Cognitive Distortions

I describe myself as a “pessimist from birth.” Seriously, I can’t remember a time when I didn’t have worst case scenarios and “all or nothing” thinking. It’s as natural to me as breathing. I berated myself if I missed a point on a test. If I got a 99%, I focused on the 1% I got wrong. If I received a compliment, I discounted it and pointed out a mistake. I dwelled on negative feedback and experiences. After a break up, I replayed the saddest possible songs and reread letters, poured over pictures, wrote depressing poems, and wallowed in my despair. It was all I knew and, ironically, I took a sick comfort in the familiar; I knew how to handle failure, rejection, disappointment, dysfunction, chaos. Happiness, optimism, success–these were feelings I couldn’t understand. I didn’t know how to be comfortable with myself. It was as if by proclaiming my contentment or celebrating my success, I would somehow “jinx” myself. Some people avoid black cats or walking  under ladders; my superstition was positive thinking.

As one of my favorite quotes states, “whether you think you can or you can’t, you’re right.” While I used to hold myself to ridiculously high standards and place myself in intensely stressful situations, I don’t have the energy for that anymore. Ever since my three year episode of debilitating depression, I have been gentler with myself.  Sure, I still slip into old habits of self-deprecation and negativity, but I can’t allow myself to stay in that mindset long.  I have to challenge and redirect my thoughts before I’m trapped in a cycle of negative thinking.

So how do I get myself out of this “stinking thinking?” I challenge my thoughts. When I think or feel a certain way, I ask myself “is this true?” “what evidence do I have?” “Is there another choice?” “how is this helping me?” Usually, I find that my thought is not rational or at least questionable.  It gets me thinking of other ways to feel about something or another way to handle or feel about a difficult situation.

David Burns, renowned psychiatrist and author of Feeling Good, explains cognitive distortions and provides examples and charts to help reframe negative, irrational thoughts. The Pennsylvania Child Welfare Resource Center created the handout “Thinking About Thinking,” which is posted below:

These are 10 common cognitive distortions that can contribute to negative emotions. They also fuel catastrophic thinking patterns that are particularly disabling. Read these and see if you can identify ones that are familiar to you.

1. All-or-Nothing Thinking: You see things in black-or-white categories. If a situation falls short of perfect, you see it as a total failure. When a young woman on a diet ate a spoonful of ice cream, she told herself, “I’ve blown my diet completely.” This thought upset her so much that she gobbled down an entire quart of ice cream!

2. Over generalization: You see a single negative event, such as a romantic rejection or a career reversal, as a never-ending pattern of defeat by using words such as “always” or “never” when you think about it. A depressed salesman became terribly upset when he noticed bird dung on the windshield of his car. He told himself, “Just my luck! Birds are always crapping on my car!”

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 discolors a beaker of water. Example: You receive many positive comments about your presentation to a group of associates at work, but one of them says something mildly critical. You obsess about his reaction for days and ignore all the positive feedback.

4. Discounting the Positive: You reject positive experiences by insisting they “don’t count.” If you do a good job, you may tell yourself that it wasn’t good enough or that anyone could have done as well. Discounting the positive takes the joy out of life and makes you feel inadequate and unrewarded.

5. Jumping to Conclusions: You interpret things negatively when there are no facts to support your conclusion. Mind Reading: Without checking it out, you arbitrarily conclude that someone is reacting negatively to you. Fortune-telling: You predict that things will turn out badly. Before a test you may tell yourself, “I’m really going to blow it. What if I flunk?” If you’re depressed you may tell yourself, “I’ll never get better.”

6. Magnification: You exaggerate the importance of your problems and shortcomings, or you minimize the importance of your desirable qualities. 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 terrified about going on airplanes. It must be very dangerous to fly.” Or “I feel guilty. I must be a rotten person.” Or “I feel angry. This proves I’m being treated unfairly.” Or “I feel so inferior. This means I’m a second-rate person.” Or “I feel hopeless. I must really be hopeless.”

8. “Should statements”: You tell yourself that things should be the way you hoped or expected them to be. After playing a difficult piece on the piano, a gifted pianist told herself, “I shouldn’t have made so many mistakes.” This made her feel so disgusted that she quit practicing for several days. “Musts,” “oughts” and “have tos” are similar offenders. “Should statements” that are directed against yourself lead to guilt and frustration. Should statements that are directed against other people or the world in general lead to anger and frustration: “He shouldn’t be so stubborn and argumentative.” Many people try to motivate themselves with should and shouldn’ts, as if they were delinquents who had to be punished before they could be expected to do anything. “I shouldn’t eat that doughnut.” This usually doesn’t work because all these should and musts make you feel rebellious and you get the urge to do just the opposite. Dr. Albert Ellis has called this “musterbation.” I call it the “shouldy” approach to life.

