# Cognitive therapy



## LostPancake (Apr 8, 2009)

I just wanted to recommend this to anyone who feels driven by emotions, like anxiety and depression. I'm not sure how much it would help with social anxiety itself, as that is a bit more complex.

Cognitive therapy is *not* just positive thinking. It's being able to see *all* aspects of a situation, both positive and negative.

The problem with the brain is, it's designed to give a lot more attention to negative things (eg threats to your social standing), because it has survival value. But it can wind up giving too much attention to potential or imagined threats. And that attention in itself can cause problems (eg your mind going blank, physical symptoms of anxiety, etc).

Say you're in some situation. There are all these aspects to it, but your brain winds up zeroing in on some small part of it, which triggers an emotional reaction. All you're aware of is the emotional reaction. Your brain has filtered out all the other information and all you're aware of is that you feel anxious or depressed or something.

But doing cognitive therapy, you can go back and analyze these situations afterwards, and identify what thoughts were going on under the surface that caused the emotional reactions.

The workbook Mind Over Mood from 1995 [http://www.amazon.com/Mind-Over-Mood-Change-Changing/dp/0898621283] is really good. The main tool is the thought record - you fill out the situation, the emotions you felt, and the thoughts you have about the situation. If it's a situation causing anxiety or depression, there are usually a lot of negative thoughts about yourself. You circle the one that seems to carry the most emotional charge (eg "I'm worthless").

Then you look for evidence that that thought is true, trying to limit it to facts. Then you look for evidence that the thought is not true, all of the time. Then you try to come up with a balanced thought that includes the negative and the positive information, or an alternative thought. Then you rerate your emotions - usually the negative emotions have gone down a lot. The book has a lot of questions to help fill out the different parts of the chart.

I've been doing these for about a month now, and I think they've been more helpful than over a year in psychodynamic therapy, at least with specific issues. For instance, I keep falling into these depressions seemingly out of nowhere, but if I go back and analyze them, there's usually some specific thoughts that triggered them. And I've had a huge amount of anxiety about working on my resume, and kept putting it off, but doing a thought record really opened my eyes to all the issues that were going on, which otherwise I was afraid to even think about. After I did a thought record on it, I was able to work on my resume, and actually enjoyed doing it. The book says if you do 20 to 50 thought records the process will start to become more automatic.

There's a similar technique called the Daily Mood Log, which someone talked about here http://www.socialanxietysupport.com...volutionary-therapy-against-depression-70539/. And I replied in that thread but I never actually tried it. And I read the David Burns book but never actually did the exercises. The Mind Over Mood book is nice though because it's a workbook, so you don't have to bother getting out a piece of paper or something to write on, you just write in the book. Although lately I've been writing the thought records in my notebook, and they sometimes go for 4-5 pages. Usually there are a LOT of negative thoughts, and putting them down on paper is really interesting. Just writing them down you start to see that they're not seeing the whole picture. But the negative thoughts are what are driving the emotional reactions.

I thought I had done CBT when I was younger, but I never did anything like this. It was more like having a cheerleader always encouraging me, and replacing negative thoughts with positive ones. I think it was temporarily helpful in going out into the world, but after I finished therapy, I was pretty lost, because I wound up just trying to replace any negative experience with a positive interpretation, which just didn't work. So I slowly sank back into low self-esteem and depression.

Anyway, I still have a LOT of problems, but I'm interested in applying this technique to them, bit by bit. It does make me feel a bit like I'm doing surgery on myself or something, but the reduction in anxiety and depression and ability to actually DO more things is worth it.


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## Pam (Feb 14, 2009)

I don't know if I already mentioned this but Learned Optimism by Martin Seligman had a good way to do cognitive disputing with yourself. But I can't find the motivation to do exercises myself--it's like thinking about doing a chore. Self-defeating I guess. 

Another general guideline I remember from Learned Optimism is that people such as athletes or commissioned salespeople that have certain attitudes are destined to fail or succeed, depending on how they interpret an event or themselves. So, if a professional athlete sees losing as permanent and general, he's going to lose (ie; Buffalo Sabres & Buffalo Bills lol) But if he sees a loss as temporary and specific, it ups the chances he will win/succeed. And vise versa. The book was full of stories showing how this really works. And one of the things you do is look at how the team members and coaches speak--what words are they using--it makes all the difference. I'm pretty sure Seligman (or someone) did predictions at the beginning of a sports season just based on the teams' spoken attitudes (general, specific, permanent, temporary) of who would be winners and he appeared to be psychic he was so accurate...This would come in handy if you want to bet on teams too! 

I guess my point was that it would be a good habit to have optimistic patterns in thinking which is what CBT is supposed to teach. Now if only I could get myself to bother doing 20-50 exercises!


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## LostPancake (Apr 8, 2009)

I'm actually pretty wary of positive thinking - I think I was kind of delusional growing up, and the times I've done it since it wound up really leading me astray. So negative thinking is kind of a protective measure. But it's not as good as being able to see the whole picture, which is what these thought records help you do. 

And I forgot to say another benefit of the cognitive therapy is that by seeing things more clearly, it's a lot easier to accept problems you might have, and see things you can do to improve them. The book talks about this, and making action plans to change things. 

But yeah, it can be hard to get the motivation to do this stuff. Or there are weird blocks in the way of it. Like I think my emotions were kind of angry that they were being dissected and almost discounted like that. And I keep falling into these depressions after doing these thought records - I think that might have something to do with it. 

And it's pretty weird combining this with psychodynamic therapy, which is about bringing repressed emotions into awareness. But I did a thought record once on the resistance I was experiencing in therapy, and it helped me get over a block, at least temporarily. 

Anyway, maybe it's something to do with the left brain vs the right brain - the left brain is more logical and language oriented, and the right brain is more intuitive and emotional. So cognitive therapy would appeal to the left brain, and psychodynamic to the right brain. But integrating them both is important. 

I might try doing some bilateral stimulation stuff and see if it helps with any of this - I think that's what lies behind that EFT tapping stuff - ie it might help the two hemispheres communicate with each other. I did a bit with that DNMS therapy, just alternately touching left and right thumbs and fingers together, and it really intensified the emotions I was feeling.

And I think I might have that Seligman book, but I might have put it down out of anxiety over the idea of positive thinking!


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## Pam (Feb 14, 2009)

Oh, I am also turned off by the idea of "positive thinking" because my grandmother used to be in to and preach that to me. It's a bunch of crap. It drove me crazy. To me, blind faith not based on anything real = massive denial and sometimes I'd go as far as saying its delusional. I'd rather be in reality and be depressed.  

My boyfriend is doing EFT tapping--for 3 days now. Already this morning his negative attitude came back saying it probably won't do anything. I'm hoping it works! But for anything to work, we have to keep doing it. I tried it for a few minutes yesterday--just went thru the motions without thinking of anything in particular and I got a little dizzy! Lol.

I am sure I have a lot of blocks--I just feel too mentally exhausted to figure out what they are. I've uncovered/discovered a lot of stuff in the past and it's kind of like--will it ever end? How much do I have to do, you know? How much more crap is there? Lol.


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