Cbt Quotes

Someone's got to do some more research, but I would really like to know: when a CBT therapist really gets distressed, who does he go see?

I was in therapy for a bit. Now I do CBT exercises.” “Do you, though?” Strike asked mildly. “Because I bought vegetarian bacon a week ago, but it’s not making me any healthier, just sitting there in the fridge.

Depression is a serious problem, but drugs are not the answer. In the long run, psychotherapy is both cheaper and more effective, even for very serious levels of depression. Physical exercise and self-help books based on CBT can also be useful, either alone or in combination with therapy. Reducing social and economic inequality would also reduce the incidence of depression.

Therapy that is focused on battling “irrational beliefs,” such as cognitive behavioral therapy (CBT), doesn’t work as well on Autistic people as it does on neurotypicals.[72] One reason for that is many of the fears and inhibitions of Autistic people are often entirely reasonable, and rooted in a lifetime of painful experiences. We tend to be pretty rational people, and many of us are already inclined to analyze our thoughts and feelings very closely (sometimes excessively so). Autistics don’t need cognitive behavioral training to help us not be ruled by our emotions. In fact, most of us have been browbeaten into ignoring our feelings too much.

Critical race Theory’s hallmark paranoid mind-set, which assumes racism is everywhere, always, just waiting to be found, is extremely unlikely to be helpful or healthy for those who adopt it. Always believing that one will be or is being discriminated against, and trying to find out how, is unlikely to improve the outcome of any situation. It can also be self-defeating. In The Coddling of the American Mind, attorney Greg Lukianoff and social psychologist Jonathan Haidt describe this process as a kind of reverse cognitive behavioral therapy (CBT), which makes its participants less mentally and emotionally healthy than before.60 The main purpose of CBT is to train oneself not to catastrophize and interpret every situation in the most negative light, and the goal is to develop a more positive and resilient attitude towards the world, so that one can engage with it as fully as possible.

Your external world mirrors your internal state. Heal the parts of you that need your attention or you will forever live out your pain for all to see.

Always look at the function, its not what you did but why do you do it? Once you find the why then you walk through another door

Evil is to be found not within things, but in the value judgements which people bring to bear upon things. People can therefore be cured of their ills only if they are persuaded to change their value judgements,

The nine in our list are based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders. For more on CBT—how it works, and how to practice it—please see Appendix 1.) EMOTIONAL REASONING: Letting your feelings guide your interpretation of reality. “I feel depressed; therefore, my marriage is not working out.” CATASTROPHIZING: Focusing on the worst possible outcome and seeing it as most likely. “It would be terrible if I failed.” OVERGENERALIZING: Perceiving a global pattern of negatives on the basis of a single incident. “This generally happens to me. I seem to fail at a lot of things.” DICHOTOMOUS THINKING (also known variously as “black-and-white thinking,” “all-or-nothing thinking,” and “binary thinking”): Viewing events or people in all-or-nothing terms. “I get rejected by everyone,” or “It was a complete waste of time.” MIND READING: Assuming that you know what people think without having sufficient evidence of their thoughts. “He thinks I’m a loser.” LABELING: Assigning global negative traits to yourself or others (often in the service of dichotomous thinking). “I’m undesirable,” or “He’s a rotten person.” NEGATIVE FILTERING: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all of the people who don’t like me.” DISCOUNTING POSITIVES: Claiming that the positive things you or others do are trivial, so that you can maintain a negative judgment. “That’s what wives are supposed to do—so it doesn’t count when she’s nice to me,” or “Those successes were easy, so they don’t matter.” BLAMING: Focusing on the other person as the source of your negative feelings; you refuse to take responsibility for changing yourself. “She’s to blame for the way I feel now,” or “My parents caused all my problems.”11

For people who are depressed, and especially for those who do not receive enough benefit from medication of for whom the side effects of antidepressants are troubling, the fact that placebos can duplicate much of the effects of antidepressants should be taken as good news. It means that there are other ways of alleviating depression. As we have seen, treatments like psychotherapy and physical exercise are at least as effective as antidepressant drugs and more effective than placebos. In particular, CBT has been shown to lower the risk of relapsing into depression for years after treatment has ended, making it particularly cost effective.

Helpful Fact: Thoughts do not change probabilities in the real world.

Life is as good as your relationship with yourself.