9. Labeling: Labeling is an extreme form of all-or-nothing thinking. Instead of saying “I made a mistake,” you attach a negative label to yourself: “I’m a loser.” You might also label yourself “a fool” or “a failure” or “a jerk.” Labeling is quite irrational because you are not the same as what you do. Human beings exist, but “fools,” “losers,” and “jerks” do not. These labels are just useless abstractions that lead to anger, anxiety, frustration, and low self-esteem. You may also label others. When someone does something that rubs you the wrong way, you may tell yourself: “He’s an S.O.B.” Then you feel that the problem is with that person’s “character” or “essence” instead of with their thinking or behavior. You see them as totally bad. This makes you feel hostile and hopeless about improving things and leaves little room for constructive communication.

10. Personalization and blame: Personalization occurs when you hold yourself personally responsible for an event that isn’t entirely under your control. When a woman received a note that her child was having difficulties at school, she told herself, “This shows what a bad mother I am,” instead of trying to pinpoint the cause of the problem so that she could be helpful to her child. When another woman’s husband beat her, she told herself, “If only I were better in bed, he wouldn’t beat me.” Personalization leads to guilt, shame, and feelings of inadequacy.

Some people do the opposite. They blame other people or their circumstances for their problems, and they overlook ways that they might be contributing to the problem: “The reason my marriage is so lousy is because my spouse is totally unreasonable.” Blame usually doesn’t work very well because other people will resent being scapegoated and they will just toss the blame right back in your lap. It’s like the game of hot potato – no one wants to get stuck with it.

Reframing Tips:

Explore what’s stressing you: View your situation with positive eyes.

Find what you can change: If you could, what parts of your situation would you most like to change? With positive reframing, you may see possibilities you weren’t aware of before.

Identify benefits: Find the benefits in the situation you face.

Discover the humor: Find the aspects of your situation that you face.

Discover the humor: Find the aspects of your situation that are so absurd you can’t help but laugh

References

Burns David, M.D. The Feeling Good Handbook. Harper-Collins Publishers: New York, 1989.

“Thinking About Thinking.” The Pennsylvania Child Welfare Resource Center 313: Managing the Impact of Traumatic Stress on the Child Welfare Professional Handout #15.

The Power of Peer Support Groups

I wasn’t going to go to my weekly DBSA meeting. I was tired, it was dark, and I had a long day. In fact, I’ve been stuck in a rut for the past two weeks–nothing severe, just low motivation and returning to old poor habits. But something pushed me, I got myself out the door, and I drove to the church where my peer support group meets every Wed.

I shared my struggle with motivation and the general heaviness I’ve been feeling lately with the rest of the group. As usual, I got helpful supportive suggestions from people who also struggle with anxiety and depression (e.g., making daily lists of small tasks, embedding a reward system, focusing on one goal at a time, being gentle with myself).

As the meeting progressed, I found myself becoming gradually more interested and invested in others’ stories and even offering feedback and encouragement. One thing is certain: it is very difficult to feel down when you are helping someone else. There is also comfort in feeling like you are not alone and no one is judging you.  Participating in peer groups also takes me out of my own head and my own self-doubt and worries.  In fact, peer support group is one of my strongest allies in fighting this disease and keeping my depression at bay. These people get me. Or as Sally Fields would say, “they like me. They really like me!”

And if that isn’t enough of a reason to drag myself off the couch, this last part is. After the meeting, a young man (19 years old) came up to me and told me that he remembered me from when I spoke at the hospital when he was hospitalized in September. He thanked me and told me my story inspired him and I was the reason he was there.

He will never know how much his words mean to me and how much I needed to hear them. A huge smile spread across my face and I swear I floated out that door.

Skeletons in the Closet

At the last DBSA meeting, a peer shared the following advice given to him by a therapist when he was a young boy struggling with PTSD:

We all have skeletons in our closets. When we leave home, those skeletons stay in the closet. You leave them behind. But when you come home, they are still there. You may not see them, but you know they are there. At first you may just look at the closet. Maybe next time you move closer to the closet, but you still don’t open the door. Then you may touch the doorknob. The next time you might open the door and peek in. Eventually, when you are ready, you open the door, and take one skeleton out.  Deal with that one skeleton.  Once that one is handled, you move onto the next.

One skeleton at a time.

Get Happy with HappyLight

Guess what I just got in the mail? My Happy Light! Can’t wait to see if it works.  At my last DBSA meeting, a couple of peers mentioned that light therapy helps them so I decided to give it another go. It affects people differently so it’s important to use light therapy with caution. Some experience mania, hyperactivity or agitation associated with bipolar disorder.

As most of us know, this time of the year can be particularly difficult for those suffering from depression or SAD (Seasonal Affective Disorder). As it starts to get darker earlier in the evening and the cold sets in, it becomes more difficult to get motivated or go outside. Even people who typically do not struggle with mental disorders find themselves feeling sad or less motivated during the fall and winter months.

