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attitude

Pain is Inevitable; Suffering is Optional

The goal of Acceptance and Commitment Therapy (ACT) is to create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. This is done by changing one’s relationship to their symptoms in order to live a more value-driven life. Further, the goal is to accept what is outsideof one’s control, and commit to taking action to enrich one’s life. It can be summed up in one basic premise: pain is inevitable, but suffering is optional.

Oftentimes, trying to get rid of symptoms actually results in being more bothered by the symptoms. For example, try to not picture a pink elephant in your mind’s eye. What happened? You saw a pink elephant. This is just what happens when we try NOT to focus on any particular thing!

Being too focused on symptoms impacts our ability to life a value-driven life. We’re too busy and using all our energy on “symptom-reduction” rather than choosing to focus on what is meaningful in our lives, such as family, friends, relationships, advancing career, rest, self-care, and so forth. When we instead focus on our values, our symptoms can drift to the background, rather than take center stage.

ACT asserts that problems are essentially caused by two things: cognitive fusion and experiential avoidance. Cognitive fusion is when we become inseparable from our thoughts, and then our thoughts dominate our behavior. Experiential avoidance happens when we attempt to avoid, get rid of, suppress, or escape unwanted experiences (thoughts, feelings, memories, sensations, etc.).

Trying too hard to control how we feel simply gets in the way of a rich, full life. We can’t do important, value-driven things if we are always trying to get rid of symptoms. Control is the problem, not the solution.

What can we do about this? Practice defusion to get stuck from our thoughts and gain distance from them. Defusion is taking a step back and seeing our thoughts for what they are: nothing more or less than words and pictures. As I like to say, look AT your thoughts, rather than FROM your thoughts.
Thought Defusion PICTURE for blog post - Copy

Here are some ways you can attempt to defuse from your thoughts:

  • Say “I’m having the thought that…”
  • Use a silly voice to say the thought
  • Sing the thought like a song
  • Repeat the thought nonstop for 30 seconds until it sounds like gibberish

Another way to defuse from unhelpful thoughts is to practice mindfulness. What is mindfulnessMindfulness means paying attention with flexibility, openness, and curiosity. It allows you to be aware of your experience in the moment as opposed to being “caught up” in your thoughts. Mindfulness involves an attitude of openness; being curious about your experience rather than fighting with it. This is helpful because often times the more we try to fight the way we feel, the more we end up feeling it.
hexagon-4
 
The goal of ACT is referred to as psychological flexibility, which entails being present, opening up, and doing what matters. An important facet of psychological flexibility is acceptanceallowing thoughts and feelings to be present, regardless of whether they are pleasant or painful.

The fun part of ACT (in my humble opinion) is valued living: doing what we want to be doing with our lives. What’s important to us? What do we want to stand for? How do we want to behave and act on a daily basis? Our values are our compass; they guide our decisions and behavior. A good way to figure out what your values are is to imagine your retirement party or funeral — Who would you want to speak about your life and what would you want to hear them say?

Once you have figured out what your values are, then final step is to take committed action (effective action motivated by your values). One helpful way to do this are to make a public commitment; tell someone about it. This will create some level of accountability for you. Another thing you can do is create an action plan worksheet. Last, but not least, simply take the first, tiniest step. The first step is often the hardest, but if you can manage to get started, the rest will follow.

For more on Acceptance and Commitment Therapy, click here and here!

How to Dispute Irrational Beliefs

Albert Ellis is known as the grandfather of Cognitive Behavior Therapy. He combined humanistic, philosophical, and behavioral therapy to form Rational Emotive Behavior Therapy (REBT) in 1955. A main assumption of REBT is that people contribute to their psychological problems by the way they interpret events. Further, our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations. REBT assumes that cognitions (thoughts), emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship. Additionally, REBT postulates that people are born with a potential for both rational and irrational thinking.

According to Ellis, we have an inborn tendency toward growth and actualization, yet we often sabotage our movement toward growth due to self-defeating patterns we have learned. We originally learn irrational beliefs from significant others during childhood, and we actively reinforce these self-defeating beliefs by repetition, and by behaving as if they are useful. But it is not useful to blame ourselves and others; instead, it is important that we learn how to accept ourselves despite our imperfections. Therefore, a major goal of REBT is to achieve unconditional self-acceptance and unconditional other acceptance; the more one is able to accept him or herself, the more likely he is to accept others.

