Mindfulness is the New Black

Like orange is the new black, mindfulness may be the new psychotherapy.

Talking to a licensed therapist can be a critical step to wellness.  It can include sharing problems, worries, and yes, those reliable and messy mainstays, family of origin issues. Getting evaluated by a professional can be one of the most important tools for treating anxiety, depression, and other emotional disorders.

Learning cognitive behavioral tools ( CBT ) is another branch on the tree called getting back to wellness. One of the most up-and-coming, state-of-the-art CBT tools is mindfulness.  Thirty years ago, when I was walking my dinosaur on my college campus, mindfulness was not echoed in the hallowed halls of learning.  I'm not sure it was even a thing back then.  But it certainly is now.

Mindfulness is a form of meditation.  It is the art and skill of redirecting one's mind away from the everyday thoughts, worries, judgments, and distractions that occupy our brain when it's on auto-pilot. Where are my keys? Did I take the load of laundry out of the dryer? Don't forget to return those pants, pick up that prescription, talk to my professor, get the car inspected.   "Monkey mind" is what Dr. Alejandro Junger, M.D., cardiologist, calls collectively, all those pesky thoughts. 

Today we all have a new worry: the pandemic. To protect us from Covid-19, many new restrictions are in place.  Mask wearing, vaccinations, avoiding unfamilliar people and crowded outdoor spaces.  Mindfulness can be used as a stress reduction tool. Try this mindfulness video, here, let by Dr. Robert Hindman, a clinical psychologist with the Beck Institute*.  

For more ideas on how to learn about and practice mindfulness, have a look at Harvard University Medical School's suggestions, here.    Because maybe, just maybe, fifteen minutes a day is the new 60 minutes on the couch.

*The Beck Institute was founded by Aaron T. Beck, MD, largely considered the father of Cognitive Behavior Therapy (CBT) and his daughter, Judith Beck, Phd. 

Sandy Andrews, Ph.D. Psychologist

Teaching CBT in South Austin, Texas

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Have Yourself a More Relaxed Holiday Season

My goal is to post every two weeks at the very minimum.  For one reason or another I looked over my blog today.  I see that I've gone months in between posts. Months! 

Yes, Virginia, even behavioral psychologists fall short of their goals.  More often than some of us would like to admit, surely.  

Another goal I've set for myself over the past few years has to do with the busy holiday season. From the time the Halloween costume box comes down from the attic it feels as though the speed of life is cresting over the highest peak of a roller coaster ride. Gaining rapid momentum with no chance to get out of the cart or make it stop until January 1st.  But then it's time to put away the decorations and think about one of the least favorite times of year:  tax season.

My goal?  To do less.  To shop less.  To let go to some holiday traditions so that I can better enjoy others.  Stress less.  Relax more.

People resoundingly complain about the all-consuming demands of the holiday season.  Recently a friend of mine proclaimed it has gotten to the point where she "hates" Christmas.  An honest and brave friend.  After all, it's downright un-American to make such a statement. 

Bah humbug. 

The reality is we all have choices when it comes to holiday traditions.  Whether it be adorning our homes with lights and decorations, sending seventy-five greeting cards and photos in the mail, baking sugar cookies from scratch, entertaining guests with a punchbowl full of homemade eggnog, singing carols, setting up the train set, hosting large family gatherings around a lavish home cooked meal, hustling over to the in-laws for a second lavish home cooked meal, attending midnight church service, or driving all over town to find just the right gift for loved ones even if it means spending ourselves into debt, we all retain the right to put a stop to the annual practice of wearing ourselves to a frazzle.  

So let's try a little CBT, shall we?

A typical rationalization and automatic negative thought might sound something like this:  

"But it wouldn't be Christmas/Hanukkah if I didn't ______ (fill in the blank)." 

A healthy cognitive replacement involves challenging our long held beliefs and rationalizations.  The holidays are not just about our hand made hot tamales (this is Texas, y'all), are not just about the gifts we give, are not just about the decorations and the lights. These are mere details that add tinsel and sparkle to the true meaning of the season. 

No, the holidays are really about ... what exactly?  

This is where you get to step in and express your own individual sentiments.  What do the holidays mean to you specifically?  Which traditions can you give yourself permission to let go of so that you are free to enjoy the true meaning of the season as it applies to you?   So that you can spend quality time with your family or friends or community and not be too busy to slow down and really appreciate what you've got in life. Or where you want to be.

