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PsychNotes December 2013

by Monica A. Frank, Ph.D.

Index

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December 22, 2013 The next 14 cognitive-behavioral therapy (CBT) tools, Initial Cognitive Training, are discussed in the third installment of this article: read articles about challenging thinking, listen to audio assistance, recognize and accept your value, give yourself a break, use cognitive diary, develop coping statements, read coping statements, look for the positive about anxiety, let go of control, examine your words, re-define labels, identify the gray, evaluate based on effort not outcome, put worry away.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.



December 21, 2013

PsychNote: CONNECTING THROUGH EMOTIONS

Frequently, people don't know how to respond when others have experienced a loss or are feeling sad. The most common response is to try and distance from the other's emotion by trying to say something to make them feel better. That rarely works.

However, when we embrace the other's emotion (literally or figuratively), we do make them feel better. Feeling understood at an emotional level is very powerful. We don't need to solve someone's problems--just being with them in a connected way is enough.

This is especially true this time of year. Don't send artificial cheer to those in need. Instead, spend some time with them. Listen to them. Give them a hug. Connect.

Great Video: The Power of Empathy



December 18, 2013 The next 5 cognitive-behavioral therapy (CBT) tools, Initial Relaxation Training, are discussed in the second installment of this article: use short stress management techniques, use regular deep relaxation, practice mindfulness, practice emotion training, and meditate.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.



December 16, 2013

PsychNote: WHAT DO YOU BELIEVE ABOUT GROWING OLD?

My image of aging is being physically and mentally active. I remember my maternal grandparents tilling, planting, and weeding a two acre vegetable garden and managing other aspects of their farm. Even into their 70's they only stopped for lunch and dinner. The grandchildren used to complain how we couldn't keep up with them! On my paternal side, my grandfather was working on designing a new type of bicycle when he was in his early 80's. So my impressions of aging is that we can continue to have fulfilling and productive lives no matter how old we are.

older couple walking Research (Wurm et al., 2013) shows that when people perceive aging to be associated with physical losses they create a negative self-fulfilling prophecy. In other words, because they believe that aging leads to unavoidable health consequences they are less likely to use coping strategies and healthy lifestyle changes when confronted with a serious health problem. As a result, they are more likely to have further deterioration of their health, overall functioning, and quality of life.

Continuing the tradition from my grandparents and instilling a positive image of aging in my grandchildren may be one of the most important gifts I can give them. When my oldest granddaughter was 16 we took a five-day 230 mile bike trip on the Katy Trail. The 11-year-old still enjoys sparring with her black belt grandmother while she pursues her own black belt training. My husband who has multiple physical disabilities and chronic pain continued to bike ride with them into his mid-60's, takes them fishing, teaches them gourmet cooking, and introduces them to intellectual discourse. Hopefully, this will provide them with an image of aging to enhance physical and mental well-being throughout their lives.

Wurm, S., Warner, L. M., Ziegelmann, J. P., Wolff, J. K., & Schüz, B. (2013). How Do Negative Self-Perceptions of Aging Become a Self-Fulfilling Prophecy?. Psychology and Aging, doi: 10.1037/a0032845.



December 15, 2013 The first 5 cognitive-behavioral therapy (CBT) tools are discussed in the initial installment of this article: reward, exercise, distraction, identifying specific goals and tracking behavior.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.



December 13, 2013

New Audio: DAILY MINDFULNESS PRACTICE--Experiencing A Neutral Object

Mindfulness can be done throughout the day in the many different activities of the day. This exercise is to focus fully on experiencing a neutral object without any preconceived judgment and see how you feel about the object after your experience.

These audios are not imaginal experiences. It is necessary to actually engage in the behavior described. This exercise helps with experiencing sensations in their pure form without any prior judgment.



December 11, 2013

PsychNote: CHANGING THINKING ABOUT WORK

Psychological research has shown for decades how employers can create environments to enhance worker satisfaction. Yet, most employers ignore this research because their "gut" tells them employees can't be trusted and need stringent oversight.

Today the work environment can include mobile technology--many employees no longer need to be chained to a desk. Although the "virtual" workforce idea is bantered about very little change is occurring.

From a cognitive perspective, this is due to a need to restructure the thinking of both employers and employees. Although some employees may take advantage of a more flexible work arrangement, if work is structured in a way to provide a sense of purpose and value most people will not only be more satisfied but more productive.

Years ago I read in an organizational psychology textbook about a small (about 50 employees) appliance retailer who decided to give his employees autonomy to set their own hours and even their own salary. He made his financial records open to them and gave them full control. What he found was that his company became more profitable!

Of course, that was a small business and people might be skeptical of giving employees more control in large companies. Yet managers don't trust the psychological research any more than they trust employees.

Why is this? Because it takes a leap of faith into the unknown which is uncomfortable. People try to avoid discomfort. In cognitive therapy we have a term called "emotional reasoning" which is listening to emotions exclusively without evaluating the validity of the emotion. So, when people listen to their "gut" in spite of research telling them otherwise, they are engaging in emotional reasoning.

