Cognitive Therapy 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?

My mama always compared bad thoughts to a bird in a barn. If a bird flies into the barn, you can acknowledge that there’s a bird in the barn, but you don’t have to suddenly make a nest for it. Just let the bird fly in and it’ll eventually fly out.” Which is, in essence, cognitive behavioral therapy

Our thoughts have prepared for us the happiness or unhappiness we experience.

my favourite emotions include 'brief calmness in good weather' and 'i am the only person alive

a kind of emptiness existed in the center of my bagel; really it was just the hole that's in the middle of all bagels; 'i need to go read my blog to find out what my politics are

note the similarities with buddhism a buddhist who has achieved nirvana is not sad primarily because it does not know the concept of sad [...]

Self-care is never selfish, but it may feel that way when you live a frenzied life.

as a teenager i experienced existential despair as an unsexy sensation of repressed orgasm in the chest; today i experience existential despair as a distinct sensation of wanting to lecture you on how i am better than you, without crushing your hopes and dreams

You have considerable power to construct self-helping thoughts, feelings and actions as well as to construct self-defeating behaviors. You have the ability, if you use it, to choose healthy instead of unhealthy thinking, feeling and acting.

If you don’t want to get stuck where you don’t want to be, have the courage to do difficult things.

We learn to become more empathic when we slow down, become present, and are fully committed to understanding another person’s uniqueness.

Awareness is the first step in rewriting old stories.

Beck’s three principles of cognitive therapy were: All our emotions are generated by our “cognitions,” or thoughts. How we feel at any given moment is due to what we are thinking about. Depression is the constant thinking of negative thoughts. The majority of negative thoughts that cause us emotional turmoil are plain wrong or at least distortions of the truth, but we accept them without question.

Ask yourself if you’re taking the time to see beyond the surface.

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,

I’ve learned how to manage my symptoms, now, of course. I have medication, physiotherapy, cognitive therapy. I’m fine, really. But I feel like a part of me hasn’t caught up with that. Like I’m still afraid of myself.

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.

that was bad; i shouldn't have done that to prevent you from entering a catatonic state i am going to maintain a calm facial expression with crinkly eyes and an overall friendly demeanor i believe in a human being that is not upset i believe if you are working i should not be insane or upset--why am i ever insane or upset and not working? i vacuumed the entire house this morning i cleaned the kitchen and the computer room and i made you a meat helmet with computer paper the opportunity for change exists in each moment, all moments are alone and separate from other moments, and there are a limited number of moments and the idea of change is a delusion of positive or negative thinking your hands are covering your face and your body moves like a statue when i try to manipulate an appendage if i could just get you to cry tears of joy one more time

Happiness is not dependent on the good or bad opinion of others, but instead upon your actions.   It

Doing good induces others to reciprocate.

When we give and receive empathy, transformation occurs.

People who help others on a regular basis are ten times more likely to be healthy than people who do not.

As applied to substance abuse, the cognitive approach helps individuals to come to grips with the problems leading to emotional distress and to gain a broader perspective on their reliance on drugs for pleasure and/or relief from discomfort.

Each morning you must choose to get out of bed or not. All the medication and cognitive therapy and latest research and self-care in the world can’t replace your choice. This decision can be aided by these resources but never replaced by them. Which means that you have to have an answer to a fundamental question: Why get out of bed? Or, more bluntly, why live?

To help people achieve the three basic REBT philosophies of unconditional self-acceptance, unconditional other-acceptance, and unconditional life-acceptance, cognitive, emotional, and behavioral methods, which are described in this monograph, are used.

There’s no reason, on paper at least, why I need these pills to get through life. I had a great childhood, loving parents, the whole package. I wasn’t beaten, abused, or expected to get nothing but As. I had nothing but love and support, but that wasn’t enough somehow. My friend Erin says we all have demons inside us, voices that whisper we’re no good, that if we don’t make this promotion or ace that exam we’ll reveal to the world exactly what kind of worthless sacks of skin and sinew we really are. Maybe that’s true. Maybe mine just have louder voices. But I don’t think it’s as simple as that. The depression I fell into after university wasn’t about exams and self-worth, it was something stranger, more chemical, something that no talking cure was going to fix. Cognitive behavioral therapy, counseling, psychotherapy—none of it really worked in the way that the pills did. Lissie says she finds the notion of chemically rebalancing your mood scary, she says it’s the idea of taking something that could alter how she really is. But I don’t see it that way; for me it’s like wearing makeup—not a disguise, but a way of making myself more how I really am, less raw. The best me I can be.