Examples of more replacement thoughts in cognitive behavioral therapy: 

"I choose to let go of _____, _____, and _____ so that I can be more relaxed."

"I can get more out of the holidays this year by deciding to ______ rather than ______."  

"I want to more fully embrace the meaning of my holiday.  This year I plan to _____ and not _____ so that I am free to devote more time to ______ instead."

Notice I wrote "this year" as opposed to forever because it's best to take it one year at a time.  Next year, who knows?  You can always revise or alternate traditions.  

So there you go, readers.  The framework of change is there.  You get to fill in the blanks.  Give it a try.

Another goal of mine this holiday season?  To give myself permission to post less often.  Maybe not until next year!

Now go and have yourself a more relaxed, more meaningful holiday season.  

The Quality of Your Thoughts

Marcus was the last Roman emperor of the age of peace and stability (161 to 180 AD).

Listen to Marcus.

Decide Not to Decide

Indecision by Pat Kumicich

It is quite common for people to enter therapy in the midst of a crisis. They want answers.

Is my marriage over?

Cognitive therapy is all about replacement thinking. A cognitive therapist will listen for faulty or dysfunctional thinking patterns that are contributing toward a client's lowered mood, anxiety, anger, or indecision.

And sometimes those problematic thoughts are questions. Especially questions whose answers involve major life decisions. Upheaval.

My job is horrible! Should I quit now or find a new job first?

One calming thought replacement is decide not to decide. At this moment, anyway. Perhaps for an undetermined period of time, if the situation allows. Give yourself the time to make a more informed decision.

I'm not happy here. Should I move back to the West Coast?

First we must explore whether there is an urgency to decide now. Many, if not most, of life's crises do not require immediate action. They may, at some point, require a decision. But right now? Not usually. And hasty decisions are often the source of regret or self-doubt down the road.

My neighbors are so toxic. Is it time to move?

What crises typically do require is calm and thorough deliberation. Careful consideration of the options available. Analyzing the situation so that we know what we're dealing with. Generating a range of steps to take before making a drastic change.

By the time someone has entered the therapy room, however, they are often worked up into a frenzy or feeling overwhelmed to the point of depression. They are not thinking clearly. They cannot focus. They are unable to come up with creative solutions. They're engaged in black or white, all or none, thinking.

So rather than focus on making the decision, we want the client to slow down, calm down, reduce the stress, increase the self care, and decide not to decide.

Concentrate on self-soothing. Take care of yourself until you are in a position where you can carefully assess the available information, until it can be gathered in a calm, deliberate and accurate manner. And then reflected on without haste. Seek opinions from respected experts or someone who has been in your shoes.

Slow down.

Get some good sleep.

Regroup.

Think of my options.

List pros and cons.

Get some support:
Consult with friends, colleagues, loved ones, a professional.

Take a walk. Appreciate the sky, the clouds, the trees. 
Sit on a park bench. 

Take deep breaths.

And full, emptying exhales.

Again.

And again.

Give myself the time to decide.

In good time.

Decide not to decide.

Until I am ready.

Sandy Andrews, PhD is a Licensed Clinical Psychologist and Psychotherapist in Austin, Texas
She practices Cognitive Behavioral Therapy or CBT

Why Does Weight Loss Have to Be So Hard?

We all know it is hard to pass on our favorite high-calorie foods. A struggle to limit portion size. Downright  daunting to get off the couch and stick to exercise goals. But these aren't always the hardest part of a weight loss plan. Keeping the weight off is usually the biggest challenge. Why is this? Learning more about the biology behind those re-appearing pounds is an important cognitive tool in the weight loss struggle. Many people find it helpful to know it isn't just me who finds themselves craving food, feeling less full, and losing less weight over time, despite reducing calories.

So do yourself a favor. Instead of that handful of cookies, grab a cognitive tool. Read My Fitness Pal's blog, Hello Healthy, for a breakdown of the physiological factors that interfere with long term weight loss. By understanding your body's hormonal changes, you can help yourself succeed over the long haul.

--Sandy Andrews, PhD 

Clinical Psychologist

Austin, TX

Mind Your Happys

 Mindfulness is a big buzzword in cognitive behavior therapy - CBT - offices today.  Paying attention and savoring the pleasant, happy moments of any given busy day can help us offset the negativity bias our brains have evolved to become.  Negativity bias is simply the tendency we all have to remember the bad events (scary, sad, hurtful, angry) and ignore or forget the feel-goods and warm-fuzzy moments.  

