The cool thing is that you can find a lot of these and more help at your local bookstore. So, a lot of these "tricks" (everyday people-ese for techniques) come from a branch of therapy called "Cognitive Behavioral Therapy" or CBT. CBT has a long history, most of which I'll avoid here except to throw out a couple of names when appropriate. The bottom line with CBT is that therapists with this orientation (and trust me, there are many) ascribe to the idea that our thoughts affect our behavior, and that if we work to change the way we're thinking, then our behavior will be easier to change and we'll feel better. The nice thing about CBT is that a lot of research has been done on it, and most of the research is very positive - it's something that generally works, if done long enough and well enough.
Here's the problem though - a lot of people think that since it seems to be based in common sense, it should be easy and quick. Creating change using CBT isn't a "quick fix" - in fact it takes a lot of commitment and practice to get to where you want to be. If you're really looking for change, though, it's likely that you're feeling lousy to start with and will do what it takes to feel better. And CBT generally helps.
The basics of CBT are grounded in the idea that what we think and how we think about and interpret the world around us affects how we behave. Cognitions are the things that go through our minds: thoughts, interpretations, judgments, hopes, dreams, expectations, reasonings, rationalizations, plants, motivations, doubts, images - pretty much anything that goes on in your conscious mind is a "cognition." (I use conscious mind deliberately here because CBT therapists generally don't work with the subconscious or unconscious mind - that's a more psychoanalytic approach.)
Here are a couple of examples of how these work:, "Geez, that driver is such an IDIOT! He cut me off! He saw me, and he cut me off anyway!" is a cognition that can be taken apart for analysis: the observation: "he cut me off,:, the interpretation: "he cut me off deliberately," the assumption:"he saw me," and the judgment:"what an idiot!" And another: "I can't do anything right. No one wants to be around me anymore because I'm such a failure. I absolutely nose-dived that interview, and I know I came across as stupid. I should have had a job 6 months ago, and I keep screwing it up. No wonder I can't find something." And here's the analysis: The observation: "I don't have a job," the interpretation: "I'm stupid," "I keep screwing up," the assumptions: ""no one wants to be around me," "I can't do anything right," the judgments: "I'm a failure," "I come across as stupid," and "I should have had a job 6 months ago." And this is just one way to take it apart!
On to the "nuts and bolts" - what do you do in CBT? Well, when you're working with a therapist, generally we're pretty empathetic people. We're not out to tell you, "Geez, get your act together...honestly!" Frankly, if most therapists were judgmental, mean people we wouldn't have much worth, now would we? Generally, therapists will sympathize with you and check in with you to see if they're understanding you - a process we call "reflection." It works like this:
Client: I've been feeling really depressed lately. I just look at where my life is and I think I"m just a huge failure. I feel like the worst person in the world.
Therapist: I'm hearing a couple of things here...first is that you've been pretty down lately, is that right?
Client: Yeah, pretty much. I still don't have a job and I just can't seem to get out of this hole.
Therapist: So it seems like you've been pretty hard on yourself...I heard you say that you felt like the worst person in the world. That's pretty harsh. (therapist's interpretation of client's statements)
So, you can see that a therapist - of any orientation - is likely to be sympathetic. From there, where you go with your therapist depends a lot on their orientation, or what style of therapy they do. A CBT therapist will focus on the way you're thinking and how it affects you. The therapist will gently challenge you on negative thinking (or "stinking thinking" as we sometimes call it), and encourage you to think of other interpretations that aren't so negative in nature. Using our earlier example, this is how a CBT therapist might continue:
Therapist: I wonder where that idea that you're the worst person in the world came from? (exploration)
Client: Well, I can't seem to do anything right. Nothing seems to work out the way I want it to. I can't get a job, I can't do things right with my husband. Even my kids are mad at me.
Therapist: Wow...that's a lot of stress. (empathizing) You know, though...somehow I think there are people who are probably a lot closer to being "the worst person in the world" than you are...you know...maybe guys like Hitler? Somehow, I'm guessing that you're a little higher up than he is on that scale. What do you think? (gentle challenge, with a little humor)
Client: <laughing a little> Yeah, you're probably right on that one. I still feel pretty lousy about myself though.
Therapist: I know you've really had a tough time with the job stuff and what's going on at home. Is it possible that maybe it's not all because of you, though? What else could be going on? (reframing)
Client: Well...I guess the economy is probably making it harder to find jobs now. I still feel like I should have gotten something by now.
Therapist: <making time out signal> whoah...hang on there...time-out. Do you remember how we talked about "shoulds"? How they're like guilt-trips inside your head? I just heard you "shoulding" on yourself... (gentle confrontation)
Client: yeah...I guess I am pretty hard on myself.
Therapist: What would it be like to ease up a little? What would change? (challenge and exploration)
And so you see, that the therapist here is working with the client's pattern of thinking negatively about herself. We use gentle challenges, reframing things ("what else could cause this"), turning negative thoughts into positive thoughts, and give clients "homework" - thing to practice and use between sessions. It's actually a pretty cool system. If you've read my posts on DBT (Dialectical Behavior Therapy), you'll recognize some of this. DBT is a specific form of CBT. Another cool thing is that you can find CBT-based self-help in a LOT of places. New Harbinger, a publisher of self-help materials, has a lot of self-help workbooks that have a CBT orientation for dealing with all kinds of issues: depression, anxiety, stress and relaxation, obsessive-complusive disorder (OCD, and I would recommend working with a therapist if you're dealing with this), PTSD, anger, and grief and sorrow. And I'm sure this is only a partial list!
The point is, CBT techniques are relatively easy to teach and learn - the tough part is putting it together, practicing them in real-life and actually continuing to use and practice them. This kind of therapy can help you learn a lot of things: coping skills, relationship skills, and all the nuts and bolts stuff we talked about: reframing, thought changing, challenging negative or all-or-nothing thinking, and a whole host of other things Next up: "Stinkin' Thinking" - how to work with negative thought patterns and some more tricks from the therapists' bag.
Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral. If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help.
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