While my wish for you is that you don't become the CBT Lady, my even greater wish is that you, too, never stop being a happy accident.

CBT-I must be used as the first-line treatment for all individuals with chronic insomnia, not sleeping pills.

Cognitive behavioral therapy (CBT) sees depression as a triad of thinking patterns: a negative view of yourself, a negative view of the world, and a negative view of the future.

The claim that patients can recover [from ME/CFS] as a result of CBT and GET is not justified by the data, and is highly misleading to clinicians and patients considering these treatments.

Despite how surprising and counterintuitive it may seem, your tendency to seek reassurance is more of a problem than your worry itself. The solution to your distress is to feel more comfortable and confident with uncertainty.

To make change not only possible but also manageable, there are three things we need to identify: 1    Goals – what do you want to achieve? 2    Objectives – how can you break this into smaller steps? 3    Strategy – where should you start?

Therapy that is focused on battling “irrational beliefs,” such as cognitive behavioral therapy (CBT), doesn’t work as well on Autistic people as it does on neurotypicals. One reason for that is many of the fears and inhibitions of Autistic people are often entirely reasonable, and rooted in a lifetime of painful experiences. We tend to be pretty rational people, and many of us are already inclined to analyze our thoughts and feelings very closely (sometimes excessively so). Autistics don’t need cognitive behavioral training to help us not be ruled by our emotions. In fact, most of us have been browbeaten into ignoring our feelings too much.

...patient evidence has repeatedly found that cognitive behaviour therapy is ineffective and graded exercise therapy can make the condition worse.

Boundaries create a healthy separation between you and others and define who you are, so you can be yourself and make choices that are right for you.

Thought challenging, also referred to as cognitive restructuring, is a process by which a person challenges the negative patterns of thinking that leads to anxiety.

We must respond to life's most difficult questions by humbly conceding 'I don't know the answer, and that's okay.

When you experience stressful events early in your life, you may have difficulty trusting other people, and you may have no models of what a “good” relationship should look like.

Many people with PTSD feel numb emotionally, particularly when it comes to positive emotions.

Also, you may feel there is no reason to plan for the future, or that you may not live to experience positive things in your life.

CBT is a much publicised and debated psychotherapeutic intervention for ME/CFS….The premise that cognitive therapy (eg. changing ‘illness beliefs’) and graded activity can ‘reverse’ or cure this illness is not supported by post-intervention outcome data. In routine medical practice, CBT has not yielded clinically significant outcomes for patients with ME/CFS.

I live with depression and anxiety.* I take medication, I practice meditation and CBT, and I see a therapist regularly to help me handle it. It doesn’t control my life, and it doesn’t define my life . . . but when it’s really bad, it sure feels like it does. When it’s really bad, it feels like it is the only thing in my entire life, the Alpha and Omega of my existence.

Its not the falling down that counts but what you do next that counts the most. Don't spend your time on your needs if you have fallen, instead get up and dust your knees clean and walk!

Its not the falling down that counts but what you do next that counts the most. Don't spend your time on your knees if you have fallen, instead get up and dust your knees clean and walk!

If our mind can teach the brain to remain depressed, anxious, angry, avoidant, overthinking, lazy, and addicted to drugs or alcohol, then it can also learn to remain aware, equanimous, and compassionate.

Some encouraging studies suggest that the answer may be yes. Dr. Isaac Marks, from the Institute of Psychiatry at the University of London, has shown that many individuals can overcome anxiety disorders using CBT techniques without face-to-face psychotherapy or medications. I’m hopeful that this book will prove just as effective for people with anxiety as Feeling Good has been for people struggling with depression. However, no

Many of the benefits of CBT (cognitive behavioral therapy) can be obtained without going into therapy. There are a number of self-help books, CDs and computer programs that have been used to treat depression and some of these have been tested in clinical trials with positive results. I can particularly recommend these two books. One is 'Control Your Depression', the lead author of which is Peter Lewinsohn, a Professor of Psychology at the University of Oregon. ... The other book that I can recommend with confidence is 'Feeling Good' by the psychiatrist David Burns. 'Control Your Depression' emphasizes behavioral techniques like increasing pleasant activities, improving social skills and learning to relax. 'Feeling Good' puts greater emphasis on changing the way people think about themselves. But both books include both cognitive and behavioral techniques.