Think of how you're likely to share that unnerving traffic story where "that guy cut me off and almost caused a wreck!" But how you usually don't remember to also share the story where "that nice guy let me cut in front of him."  Only remembering the unpleasant events is negativity bias in a nutshell.  

We can help our brains become less negative minded by using self-directed neuroplasticity exercises:  actively choosing to pay attention to and stay focused on positive events rather than let our auto-pilot selves skip over and forget them. 

Peeling an orange?  Take a few seconds to smell the fresh orange peel and switch over to how good it feels.  Even better, turn it into a deep breathing exercise.  Take a really deep breath while you enjoy such a fresh, pleasant scent. .  Take a whiff.  Focus on the orange scent.  Enjoy. Exhale. Repeat.  

In her post, psychologist and self-identified mindfulness teacher, Kellie Edwards, suggests a Happy Jar as one example of helping ourselves remember and amplify daily pleasantries.  Hers is an exercise that can help us ward off or treat symptoms of depression and anxiety disorders: 

Jar Full of Happy

1.  Find a transparent jar that is large enough to hold at least 7 notes from every person in your family.

2.  Take some colored paper (several different colors) and cut it up into note sized pieces, or use sticky notes like we have.

3.  Pick a time towards the end of each day - during dinner or just before bed, say - and take turns recalling something good that you noticed today.

4.  Write it down and then share it with each other, taking at least 20-30 seconds to bask in the glow of the goodie. If your children are not writing yet, you can write it for them in their own words.

5.  Place the colored pieces of paper in the jar. Leave it in full view to remind everyone to notice the good moments and to complete the ritual each night.

6.  At the end of the week - perhaps when you have 5 minutes or so on the weekend — sit down as a family and pull each piece of paper out of the jar and read them aloud to recall all the warm fuzzies that have happened during the week. 

7.  Celebrate by doing something fun together as a family, even a family hug!

8.  Keep your notes from each week together and anytime anyone needs some sprinkles of happiness to brighten their mood, they are right there at your fingertips.

Is Stress Hurting You? Or What You Think About Stress?

One area of expertise common to most CBT psychologists is stress management.  A new study sheds light on one cognitive aspect of stress.  Standford University psychologist Kelly McGonigal suggests that what we believe about stress, and how we respond to stress, predicts how harmful it is to our health  Signs of stress, such as elevated heart rate, sweating, muscle tension, and throat constriction is a sign of our body's strength, our body's way of mounting a defense against the worrisome event, our body's campaign to succeed in the face of something scary.  When we are taught to see stress as a good thing?  The risk of harm caused by stress goes way down, perhaps disappears.

So the next time you're studying for that test and are freaking out because you waited too long?  Feel that adrenaline pumping through your body and believe that it's there to help you study better, remember more, and ultimately pass the class.

Watch Dr. McGonigal talk about letting stress be our friend, HERE.

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist who practices CBT in Austin, Texas

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Recovery International: A Cognitive Tools Support Group

This a repost from two years ago.  As a cognitive behavioral psychologist, I continue to believe in the potential effectiveness of this support group for people with anxiety, depression and other disorders.

There's a little known but excellent support group resource available here in Austin, Texas and in hundreds of cities nationwide. Historically it was known by the name, Recovery, Inc.  But more recently, thanks to its expanding influence, it now goes by Recovery International.  

Recovery International was started many years ago by a physician, Dr. Abraham Low, who himself was working to recover from his own bout with depression.  The name "Recovery" is misleading (which may explain the relative obscurity of the support group). Recovery is a term that most people, including myself, associate with substance abuse recovery. But Recovery International. is a self-help support group designed to assist people struggling with anxiety and depression. It can also help people with a variety of different psychological and emotional difficulties. For a list of the many struggles Recovery International can offer assistance with, click here. People who have alcohol and drug abuse issues can be helped, too, so long as their substance abuse is under control.

But the name isn't so important. What matters is the group's core focus: teaching and helping group members persistently use cognitive skills to reduce symptoms.

I've had a few patients attend these groups. I have been consistently impressed with the quality of the skills taught there. I often refer my clients to the group in the hopes they will use it as a place to practice the cognitive skills learned in my individual therapy sessions, learn new skills above and beyond what our sessions have covered, and gain social support. I also refer individuals who are not attending therapy but would like some free-of-charge group support.

