Thursday, 27 October 2011

Therapy Thursday: Cognitive Distortions

Just as we all have Automatic Thoughts, we also all fall prey to certain styles of distorted thinking that inevitably end up making us feel miserable, and/or sabotaging our lives and relationships. Look through the list below, and see if you can identify the types of cognitive distortion that most frequently ensnare you. There will probably be two or three that stand out.

  1. All or nothing thinking: You see things as either black or white. There is no middle ground, no shades of grey. Anything less than perfection is utter failure. And if you can't have things exactly how you want them, what's the point?
  2. Overgeneralization: You draw general conclusions based on a single incident or piece of evidence. If something bad happens once, you assume it will happen again and again. You use the words always and never a lot.
  3. Filtering: You take the single negative detail of any situation and magnify it out of all proportion, while filtering out all of the positive aspects. You will dwell on a word of criticism and ignore heaps of praise.
  4. Discounting the positive: You reject positive results or experiences by insisting that they don't count. If you do something great, you tell yourself anyone could have done it. Meanwhile, the negative stuff is yours alone.
  5. Catastrophizing: You expect disaster. You take a small problem or event, and imagine extreme and horrible consequences that could ensue. Or you hear about a problem and start with the what ifs. What if that were to happen to me? What if the results were tragic? Such fear can be crippling.
  6. Personalization: You think that everything people do or say is some kind of a reaction to you. If they laugh, it's you they're laughing at. If they whisper, they're whispering about you.
  7. Mind reading: You think you know what other people are thinking or feeling, or why they act the way they do, especially with regard to yourself. You tend to focus on negative interpretations.
  8. Blaming: You hold other people responsible for your pain. Or you blame yourself for everything that happens to yourself and others. Either way, the finger has to point at someone.
  9. Shoulds: You tend to carry around a list of ironclad rules about how you and other people should act. You tell yourself things should be the way you hope or expect them to be. You are thus continually disappointed by yourself, other people, and life in general.
  10. Fallacy of fairness: You cannot get over the fact that the world is not always fair. And you feel resentful when other people's idea of fairness does not match up with your own.
  11. Control fallacies: You either see yourself as a helpless victim of fate (external control fallacy), or you hold yourself responsible for the pain and well-being of everyone around you (internal control fallacy).
  12. Emotional reasoning: You automatically assume that what you feel must be true, and that your negative emotions reflect the way things really are. If you feel stupid and boring, then you must be stupid and boring.
  13. Fallacy of change: Rather than change yourself, you tend to want to change other people, and expect that they will change to suit you if you just pressure them enough.
  14. Global labelling: You tend to take one or two of a person's qualities, and generalize these into a global (and usually negative) judgement.
  15. Being right: You need to be right all the time, and will go to any length to demonstrate that your opinion and actions are correct.
  16. Heaven's reward fallacy: You expect all your sacrifices and self-denial to pay off one day, as if someone (God?) were keeping score. When the reward fails to materialize, you feel bitter.
Identifying your own cognitive distortions is perhaps the most important part of the process. As with Automatic Thoughts, the next (and hardest) step is to catch yourself red-handed as you follow your habitual patterns and fall into one of these seductive and destructive traps. This involves getting to know yourself better, stalking yourself as you would some wild prey; stepping back and observing your thoughts, rather than being swept away by them. This is mindfulness, once again, and it requires practice.

Next week, I'll offer some suggestions as to what to do with your cognitive distortions once you have got used to recognizing them.