This is not an argument with psychiatry. Mental and physical illness are equally real and horrible. As with any long-term illness, some people with ME/CFS will develop comorbid depression and other mental health problems – where CBT can be of help alongside good quality general management. The argument here is with a flawed model of causation assuming efficacy for CBT and GET while taking no significant account of varying clinical presentations and disease pathways.

If an adult tells a small child that he or she is a failure, not smart enough, too fat, or not talented, the child will accept this as fact and internalize these beliefs about himself or herself. The child then continues to unconsciously find evidence to support this belief. So, if your mother has been telling you that you’re fat since you were four years old, you probably still think you’re unattractive or overweight, or you worry about your weight (unless you’ve worked hard to undo this belief).

As a physician bedridden with myalgic encephalomyelitis (ME) for more than a decade who is totally dependent on others, all thanks to a major relapse caused by GET, I am in a unique position to answer how harmful GET and cognitive behavioral therapy (CBT) really are. The basis of these therapies is false illness beliefs, meaning that it is all in the mind. These beliefs ignore all of the evidence that ME is a physical disease, such as intracellular immune dysfunctions, which not only restrict exercise capacity but also worsen with exercise (2).

Self-compassion practice can be fruitfully compared to the techniques of cognitive behavioral therapy (CBT). This is a highly respected form of treatment, with a considerable amount of evidence that it is effective for many individuals. An important aspect of the therapy, as described in the popular book Feeling Good by the psychiatrist David Burns, is challenging irrational thoughts. For instance, if you make an overly broad generalization, like “I’m such a loser,” you might dispute it by trying to recall situations where you demonstrated poise and accomplishment.

ME/CFS has been classified as a neurological disease by the WHO since 1969 [59] and a growing number of researchers theorize that ME/CFS might be a neuro-immunological condition [60–63]: yet the BPS framework does not account for ME/CFS as a neurological or immunological disease – instead, much of the pro- BPS model literature on ME/CFS adopts what Nassir Ghaemi terms the ‘eclectic approach’; whereby everything appears important, all bio, all psycho, and all social factors [33]. Yet in clinical practice (the BPS framework), there is strong emphasis on psychological interventions (CBT and GET).

Imagine you’re diagnosed with epilepsy: what would you think if you weren’t referred to a specialist but taken to a psychiatrist to treat you for your ‘false illness beliefs’? This is what happens to Myalgic Encephalomyelitis (ME) patients in the UK. They are told to ignore their symptoms, view themselves as healthy, and increase their exercise. The NHS guidelines amalgamate ME and Chronic Fatigue Syndrome, assuming symptoms are caused by deconditioning and ‘exercise phobia’. Sufferers are offered Graded Exercise to increase fitness, and Cognitive Behavioural Therapy (CBT) to rid them of their ‘false illness beliefs’.

If for example you are diagnosed with depression, then your clinician might prescribe therapy to reduce your depression and or recommend anti-depressant medication. As we have discussed previously though, reducing the symptoms of mental illness does not seem to reduce the probability that someone will make a suicide attempt. Two treatments in particular, dialectical behavior therapy DBT and cognitive behavioral therapy for suicide prevention, CBT-SP, have demonstrated the ability to reduce the probability of suicidal behaviors in multiple studies conducted by multiple research teams. Other treatments that share many of the same characteristics and components as these treatments via attempted suicide.

One subtle form of memory checking happens while reading: you find yourself going back over what you just read, over and over, to make sure you remember or understand it fully, to be certain of what you just read. People with this form of memory checking often think of themselves as slow readers, but they are actually dealing with constant checking compulsions.

A very common compulsive checking reassurance is reading and rereading and re-rereading information on the Internet, looking for unattainable certainty. Or checking texts and emails to make sure everything is okay or no one needs you urgently. Another is to apologize over and over to make sure that another person is not angry or upset about something you may have said or done.

But for those of us who would like to make some headway on those onerous tasks that would truly make us feel better once they’re in our rearview mirror, I offer an old CBT trick called the five-minute rule. What’s the idea? Here it goes: you pick the task you want to work on, and you vow to work on it for five minutes, and five minutes only. Yes, you must stop after just five minutes. “What can I possibly get done in five minutes?” you ask yourself. But that is the procrastinator talking, the voice that would at this very moment lobby for doing nothing rather than doing anything at all. Are you going to listen to that voice? Don’t. So let’s ask again: What can you get done in five minutes? Five minutes more work than you would have done otherwise, and often the hardest part of all.