Recovery International, in short, teaches people tools to help cope better with situations that provoke unpleasant feelings and emotions. They call these tools "Recovery Language."

One typical example: Many people experience significant anxiety walking into a support group for the very first time. Anxiety that, for so many, is anticipated ahead of time to such an extent that they fail to go to the group at all. Typical thoughts are, "I won't know anyone and I'll feel stupid." "I won't know what to say." "I'll be too nervous to talk and then I'll look ridiculous." "What if I walk into the room and everyone stares at me?"

The anxiety, fed by these negative, fear inducing thoughts, can mount until one feels overwhelmed and stays home, or stays in the car and drives away.  Recovery language might encourage you to "spot" and replace these negative thoughts with more realistic and empowering ones, such as:

"These thoughts are distressing, not dangerous."

"It is perfectly average for someone to feel nervous when walking into a new group."

"I can do this. I am capable."

"I will move my muscles and start heading inside."

"Bear the discomfort and comfort will come."

I've had a few patients attend only one meeting. Their complaint was that they didn't quite "get it." As I understand the group format, members use Recovery Language and new people feel a bit lost and confused. My advice to patients is this: Plan to attend at least three groups. See if some of the initial confusion, which again is average (a recovery term) lessens over time. See if you don't start to feel a little more comfortable. Find out how you can learn the Recovery Language for yourself. You will likely be encouraged to buy a book but it isn't essential.

So take the first step. Move your muscles to use the following link to find the support group closest to you.  Two groups per week are currently offered in the Austin area:  South Austin on Thursday evenings at 6:30pm and Northwest Austin on Wednesday nights, 7:30pm.  But I advise you to double check before heading their way.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas   

Stay Faithful: A Cognitive Strategy

When an individual or a couple presents for therapy because of infidelity, the unfaithful partner often says they weren't "looking" to have an affair, that the unfaithful partner felt content in the relationship. The cheating partner sometimes reports that a chance meeting or newly assigned co-worker is what sparked the affair.  So what to do when you find yourself attracted to a forbidden someone?

Telling yourself to "stop thinking about" the romantic interest doesn't work.  Conventional wisdom tells us this and a 2008 study* confirms it.  Instead, researchers recommend that you think about the love you feel for your partner instead.  Think of a time you felt close and connected to your partner.  In the experiment, loving thoughts and memories of your current partner decreased thoughts of another person. Interestingly, thinking sexual thoughts about your current partner wasn’t nearly as effective.

 *Gonzaga, G., Haselton, M. G., Smurda, J., Davies, M. S., & Poore, J. C. (2008). Love, desire, and the suppression of thoughts of romantic alternatives. Evolution and Human Behavior, 29, 119-126.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas  

Happy Is As Happy Does

We're all in search of happiness and nothing makes this more certain than a search of recent research in the field of psychology.  Lots of studies looking for ways to increase our feelings of happy.

A Washington Post journalist spoke to Shawn Achor, a Harvard trained expert on positive psychology.  Achor recommends several exercises to increase feelings of wellbeing, including.

(1) Gratitude.  Spend two minutes every day thinking of three new things you appreciate, enjoy, or are thankful for.
(2) Positivity. Spend two minutes every day recalling a positive experience from your day.  Recollect every detail you can think of and let yourself feel the pleasant feelings associated with each detail.  This can be as simple as observing a beautiful flower or seeing a dog chase a frisbee.
(3) Exercise.  Fifteen minutes a day of high energy physical movement.  Get your heart rate up AND your feelings of happiness.
(4) Breathe.  Here's the magic time again, two minutes.  Push away from your keyboard, silence your phone, turn off the tv, sit under a tree, lay beneath a ceiling fan.  For two minutes, just listen to your breathing.  That's it.  Just listen and stay focused on the sound of the air moving in and our.
(5) Kindness.  Each day send an email or text someone a message telling them how much you appreciate something about them or something they have done.  According to Achor, this is one of the most powerful happy-getters.

You can read the Washington Post article and interview in full, here.

--Sandy Andrews, PhD 

Clinical Psychologist

Austin, TX 

Just Do It - Use the One Minute Rule

And speaking of doing it now rather than procrastinating, here's a quick and helpful pointer. It's called the one-minute rule and it's courtesy of Gretchen Rubin of The Happiness Project.

I mean, who doesn't love reading, or in this case watching a video clip, about a one-minute-solution?