Thursday, 20 October 2011

Therapy Thursday: Automatic Thoughts

  Last week's post discussed the notion that 'what fires together wires together.' If we want to change our minds and our lives, the key is to challenge and replace our habitual, default ways of thinking and behaving. We become who we want to be through practice. Instead of remaining stuck in a rut, we choose a new path, and deliberately walk that path until it becomes our reality. This is not wishful thinking: it is backed up by hard science. Today's post builds directly upon this foundation.
Researchers estimate that the average person has around 60,000 thoughts per day. Most of these thoughts – some 90% in fact – remain just below the level of awareness. We have no conscious control over them, and do not even realize that we are thinking them. These are known as automatic thoughts. We are continually talking to ourselves in our heads, trying to make sense of our world, looking for patterns, dangers and vulnerabilities. In the past, this feature of the human brain undoubtedly had great survival value. In today's world, however, our overactive, over-critical minds can be their own worst enemy. Many, if not most, psychological problems begin with negative, self-sabotaging automatic thoughts that can be self-fulfilling prophecies. We doubt ourselves, our self-doubt causes us to fail, and our failure reinforces our self-doubt.
In the West, we tend to mistrust our emotions. What we don't realize is that those emotions are almost always preceded and provoked by our thoughts: automatic thoughts which we don't even realize we're thinking. The emotions, in fact, are very useful: like toothache, they alert us to the fact that something is happening that requires our attention. They nag us to change what is not working for us.
Here's an example. I once knew someone who couldn't help talking his thoughts out loud. It was very useful for me, as I got to hear all his automatic thoughts. He'd be alone in his room, talking to himself about some neutral subject, then would start to complain about how no-one ever listens to his point of view, how they don't respect him, how they gang up on him and laugh behind his back, and so on. Most of this was untrue, but after about ten minutes of ruminating he will have whipped himself into a seething rage. Those of us who don't talk our thoughts out loud would most likely find ourselves in such a rage, and wonder how we got there. Or we might find ourselves feeling frustrated, sad, lonely, depressed, anxious, bitter, jealous, overwhelmed, afraid. And wonder why. The answer is clear: Automatic Thoughts!
Going Deeper
I end up addressing automatic thoughts with almost every client I see, because they are so pervasive. Almost all of us have developed the habit of repeating to ourselves nasty little messages that sabotage our plans, crush our self-esteem, feed our insecurities, and leave us feeling unhappy and inadequate. These automatic thoughts might be constant, or might appear as a reaction to particular situations. Either way, the steps for dealing with them are as follows:
  1. Identify your negative automatic thoughts. This is not always easy, because, by definition, they tend to remain below the level of awareness. You have to be vigilant, watchful, and hunt those thoughts down. Your emotions can help you. If you find yourself feeling angry, sad, frustrated etc, try to identify what you were thinking before the emotion arrived.
  2. Once you identify an automatic thought, write it down using the very words you say to yourself in your head, such as 'Matt, you're such a loser!' or 'You'll never get it right!' or 'No-one's gonna read your stupid blog anyway!' Try to identify 5 to 10 thoughts that come up again and again, perhaps in slightly different forms.
  3. Argue with those thoughts. The chances are, they're just plain untrue. At best, they're highly skewed generalizations. If you're saying 'You never do anything right!', look at the evidence as honestly and objectively as you can. Think about all the things you have done right. Clearly the voice in your head is unreliable.
  4. For every negative automatic thought, write down a more positive, more truthful alternative. Such as 'most of the time I do things well, and when I make mistakes I learn from them'.
  5. Continue to practice being watchful for automatic thoughts. Having identified them and written down the very words they use, it should become increasingly easy to recognize them when they arise. When you catch one, MAKE IT STOP! You could say STOP! out loud, say it loudly in your head, or visualize a red stop sign. Whatever works.
  6. Once you've identified and stopped the automatic thought, replace it with your positive, realistic alternative. Again, you could say this out loud, or say it in your head. The important thing is to do so consistently.
Some people are originally suspicious of this method. They confuse it with the kind of happy-clappy affirmations that fill the worst kind of self-help book. This is untrue for two reasons. Firstly, because of step 3. You have unmasked your automatic thoughts, and revealed them to be objectively untrue. This is not just wishful thinking! Secondly, because of the science of neural plasticity. Your mind will not change overnight. You will continue to be plagued by unwelcome automatic thoughts, and your alternatives may feel inauthentic and awkward at the beginning. In time, however, the positive thoughts will replace the negative ones, and will themselves become automatic, your new default setting, creating an upward spiral, a positive self-fulfilling prophecy, encouraging a happier, more productive, more confident you.
As ever, the key is practice.
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Thursday, 13 October 2011

Therapy Thursday: The Pivotal Role of Choice

'Neural plasticity' sounds like a mouthful, but it's actually a pretty simple concept. The fact is, our brains are much more flexible, and capable of change, than we usually believe. A basic understanding of how the brain works can be helpful on an extremely practical level, and underlies much of the work that I do as a counsellor.