Perhaps that is the reason why Alaska, known for its long, dark winters, has the highest suicide rate. According to recent national data, Alaska’s suicide rate is nearly twice the national average and the leading cause of death in Alaska for people ages 15 to 24 (Epidemiology Bulletin, 2016).

Exposure to artificial light affect brain chemicals linked to mood and sleep, which, in turn, may alleviate symptoms of depression. We’ll see!

Read more about the benefits of Using the Happy Light

https://verilux.com/pages/light-therapy

The Power of Self-Affirmations

I must admit the first time I learned about self-affirmations, I thought the idea was ridiculous. I remember thinking I can write or say “I am beautiful” or “I am worthy”  but that doesn’t mean I’ll ever believe it.  Undeterred, my therapist challenged me to just write down a few affirmations in a journal each day, even if I didn’t believe it.  I picked “I AM LOVED,” because I knew my family loved me so I couldn’t argue with that one. Gradually, I started adding some others to my list: “I AM WORTHY.” “I AM STRONG.” “I AM PERSISTENT.” These statements became my “go-tos.” My mantras. And though I didn’t always feel strong or worthy, I still wrote it. After all, that was our deal. I figured I had nothing to lose anyway so it couldn’t hurt to try it.  I decided to write them down before bed so at least I would go to sleep with a positive thought in my head rather than an endless cycle of self deprecation.

Then I took it a step further. I started to not just write my mantras or self-affirmations at the end of the day, but use them throughout the day. Whenever I had a negative thought, I would stop it and replace that thought with the mantra. So, “I am a loser” would become “I am worthy.”  Even if I didn’t feel worthy at that time, the mantra briefly interrupted my negative thought pattern and moved my thoughts in a positive direction.

At one point, I turned it into a game. For each negative or self-deprecating thought I had, I made myself think of 3 positive things. That really helped, (mostly because I didn’t want to have to think of three things). Often, I resorted to the same ones: thankful for food, shelter, my daughter, the sun, my physical health, my sight, my legs, etc. Expressing gratitude for all the things I had rather than focusing on all the things I didn’t have helped me to stay positive and keep my irrational thoughts in check.

Now I use mantras all the time. I repeat them in my head to counteract a feeling (e.g., thinking “I am calm” when my anxiety strikes). I post them on my mirror. When I speak at the hospitals, I give the patients written self-affirmations to remind them of their worth and value. Each of us is unique with different talents, strengths, beliefs, qualities, and experiences. Why not appreciate what we do have rather than resent what we do not? Why not embrace who we are rather than berate ourselves for all we are not? I believe in the power of self-affirmations, not just on low days, but every day.

By treating ourselves with the same love and compassion we show to those we love, we can begin to heal and learn to love ourselves.

My Favorite Affirmations:

I am hopeful.

I am worthy.

I am resilient.

I am smart.

I am kind.

I am strong.

I am thankful.

I am proud.

I am brave.

I am enough.

Gratitude

Depression feeds on negativity and grows stronger with each negative thought. When depressed, it is easy to fall into that vicious cycle of bad thoughts. Practicing gratitude stops that pattern and changes brain chemistry by releasing serotonin and dopamine. However, it can be difficult to find anything positive when depression sets in. Start with writing or verbalizing three things or people for whom you are grateful each day until it becomes a habit (experts suggest 21 consecutive days of practice to form a habit).  Many find it helpful to write thank you letters, cards, e-mails to people who have helped you in the past. Whenever, I feel those negative thoughts building (what I don’t have, what is wrong, what I’ve lost, etc.) I stop and focus on what I do have (e.g., life, shelter, food, family, friends, pet, therapy, medication, books, music), what is right (I’m physically well), and what I’ve gained (empathy, perspective, knowledge, etc.) In time, my perspective shifts and my positivity attracts more good thoughts.

Find Your People

This is another thing that took me years to figure out. Years ago, I joined a moms’ meet up group. Even though I had little in common with the majority of the members (except for the fact that we were, of course, moms), I attended the events and tried to connect with everyone. Needless to say, disappointment ensued as I was excluded from meetups that were “not scheduled.” I remember seeing pictures on Facebook and thinking “how did I miss that meetup?” It turned out I hadn’t missed any meetup; they were all friends and just got together.

I will never forget the day when I was yet again in tears and my husband asked me, “when are you going to realize that they are not your friends?” I was furious at his reply at the time, but it hit me like a punch in the gut: he was right. They weren’t my friends. And what a blessing that turned out to be! They were NOT MY PEOPLE. Celebrate your uniqueness and know that in time you will find your people.

A LIFETIME IN RECOVERY

Working My Recovery Every. Single. Day.