In this world of looking for unrealistic, so-called quick solutions, isn't it wonderful to find a one-minute-rule that might actually do some real good? Maybe help boost our organization?

And maybe even a blog post that takes one minute to read? (Give or take.) Grammar check: does the period go inside or outside the parentheses? And yes, I do have an MLA Handbook on the shelf behind me. And no, I will not reach up to grab it and risk an allergic reaction to the dust that will surely find it's way into my nostrils.

In the words of Gretchen, outer order contributes to inner calm.

--Sandy Andrews, PhD 
Clinical Psychologist
Austin, TX 

Meditating with Visual Aids

Think about changing the channel that' plays mindlessly in your head.  Change your thoughts away from the thousands of stress inducing thoughts that permeate your thinking toward calm, pleasant, physically soothing thoughts and you can take your body toward a more physically healthy space.

One way to do this is with visual aids.  In this case, pictures of highly pleasurable scenes.

Take a look at the pictures posted on Bored Panda, below.   Take time to really let the images sink in.  Enhance the experience by taking long, slow inhales followed by long, full exhales, while you will your body to relax with each exhale, while simultaneously enjoying the pictures.

22 Unbelievable Places that are Hard to Believe Really Exist

 Let your mind luxuriate in the sensations you might feel if you were actually present in the picture.  Imagine the sounds you might hear, the smells.  What might you see in the scene if the picture were expanded to include what is behind you?

Pictures of beauty found in the nature are highly inspirational to me.  They help me refresh and appreciate the world around me.  Others find works created by visual artists inspiring:  paintings, collage, sculpture.

What inspires you?  What kinds of images do you find pleasurable, refreshing, or relaxing?  

Cognitive Therapy as Commencement Address

A commencement speech given by the author, David Foster Wallace, to the 2005 graduating class of Kenyon College.

Though Mr. Wallace was addressing college graduates, his words of encouragement are promoting CBT skills and can apply to all of us, in every moment of daily living.

Thanks to the person who suggested I listen to this video.  You know who you are.

Diet Tip in the New Year

Dr. Aaron Beck, M.D., known worldwide as the father of Cognitive Therapy, and his daughter, Dr. Judith Beck, Ph.D. psychologist founded The Beck Institute at the University of Pennsylvania.   Dr. Judith Beck is also the author of The Beck Diet Solution, a book that provides cognitive and behavioral weight loss strategies.

The Beck Diet Solution website emails dieting tips taken from her book.  Since it's the new year and many of us make resolutions to get healthy and lose weight, I thought I'd post the most recent suggestion. It features a cognitive approach to addressing one of the most frustrating aspects of dieting:  relapses or slips.   It also illustrates a core cognitive principle of thought replacement.


Recovering from Mistakes Immediately: A Key to Weight Loss and Maintenance Success

Dieters often make resolutions this time of year to lose weight and keep it off. Many dieters have made this same resolution in previous years and have ultimately not been successful.  One of the biggest stumbling blocks that dieters face is getting back on track after a dieting mistake, often because they say to themselves things like:

I've made a mistake. I've really blown it for the day. I might as well keep eating whatever I want and start again tomorrow.  

But it takes most dieters much longer to get firmly and consistently back on track -- perhaps a week, a month, or even a year. As a result, they likely gain back any weight they had lost.

We teach dieters many techniques to get back on track after making a single eating mistake.  One such technique is the use of analogies to demonstrate that making one mistake is not a valid reason to continue making more mistakes.  For example, we might say:

If you were walking down a flight of stairs and stumbled down a few, would you think, "Well, I've really blown it now!" and throw yourself down the rest?

If you were washing your fine china and dropped a plate, would you throw the rest of your plates on the floor?

If you were driving on the highway and missed your exit, would you continue to drive 5 more hours in the wrong direction?

We help dieters see that it makes no sense to compound one eating mistake with a second (or more). Once they accept that all mistakes, even dieting mistakes, are a part of life and learn how to recover from them right away, they're able to lose weight and keep it off without disrupting and undoing their hard work and weight loss achievements. 

Experimenting with Different Breathing Styles

Heart Says Breathe by Laurie Maves

Noting dysfunctional breathing patterns and changing them are two frequent goals of cognitive behavioral therapy.  Breathing exercises are one of the behavioral changes clients can make as opposed to the thought patterns that bring on and maintain the anxious breath.

There are a variety of ways to alter one's breathing therapeutically.  In an earlier post, I described what is often called lower abdominal breathing (LAB).  Many people report success lowering anxiety, stress and anger, for example, using LAB.  Click HERE to review my previous post.