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.

Through a polyvagal lens, we understand that actions are automatic and adaptive, generated by the autonomic nervous system well below the level of conscious awareness. This is not the brain making a cognitive choice. These are autonomic energies moving in patterns of protection. And with this new awareness, the door opens to compassion.

Authenticity soothes the soul.

It takes enormous courage and humility to be open to others to find out who we really are.

How We

Values give rise to goals, and we reach those goals by planning and completing specific activities.

People whose cognitions fuse are likely to ignore direct experience and become relatively oblivious to environmental influences.

Burns helped to establish a new method of treatment, cognitive therapy, and Feeling Good: The New Mood Therapy is his attempt to explain how it works and why it is different. The

So remember three crucial steps when you are upset: Zero in on those automatic negative thoughts and write them down. Don't let them buzz around in your head; snare them on paper! Read over the list of ten cognitive distortions. Learn precisely how you are twisting things and blowing them out of proportion. Substitute a more objective thought that puts the lie to the one which made you look down on yourself. As you do this, you'll begin to feel better. You'll be boosting your self-esteem, and your

Object relations theorists are interested in understanding how formative interactions between parents and children become internalized by the child and, akin to cognitive schemas, serve as mental representations that shape or guide how children establish and carry out subsequent relationships with others.

Table 3–1. Definitions of Cognitive Distortions 1. ALL-OR-NOTHING THINKING: You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure. 2. OVERGENERALIZATION: You see a single negative event as a never-ending pattern of defeat. 3. MENTAL FILTER: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that colors the entire beaker of water. 4. DISQUALIFYING THE POSITIVE: You reject positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences. 5. JUMPING TO CONCLUSIONS: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. a. Mind reading. You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out. b. The Fortune Teller Error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact. 6. MAGNIFICATION (CATASTROPHIZING) OR MINIMIZATION: You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.” 7. EMOTIONAL REASONING: You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.” 8. SHOULD STATEMENTS: You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment. 9. LABELING AND MISLABELING: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to him: “He’s a goddam louse.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. 10. PERSONALIZATION: You see yourself as me cause of some negative external event which in fact you were not primarily responsible for.

Action seems to follow feeling, but really action and feeling go together; and by regulating the action, which is under the more direct control of the will, we can indirectly regulate the feeling, which is

In projecting onto others their own moral sense, therapists sometimes make terrible errors. Child physical abusers are automatically labeled “impulsive," despite extensive evidence that they are not necessarily impulsive but more often make thinking errors that justify the assaults. Sexual and physical offenders who profess to be remorseful after they are caught are automatically assumed to be sincere. After all, the therapist would feel terrible if he or she did such a thing. It makes perfect sense that the offender would regret abusing a child. People routinely listen to their own moral sense and assume that others share it. Thus, those who are malevolent attack others as being malevolent, as engaging in dirty tricks, as being “in it for the money,“ and those who are well meaning assume others are too, and keep arguing logically, keep producing more studies, keep expecting an academic debate, all the time assuming that the issue at hand is the truth of the matter. Confessions of a Whistle-Blower: Lessons Learned Author: Anna C. Salter. Ethics & Behavior, Volume 8, Issue 2 June 1998 p122

Every addiction story wants a villain. But America has never been able to decide whether addicts are victims or criminals, whether addiction is an illness or a crime. So we relieve the pressure of cognitive dissonance with various provisions of psychic labor - some addicts got pitied, others get blamed - that keep overlapping and evolving to suit our purposes: Alcoholics are tortured geniuses. Drug addicts are deviant zombies. Male drunks are thrilling. Female drunks are bad moms. White addicts get their suffering witnessed. Addicts of color get punished. Celebrity addicts get posh rehab with equine therapy. Poor addicts get hard time. Someone carrying crack gets five years in prison, while someone driving drunk gets a night in jail, even though drunk driving kills more people every year than cocaine. In her seminal account of mass incarceration, The New Jim Crow, legal scholar Michelle Alexander points out that many of these biases tell a much larger story about 'who is viewed as disposable - someone to be purged from the body politic - and who is not.' They aren't incidental discrepancies - between black and white addicts, drinkers and drug users - but casualties of our need to vilify some people under the guise of protecting others.