Self-acceptance means fully accepting yourself no matter what your traits or how you perform or achieve. It does not mean self-esteem, self-confidence, or self-regard. These terms imply that you accept yourself because you perform or behave in a specific way or because people accept you based on your achievements. Self-acceptance means that you non-judgmentally accept yourself for who you are without rating or evaluating yourself, or requiring the approval of others.

Although substance use helps in the short term to numb you to feelings of sadness or anxiety, in the long term it simply makes it more difficult to function from day to day. For example, although drinking several drinks every evening may help you cope with anxiety and help you to fall asleep, this same behavior almost always has a downside. You might find that you wake up very easily in the middle of the night, and that the anxiety you suffer when you are sober is even worse.

For five years, I have been sick and I have been trying to will myself to be better. To think harder about being better, to improve more. To become a better breather, reactor, meditator, hoping that if I just try hard enough, the symptoms will go away and I’ll feel like myself again, like a self I remember as if out of a rearview mirror except with this one, the objects are smaller than they appear. I have tried to force myself to be more clearheaded, energetic, grounded. Tried yoga, acupuncture, cognitive behavioral therapy, talk therapy, and long walks in the woods. And every few months, when I finally felt I’d reached a zenith of my abilities with yoga, CBT, or talk therapy, I would give it another shot: go to another doctor, a Western doctor, one with an M.D. and a white coat, and I would tell him or her my symptoms (for the gender of the doctor does not matter only, it would seem, my gender), and hope that once again, the doctor would pay attention, would take my case, would try to help me so that I didn’t have to so deeply and fervently try to help myself.

Virtually every version of CBT for anxiety disorders involves working through what’s called an exposure hierarchy. The concept is simple. You make a list of all the situations and behaviors you avoid due to anxiety. You then assign a number to each item on your list based on how anxiety provoking you expect doing the avoided behavior would be. Use numbers from 0 (= not anxiety provoking at all) to 100 (= you would fear having an instant panic attack). For example, attempting to talk to a famous person in your field at a conference might be an 80 on the 0-100 scale. Sort your list in order, from least to most anxiety provoking. Aim to construct a list that has several avoided actions in each 10-point range. For example, several that fall between 20 and 30, between 30 and 40, and so on, on your anxiety scale. That way, you won’t have any jumps that are too big. Omit things that are anxiety-provoking but wouldn’t actually benefit you (such as eating a fried insect). Make a plan for how you can work through your hierarchy, starting at the bottom of the list. Where possible, repeat an avoided behavior several times before you move up to the next level. For example, if one of your items is talking to a colleague you find intimidating, do this several times (with the same or different colleagues) before moving on. When you start doing things you’d usually avoid that are low on your hierarchy, you’ll gain the confidence you need to do the things that are higher up on your list. It’s important you don’t use what are called safety behaviors. Safety behaviors are things people do as an anxiety crutch—for example, wearing their lucky undies when they approach that famous person or excessively rehearsing what they plan to say. There is a general consensus within psychology that exposure techniques like the one just described are among the most effective ways to reduce problems with anxiety. In clinical settings, people who do exposures get the most out of treatment. Some studies have even shown that just doing exposure can be as effective as therapies that also include extensive work on thoughts. If you want to turbocharge your results, try exposure. If you find it too difficult to do alone, consider working with a therapist.

Conscientiousness Not every anxious person is conscientious, but because you’re reading a CBT-based self-help book, there’s a good chance you’re at least moderately high in conscientiousness—a personality trait associated with having a strong work ethic and a thorough, orderly approach to tasks. People high in conscientiousness often get particularly great results from learning cognitive behavioral principles and skills. Why? They tend to like the systematic nature of a cognitive behavioral approach. They do well because they work hard to understand themselves and are diligent in applying their learning to their lives. Anxious people sometimes underestimate how conscientious they are, so make sure you give yourself enough credit for your conscientiousness. It’s important to understand that conscientiousness is not the same thing as perfectionism. For example, perfectionists might spend so long trying to make something “just right” that they don’t have any willpower left over for other important tasks. Perfectionism and conscientiousness tend to be associated with opposite outcomes. For example, in a study of older adults, perfectionism was associated with an increased risk or mortality. Conscientiousness was associated with a decreased risk. There are big advantages to reducing perfectionism but retaining your conscientiousness!