Here, I will post a link to an article where Deborah Rozman talks about a different approach called Heart-Focused Breathing.  Different in that the mental focus on one's heart is suggested rather than strictly on the mechanics of the breath.  Shifting one's focus toward gratitude or a scene that has positive associations is also part of Heart-Focused Breathing.  Click HERE to read Rozman's full post.

So often in therapy my message is  this:  Don't give up.  Experiment with different styles of breath work.  Finding the style that assists in calming your body and quieting your mind is what we're after ... not sticking to any particular, recommended type.

Painting, Heart Says Breathe by Laurie Maves and can be viewed HERE. 

15 Steps to Better Mental Health

Walking in the Rain

by L C Neill

Yet another excellent post by Dr. Deb -- A list of 15 Tips for Mental Fitness that she found on a University of Washington publication. It's such a great list, in fact, I had to post it here:

1. Learn to Relax
Allow yourself to let go of inner tensions by giving yourself a “mini vacation.” Give your mind a break by becoming engrossed in a good book, watching a movie, listening to music, taking a walk, working on a hobby, meditating or similar activity that is relaxing for you.

2. Be Kind To YourselfPeople are frequently too hard on themselves when things don’t go right. Tune into your self talk, and counteract your negative thoughts about yourself with positive statements.

3. Eat ProperlyNutrition has a direct impact on feeling mentally positive. Limit your intake of sugar, fat, salt, caffeine and alcohol and help yourself stay mentally fit.

4. Find A Friend
Friendships are very important to mental fitness. Working on developing and maintaining friendships is one of the best ways to continue growing as a person. Expressing feelings and ideas to another person can help us clarify what’s truly important to ourselves.

5. Learn to Say “No”Often people feel the need to respond immediately when a friend or family member make a request. Help yourself set limits by avoiding the quick “knee jerk” response in the affirmative. Instead, let them know you will get back to them shortly. Then do a check of your schedule; ask yourself if you really want to add to your load. Give yourself permission to say “No” when you are too busy to take on additional commitments of your time or energy.

6. ExerciseCheck with your doctor about what level is best for you. Even a brisk 15-minute walk, three times a week does wonders for how you think and feel.

7. Do It NowProcrastination can lead to negative feelings about yourself. One doesn’t have to go to extremes, but it can feel very satisfying at the end of the day to have accomplished a hard task or met a difficult situation head-on.

8. Adapt To Rather Than Resist ChangeChange is inevitable and is a necessary part of life. The important thing is to be patient with yourself when you are going through change, and to give yourself time to go through the phases of transition. Realize it takes time to let go of the old and embrace the new.

9. Test Your Assumptions
Sometimes in our interactions with other people, we make the most incredible assumptions and act as if they are true. Rather than assuming, it might be worth the risk to ask directly what was meant.

10. Express Your Feelings
Emotions are a natural response to life. It is important to find ways to express your feelings. Journaling your thoughts is one way that can help you clarify what you are feeling. Once you have identified your feelings, you may find it easier to share them with others.

11. Grieve Losses
Sadness and grief are natural and appropriate responses to the losses which we all experience. Grief over the loss of a love one can be very painful and may last for some time. By being kind and allowing ourselves the time to grieve, we have the potential to be stronger than ever

12. Rest
Get a good night’s sleep. Not everyone needs the same amount of sleep, but it should be restful sleep. There are many techniques available to help promote relaxation; or, you might want to check with your doctor rather than assuming your restless sleep is simply something you have to live with.

13. Review Your “Shoulds”If you feel stuck by some things you “should” be doing and aren’t, set a time limit by which you will either have them done or get rid of them. Staying stuck in the middle is a good way to punish yourself and cause mental anguish and stress.

14. Have A Laugh
Nurture your sense of humor, especially about yourself. Trying to see the humorous side of things makes even the most difficult situations easier to bear. Laughter is good medicine. Being too serious limits your ability to enjoy life.

15. Ask For HelpIf you need emotional support or just someone to talk to, don’t be afraid to ask for it. There are times in life when everyone must look outside themselves for comfort and advice. If friends can do the job, ask them to help. If not, be assured that professional help is available through your employee assistance program.

I would like to add a suggestion of my own to the list: Look at art. Even better, create some yourself.

How about you, reader? Anything you'd like to add to the list?

January's Here!