Cognitive therapy’s revolutionary idea is that depression is not an emotional disorder. The bad feelings we have in depression all stem from negative thoughts, therefore treatment must be about challenging and changing those thoughts.

Top-down cortically mediated techniques typically use cognition to regulate affect and sensorimotor experience, focusing on meaning making and understanding. The entry point is the story, and the formulation of a coherent narrative is of prime importance. A linguistic sense of self is fostered this process, and experience changes through understanding

Many research studies, as well as my own clinical experience, have confirmed that severely depressed patients who appear very "biologically" depressed with lots of physical symptoms often respond rapidly to cognitive therapy alone without any drugs.5

Acceptance and commitment therapy, a variant on cognitive therapy, attempts to teach people to accept rather than change their emotions and make decisions within the context of what they value, as opposed to letting negative feelings control their behavior.

I’m going to recommend a simple framework for evaluating and changing your behavior based on a combination of cognitive-behavioral therapy and ancient Stoic practices. It consists of the following steps: 1. Evaluate the consequences of your habits or desires in order to select which ones to change. 2. Spot early warning signs so that you can nip problematic desires in the bud. 3. Gain cognitive distance by separating your impressions from external reality. 4. Do something else instead of engaging in the habit.

Although the idea has been around for ages, most depressed people do not really comprehend it. If you feel depressed, you may think it is because of bad things that have happened to you. You may think you are inferior and destined to be unhappy because you failed in your work or were rejected by someone you loved. You may think your feelings of inadequacy result from some personal defect—you may feel convinced you are not smart enough, successful enough, attractive enough, or talented enough to feel happy and fulfilled. You may think your negative feelings are the result of an unloving or traumatic childhood, or bad genes you inherited, or a chemical or hormonal imbalance of some type. Or you may blame others when you get upset: “It’s these lousy stupid drivers that tick me off when I drive to work! If it weren’t for these jerks, I’d be having a perfect day!” And nearly all depressed people are convinced that they are facing some special, awful truth about themselves and the world and that their terrible feelings are absolutely realistic and inevitable. Certainly all these ideas contain an important gem of truth—bad things do happen, and life beats up on most of us at times. Many people do experience catastrophic losses and confront devastating personal problems. Our genes, hormones, and childhood experiences probably do have an impact on how we think and feel. And other people can be annoying, cruel, or thoughtless. But all these theories about the causes of our bad moods have the tendency to make us victims—because we think the causes result from something beyond our control. After all, there is little we can do to change the way people drive at rush hour, or the way we were treated when we were young, or our genes or body chemistry (save taking a pill). In contrast, you can learn to change the way you think about things, and you can also change your basic values and beliefs. And when you do, you will often experience profound and lasting changes in your mood, outlook, and productivity. That, in a nutshell, is what cognitive therapy is all about. The theory is straightforward

Cognitive Therapy Instead of behavior, cognitive therapy emphasizes changing thoughts and beliefs. Cognitive therapists believe that irrational beliefs or distorted thinking patterns lead to social anxiety so they teach patients to think in more rational, constructive ways.

In my research, I have discovered practical, effective ways to do so. I’ll explain more in chapter 11, but for now let it suffice to say that you can modify your Emotional Style to improve your resilience, social intuition, sensitivity to your own internal emotional and physiological states, coping mechanisms, attention, and sense of well-being. The amazing fact is that through mental activity alone we can intentionally change our own brains. Mental activity, ranging from meditation to cognitive-behavior therapy, can alter brain function in specific circuits,

إن محور الإكتئاب في أغلب الأحوال، إن لم يكن معظمها، أساسه التفكير (وكيمياء التفكير هي الدوبامين)، ومن ثمَّ فإن إعادة تغيير مزاج الإنسان وتفكيره تأتي عن طريقتين، مساعدته داخلياً بتنظيم مادة الدوبامين، عن طريق عقاقير معينة يصفها الطبيب النفسي، ولا أحد غيره طبق فترة علاجية محددة، وخارجيًا عن طريق العلاج بالمنطق (العلاج التحليلي المعرفي) cognitive analytic therapy، يعني تصحيح المفاهيم النفسية المغلوطة، يعني تبطّل حساسية زائدة، وإحباط ص 323

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.

