As you may realize as you read the articles on this site, the underlying core issue for many problems resides with irrational thinking styles. That, of course, is the basic premise of cognitive-behavioral therapy (CBT). We develop styles of thinking based upon our learning experiences, our parents' thinking, and societal/community beliefs and expectations.

Learning Experiences. When we are growing up, we have many experiences and the outcome of these experiences contribute to beliefs or ways of thinking that we develop. For instance, as a child I was very shy and fearful of speaking in public due to fear of making a mistake and being ridiculed. In the 7th grade I had a teacher who encouraged me to attend speech competitions. I was so excited that she thought I could be good at this that I was willing to face my fear and engage in speech competitions which I continued even throughout high school. As a result, I developed the belief "Even though talking in front of people causes anxiety I am capable of doing it." Now, if I had not had that experience and my main experience was being embarrassed in front of my class because I couldn't say the word "peculiar" when I was reading out loud (it sounds different than it looks and I couldn't get my brain to switch from the visual to the auditory because I was so anxious), I may have developed the belief "Talking in front of people leads to embarrassment which I must avoid." The problem that causes this belief to be irrational is that it is black and white--it leaves no room for alternatives. I would be assuming that talking in front of people always leads to embarrassment. Instead, by doing speech competitions I learned that talking in front of people could be enjoyable and could lead to awards.

Trauma is an important subset of learning experiences that severely affects an individual's belief system. For example, an individual who survived a fire has a fear of low probability catastrophes. Due to the fact that a low probability catastrophe occurred to him or her, it is more difficult to challenge the thinking with a statement such as "It is unlikely to occur." Or a person who was raped and then told it was her fault because she left her door unlocked may tend to unreasonably blame herself for things that happen.  READ MORE...

Often, when I suggest to my clients to use the Cognitive Diary to help change irrational thinking styles, they protest "But I know my thinking is wrong and how I should think. That doesn't make a difference. How will writing it down help?" Many people, even medical professionals, believe that cognitive therapy is about telling someone to think accurately. If that were the case, then we should all be thinking rationally because people are always telling one another how they should think.

However, several aspects of using the Cognitive Diary help people to actually learn how to change their thinking. The first is developing a rationale that you can believe more than the irrational thinking. The second is repeatedly using this rationale until it becomes automatic thinking. And the third is using different sensory modalities to help reinforce the thinking.  READ MORE...

Many times when I first meet clients some comment, “I've tried that positive thinking and it doesn't work.” What they don't expect is that I tell them I am fully in agreement with them that positive thinking doesn't work. However, negative thinking doesn't work either. We need to develop realistic, believable thinking. Positive thinking is believing “Everything will be all right” whereas realistic thinking is “I might encounter some obstacles but I can figure it out.” As you can see, realistic thinking is more believable than positive thinking and that is what makes it effective.

However, all too often, people believe that their negative thinking is realistic. Therefore, they need to be able to evaluate it and determine how to look at the problem more realistically. The two main problematic areas of negative thinking are negative evaluation whether of yourself, others, or the situation and negative labeling of yourself or others. Let's examine each of these types of thinking.  READ MORE...

When I ask clients what they do for daily relaxation I usually get responses such as:

"I relax by watching TV every night."

"I have a glass of wine."

"I read a book."

"I go out with friends."

"I go to the gym and work out."

"I find gardening relaxing."

"I like to fish."

Although each of these activities may be perceived as relaxing and may even have an element of mindfulness, they don't provide the brain and body with the deep meditative relaxation we require. In fact, most of these activities are stimulating to the brain or the body rather than quieting.  READ MORE...

After experiencing severe heart palpitations and shortness of breath while driving, Diane rushed to the emergency room of the nearest hospital. Extensive tests showed no physical abnormalities or problems. She was told she had a panic attack and was given an anti-anxiety medication. As a result of the panic attack, she quit driving by herself because she became fearful of having another panic attack and losing control while driving. Whenever she would attempt to drive by herself, she would have a panic attack. Her family physician explained to her that Panic Disorder was a chemical imbalance and that medication helps to regulate the chemicals in the brain. An anti-depressant was prescribed in addition to the anti-anxiety medication. Diane found that she began to feel less anxious with the medications, but that she was still avoiding the driving due to her fear of having a panic attack. Additionally, she became concerned about needing to be on the medication for a long time and wondered if any other treatment could help. READ MORE...

A serious problem exists with the public's understanding of depression. The problem occurs because of the clinical term "Major Depression" and the general use of the word "depression." One of the definitions in the Merriam-Webster dictionary indicates that depression is "a state of feeling sad." Therefore, the general public typically defines "depression" interchangeably with "sadness" as in "I'm so depressed today." The tendency, then, is to assume that clinical depression is just extreme sadness or the inability to handle normal stress and sadness of life.

This assumption is not only wrong but it is a disservice to all individuals who experience one of the clinical forms of depression: Major Depressive Disorder, Dysthymic Disorder, Depression NOS (Not Otherwise Specified), or Adjustment Disorder with Depression.  READ MORE...

Listening to the weather forecast one frigid day, I realized how much we are influenced by the catastrophic thinking of the media.  The weatherman reported, "The weather has brought more misery to the St. Louis area."  Certainly, the weather was causing problems that day.  An ice storm caused car doors and locks to be frozen so that people had a great deal of trouble getting into their cars.  However, I thought, unless someone was in the middle of nowhere with no cell phone and they were unable to open their car door because of the ice, this was not "misery."  Instead, I would call it an "inconvenience."  Most of us walked out to our cars to find that we couldn't open the door, went back inside a warm house or office, and found some solution to our problem.  READ MORE...


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Most of the time parents and spouses of individuals with depressive or anxiety disorders truly want to assist in the treatment. However, sometimes their efforts may interfere due to lack of understanding or due to fears and their own internal pressure to make the situation better. So often family members may have their own irrational thinking that might influence the person with the disorder. Therefore, if you have a loved one with anxiety or depression, you may need to examine your behavior to prevent interference with their improvement. The following is a list of ways that family members interfere with treatment and some ways to change these behaviors. READ MORE...

Janine is a 38-year-old married woman with two young children. She obsesses continuously about whether her house is neat and clean enough. She frequently stays up until three in the morning scrubbing and straightening. In addition, Janine is painfully shy and has few friends. She worries about what other people think of her and is terribly afraid of rejection. Some of her neighbors get together with their children to play in a nearby park or each other’s homes, but Janine never joins them.

You may easily recognize that Janine has obsessive-compulsive disorder (OCD). What you may not recognize is that she has an additional anxiety disorder called social phobia. Janine is not alone; recent research (1) estimates that 24% of individuals diagnosed with OCD receive an additional diagnosis of social phobia. In fact, this study found that social phobia is the most common additional anxiety disorder diagnosis made for those individuals with OCD.  READ MORE...