The therapeutic process involves identifying irrational beliefs, and replacing such beliefs with more rational and effective ways of thinking. Changing one’s thinking results in changing one’s emotional reactions to situations. Ellis succinctly puts it this way, “You mainly feel the way you think.” Some examples of irrational beliefs that lead to self-defeat include: I must have the approval of all the people in my life, or else I am worthless. I must perform all tasks perfectly, or else I am a failure. It is better to avoid life’s difficulties than to try and end up looking foolish.

The A-B-C framework and method of disputing irrational beliefs is central to REBT theory and practice.

A = an event, behavior, or attitude
B = belief about the event
C = emotional & behavioral consequence or reaction (can be healthy or unhealthy)
D = disputing irrational or self-defeating beliefs
E = effective philosophy of replacing unhealthy thoughts with healthy ones
F = a new set of healthy feelings

A (the activating event) does not cause C (the emotional consequence); rather, B (the person’s belief about the event) largely causes C. D is the application of methods to challenge irrational beliefs by detecting, debating, and discriminating irrational (self-defeating) beliefs from rational (self-helping) beliefs. E is the new and effective belief system that consists of replacing unhealthy thoughts with healthy ones. In doing this, F (a new set of healthy feelings) is created.ABC Framework 11

In summary, Rational Emotive Behavior Therapy entails the following steps: (1) acknowledge that we are largely responsible for our own emotional problems, (2) accept that we have the ability to change these disturbances significantly, (3) recognize that our emotional problems often stem from irrational beliefs, (4) accurately perceive these beliefs, (5) see the value of disputing such self-defeating beliefs, (6) accept that we need to counteract our dysfunctional beliefs/feelings/behaviors, and (7) practice these methods to improve current and future circumstances.

References:
Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

3 Core Conditions for Therapeutic Change

The person-centered counseling approach was established in the 1940’s by humanistic psychologist, Carl Rogers. The goal of a person-centered therapy is to create the necessary conditions for clients to engage in meaningful self-exploration of their feelings, beliefs, behavior, and worldview, and to assist clients in their growth process, enabling them to cope with current and future problems.

A major concept of this approach is that people are generally trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Another key concept is that the attitudes and characteristics of the therapist, and the quality of the client-therapist relationship are prime determinants of the outcome of the therapeutic process.

Rogers maintains that therapists must have three attributes to create a growth-promoting climate in which individuals can move forward and become capable of becoming their true self: (1) congruence (genuineness or realness), (2) unconditional positive regard (acceptance and caring), and (3) accurate empathic understanding (an ability to deeply grasp the subjective world of another person).

1. CONGRUENCE (GENUINENESS)
Congruence refers to the therapist being real, authentic, and genuine with their clients. It’s called congruence because their inner experience and outward expression match. In being authentic, the therapist shows they are trustworthy, which helps in building a good therapeutic relationship with the client. It also serves as a model for clients, encouraging them to be their true selves, expressing their thoughts and feelings, without any sort of false front.

2. UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE
Unconditional positive regard means the therapist genuinely cares for their clients and does not evaluate or judge their thoughts, feelings, or behaviors as good or bad. Each client is accepted and valued for who they are, as they are, without stipulation. Clients need not fear judgment or rejection from the therapist.

3. ACCURATE EMPATHIC UNDERSTANDING
Accurate empathic understanding means that the therapist understands their client’s experience and feelings in an accurate and compassionate way. The therapist recognizes that each client’s experience is subjective and therefore strives to see things from the client’s unique perspective. An important part of accurate empathic understanding is for the therapist to convey that they “get it” by reflecting the client’s experience back to them. This encourages clients to become more reflective with themselves, which allows for greater understanding of themselves.

If you’ve ever had an experience where you felt like someone just really got you…they completely understood where you were coming from, or could truly relate to the way you felt – that’s accurate empathic understanding.

Rogers asserts that empathy helps clients (1) pay attention and value their experiencing; (2) see earlier experiences in new ways; (3) modify their perceptions of themselves, others, and the world; and (4) increase their confidence in making choices and pursuing a course of action. Jeanne Watson (2002) states that 60 years of research has consistently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts it this way:

“Therapists need to be able to be responsively attuned to their clients and to understand them emotionally as well as cognitively. When empathy is operating on all three levels – interpersonal, cognitive, and affective – it is one of the most powerful tools therapists have at their disposal.”