Burns points out that the basic idea of cognitive therapy—that our thoughts affect our emotions and mood, not the other way around—goes back a long way: The ancient philosopher Epictetus rested his career on the idea that it is not events that determine your state of mind, but how you decide to feel about the events. This

The wound is the place where light enters you.

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

You are the artist. Your emotions are your own creation.

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.

If you don’t want to get stuck where you don’t want to be, have the courage to do difficult things.

Generous people are likely to receive more respect from their peers.

Empathy plays a crucial role in the reduction of stress from the moment of birth.

Doing good does us good.

Goodness makes our world a better place because human beings are kinder to each other when we feel safe and secure.

Empathy allows us to enter the world of another. It allows us to take a mental vacation from ourselves.

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.

Mindfulness-based cognitive therapy encourages patients to observe thoughts as “passing events of the mind” rather than something that needs to be attended to or believed. So often when we have a troubling thought, it leads to another one, which in turn leads to another one, and before we know it, several minutes (or hours or weeks or even months) have elapsed.

The human feeling experience, much like the weather, is often unpredictably changeable. No “positive” feeling can be induced to persist as a permanent experience, no matter what Cognitive-Behavioral Therapy tells us. As disappointing as this may be, as much as we might like to deny it, as much as it causes each of us ongoing life frustration, and as much as we were raised and continue to be reinforced for trying to control and pick our feelings, they are still by definition of the human condition, largely outside the province of our wills.

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.

If I try to flirt with her, I’ll probably get shot down. That would show what a loser I am.” This thought contains nearly all ten cognitive distortions, but it’s a classic example of Self-Blame,

ACT uses acceptance and mindfulness processes and commitment and behavioral activation processes to produce psychological flexibility. It seeks to bring human language and cognition under better contextual control so as to overcome the repertoire-narrowing effects of an excessive reliance on a problem-solving mode of mind as well as to promote a more open, centered, and engaged approach to living.

For example, in order to identify these schemas or clarify faulty relational expectations, therapists working from an object relations, attachment, or cognitive behavioral framework often ask themselves (and their clients) questions like these: 1. What does the client tend to want from me or others? (For example, clients who repeatedly were ignored, dismissed, or even rejected might wish to be responded to emotionally, reached out to when they have a problem, or to be taken seriously when they express a concern.) 2. What does the client usually expect from others? (Different clients might expect others to diminish or compete with them, to take advantage and try to exploit them, or to admire and idealize them as special.) 3. What is the client’s experience of self in relationship to others? (For example, they might think of themselves as being unimportant or unwanted, burdensome to others, or responsible for handling everything.) 4. What are the emotional reactions that keep recurring? (In relationships, the client may repeatedly find himself feeling insecure or worried, self-conscious or ashamed, or—for those who have enjoyed better developmental experiences—perhaps confident and appreciated.) 5. As a result of these core beliefs, what are the client’s interpersonal strategies for coping with his relational problems? (Common strategies include seeking approval or trying to please others, complying and going along with what others want them to do, emotionally disengaging or physically withdrawing from others, or trying to dominate others through intimidation or control others via criticism and disapproval.) 6. Finally, what kind of reactions do these interpersonal styles tend to elicit from the therapist and others? (For example, when interacting together, others often may feel boredom, disinterest, or irritation; a press to rescue or take care of them in some way; or a helpless feeling that no matter how hard we try, whatever we do to help disappoints them and fails to meet their need.)

Following Strupp (1980), clients change when they live through emotionally painful and long-ingrained relational experiences with the therapist, and the therapeutic relationship gives rise to new and better outcomes that are different from those anticipated and feared. That is, when the client re-experiences important aspects of her primary problem with the therapist, and the therapist’s response does not fit the old schemas or expectations, the client has the real-life experience that relationships can be another way. When clients experience this new or reparative response, a response that differs from previous relationships and that does not fit the client’s negative expectations or cognitive schemas, it is a powerful type of experiential re-learning that readily can be generalized to other relationships (Bandura, 1997).