Therefore, to change the concept of the work environment it is necessary for employers, managers, and employees to change their thinking. Instead of relying on FEELINGS of distrust and guilt to determine the work environment of the future, they need to recognize what research has been telling us for decades: people need a sense of purpose and to feel valued.

Interesting video: Re-Imagining Work



December 10, 2013

New Audio: DAILY MINDFULNESS PRACTICE--Experiencing Rain

Mindfulness can be done throughout the day in the many different activities of the day. This exercise is to focus fully on experiencing rain without any judgment. Although mindfulness can be relaxing, it is really about being present with your immediate experience even if it is not entirely pleasant.

These audios are not imaginal experiences. It is necessary to actually engage in the behavior described. This exercise helps with experiencing sensations in their pure form without the usual judgment or avoidance.



December 9, 2013

WHY CBT INSTEAD OF MEDICATION?

I am in the process of researching the professional literature to write an article about anti-depressant use vs. cognitive-behavioral therapy (CBT) for the treatment of anxiety and depression. Although I was trained in behavioral medicine and supported the need for medication for these conditions, the more I research and read the literature the more concerned I have become about medication.

In a nutshell, the research does not show medication to be more effective than CBT but does show greater serious side effects. The question is: are the side effects of medication really worth the ease of use when it is no more effective than more natural methods provided by CBT?

Until I finish my more comprehensive review I thought I would share the following article I came across that is written by a psychological researcher: Things Your Doctor Should Tell You About Antidepressants



December 5, 2013

PsychNote: MAKING AN ASSERTIVE COMPLAINT

I'm sure that you have experienced the frustration of making a complaint to the customer service of a large company such as the phone company or cable company. Recently I heard my husband handle a complaint about a package delivery and I thought his words were pure magic.

How we handle the daily "hassles" of life can impact our overall stress level which can influence our health. People recognize the impact of major stressors but they may not realize how much these daily hassles can add up to impact our quality of life. Living in this modern world, our daily hassles seem to have multiplied exponentially. So we need to have methods to manage these situations. Unfortunately, many people either release their frustrations to the customer service representative or they hold their feelings in. Either of these methods are probably not very effective at solving the problem.

So, what can you do? First, it is important with assertive communication to remain calm and pleasant. Explain the problem as clearly and succinctly as you can.

And the magic words? "I'm sure this is not up to <COMPANY NAME> standards." I love this! How can they argue with you? The most likely response is "No, that is not up to our standards" and once you have someone agreeing with you they are more likely to help you. One caveat: this may be more effective when talking to someone at the managerial level.



December 4, 2013

New Audio: DAILY MINDFULNESS PRACTICE--Getting Dressed

The above audio is part of a series of short mindfulness practice exercises to help train your brain to be more mindful or present focus. This mindfulness practice is particularly helpful in learning to create a trigger for being more mindful in daily activities. By practicing mindfulness with one of your first activities of the day, it can help you remember to create mindfulness throughout the day.



December 3, 2013

PsychNote: MANAGING CHRONIC PAIN THROUGH “DECENTERING”

For many people with chronic pain, the pain becomes the center of their attention, focus, and life. They feel unable to engage in many of life's pursuits and often avoid activities and isolate. Unfortunately, this self-protective behavior may have the opposite effect of what is intended. The individual is trying to reduce pain by reducing demands and activities. Yet, instead of reducing pain, this behavior may prevent the individual from functioning and may even increase the experience of pain.

Cognitive-behavioral therapy (CBT) methods can help reduce the intensity of pain as well as improve functioning. In particular, the concept of “decentering” is to learn to observe the self and the pain from a distance or in a more detached manner. Researchers Lance McCracken and colleagues (2013) suggest this approach is related to mindful acceptance and psychological flexibility which is the ability to be present-focused and aware in a non-judgmental way of immediate experience. Although this research found a relationship between the ability to “decenter” and a higher quality of life for chronic pain patients, they did not examine teaching this method to determine if life function improved.

However, these methods are standard procedures in CBT which focuses on teaching people how to think differently to better manage problems. The “decentering” method teaches people to mindfully step back from the thoughts and feelings and examine them more objectively. As they do, thoughts such as “I'm in too much pain to go out with friends” can become “I will hurt no matter what so I might as well enjoy the company of friends.” By focusing on the event rather than the pain, the individual is able to detach from the pain experience. The pain becomes less of a focus and is more likely to decrease in intensity.

Obviously, this method takes practice and time to master so it is not as attractive as fast-acting medication. Yet it is more likely to improve the overall quality of life and does not have the side-effects of medication.

McCracken, L.M., Gutierrez-Martinez, O. and Smyth, C. (2013). “Decentering” Reflects Psychological Flexibility in People With Chronic Pain and Correlates With Their Quality of Functioning. Health Psychology, 32, 820–823.



Index

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