To Greg, who had suffered from bouts of depression throughout his life, this seemed like a terrible approach. In seeking treatment for his depression, he—along with millions of others around the world—had found that cognitive behavioral therapy (CBT) was the most effective solution. CBT teaches you to notice when you are engaging in various “cognitive distortions,” such as “catastrophizing” (If I fail this quiz, I’ll fail the class and be kicked out of school, and then I’ll never get a job . . .) and “negative filtering” (only paying attention to negative feedback instead of noticing praise as well). These distorted and irrational thought patterns are hallmarks of depression and anxiety disorders. We are not saying that students are never in real physical danger, or that their claims about injustice are usually cognitive distortions. We are saying that even when students are reacting to real problems, they are more likely than previous generations to engage in thought patterns that make those problems seem more threatening, which makes them harder to solve. An important discovery by early CBT researchers was that if people learn to stop thinking this way, their depression and anxiety usually subside. For this reason, Greg was troubled when he noticed that some students’ reactions to speech on college campuses exhibited exactly the same distortions that he had learned to rebut in his own therapy. Where had students learned these bad mental habits? Wouldn’t these cognitive distortions make students more anxious and depressed?

Most people say "I'd do anything for my child," but the Harm OCD sufferer has to do more than just show up for the job. You have to show up to this amazing beautiful being even knowing that it aggravates your disorder. You have to do exposure to the darkest, most terrifying corners of the mind. You have to cope with extreme love, often reminding you of extreme fear. You have to tolerate the uncertainty that your child may have a short or painful life in order to maximize the possibility that she has a happy one. To love your children is to be vulnerable to them and to see their vulnerability. You have to risk being harmed and you have to risk harming in order to be close to anyone. OCD can make you think you're too crazy to deserve this closeness with a child. But you're not crazy. You got this.

Catastrophizing. Predicting extremely negative future outcomes, such as “If I don’t do well on this paper, I will flunk out of college and never have a good job.”   All-or-nothing. Viewing things as all-good or all-bad, black or white, as in “If my new colleagues don’t like me, they must hate me.” Personalization. Thinking that negative actions or words of others are related to you, or assuming that you are the cause of a negative event when you actually had no connection with it. Overgeneralizations. Seeing one negative situation as representative of all similar events. Labeling. Attaching negative labels to ourselves or others. Rather than focusing on a particular thing that you didn’t like and want to change, you might label yourself a loser or a failure. Magnification/minimization. Emphasizing bad things and deemphasizing good in a situation, such as making a big deal about making a mistake, and ignoring achievements. Emotional reasoning. Letting your feelings about something guide your conclusions about how things really are, as in “I feel hopeless, so my situation really must be hopeless.” Discounting positives. Disqualifying positive experiences as evidence that your negative beliefs are false—for example, by saying that you got lucky, something good happened accidentally, or someone was lying when giving you a compliment. Negativity bias. Seeing only the bad aspects of a situation and dwelling on them, in the process viewing the situation as completely bad even though there may have been positives. Should/must statements. Setting up expectations for yourself based on what you think you “should” do. These usually come from perceptions of what others think, and may be totally unrealistic. You might feel guilty for failing or not wanting these standards and feel frustration and resentment. Buddhism sets this in context. When the word “should” is used, it leaves no leeway for flexibility of self-acceptance. It is fine to have wise, loving, self-identified guidelines for behavior, but remember that the same response or action to all situations is neither productive nor ideal. One size never fits all.  Jumping to conclusions. Making negative predictions about the outcome of a situation without definite facts or evidence. This includes predicting a bad future event and acting as if it were already fact, or concluding that others reacted negatively to you without asking them. ​Dysfunctional automatic thoughts like these are common. If you think that they are causing suffering in your life, make sure you address them as a part of your CBT focus.