Cognitive behavioral therapy, counseling, psychotherapy—none of it really worked in the way that the pills did. Lissie says she finds the notion of chemically rebalancing your mood scary, she says it’s the idea of taking something that could alter how she really is. But I don’t see it that way; for me it’s like wearing makeup—not a disguise, but a way of making myself more how I really am, less raw. The best me I can be.

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.

Unless a theologian has the inner fortitude of a desert saint, he has only one effective remedy against the threat of cognitive collapse in the face of these pressures: he must huddle together with like-minded fellow deviants⁠—and huddle very closely indeed. Only in a countercommunity of considerable strength does cognitive deviance have a chance to maintain itself. The countercommunity provides continuing therapy against the creeping doubt as to whether, after all, one may not be wrong and the majority right. To fulfill its functions of providing social support for the deviant body of "knowledge," the countercommunity must provide a strong sense of solidarity among its members (a "fellowship of the saints" in a world rampant with devils) and it must be quite closed vis-à-vis the outside ("Be not yoked together with unbelievers"); in sum, it must be a kind of ghetto.

our ability to feel our feelings as they move as energy through our body with our ability to talk about what we feel. We can sit in therapy, tell sad stories, and talk about feeling sad without ever having the bodily experience of sadness. Psychology has historically focused too much on cognition and behavior while neglecting the process that underlies them both: emotion. But current neuroscientific research reveals emotion (also called affect in the scientific literature) as the central driver behind why we are the way we are, and how we develop and heal.2 We now know that most psychopathology, or mental illness, is the result of the inability to effectively regulate emotion.

The hamster friend said being able to do front rolls didn't make the hamster as good as Bruce Lee, which was not a true statement and not an untrue statement, because the word 'good' is meaningless until defined within a context and a goal, and hamsters when enjoying the company of other hamsters rarely define or think about contexts and goals, because to do so would make them aware of certain things about the universe that would make them feel a kind of emptiness or 'neutrality of emotion' that is usually desirable only in situations where the hamster wants to stop his or her self-perpetuating cycle of negative thinking, in order to fight severe depression or crippling loneliness. In a situation of severe depression or crippling loneliness caused by a period of time of uncontrollable negative thinking this 'kind of emptiness'--effected by an understanding (of the arbitrary nature of the universe) that is attained by thinking comprehensively about context, goals, and meaning--can be used to neutralize the hamster's automatic and self-perpetuating pattern of negative thoughts, at which point the hamster can form new thoughts, that will cause new behaviors, that will cause new patterns of thought, with which the hamster can better function in life and in relationships with other hamsters.

Trying to solve an emotional problem at the same time as calling yourself useless, worthless and pathetic is much like trying to learn a foreign language while hitting yourself over the head with a textbook - your actions are likely to make both jobs much harder.

Masha is a professional, qualified counselor and psychotherapist. Her techniques include cognitive behavioral therapy, neuro-linguistic program and hypnotherapy. Her background also includes teaching senior executives and makes them understand how to manage a major emergency.

What’s so interesting here is that through the course of development, these secure children increasingly “internalize” their parents’ emotional availability and responsiveness and come to hold the same constant or dependable loving feeling toward themselves that their parents originally held toward them (certainly, a beautiful developmental process to watch unfold in securely attached children). Said differently, cognitive development increasingly allows securely attached children to internally hold a mental representation of their emotionally responsive parents when the attachment figures are away and they can increasingly soothe themselves as their caregivers have done—facilitating the child’s own capacity for affect regulation and independent functioning. Thus, as these children grow older and mature cognitively and emotionally, they become increasingly able to soothe themselves when distressed, function for increasingly longer periods without emotional refueling, and effectively elicit appropriate help or support when necessary. In this way, object constancy and more independent functioning develops—facilitating their ability to comfort themselves and become the source of their own self-esteem and secure identity as capable, love-worthy persons. Furthermore, they possess the cognitive schemas or internal working models necessary to establish new relationships with others that hold this same affirming affective valence.

