Stress Reduction Tip #1: It’s the Thoughts (& Actions) That Count With Cognitive-Behavioral Therapy
Our first stress reduction tip is brought to us by Daryaneh Badaly, a doctoral student, psychotherapist, and researcher at the University of Southern California (USC). She has worked in the Departments of Psychology and Neurology at USC, as well as at the Kedren Acute Psychiatric Hospital in Los Angeles, California.
Does this scenario sound familiar?
“Hi, Carrie. Were you able to finish Mr. McGuire’s report? The doctors need it for feedback.”
Oh my gosh! Was I supposed to be working on the McGuire report?!? I haven’t even finished with last week’s reports.
I’m too slow, I should be faster. I’ll bet that if I were younger I’d be sharper, quicker, and more able to focus. I don’t even know where I put the McGuire test results. Did I even test McGuire? I can’t even remember McGuire! If I say that I don’t remember testing McGuire, the doctor will just think I have finally lost it. He’ll stop referring patients to me and start complaining about me to the other doctors. And, then, gradually I’ll lose my practice. Then, I’ll have to dip into the college fund to pay the mortgage. It’ll be my fault that the kids can’t go to college. Argh!! I should have been putting more money in the college fund. I fail at being a mother.
“I don’t have those results. Are you sure that I tested McGuire?”
“Oh, you’re right. You don’t test him until next week.”
Carrie’s benign encounter with a co-worker stressed her out. When her heart finally stopped racing, she felt exhausted and drained so (naturally) she dug out that bag of mini Snickers bars.
When watching someone else, it’s easy to see how anxiety is truly in the eye of the beholder. It’s not necessarily an event or a situation that causes anxiety, but rather our perception of the event – our thoughts and feelings that the event triggers. Stress and anxiety are most often the product of us “should-ing” all over ourselves. Thinking that you should be working harder, doing better, or looking better can add up overtime resulting in high (and potentially fatal) levels of stress. Of course, we need to learn to manage our stress. But how do we do it? How do we turn off those worries when the hot flashes wake you up at 4am?
Through Cognitive-Behavioral Therapy (CBT), you can learn tools and techniques to help you manage your thoughts, feelings and behaviors. Although this can be done on your own, most people benefit from working with a therapist who can take an objective view of your thoughts, feelings, and behaviors. If a therapist isn’t an option, chat it out with a friend (but keep in mind this won’t be totally objective). Many research studies have shown that CBT can effectively reduce stress, as well asanxiety, depression, and even menopause symptoms.
So, what’s CBT… really?
Cognitive-Behavioral Therapy is one approach to stress reduction. It focuses on the interaction between thoughts, feelings, and behaviors. The great thing about CBT is that making a change in any one of these three areas can elicit changes in the others. For example, changing the way you think about a situation can change how your feel and behave in that situation or others like it. When Carrie began thinking that she’s a bad mother, she could stop herself and reevaluate this thought. Is this really true? Isn’t there proof that she’s not a terrible mother? This can make her feel less anxious or disappointed in herself. It could also lead her to figure out a different way to manage her time. Changing a behavior, like Carrie taking a walk instead of downing that chocolate, could lead to more positive emotions and feelings about herself, especially since exercise can help your mood improve. Then her thoughts become less negative, and so on.
CBT is a form of psychotherapy, BUT it’s not like psychoanalysis, which can take years involves digging around into negative childhood experiences. CBT is different…
It’s usually limited to 12 to 16 sessions.
It’s goal-oriented and problem-focused, and emphasizes learning a variety of new skills.
Sessions are structured, and homework assignments are given between sessions so skills can be practiced in real-world situations.
The CBT approach typically focuses on teaching you how to:
Identify troubling situations, thoughts, feelings, and behaviors. In treatment, Carrie might be asked to log each time during the day during which she felt stressed, note where she was and what she was doing at the time, and record her thoughts. (You can use your handy spiral notebook for this!).
Manage your thoughts. Techniques such as “thought stopping” and “thought substitution” can help to keep negative thoughts from spiraling out-of-control.
Reevaluate the probability of a negative event actually happening. Carrie’s therapist might ask her to her to review the probability that doctors would stop referring patients to her.
Put things into perspective. Carrie’s therapist might also ask: “So what would happen if you had to cut back your practice?” Yes, this sounds scary but deep down, do you think you can survive this? Our bet is that the answer is yes.
Engage in relaxation techniques. For example, deep breathing exercises can dramatically diminish the physical side effects of stress (e.g., headaches and heart racing). Or, by taking a short walk after her encounter at work, Carrie might have been able to avoid those Snickers bars.
How do you find a therapist who offers CBT?
Finding a therapist can sometimes be tricky and may require some detective work on your part. A good place to start is asking for a referral from your primary care physician or specialist. This is probably the most common approach to therapist hunting, but keep in mind that your physician may just have a name of someone s/he met at a cocktail party, so there’s no quality guarantee here. Personal recommendations are probably better. Then there’s always your health insurance provider list, which will take some trial and error to find a good match for you, but it’s not impossible. Once you get a name, do some research. A simple Google search can get you a therapists training history. Once you make contact, ask about the therapist’s general therapeutic approach and if s/he does CBT. (We’ll have a post coming up with more tips on finding a therapist, so stay tuned!)
Read more about cognitive-behavioral therapy:
Mayo Clinic: Cognitive-Behavioral Therapy
National Alliance on Mental Illness: Cognitive-Behavioral Therapy
These resources are designed to provide background on what cognitive-behavioral therapy is, whom the treatment might be helpful for, and what you might expect from therapy sessions.
The Feeling Good Handbook by David Burns
Mind Over Mood: Change How You Feel by Changing the Way You Think by Dennis Greenberger and Christine Padesky
Both of these books can be used alone or in conjunction with psychotherapy. They provide clear instructions for identifying and tracking your thoughts, feelings, and behaviors, changing the thoughts that contribute to problems, and taking action to improve daily living and relationships.