In recent years, modern technology, in the form of machines such as MRIs, has enabled researchers to understand the workings of the human brain with ever-greater clarity. Such research has loaned great credence to the old, intuitively appealing notion that 'what fires together wires together'. When we have a thought or experience, thousands of neurons fire simultaneously. The wiring that accompanies this event makes it more natural for those neurons to fire together again in the future. And each time the pattern is repeated, the stronger the wiring gets, until it becomes an automatic response. It is like walking through a field of long grass. The first time you cross the field, the going is fairly tough and your route is not at all obvious. Your next walk across the field is easier: you can retrace your footsteps by following the trampled down grass. The third time is easier still, and so on. Soon your route becomes a path, and the more you walk it, the clearer the path becomes. When we lived in the Kootenays, Alison and I had a long, steep driveway. When it was wet, our tires would leave tracks that pretty quickly turned into ruts. In no time at all, it was almost impossible to go up that driveway without the tires getting sucked into those ruts, and once in the ruts it was very hard to get back out. If we were not happy to drive in those ruts, we had to steer well clear of them from the very start, and forge a new route, which inevitably became a new set of ruts.

Our minds are just like this. And the metaphor of being 'stuck in a rut' is a very accurate and helpful one. All of our habits of thinking, feeling, perceiving, acting and reacting could be seen as networks of neurons that have become accustomed to firing together. The bad news is that this process can easily lead to the perpetuation of really negative thoughts and behaviours. A traumatic event, for instance, by dint of having so powerful an effect on us, can instantly create a lot of wiring, a deep rut that sucks us in again and again, becoming deeper and more difficult to escape over time. Similarly, drugs such as cocaine can make us feel so good so quickly that they too instantly create a lot of wiring. Other drugs, like alcohol or cigarettes, suck us in more insidiously through sheer repetition, but the rut they dig is just as deep, and just as hard to escape. This is one reason why it's so unhelpful to look at an addict with judgement saying, 'why doesn't he just stop?' It's not so easy to reverse that much wiring. Anxiety, stress, panic attacks, repetitive negative thoughts, low self-esteem, and anger are all examples of deep ruts. And ironically, the more we fear or loathe these things, the more wiring our fear builds around them, and the deeper the rut becomes.

The good news is that the brain is flexible so, deep as our ruts may be, we always have a choice. We can choose to avoid the rut and forge a new path. And the more times we follow that new path, the clearer it becomes, until the rut we're in is exactly where we want to be. Freewill means that we can choose who we want to be and how we want to live, but these choices are not abstract, they cannot remain on the level of thought and intention: we make them reality through practice, through the small decisions we make and actions we take every day. Every time we choose to think one thing instead of another, every time we choose to act one way instead of another, we are literally changing our minds and shaping our future selves.

In Sharon Begley's book Train your Mind, Change your Brain (2007), the Dalai Lama talks of how even he, as a child, had times of anger and aggression, and even bullied other children. He did not get to be the person he is today through the blessings of an auspicious birth alone, but by choosing what to believe and how to behave. By acting consistently in accordance with those choices, he has now extinguished the unwanted aspects of himself entirely, and has replaced them with love and compassion, which are now effortlessly his true state of being, a well-worn rutted road of behavioural and emotional response.

Similarly, one of many variations of a First Nations parable goes as follows: A young Cherokee is brought before the tribal elders, who are concerned about his aggressive tendencies. One of the elders takes the young man aside and tells him that his anger is understandable, since all humans have within them two wolves. One wolf is good and peaceable, and the other is evil and angry. The two wolves are in constant battle with one another, since neither is powerful enough to destroy the other. The young man asks the elder "But if they are of equal power, which wolf will win?" And the elder replies, "The one you feed the most."

Thursday, 6 October 2011

Therapy Thursday: Making Your Relationship Work Pt 2 – Dealing with Conflict

According to John Gottman in The Seven Principles for Making Marriage Work, all relationship conflicts fall into two groups: resolvable and perpetual. If you're experiencing conflict with your partner, it's useful to identify which of these two categories it belongs to, so that you can use the most effective method for dealing with the issue.

The real key to all conflict resolution is the same, however: before you ask your partner to change anything, it is important that they feel understood and accepted. If either (or both) of you feels judged, misunderstood, or rejected by the other, it will be very hard to deal with your problems. In fact, the gulf between you is likely to get wider. People can change only if they feel that they are basically liked and accepted as they are. When people feel criticized, disliked, and unappreciated, they are unable to change. Instead, they feel under siege and dig in to protect themselves.

How to Distinguish between Resolvable and Perpetual Conflicts
We all encounter relationship conflicts that will never be entirely resolved, and the reason is that they symbolize some profound difference between ourselves and our partner. As a result, they frequently lead to a state of gridlock. The tell-tale signs of such a conflict are as follows:
  • It makes you feel rejected by your partner
  • You keep talking about it but make no headway
  • You become entrenched in your positions and are unwilling to budge
  • When you discuss the subject, you end up feeling more frustrated and hurt
  • Your conversations about the subject are devoid of humour, amusement or affection
  • You become even more unbudgeable over time, which leads you to vilify each other during these conversations
  • This vilification makes you even more rooted in your position, extreme in your view, and less willing to compromise
  • Eventually you disengage from each other emotionally.