Two powerful factors drive avoidance of activities: 1An immediate sense of relief from dodging what we think will be difficult 2Not experiencing the reward from engaging in the activity, thereby further diminishing our motivation for it Behavioral activation is designed to break these patterns. Lead with Action Like Beth, many of us are waiting to feel better so we can get back to the things we used to enjoy. However, it’s much more efficient to gradually start doing rewarding activities, even if we don’t feel like it. The interest in the activities will follow. This approach is the foundation of behavioral activation for depression.

Suffering occurs when people so strongly believe the literal contents of their mind that they become fused with their cognitions. In this fused state, the person cannot distinguish awareness from cognitive narratives since each thought and its referents are so tightly bound together. This combination means that the person is more likely to follow blindly the instructions that are socially transmitted through language. In some circumstances, this result can be adaptive; but in other cases, people may engage repeatedly in ineffective sets of strategies because to them they appear to be “right” or “fair” despite negative real-world consequences.

4. Attachment offers a secure base. Secure attachment also provides a secure base from which individuals can explore their universe and most adaptively respond to their environment. The presence of such a base encourages exploration and a cognitive openness to new information. It promotes the confidence necessary to risk, learn, and continually update models of self and the world.

Although Megan "knew" she was not in danger, her body told her that she was. If sensorimotor habits are firmly entrenched, accurate cognitive interpretations may not exert much influence on changing bodily orgamzation and arousal responses. Instead, the traumatized person may experience the reality of the body rather than that of the mind. To be most effective, the sensorimotor psychotherapist works on both the cognitive and sensorimotor levels. With Megan, a purely cognitive approach might foster some change in her integrative capacity, but the change would be only momentary if the cowering response were reactivated each time she received feedback at work... However, if she is encouraged to remember to "stand tall" in the face of criticism, her body and her thoughts will be congruent with each other and with current reality.

The psychological view of ME led to the controversial and now debunked PACE trial—PACE is “Pacing, graded Activity, and Cognitive behaviour therapy; a randomised Evaluation”... As the trial progressed and the results did not meet the authors’ expectations, they simply lowered the threshold to define improvement. In some cases, those whose condition had deteriorated were classed as “recovered”. That is simply not good science.

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.

However one may interpret this culturally, the upshot is the same: people carry within them a great number of wishes to which they react passively and which they hide. Stoicism, in our day, is not strength to overcome wishes, but to hide them. To a patient who, let us say, is interminably rationalizing and justifying this and that, balancing one thing against another as though life were a tremendous market place where all the business is done on paper and tickertape and there are never any goods, I sometimes have the inclination in psychotherapy to shout out, “Don't you ever want anything?” But I don't cry out, for it is not difficult to see that on some level the patient does want a good deal; the trouble is he has formulated and reformulated it, until it is the “rattling of dry bones,” as Eliot puts it. Tendencies have become endemic in our culture for our denial of wishes to be rationalized and accepted with the belief that this denial of the wish will result in its being fulfilled. And whether the reader would disagree with me on this or that detail, our psychological problem is the same: it is necessary for us to help the patient achieve some emotional viability and honesty by bringing out his wishes and his capacity to wish. This is not the end of therapy but it is an essential starting point.

Albert Ellis, who founded Rational Emotive Behavior Therapy, a precursor to cognitive behavior therapy, taught me the extent to which we teach ourselves negative feelings about ourselves—and the negative and self-defeating behaviors that follow from these feelings. He showed that underlying our least effective and most harmful behaviors is a philosophical or ideological core that is irrational but is so central to our views of our self and the world that often we aren’t aware that it is only a belief, nor are we aware of how persistently we repeat this belief to ourselves in our daily lives. The belief determines our feelings (sadness, anger, anxiety, etc.), and our feelings in turn influence our behavior (acting out, shutting down, self-medicating to ease the discomfort). To change our behavior, Ellis taught, we must change our feelings, and to change our feelings, we change our thoughts.

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.

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).

The Pathe & Mullen (1997) sample almost unanimously reported deterioration in mental and physical well-being as a consequence of the harassment. (..) These victims often described a preoccupation with their stalker, one commenting: "I think I’ve become as obsessed as the stalker himself". (..) Whenever stalking victims present it is essential to assess their suicide potential and continue to monitor this. (..) Victims of stalking often respond to cognitive-orientated psychological therapies because stalking breaches previously held assumptions about their safety. The belief of victims in their strength and resilience and their confidence in the reasonable and predictable nature of the world are frequently shattered, to be replaced with feelings of extreme vulnerability and an expectation of pervasive danger and unpredictable harm. Cognitive therapies attempt to restructure these morbid perceptions of the world that threaten the victim’s adaptation and functioning. (..) Avoidance can respond to behavioural therapies such as prolonged exposure and stress inoculation, which aim to assist victims to gradually resume abandoned activities and manage the associated anxiety.

