Here's a hint...if you have a hard time breaking the depressive thought down it is probably a compound thought ! See if you need to break your negative thought down into several different negative thoughts (cognitions). (eg. "I am a basket case" is labeling and needs separaote handling)
(Research now shows the brain's connectional chemistry actually changes for the better with cognitive-behavioral inputs.)
Again here are my simulated columns as if I drew them vertically down the paper in 3 columns= ///
column I /// column II /// column III
negative thought /// distortion /// remedy cognition
"this will never work... /// emotional reasoning... /// I should just try for a while and see...etc
NOW...YOU HAVE TO FILL IT OUT EVERY TIME YOU GET DOWN. DON'T ALLOW DEPRESSING THOUGHTS AT ALL !!
YOU CAN LEARN TO CATCH THEM BEFORE THEY DO DAMAGE TO YOUR PSYCHE. I TOLD ONE PATIENT "DO IT 45 TIMES' ON PAPER, THEN YOU CAN SWITCH TO 'IN YOUR HEAD' MODE"
The truth is that you or I do NOT have to let depressing thoughts roam around in our heads and do damage. There is a real logic here. Think of the Monty Python depiction where the priests are marching and chanting and hitting themselves in the head with boards every few steps. This is a useful and perhaps humorous analogy. Don't do this with your INTERNAL DIALOGUE.
Which is better, to have to march and chant...or to march, chant and whack ourselves repeatedly on the head. Although we are blinded to our choice this is what we do when we beat ourselves up with negative cognitions. A negative INTERNAL DIALOGUE will get your depressed (or anxious) and keep you stuck.
Lets look at the error of "labeling". This occurs when I call myself a "fool", a "flake", a "loser" or any of an infinite number of names. Now lets see how that works. Imagine Michael Jordan is on the freethrow line with the chance to make the game winning freethrow. He decides to berate himself as a "loser", a "choker" and a 'goat". Does this help or hurt his chances for success. Obviously, he makes himself LESS likely to make the shot. If he replaces this INTERNAL DIALOGUE with "my stats say I'm about 80% likely to make this" or "I am a pressure cooker "...."I'm good in the clutch" he ups his chances of a happy outcome obviously.
The trouble is that we do this negative kind of thinking AUTOMATICALLY. Maybe we learned it from family ? But it needs to go ! The purpose of this thought system is to de-activate the negative thinking autopilot. If you are really committed and begin really tuning in to the INTERNAL DIALOGUE, you will see that IF you are depressed you have a LOT of "awful-izing" and negative cognitions that are just making you feel worse and worse, helpless and hopeless. STOP IT !! You don't have to do this one more minute...YES, you have to change habits which takes a while but you will be SURPRISED how well this stuff works IF you work it. Watch that you don't "minimize" with yourself about your own negative self-talk because that can be the most insidious kind. ("I don't do it THAT bad or THAT much" will creep on you or hide from your cognitive self-analysis)
I like to tell patients the story of me in the shower one morning realizing that I was getting depressed again. I was very dismayed as bouts of depression can be literally hell on earth as you may know. I then suddenly confronted myself..."WAIT A MINUTE!! You are going to go to your office and teach people all day how to get out of this hell. What would you tell them? Then I did the 3 column technique in my head (I have done it on paper many times ;-) Suddenly I began having hope and perspective again and I said out loud, "Wow, this stuff really works!" and laughed out loud at myself.
Its amazing how many people suffer hugely but just won't make themselves try this simple technique. Of course, you don't feel perfectly afterward, but you do see how doing these excercises moves you toward hope and better mental health.
This style of therapy has gotten a lot of support based on the research that has been done in the field of psychotherapy.
CBT was developed under several different names by frustrated psychoanalysts who could not seem to help their depressed patients much with psychoanalysis. They found that it is possible to go at the problem of depression or anxiety in a very direct manner. CBT teaches you to self-monitor depressing or anxious thoughts and learn to stop them at their source.