 

References:
1. Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). American Psychological Association, Washington, DC.
2. Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

Mental Attitude

I recently came across Elbert Hubbard’s essay on “Mental Attitude” in a book I was reading, and I enjoyed it so much that I wanted to share it with others. For me, it speaks an optimistic message of how having the right combination of self-confidence, courage, and determination will lead you to success. I hope you enjoy it as much as I do!

Whenever you go out of doors, draw the chin in, carry the crown of the head high, and fill the lungs to the utmost; drink in the sunshine; greet your friends with a smile, and put soul into every hand-clasp.

Do not fear being misunderstood, and never waste a minute thinking about your enemies.  Try to fix firmly in your mind what you would like to do, and then without veering off direction, you will move straight to the goal.

Keep your mind on the great and splendid things you would like to do; and then, as the days go gliding by, you will find yourself unconsciously seizing upon the opportunities that are required for the fulfillment of your desire, just as the coral insect takes form the running tide the elements it needs.  Picture in your mind the able, earnest, useful person you desire to be, and the thought you hold is hourly transforming you into that particular individual.

Thought is supreme.  Preserve a right mental attitude – the attitude of courage, frankness, and good cheer.  To think rightly is to create.  All things come through desire, and every sincere prayer is answered.  We become like that on which our hearts are fixed.  Carry your chin in and the crown of your head high. 

 

Works Cited:
Knox, George.  Thoughts That Inspire.  Des Moines.  Personal Help Publishing Co. 1906.
Carnegie, Dale. How to Win Friends & Influence People. New York. Simon and Schuster, Inc. 1981.

A Young Woman’s Personal Experience with Anxiety

Anxiety is something that everyone deals with, to some extent, during their life. For some people it’s a passing experience of feeling stressed and overwhelmed. For others, though, anxiety can be crippling. I mean truly, intolerably, despairingly crippling.

You can’t sleep, you can’t eat, you can’t focus. Your work suffers; your relationships suffer.  You question everything you do, and everything you say. Your mind never stops churning things over. You’re filled with feelings of self-doubt and never being good enough. It’s pure agony.

The term “anxiety” gets thrown around for everything, ranging from feeling nervous to experiencing unrelenting, incapacitating panic attacks. Because of this, there are people who equate “feeling stressed” to knowing what having an anxiety disorder feels like. Unfortunately, this attitude feels discrediting and invalidating to the person who truly experiences the wrath and magnitude of anxiety.

Anxiety can manifest itself as a condition, such as a phobia, social, or generalized anxiety; or on a greater level, it can present comorbidly with other conditions, such as Depression, ADHD, Schizophrenia, and so forth. Anxiety is not a character flaw. I repeat: ANXIETY IS NOT A CHARACTER FLAW. Anxiety is a neurological imbalance. It is the result of obtaining some unfortunate genetics and/or exposure to certain life experiences. None of those things are your fault in any way.

I am the youngest child of two girls. Some people believe that being the youngest child makes you “selfish.” I would say that I do, in fact, have a tendency towards selfishness. But my selfishness isn’t due to being the youngest child; rather, it’s a result of having to manage my anxiety.

For instance, I can’t be the person who goes and offers comfort to a friend in the middle of the night because of a break-up, or some other challenging situation. I have to be selfish; I need to sleep. Because altering my routine and extending myself could offset my own mental stability. I need to rest. I need to relax. I need time to myself.

I have to “be selfish” in order to operate in a fast-paced, high-producing, performance-based society. I’m at a disadvantage to others, who function at a higher level, and with more ease. Because of my anxiety, my mental and emotional reserves are easily and quickly depleted.

I want to be there for my friends in the middle of the night, when they are hurting, but the fact of the matter is that I can’t. I have to take care of myself. This doesn’t mean that I don’t care. It doesn’t discredit me as a kind-hearted person. I absolutely want what is best for the people around me. I simply need my time, time when I am off limits, time to recuperate.

I’ve learned from past mistakes of over-extending myself. There have been times when I’ve tried to be everything to everyone. I went out of my way, above and beyond, to be there for people. Even when I did all that I could, I still felt this hankering guilt that it wasn’t enough; that I wasn’t enough.

I have since learned that the care and support I am able and willing to offer others is enough. I have since learned that I am enough. I realize that I owe it to myself (and others) to take care of me. I have to care for myself at least as well as I care for others. Self-care is a requirement for others-care. And when you think about it, there’s really nothing selfish about that.

 

* Special thanks to my considerate, generous, hard-working, and capable niece for sharing her story, in hopes of providing understanding and validation for those who face their own struggles, and in hopes of providing insight for others to develop empathy for such challenges.