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).

this regard, a hotly disputed topic is whether the spiritual/transpersonal stages themselves can be conceived as higher levels of cognitive development. The answer, I have suggested, depends on what you mean by “cognitive.” If you mean what most Western psychologists mean—which is a mental conceptual knowledge of exterior objects—then no, higher or spiritual stages are not mental cognition, because they are often supramental, transconceptual, and nonexterior. If by “cognitive” you mean “consciousness in general,” including superconscious states, then much of higher spiritual experience is indeed cognitive.

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.

What was I doing right before I felt like that? Where was I when I felt like that? Are there places where I never have those feelings? How was I acting just beforehand? What was I thinking about before those feelings started? Are there certain beliefs I hold that seem to increase those feelings? Whom was I with when I felt like that? Do I feel like that with everyone? ​For example, some people may feel sad and hopeless in relation to a fear that they will be alone their whole lives. Focusing on that situation, you could notice the fact that this feeling might arise more often when home alone late at night, but rarely feel this way when spending time with friends. You might realize that you think things like “I will never find a girlfriend/boyfriend” based on negative beliefs about your desirability as a partner.

Patients who develop ME/CFS often lose the natural antidepressant effect of exercise, feeling worse after exercise rather than better. Patients may have a drop in body temperature with exercise. Thus fatigue is correlated with other symptoms, often in a sequence that is unique to each patient. After relatively normal physical or intellectual exertion, a patient may take an inordinate amount of time to regain her/his pre-exertion level of function and competence. For example, a patient who has bought a few groceries may be too exhausted to unpack them until the next day. The reactive fatigue of post-exertional malaise or lack of endurance usually lasts 24 hours or more and is often associated with impairment of cognitive functions. There is often delayed reactivity following exertion, with the onset the next day, or even later.

golden opportunity to learn to cope with criticism and anger effectively. This came as a complete surprise to me; I hadn't realized what good fortune I had. In addition to urging me to use cognitive techniques to reduce and eliminate my own sense of irritation. Dr. Beck proposed I try out an unusual strategy for interacting with Hank when he was in an angry mood. The essence of this method was: (1) Don't turn Hank off by defending yourself. Instead, do the opposite—urge him to say all the worst things he can say about you. (2) Try to find a grain of truth in all his criticisms and then agree with him. (3) After this, point out any areas of disagreement in a straightforward, tactful, nonargumentative manner. (4) Emphasize the importance of sticking together, in spite of these occasional disagreements. I could remind Hank that frustration and fighting might slow down our therapy at times, but this need not destroy the relationship or prevent our work from ultimately becoming fruitful. I applied this strategy the next time Hank started storming around the office screaming at me. Just as I had planned, I urged Hank to keep it up and say all the worst things he could think of about me. The result was immediate and dramatic. Within a few moments, all the wind went out of his sails—all his vengeance seemed to melt away. He began communicating sensibly and calmly, and sat down. In fact, when I agreed with some of his criticisms, he suddenly began to defend me and say some nice things about me! I was so impressed with this result that I began using the same approach with other angry, explosive individuals, and I actually did begin to enjoy his hostile outbursts because I had an effective way to handle them. I also used the double-column technique for recording and talking back to my automatic thoughts after one of Hank's midnight calls (see Figure 16–1, page 415).

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.

We can see that there are many ways in which we actively contribute to our own experience of mental unrest and suffering. Although, in general, mental and emotional afflictions themselves can come naturally, often it is our own reinforcement of those negative emotions that makes them so much worse. For instance when we have anger or hatred towards a person, there is less likelihood of its developing to a very intense degree if we leave it unattended. However, if we think about the projected injustices done to us, the ways in which we have been unfairly treated, and we keep on thinking about them over and over, then that feeds the hatred. It makes the hatred very powerful and intense. Of course, the same can apply to when we have an attachment towards a particular person; we can feed that by thinking about how beautiful he or she is, and as we keep thinking about the projected qualities that we see in the person, the attachment becomes more and more intense. But this shows how through constant familiarity and thinking, we ourselves can make our emotions more intense and powerful.