It is possible to use your thoughts to "bridle" your runaway emotions.I use the word bridle because emotions can feel uncontrollable like a wild horse. We all know, though, how much control of that wild horse can be gained with a bridle and training. Brains are very similar but you must do the work. Pills are quick and easy skills take a little time. Pills and skills both show about the same effectiveness, but CBT skill development functions like a vaccination against depression. These techniques even change brain chemistry.
Many persons with depression and anxiety feel victimized by the world and they also feel like there is nothing they can do about feeling victimized and they also tend to believe that this issue will probably continue to torment them in the future.
So people who are clinically depressed or anxious often have toxic views of themselves, their world and their future or past. There is a famous guru who used to say, "What...at this moment...is missing ?" Most often the answer is 'nothing' or 'not much actually'. It is our rumination about the past and/or catastrophizing about our future that wrecks an otherwise good moment of NOW. This last little paragraph is the whole CBT conceptual universe in a single nugget.
A good first technique to try is "thought stopping" . Whenever you find your self 1) ruminating about the past or 2) catastrophizing about the future, say "STOP !!" Then RE-SET your mind onto the now.
Try this...if you want to reflect on the past or plan for the future, do this ON PAPER so that you accomplish something other than merely punishing yourself with negative criticism. Otherwise, if you are depressed or anxious, assume you should get better daily at THOUGHT STOPPING.
Hint: If you need a little something extra to put the brakes on your brain, wear a big wide rubber band on your wrist and pull it back and give your wrist a strong POP if your mind doesn't want to cooperate with THOUGHT STOPPING. Refuse to let your brain get away with these "automatic" thoughts. After you pop your wrist, RE-SET your thinking onto something positive. Don't quit...don't give up. It takes a while to train a wild horse so that it rides nicely. When you are depressed your brain will say. "Aw whats the use...this ain't gonna help anyway!" That is the depression talking. Take this statement and put it in your three column exercise below if this is what your brain tries to pull on you.
3 Columns simulated by ///
///a bunch of words can't help////emotional reasoning, jumping to conclusions///this stuff wouldn't sell books if it didn't work-it worked for people I know, I should try it
Then you do the Behavioral part of the Cognitive Behavioral Therapy system. Like for example getting a pencil and paper for the 3 Column Technique would be Behavioral. On a large scale, you have to go forth and act out your new resolution with initially small goals in mind. Make them small enough to be easy. Don't give up, but rather be as intense and repetitive as you need to be to get your brain to start breaking this habit of negative thought and emotional stuckness.
The next level of the "Behavioral" is simply to STOP reading after this short paragraph and TAKE the time and effort to find a stupid pencil and stupid piece of paper and do the stupid exercise. (Aha, I quickly realize that throwing in "stupid" is a labeling that only burdens me further) Other behaviors would be setting goals, posting them, posting progress toward sub-goals and generally breaking down the goal directed behavior of changing depressing thoughts and behaviors until I have a clear idea of WHAT the next logical, positive and helpful BEHAVIOR would logically be. (even if it is to meditate or take a nap ;-)
COGNITIVE DISTORTIONS
These are thought patterns that get us down and keep us down that need to change in order to heal depression.
1. Dichotomous reasoning ....is All or nothing thinking...seeing everything as black or white
2. Discounting...eg the good stuff was just luck or..."that wasn't nothin' "
3. Mental filter...focusing on the bad stuff instead...often a judgmental need to see the negative too often
4. Mindreading... AKA jumping to conclusions...assuming
5. Personalizing...like fault finding...their fault, my fault...or "They did it to me"... and ongoing hurt feelings
6. Overgeneralizing... "always"..."never"..."totally"...watch out for charged up words that are secretly toxic
7. Labeling... ie self name calling... or cubbyholing ...stereotyping
8. Magnification... ie making mountains from molehills...blowing things out of proportion...catastrophizing
9, Emotional Reasoning...trying to use hunches and feelings for your logic...justifying feelings as your ultimate proof