Even though it’s been several years since I have had a depressive “episode” (that’s the term doctors have given it, though I associate “episodes” with sitcoms like The Office or Seinfeld—rather ironic, right?), that doesn’t mean I am out of the woods. There is no cure for mental illness and I know that I am vulnerable to more episodes, especially after the initial breakdown. Therefore, I have to work my recovery every day. Mornings tend to be the roughest. I still struggle to get out of bed and begin the day. I used to rise at 5:30 am like clockwork for my teaching job, but those days are gone. It’s pointless to think about what I used to do, because I am not able to juggle all the things I once did (god knows I’ve tried). I’ve accepted that teaching full-time at a public high school is not a part of my new reality (though I fought that notion for YEARS and ended up in the hospital again and again).

Anyway, this summer my daughter is in a playground program so she is gone from 9-12 and yesterday I found myself sucked into the couch watching reruns on ID Discovery Channel until it was time to pick her up. As I started to berate myself for not going to the gym like I planned and for just lying around rather than getting ready for my stepson’s graduation party on Sat., I remembered what my therapist said about “being gentle with myself”–an approach that does not come naturally to me. At all. So I stopped and chose to be gentle with myself.  I reminded myself that the day wasn’t over. Sure, I  missed the gym class, but It was nice outside and I COULD take a short walk. And just because I didn’t make it to the gym this time, there was still tomorrow.

So instead of continuing to lie around, I forced myself to get dressed, put on one of my favorite Spotify playlists, and take a walk. I’m not going to lie and say it was all rainbows and unicorns, but I can say I felt much better than if I had stayed on the couch.  I also noticed I was a bit more productive with the rest of my day.

FLASH FORWARD to this morning.  Again I found myself resisting the gym (I do not have the discipline to work out at home so I gave up that battle long ago—not gonna happen).  Naturally, I first thought of all the reasons to skip the gym (and most likely return to that godforsaken couch):

  1. I would be late to class, which was always embarrassing.
  2. The best weights, mats, etc. would be taken.
  3. It would be crowded and I detest crowds. 9 am is a popular workout time.
  4. I wasn’t even dressed yet. Did I even wash any of my workout clothes?
  5. I am overweight so exercising is hard for me. I am 5’ 3’’ and weigh 180, which I never imagined would happen, but here I am. 180.
  6. I probably can’t even do half the exercises anyway. See #4
  7. Most of the people in the class are trim and fit, which makes me feel worse.
  8. You get the idea……

Then I reminded myself that I didn’t go yesterday and how that made me feel about myself. So I dressed (incidentally, there was plenty of workout clothes because you actually have to wear them in order for them to be dirty) and left for the gym in a pretty foul mood (Be gentle, Deep breaths.)

Turns out I was late to a full class, but I was there so I figured I might as well go in. I found a spot in the back corner (thank god for those) and retrieved my equipment—a bar, two sets of weights, a step, blocks that go under the step to raise it more (seems overly ambitious), and a mat. Needless to say, setting up was a workout in itself! In fact, I was already sweating, though one side effect of my medication is excessive sweating so, to be honest, it doesn’t take much. People comment on my profuse sweating all the time, (which is actually rather rude, but whatever.)

Once I positioned all my accoutrement,  I jumped into the routine –well, begrudgingly moved is more accurate. Every time those negative thoughts entered my head (and they did!), I reframed them. To illustrate this, here is a script between the two parts of my brain, which I will call GOOD and BAD for now.

BAD: Why are these people so fit? Like they even need to come to the gym. (snort)

GOOD:  They are fit, BECAUSE they come to the gym. You can be fit, too.

BAD:  My weights are clearly lighter than everyone else’s.

GOOD:  So what? Everyone starts somewhere. You don’t want to overdo it and hurt yourself like last time.

BAD:  That instructor doesn’t even care about her class. She just uses it to get in her own work out. It’s all so fast like we already know what we’re supposed to do. And where are the modifications, for crying out loud?

GOOD: This must be her passion. I’m just glad I know how to adjust my expectations and modify these exercises–

BAD: Or I’d never walk again.

GOOD: Oh come now, that’s unlikely. You’re catastrophizing.

BAD:  How do these tiny women lift such heavy weights?! Why aren’t they sweating?!

GOOD: Stop comparing yourself to others. It just brings you down. They’ve probably been lifting weights for a long time and you just started. The fact that you are sweating is a good sign; it’s a natural consequence of exercising.

BAD: I will never be that fit.

GOOD:  First, “never” is an absolute; you don’t know that. If you exercised regularly, you might be. Each time you come you get stronger. Give yourself credit for coming, even though you didn’t want to. That’s a huge step.

BAD: Well, I guess it’s better than nothing.

And so it goes.  Well, I have rambled long enough for now (and even enjoyed it) so I will bid you all farewell and leave you with this:

EVERY JOURNEY BEGINS WITH A SINGLE STEP. 

So, what first step will you take today?