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sensations. Compulsive means that we feel compelled to act or behave in a certain way. It feels like we have no choice.” replied Dr Jones. Dr Jones got up from his seat to point at his white board. “For many people there can

The technique known as cognitive challenging, which is a hallmark of CBT, involves challenging beliefs that may trigger anxiety or that may result from feeling chronically stressed. CBT consists of a structured set of steps in which you are first encouraged to identify beliefs or thoughts that are associated with anxiety. When you are feeling stressed or anxious, you may have a whole constellation of anxiety-related thoughts. Step 1 is to focus on one particular thought, such as “I fear that my partner will leave me unless I have a good sexual response.” In Step 2, you are asked to analyze the validity of that thought by considering such factors as whether it is true, how logical it is, and what the probability is for it to be true. In this step, you also consider the evidence supporting the thought. In Step 3, you would examine counter-evidence to the thought by asking yourself the following questions: 1.Is there another way of looking at this thought? 2.Is there another explanation? 3.How would someone else consider the same situation? 4.Are my beliefs based on my emotions rather than on facts? 5.Am I setting unrealistic or unachievable standards for myself? 6.Am I forgetting relevant facts or overemphasizing other ones? 7.Am I engaging in all-or-nothing thinking? Once you consider the evidence for the particular thought and the evidence against (with the against evidence far outweighing the for evidence in most cases), you then come up with a thought that is a more accurate reflection of reality and probabilities. This new belief will replace the original maladaptive belief you had.

Anxiety interferes with presence because it takes you out of the current moment. Anxiety changes your posture—it makes you tense, awkward, or even slumped over, as your shoulders tighten. People with straighter postures are seen as more appealing than those who slouch (Mehrabian and Blum 1997). Slouching conveys a shut-down, uninviting body language to observers and makes the sloucher feel shut down as well.

Attention in Action Over time, a daily practice—even if it’s just for a few minutes—will help you focus your attention and observe your thoughts and sensations. This process, called attention in action, can help you manage your anxiety by teaching you to stay in the present moment instead of being distracted by worries about the past or fears about the future. Attention in action is not just a part of your daily practice; it’s a state of mind to cultivate throughout the day.

Instead of passively giving in to a welter of conflicting thoughts, you can choose instead to actively focus your attention and observe your thoughts and sensations. If you do this compassionately, you will begin to see how and where your thoughts connect and relate to one another. In turn, this process will help you reduce your anxiety.

The study by Falk Hvidberg et al. [69] confirms the findings from the health status report by Komaroffet al. from 1996 [70]. It also means that nothing has changed in the health situation of ME/CFS patients in the last 20 years and that means that the current 2 available treatments, CBT and GET, which have been heavily promoted for more than 20 years as the treatments for ME/ CFS, which most ME patients have tried, because they desperately want to get better, are not effective at all, or even harmful, as patients have been saying for a long time [32] which was confirmed and objectified by Black et al. [31].

you may feel like the compulsions are protecting you from something terrible happening. This is a very nice idea, but the cost of carrying them out ‘effectively’ enough is very high.

buying a house insurance policy that protects against everything but costs £1 million per year.

OCD is a problem of worry about danger.

the question is, how much are you really paying to carry out your OCD compulsions?

It made sense that all his rumination and avoidance was designed to protect others which only a caring and sensitive person would do.

The largest and most recent ME Association survey (ME Association, 2015) of patient evidence on the acceptability, efficacy and safety of CBT, GET and Pacing involved 1428 respondents. In this case, 73 per cent of respondents reported that CBT had no effect on their symptoms and 74 per cent reported that their symptoms were made worse by GET.

That’s where Y-CBT comes in. Y-CBT seeks to break this ping-pong cycle by simultaneously addressing the physical and cognitive symptoms of anxiety.

Remember that excess carbon dioxide confuses the body into thinking it’s suffocating and triggers rapid, shallow breathing, which keeps the cycle going!

A distressed person may hold on to destructive thoughts and beliefs with great conviction. With help, an anxious person can learn to view negative beliefs as hypotheses rather than facts and to test them out by running “experiments” that try out new ways of thinking and behaving.

Daily Living Practice Your practice this week is to deepen your awareness of what happens in your mind and your body when you are anxious, and to work on quieting your patterns of worry. As you go through each day this week, remind yourself to: Notice your worry patterns and begin to change them by challenging the fear with facts. Practice Powering Down to Transform Anxiety to experience the state of having a quiet mind and a quiet body. Comfort yourself, and challenge yourself to be victorious as you face small and large stresses throughout the week. Read the inspirational quote you have written on the index card. Daily Practice Log Sunday Monday Tuesday Wednesday Thursday Friday Saturday Time of Day B A B A B A B A B A B A B A Yoga/Meditation I Used Y-CBT Techniques I Used B = Before, A = After 1 2 3 4 5 6 7 8 9 10 Low Anxiety Moderate Anxiety High Anxiety

Habits of the mind influence our lives. What you think affects how you feel. Your thoughts are of your own making. Because you are the only one who is thinking your thoughts, you can choose to create habits of the mind that claim your self-value and give you freedom from anxiety.