What to do about Perpetual Conflicts
Perpetual conflicts are an inevitable part of any relationship, much as chronic physical ailments are inevitable as you get older. By definition, these conflicts cannot be resolved. Fortunately, you don't have to resolve them in order for your relationship to thrive. They do, however, need to be addressed, so that you can both cope with them, avoid situations that worsen them, and develop strategies and routines that lessen their impact.

According to Gottman, unrequited dreams are at the core of every gridlocked conflict. Our deeply personal dreams frequently go unspoken or underground when we commit to a long-term romantic relationship, because we assume they must in order to make that relationship work (especially when kids come along). But when you bury a dream, it just resurfaces in a disguised form, as a gridlocked conflict. Don't give up on your dreams! Research shows that couples who are demanding of their marriage are more likely to have deeply satisfying unions than those who lower their expectations. Happy couples understand that helping each other realize their dreams is one of the goals of marriage.

The dream is unlikely to emerge until you feel that your marriage is a safe place to talk about it, so building safety is the first step. The following steps are:
  • Be a dream detective: identify your unfulfilled dreams. They might not be earth-shattering. And what Gottman labels as dreams could often be just as easily described as values or aspirations. Your dream might be to travel around the world. Your partner's dream might be to pay off the mortgage and live debt-free. It's easy to see how these dreams might lead to conflict. But nobody is wrong, and the sooner you stop seeing the other person as the enemy the better.
  • Arrange a time and place to talk about your dreams with your partner. Agree that each person will have a certain amount of time (15 minutes perhaps) as speaker, then the same time as listener. Do not try to solve the problem. Your goal at this stage is simply to explore and understand why each of you feels so strongly about this issue.
  • When talking, make “I” statements and talk only about your feelings and your needs. When listening, suspend judgement and listen with empathy, the way a friend would. Do not argue or criticize.
  • Tell your partner that you support their dream, even if you don't believe the dream can or should be realized. There are 3 beneficial ways of honouring your partner's dream. By expressing understanding and being interested in learning more about it, even if you don't share it. By offering financial support. And by becoming part of the dream.
  • Soothe each other.
  • End the gridlock by making peace with the issue: accept your differences, and establish some kind of initial compromise. The purpose is not to resolve the conflict: it will probably never go away completely. The goal is to de-claw the issue, removing the hurt so that the issue stops being a source of great pain. Hopefully you'll come to see each others dreams not as threats, but as deep desires held by someone you love.
  • Say thank you.

What to do about Resolvable Conflicts
Dealing with your solvable conflicts often comes down to good manners: treating your partner with the same respect you'd offer to a guest. Here are some tips:
  • Soften your 'start-up':
    Be gentle
    Be polite
    Complain but don't blame
    Make statements that start with “I” instead of “you”
    Describe what is happening, don't evaluate or judge
    Be clear
    Be appreciative
    Don't store things up
  • Learn to make, recognize and and respond to 'repair attempts'
  • Soothe yourself and each other
  • Be tolerant of each others faults
  • Find common ground

An Exercise for Finding Common Ground
  • Decide together which solvable problem you want to tackle
  • Sit separately and think about the problem
  • On a piece of paper, draw two circles, a smaller one inside a larger one
  • In the inner circle, list the aspects of the problem that you absolutely cannot give in on
  • In the larger circle, list all the aspects of the problem that are important enough to mention, but that ultimately you can compromise about. The principle to remember here is 'yield to win': the more you can compromise, the better able you'll be to persuade your partner to compromise on the issues that are really important to you
  • Share your circles and begin negotiations. First, find a way for both of you to honour your inner circles. If you cannot do this, either one of you has to shift that sticky issue to the outer circle and compromise, or you have to redefine the problem as perpetual
  • Make a list of the items in your outer circles that you are both happy to agree to, and remove those from the circle
  • Those that remain will require compromise. Don't be afraid of a tit-for-tat discussion. 'If you do this for me, I'll do that for you.' Again, the key is to be fair and reasonable. Try to remember that you're dealing with a person you love, not an adversary; and that you are an adult, not a child
  • Stick to your end of the deal.