The Blue Mind Rx Statement Our wild waters provide vast cognitive, emotional, physical, psychological, social, and spiritual values for people from birth, through adolescence, adulthood, older age, and in death; wild waters provide a useful, widely available, and affordable range of treatments healthcare practitioners can incorporate into treatment plans. The world ocean and all waterways, including lakes, rivers, and wetlands (collectively, blue space), cover over 71% of our planet. Keeping them healthy, clean, accessible, and biodiverse is critical to human health and well-being. In addition to fostering more widely documented ecological, economic, and cultural diversities, our mental well-being, emotional diversity, and resiliency also rely on the global ecological integrity of our waters. Blue space gives us half of our oxygen, provides billions of people with jobs and food, holds the majority of Earth's biodiversity including species and ecosystems, drives climate and weather, regulates temperature, and is the sole source of hydration and hygiene for humanity throughout history. Neuroscientists and psychologists add that the ocean and wild waterways are a wellspring of happiness and relaxation, sociality and romance, peace and freedom, play and creativity, learning and memory, innovation and insight, elation and nostalgia, confidence and solitude, wonder and awe, empathy and compassion, reverence and beauty — and help manage trauma, anxiety, sleep, autism, addiction, fitness, attention/focus, stress, grief, PTSD, build personal resilience, and much more. Chronic stress and anxiety cause or intensify a range of physical and mental afflictions, including depression, ulcers, colitis, heart disease, and more. Being on, in, and near water can be among the most cost-effective ways of reducing stress and anxiety. We encourage healthcare professionals and advocates for the ocean, seas, lakes, and rivers to go deeper and incorporate the latest findings, research, and insights into their treatment plans, communications, reports, mission statements, strategies, grant proposals, media, exhibits, keynotes, and educational programs and to consider the following simple talking points: •Water is the essence of life: The ocean, healthy rivers, lakes, and wetlands are good for our minds and bodies. •Research shows that nature is therapeutic, promotes general health and well-being, and blue space in both urban and rural settings further enhances and broadens cognitive, emotional, psychological, social, physical, and spiritual benefits. •All people should have safe access to salubrious, wild, biodiverse waters for well-being, healing, and therapy. •Aquatic biodiversity has been directly correlated with the therapeutic potency of blue space. Immersive human interactions with healthy aquatic ecosystems can benefit both. •Wild waters can serve as medicine for caregivers, patient families, and all who are part of patients’ circles of support. •Realization of the full range and potential magnitude of ecological, economic, physical, intrinsic, and emotional values of wild places requires us to understand, appreciate, maintain, and improve the integrity and purity of one of our most vital of medicines — water.

Cognitive-Behavioral Therapy There are almost no pure cognitive or behavioral therapists. Instead, most therapists use a combination of both techniques. This is known as cognitive-behavioral therapy. It is generally recognized as the best therapy for social anxiety. In cognitive-behavioral therapy, a therapist helps you identity maladaptive thinking patterns and replace them with new ways of thinking. He or she also teaches you relaxation techniques and new behaviors that make you feel more comfortable in social situations. Cognitive-behavioral therapy uses many of the same techniques that we explored in the previous chapter. Although you might make great strides on your own, sometimes it is easier and faster to have someone guide you. Often it is difficult for people to explore hidden beliefs about themselves. A professional therapist is experienced in working with people who are trying to change. Often a therapist will see connections in your situation that you cannot. Carlos was terrified of speaking in class. Whenever the teacher called on him, his heart raced, he blushed, and his stomach felt upset. His therapist first had him focus on his thoughts during class. As an experiment, she had him purposely answer a question incorrectly during biology class. To his surprise, the teacher didn’t make a big deal out of it, and the other students didn’t laugh. As a result, Carlos realized that his imagined consequences for making errors were greatly exaggerated. He also realized that he held himself to a higher standard than other people, including the teacher, did. Next, his therapist showed him various relaxation techniques to lessen the physical symptoms of anxiety. Soon, he felt more comfortable and even volunteered to lead a discussion group.

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.