10. Automatic Injunctions...Should statements also oughts, musts, have to's...
This is the general list of "depressogenic assumptions". Get it ?...things you automatically assume you should believe and continue to do that get you...and keep you...DEPRESSED ! Perhaps you will find a new depressogenic assumption of your own that is not on the list. If you do, feel free to email me and if it is ubiquitous, I would want to add your newly discovered one to this traditional list. One famous salesman used to say, "I'm doing a checkup from the neckup to get rid of stinkin' thinkin'."
The Remedy
(by the numbers)
1. Think in shades of gray. So many people are actually "proud" of their tendendcy "of thinking in black and white". Its quite problematic.
2. Take credit where credit is due. Get a consult from a friend. Think about what you would say to your friend in that situation.
3. You just don't HAVE to think negatively. Reframe problems as opportunities. Chose optimistic perspectives. Problems bring gifts.
4. Be data oriented. Ask questions to ensure your view is accurate, Look before you leap to a conclusion.
5. Don't fall for the blame game. Don't blame others or yourself. Just do what you can to better the situation.
6. Avoid infinity words. Use often instead of always. Seldom instead of never. And don't see one event as an indication that things can't change.
7. Use less emotional wording. Don't call yourself names, It doesn't help you.
8. You could move a mountain if you go at it one shovel at a time. Don't blow your situation up needlessly.
9. Use the correct tool. Emotions are not meant for logical analysis. Put things on paper to check yourself.
10. As Al Ellis said, "Don't go shoulding all over yourself." Catch "should" "must" ought" and nip them in the bud.
(This is all about gaining control of your INTERNAL DIALOGUE !! Many times we are secretly wanting to keep on wearing the "cruel shoes" cause "that's the way I've always been...and my father was black and white before me and his father...my situation is chronic...nobody knows the trouble I seen..." etc etc)
Think of COST/BENEFIT ANALYSIS: What does my beloved/ "justified" depressive internal dialogue gain me ? What burdens is it putting on me ? Have I ever TRULY tried to take this bull(^%#) by the horns ? If I didn't mentally say negative things to myself would my emotional state be worse or better.
OK LETS DO IT !!! (that's your behavioral primer phrase...get ready to do a behavior:
GET THAT PEN AND PAPER NOW...(or else quit reading...ok?)
Make a 3 column chart on paper. Just draw a line from top to bottom on the paper dividing the page into thirds. Put DEPRESSING THOUGHT at the top of the first column, DISTORTION in second column and REMEDY in third column. Write down a negative thought and put it through the process. If you can't find one of your own to use, do someone else's or make up an easy one for practice.
In column one I would put eg, "I'll never get out of debt". In column two I put "all or nothing","emotional reasoning" and any other distortion I notice. In column three I write, "I need to stay positive. Others have done it, I can do it too. One small step at a time. I need to reinforce and reward my small steps."
This is not a thorough example but perhaps you get the idea. Start now and write down your negative thought, Identify the cognitive distortion and try to correct it with some healthier statements in column three. Just doing the actual writing brings the thought into the concrete world. Lasso that cognitive trouble maker ! Then the next behavioral part is often taking this new perspective "to the street" and applying it with your behavioral choices. Or perhaps the main thing is just constantly reminding your internal dialogue of your new correction. If you start to "dis" your cognitive correction...seriously...put the "dis" in column one and work it thru to 3. Do this WHENEVER it happens and until the "dis" ing stops. (For the less modern dis is short for disrespect)
You are probably wasting your current reading time if you are not NOW ready to try this. Get a piece of paper and draw three up and down lines dividing the paper into thirds. Get busy. Do it now. There is never any other time than NOW. You will find that its not perfect but it DOES work and you will begin to feel better. The more you do this, the better you get at it. It is far more useful to start now and forgive yourself for a lackluster effort than to just read the rest and not go thru the motions. Sure it feels like an inept excercise...but isn't that also the depression talking ?