You may need to simply accept the situation and do nothing for the moment. And sometimes, there is nothing that you can do to change your circumstances. The goal is to learn to stay calm when you have a problem to solve and do the best you can to work through it. Worry and rumination will not help you with that.

When you worry, your mind is busy, and so your body becomes activated and energized. This active state makes you feel as if you are doing something constructive. For example, let’s say you are throwing a party

In the moment, all of this anticipatory anxiety keeps you actively engaged in your fears, which makes you feel as if you are in control of them. However, there is nothing actually being accomplished. As noted above, no matter how much energy you expend on worry, it accomplishes nothing other than putting you into this futile activated state, which only leaves you feeling exhausted.

Worry should not be confused with logical problem solving. The difference is that worry actually constricts our thinking rather than opening it up to possible solutions. Instead of moving toward productive outcomes and the resolution of a problem, worry just keeps us going around in circles.

What about the claim, by the PACE trial, that Graded Exercise Therapy and CBT can treat ME? This is a trial where you could enter moderately ill, get worse in the trial, and be declared ‘recovered’ at the end. Even the recent follow-up study conceded that, long-term, Graded Exercise and CBT are no better for ME than doing nothing. Investigative journalists and academics alike have dismissed the PACE trial as ‘clinical trial amateurism’. Like MS or epilepsy, which were also once wrongly believed to be psychiatric disorders, ME is a neurological disease, and the World Health Organisation lists it as such. I am too weak to walk more than a few metres, needing to lie in bed 21 hours a day. With the little energy I have, I am an ME patient activist.

But even drugged to the gills, I remained filled with dread about the impending book tour, so I went also to a young but highly regarded Stanford-trained psychologist who specialized in cognitive behavioral therapy, or CBT. “First thing we’ve got to do,” she said in one of my early sessions with her, “is to get you off these drugs.” A few sessions later, she offered to take my Xanax from me and lock it in a drawer in her desk. She opened the drawer to show me the bottles deposited there by some of her other patients, holding one up and shaking it for effect. The drugs, she said, were a crutch that prevented me from truly experiencing and thereby confronting my anxiety; if I didn’t expose myself to the raw experience of anxiety, I would never learn that I could cope with it on my own.

CBT is not for everyone. Some find it exceptionally helpful, but the truth is that changing the way you think is really, really hard. It can feel like the equivalent of trying to change your political or moral beliefs, or changing who you love.

The hippocampus is central to verbal learning, and the retention of memory. If the hippocampus is damaged, you can lose your ability to learn new things or to store new memories.

hypothalamus is one of the components of the brain that are responsible for the kind of addiction that leads to substance abuse.

Even though we have a split brain with two distinct hemispheres, the corpus callosum ensures that the functions of each hemisphere of the cerebrum are closely interlinked and properly coordinated, so the brain generally functions as one. Still, largely either one hemisphere or the other controls higher brain functions

Compulsions show up in three major ways: physical compulsions, mental compulsions, and avoidance.

Our point is not to cast blame on anyone who did not recognize your ADHD, or to absolve you from past mistakes, but rather to acknowledge that ADHD is a game changer that affects most areas of life and requires a unique set of skills to manage, not the least of which is addressing your self-regard (see Table 7.4).

control of your pain dial by managing (1) stress and anxiety, (2) mood, (3) attention, (4) interpretations and understanding of pain, and (5) coping behaviors.

Reminding myself that hurt doesn’t equal harm (belief that my body is safe, relaxed)

For this example, our trigger will be pain. Figure

pain is biopsychosocial. The Three Prongs of Pain: Bio-Psycho-Social The causes of pain—and therefore the most effective methods for treating it—are biopsychosocial. This means that there are three interconnected, equally important domains to target if we want to effectively treat chronic pain and other health issues: biology (“bio”), psychology (“psych”), and social factors. These three domains overlap to both produce and reduce pain and symptoms. Because

Healing Anger If you loathe and feel ashamed of your anger, try using imagery to change your relationship with it, transforming it from a dangerous, hateful monster to a gentle, helpless animal, a creature you can love and manage. For example, practice imagining that your anger is a furry dog with big, sweet eyes. (Sound silly? Try it anyway!) Whenever you hear your anger yowling, instead of raging at it, hating it, and stuffing it into a tiny cage, put him on a leash and take him outside for a walk. Speak to him soothingly and kindly in a voice you’d use with someone you love.