It's official! January is here! Right now! On this very blog!

Ok, maybe it's not Mad Men's January Jones. Not a television star. Not as good as that.

It's the month of January. The month of resolutions.

Here we go again, right? How am I gonna change this year?

You know the drill. Take inventory. Have my my ready made list of personal disappointments. Doesn't take long, does it? We know each and every one of those suckers by heart, don't we? Every failure? Every mistake?

Now whip it into a to-do-list:

Lose weight.

Drink less.

Exercise more.

Yell less.

Work more.

Spend less.

But enough of that noise. How about something completely different this year?

Maybe resolutions where we take stock in our strengths. Our good points.

What do I like about myself?

That's right. A List of Likeables. What I accomplished this year. What I'm proud of. What brought me joy. Pleasure. Happiness. What I wouldn't change about myself.

Here are some examples of what might apply:

I experimented with a few new recipes. Even liked one of them.

I made my friends laugh.

I finally cleaned out the garage back in June. The fact that it's chaos again? No matter.

Went two months without arguing with my co-worker.

Made a new friend. Or two.

Took a risk.

Volunteered my time.

Showed compassion.

Passed my annual performance eval. Everybody else did, too? So what. I showed up and didn't get fired.

Passed on second helpings. Most Some of the time.

Helped my sour puss neighbor.

Held my tongue.

Paid my bills on time.

Paid down my credit card debt.

Listened to someone who needed to talk.

So, that's the gist of it. An agreement to recall what I like about myself. What I'm happy about.

Therapy couches are full of people who focus exclusively on their faults.

Yes, especially Super Man.

One part of my job is to help people reframe in a more healthy direction. To help clients take credit for the things they have done right instead of continually echoing things they feel shame about. Giving permission to make mistakes. Understanding that inconsistency is the human condition.

So maybe this year we can vow to take it easy on ourselves. Make this a year of uplifting changes. Appreciate my strong points. Cut down on the self-criticism. Try out a kinder, gentler me. Feel good for a change.

And now it's your turn, reader. What is something you will put on your list? What is something you did in the past year that you feel good about? Proud of? Happy about, even? What are your positive traits? What do others like about you? What do you like about you?

Out, Out, Belief System!

One important therapy tool in Cognitive Behavioral Therapy is exploring thoughts and beliefs that contribute toward an emotional or mental health disorder.

Thoughts can be viewed as relatively simple ideas or statements that guide our self-talk. For people suffering from depression, for example, these thoughts tend to run toward negative, discouraging themes. They may seem quick and random, such as,

I'm never going to get this right!

Or, What is wrong with me?

Or, There's no point in trying.

Cognitive therapy involves paying attention to these automatic negative thoughts, or cognitions, and coming up with healthier alternatives. That is, ultimately changing them or replacing them with more accurate, positive, uplifting, and/or calming thoughts.

Often, in therapy, we CBT psychologists look a little deeper for underlying belief systems that influence our clients' moods and actions.

Gloom and Foreboding

These belief systems, or beliefs, for short, can be made up of a single powerful statement, such as the following examples,

I'm destined for failure.

I can't say no. I hate letting other people down.

Nobody will ever love me.

Something is wrong with me.

Or they can be made up of a series of thoughts that clump together:

Why is my life so hard? At this rate, I'll never get ahead. Why keep trying? It's no use. Every time I take one step forward, something happens that sets me back. I may was well give up.

Belief systems are typically made up of a complex pattern of thoughts that group together to feed and maintain the one, highly charged belief.

Let's take for example a common underlying belief found among people experiencing anxiety and depression symptoms:

Nobody loves me.

Or,

I am unworthy of love.

This belief is usually fueled by dozens or hundreds of smaller impact thoughts.

Look at me! I'm in terrible shape.

She won't come back, I just know it.

I need him. There is noone else out there for me.

I'm not going. What's the use? There's no point in trying to meet anyone.

I'll never find anyone else.

Why would anyone want to go out with me? I have nothing to offer.

I feel so fat and horrible.

I'm disgusting. No wonder he hasn't called me.

All of these thoughts could be related to the core, underlying belief, Nobody loves me. Or, I am unloveable.

One of the keys of CBT is uncovering dysfunctional belief systems, bring them to the light, and helping the client let go of their powerful hold, and move forward.

Sometimes dysfunctional beliefs are formed in early childhood. An abusive, neglectful parent can contribute to their formation. A group of teasing, bullying kids in the neighborhood can do the same.