OK...here's a better example: "This will never work. I am seriously depressed. What difference is writing a few things on paper gonna make. I am a basket case."
Jot that down in column one. Here's a hint...if you have a hard time breaking the depressive thought down it is probably a compound thought ! See if you need to break your negative thought down into several different negative thoughts (cognitions). (eg. "I am a basket case" is labeling and needs separaote handling)
(Research now shows the brain's connectional chemistry actually changes for the better with cognitive-behavioral inputs.)
Again here are my simulated columns as if I drew them vertically down the paper in 3 columns= ///
column I /// column II /// column III
negative thought /// distortion /// remedy cognition
"this will never work... /// emotional reasoning... /// I should just try for a while and see...etc
NOW...YOU HAVE TO FILL IT OUT EVERY TIME YOU GET DOWN. DON'T ALLOW DEPRESSING THOUGHTS AT ALL !!
YOU CAN LEARN TO CATCH THEM BEFORE THEY DO DAMAGE TO YOUR PSYCHE. I TOLD ONE PATIENT "DO IT 45 TIMES' ON PAPER, THEN YOU CAN SWITCH TO 'IN YOUR HEAD' MODE"
The truth is that you or I do NOT have to let depressing thoughts roam around in our heads and do damage. There is a real logic here. Think of the Monty Python depiction where the priests are marching and chanting and hitting themselves in the head with boards every few steps. This is a useful and perhaps humorous analogy. Don't do this with your INTERNAL DIALOGUE.
Which is better, to have to march and chant...or to march, chant and whack ourselves repeatedly on the head. Although we are blinded to our choice this is what we do when we beat ourselves up with negative cognitions. A negative INTERNAL DIALOGUE will get your depressed (or anxious) and keep you stuck.
Lets look at the error of "labeling". This occurs when I call myself a "fool", a "flake", a "loser" or any of an infinite number of names. Now lets see how that works. Imagine Michael Jordan is on the freethrow line with the chance to make the game winning freethrow. He decides to berate himself as a "loser", a "choker" and a 'goat". Does this help or hurt his chances for success. Obviously, he makes himself LESS likely to make the shot. If he replaces this INTERNAL DIALOGUE with "my stats say I'm about 80% likely to make this" or "I am a pressure cooker "...."I'm good in the clutch" he ups his chances of a happy outcome obviously.
The trouble is that we do this negative kind of thinking AUTOMATICALLY. Maybe we learned it from family ? But it needs to go ! The purpose of this thought system is to de-activate the negative thinking autopilot. If you are really committed and begin really tuning in to the INTERNAL DIALOGUE, you will see that IF you are depressed you have a LOT of "awful-izing" and negative cognitions that are just making you feel worse and worse, helpless and hopeless. STOP IT !! You don't have to do this one more minute...YES, you have to change habits which takes a while but you will be SURPRISED how well this stuff works IF you work it. Watch that you don't "minimize" with yourself about your own negative self-talk because that can be the most insidious kind. ("I don't do it THAT bad or THAT much" will creep on you or hide from your cognitive self-analysis)
I like to tell patients the story of me in the shower one morning realizing that I was getting depressed again. I was very dismayed as bouts of depression can be literally hell on earth as you may know. I then suddenly confronted myself..."WAIT A MINUTE!! You are going to go to your office and teach people all day how to get out of this hell. What would you tell them? Then I did the 3 column technique in my head (I have done it on paper many times ;-) Suddenly I began having hope and perspective again and I said out loud, "Wow, this stuff really works!" and laughed out loud at myself.
Its amazing how many people suffer hugely but just won't make themselves try this simple technique. Of course, you don't feel perfectly afterward, but you do see how doing these excercises moves you toward hope and better mental health.