Your thoughts are not a punishment, but they are indeed a challenge.

chapter with a quotation from the Greek Stoic philosopher Epictetus, but we could just as easily have quoted Buddha (“Our life is the creation of our mind”)2 or Shakespeare (“There is nothing either good or bad, but thinking makes it so”)3 or Milton (“The mind is its own place, and in itself can make a heaven of hell, a hell of heaven”).4 Or we could have told you the story of Boethius, awaiting execution in the year 524. Boethius reached the pinnacle of success in the late Roman world—he had been a senator and scholar who held many high offices—but he crossed the Ostrogoth king, Theodoric. In The Consolation of Philosophy, written in his jail cell, he describes his (imaginary) encounter with “Lady Philosophy,” who visits him one night and conducts what is essentially a session of cognitive behavioral therapy (CBT). She chides him gently for his moping, fearfulness, and bitterness at his reversal of fortune, and then she helps him to reframe his thinking and shut off his negative emotions. She helps him see that fortune is fickle and he should be grateful that he enjoyed it for so long. She guides him to reflect on the fact that his wife, children, and father are all still alive and well, and each one is dearer to him than his own life. Each exercise helps him see his situation in a new light; each one weakens the grip of his emotions and prepares him to accept Lady Philosophy’s ultimate lesson: “Nothing is miserable unless you think it so; and on the other hand, nothing brings happiness unless you are content with it.”5

At the same time, in my reading, I discovered some evidence that traditional talk therapy might not actually be particularly effective for C-PTSD. In The Body Keeps the Score, Bessel van der Kolk writes about how talk therapy can be useless for those for whom “traumatic events are almost impossible to put into words.” Some people are too dissociated and distanced from these traumatic experiences for talk therapy to work well. They might not be able to access their feelings, let alone convey them. For others, they’re in such an activated state that they have a hard time reaching into difficult memories, and the very act of recalling them could be retraumatizing. One study showed that about 10 percent of people might experience worsening symptoms after being forced to talk about their trauma. Between 40 percent and 60 percent of people drop out of therapy at some point. Most drop out within the first two sessions. And plenty of statistics show that even pointed, skills-based talk therapy is ineffective for PTSD. Cognitive behavioral therapy (CBT), a form of talk therapy where patients unlearn negative patterns of behavior and try to practice strategically positive patterns, is widely accepted as a treatment for PTSD. But it has abysmal statistics. In one study of seventy-four patients, eight got better with CBT, compared with four who received no therapy at all.

You don’t have to have all the answers to be happy.

Seeking certainty breeds more uncertainty.

the real answer is to accept no answer at all.

conditions like panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD) are exactly that—they are the result of overactivity in an almond-shaped cluster of neurons called the amygdala.

When functioning correctly, the amygdala scans the environment and decides whether to trigger a threat response (fight, flight, or freeze) or give the all-clear signal to the brain to “Move along, nothing to see here!

Why then, do some people have a hyperactive amygdala while others view threat more rationally? The answer, like so many things in the world of psychology, is a mixture of genetics and upbringing, of nature and nurture.

amygdala can also become sensitized through environment, most notably through how safe or unsafe we felt as children and how our caregivers managed their own fears and anxieties.

attempting to solve chronic doubt is the exact wrong thing to do: it gets you in trouble and keeps your anxiety alive and well.

Because the fight you’ve been waging on anxiety, all the ways you’ve been trying to solve, escape, or avoid it, is keeping you from the very thing you want most: to love and to be loved.

love, in words attributed to relationship philosopher Erich Fromm, “isn’t something natural. Rather it requires discipline, concentration, patience, faith, and the overcoming of narcissism. It isn’t a feeling, it is a practice.

fear blocks attraction. It blocks intimacy and it blocks connection. Fear blocks love. If you want to find the love you seek, you will have to let go of fear and embrace uncertainty with open arms.