Sometimes beliefs get started in adolescence or later in adult life, say, when a cherished lover or spouse is abusive, unfaithful, or abandons.

Whatever their origins, the good news is they can be outed and purged using CBT techniques.

More examples of dysfunctional belief patterns to come.

Are you Shoulding on Yourself Again?

In the cognitive part of cognitive behavioral therapy (CBT) we look for thinking patterns that get in the way of healthy feelings and behavior. Thoughts associated with unhappy feelings.

Sad, anxious, angry, shameful, hurtful feelings.

One of the easiest thoughts to identify and change are those that contain the word "should."

Should statements, as they are called.

You should go check on your neighbor. He hasn't been out much lately.

I should exercise more.

She shouldn't talk to her in that tone of voice.

Should statements are one form of automatic negative thoughts, or ANTS. Should implies that someone has done something wrong. Or bad. That someone behind you is shaking a finger, going, "tsk, tsk, tsk, bad person."

The shoulds are often immediately followed by subtle feelings of shame and guilt. Sometimes not consciously detected. But it's there. The essence of it. Building up throughout the day, if you happen to be a daily should-er. Many of us use should statements dozens of times a day, if not hundreds. Out loud or silently, to ourselves.

I should be able to figure this out.

She should be more careful.

You should buy the red sweater.

Shoulding on oneself. Shoulding on others.

The examples above aren't all that toxic, granted. But the effect is insideous. Disapproval. Judging. You're doing wrong. I'm unworthy. These feelings can add up. At the end of the day, we feel more stressed out. More hostile. More _____ (fill in the blank with an unpleasant feeling). Its cumulative. It adds up. I know this personally. I know this professionally.

Even the innocuous, commonly heard response to receiving an unexpected gift, "You shouldn't have!" It delivers an entirely different message when, instead, we say, "You are so thoughtful. Thank you."

How to remedy this common thinking error? In some cases, change should to want. Or wish. Or like.

I want to figure this out.

I wish she would be more careful.

I like the red sweater. I hope you buy that one.

The idea is to change the negative, judgemental idea to something with a positive message. Or more positive. More upbeat. More hopeful.

Below are a few examples that are a little more toxic. Try to change them yourself.

You should watch what you eat.

He should take better care of his car. We're not made of money!

I shouldn't be having these thoughts. She just died, afterall.

And how about the image at the top of this post. Vanity Fair cover of teen television star, Miley Cyrus, aka Hannah Montana, of Disney Channel. Does this image of a 15-year-old bring up a should statement or two?

I don't know about you, but I feel slightly better when I say, "I wish young stars (and their agents) didn't feel pressure to pose in such a sexually suggestive manner." Instead of, "She should not be posing like that. What were her parents thinking?"

cognitive behavioral therapy, 101

I get a lot of phone calls from new clients who want to schedule with a therapist who specializes in Cognitive Behavioral Therapy (CBT). They've been told by their doctor, attorney or friend to seek out CBT but they don't know what it is, exactly.

I welcome these questions. When clients are more informed about their treatment, they tend to feel more comfortable in our sessions and do better when they get home. And I don't believe clients who ask these questions are dummies, just so you know (I can't speak for the authors of the book). I expect that most people have little idea what CBT is and I'm happy to explain.

CBT refers to two different components: Cognitive is the thinking part of therapy; Behavioral is the doing.

Very simply, CBT aims to help us change how we think and change how we behave. To recognize patterns of thinking that lead to unpleasant

feelings. To change what we do so that we feel better more of the time.

The example I give most often: You're depressed because you've gained a lot of weight. You feel hopeless about ever losing the extra pounds. Your depression leaves you feeling unmotivated to exercise more.

The cognitive piece of CBT will help identify faulty thinking patterns

that contribute toward gaining weight and feeling depressed:

"I'm never going to lose this weight. Why even try? I give up."
"All I can think about is food."
"I deserve to eat this dessert."

"I can't stand how I look."

"I feel just awful."

"I want to crawl into bed and stay there."

The behavioral component will help identify small changes in behavior that will help you reach your goals (exercise more, eat less). Tweaking the goals in such a way that you are more likely to succeed. Small, doable steps replace lofty, out-of-reach goals.

There are many common, nearly universal thinking patterns that I listen for and teach my clients to hear within themselves. And to change. We'll get to those in later posts.

1st image source here

2nd image source here, but originally found here