PsychNotes October 2014
by Monica A. Frank, Ph.D.
Clinical and Sport Psychologist
October 31, 2014
Mindfulness Practice is Not Focusing, It is Re-Focusing
One of the most common misunderstandings of mindfulness practice, in my experience, is to equate it with being focused. Many initial practitioners will complain, "I couldn't do it! I kept getting distracted!"
Such a statement means they don't understand what the practice of mindfulness is. Because if they did, there is no way they "couldn't do it."
If you think of mindfulness practice as learning to re-focus, rather then being focused, distraction becomes your friend. What I mean by this is that the purpose of mindfulness training is to teach your brain how to be more presently focused. The most common interference with being focused is distraction. Therefore, what you need to learn is how to re-focus when you become distracted.
Instead of thinking of distraction as meaning "I can't do it," think of distraction as an opportunity to train your brain to re-focus. The more you are distracted and gently re-focus to the present, the better your brain is trained. Eventually, it becomes easier and easier to re-focus. The result: greater mindfulness!
To learn more, listen to the Understanding Mindfulness audios (or read the transcripts).
October 25, 2014
The most common cause of insomnia is not being able to quiet the mind. This audio, Insomnia Education
, provides education to learn how to address the thinking that
occurs for many people who experience insomnia. Even if the cause of your insomnia may be physical, learning some of
the methods to quiet the mind and improve sleep can still be helpful.
In addition to this audio, the mindfulness
techniques can be helpful for insomnia. Also, if worry is the main cause of your insomnia,
the Worry Box
audio and Excel At Life's Android app, Worry Box--Anxiety Self-Help
, and learning how to put worries away before you go to bed can be helpful. Be sure to check out the relaxation
October 24, 2014
Yogic Breath Training
is a meditative type of breathing that is often good to use at the beginning of your daily meditative practice. However, it can also be practiced periodically throughout
Although this method is not for immediate anxiety relief, the daily practice of it can help prevent or reduce overall levels of anxiety.
Initially, when you begin this practice you may not be able to do it as slowly as it is described. Start with a count that is comfortable for you and eventually you will be able to
gradually slow down your breath. The transcript for the audio is included so that you can practice this method in the way that works best for you.
October 20, 2014
Older, but Happier
Although as people age and they experience more health problems, more losses, and other significant changes in their lives, research shows that older people are happier. Specifically, fifty appears to be the magic number in which overall well-being improves and anger, stress, and worry decline. Interestingly, sadness doesn't change as much as these other states (Stone, et al., 2010).
Why Are People Happier As They Grow Older? An opinion.
Most young people are focused on external validation which means their self-assessment is based on achievement and outside opinions. In other words, they need to achieve at work and/or school, obtain the approval of others, raise successful children, and acquire objects of status such as homes, cars, and other material items. Such a focus tends to be stressful, competitive, and not completely under their control. They are at the mercy of outside forces such as the economy and the decisions of other people. As a result, they may worry about uncontrollable events that interfere with their goals and they become easily frustrated with others who get in their way.
However, wisdom comes with aging. In particular, older people more frequently have developed a sense of internal validation which is a self-assessment based upon self-esteem, sense of purpose, and other qualities that are based within the individual. Thus, for the most part, they don't try to control external events or other people. They have developed a more mindful attitude towards life which allows them to be more at peace with all experience instead of trying to make life what they believe it “should” be. This attitude of acceptance tends to reduce anger, stress, and worry, although sadness is likely to still be present when relevant such as when losses occur.
Stone, A.A., Schwartz, J.E., Brodericka, J.E. and Deaton, A. (2010). A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences, 107, 9985-9990. doi.10.1073.pnas.1003744107
October 15, 2014
Anxiety Disorders May Not Be As Prevalent As We Thought
Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a survey of the prevalence of mental disorders in the U.S. population. The survey evaluated the presence of a disorder in the previous year. Interesting, this survey showed much lower one-year prevalence* rates for anxiety disorders than previous major studies.
Although the one-year prevalence for the depressive disorders is down slightly from about 9% of the population to 7%, the prevalence for anxiety disorders is substantially lower. Overall, anxiety disorders has dropped from 19% of the population to a little less than 6% with the largest drops in Social Phobia and Specific Phobias.
What does this mean? Is mental illness decreasing in our population? Or, is there a problem with the way these studies have been conducted? If so, which one is accurate?
The previous comparison study conducted from 2001-2003 involved in-person interviews conducted by lay persons with no professional training using a script of questions without follow-up. The current study involved telephone interviews conducted by clinically trained interviewers who could ask follow-up questions to ascertain the diagnosis. Thus, this study could be illuminating problems with the different interview questionnaires used and how the interviews were conducted.
My tendency is to think that the current study may have been a more rigorous study due to the use of clinically-trained professionals and reflects the actual rates of mental illness. Therefore, the prevalence rates haven't changed but the way they are measured influences the outcome. In other words, anxiety disorders are not decreasing but may have been over-estimated in the past.
*Note: One-year prevalence is typically much lower than lifetime prevalence as it is measuring how many people can be diagnosed with the disorder at any particular time versus how many people may have the disorder at some point in their lives. Since many of these disorders aren't present throughout the lifetime but only periodically or for a short time, the rates will differ significantly.
Karg, R.S., Bose, J., Batts, K.R., Forman-Hoffman, V.L., Liao, D., Hirsch, E., Pemberton, M.R., Colpe, L.J. and Hedden, S.L. Center for Behavioral Health Statistics and Quality (2014). Past Year Mental Disorders among Adults in the United States: Results from the 2008-2012 Mental Health Surveillance Study. http://beta.samhsa.gov/data/sites/default/files/NSDUH-DR-N2MentalDis-2014-1/Web/NSDUH-DR-N2MentalDis-2014.htm
October 10, 2014
Choose Your Own Dream: Don't Pursue What You “Should”
Often, young people feel pressure from parents, teachers, and others to pursue certain goals in life. These goals may not be the passion of the young person, but instead, reflect the expectations of others. In cognitive therapy, we refer to these as “shoulds” which, in this case, is an irrational belief about the necessity of meeting the demands of others. As a result of this pressure, many young people choose educational goals and careers that do not reflect their own dreams, desires, or goals.
Certainly, the people applying pressure probably have good intentions and believe they know what is best for the young person. However, the problem is that success is related to developing intrinsic goals based on the individual's interests and passions (Koestner, 2008). A person who pursues a career or interest because of the expectations of others is less likely to be motivated which leads to being less successful.
What does this mean?
If you are a young person, pursue your dream no matter the demands of others. If you are a parent or teacher, recognize that motivation and success comes from the young person discovering and choosing what is personally meaningful.
Koestner, R. (2008). Reaching One’s Personal Goals: A Motivational Perspective Focused on Autonomy. Canadian Psychology, 49, 60 – 67. DOI: 10.1037/0708-55188.8.131.52
October 8, 2014
Please help translate Excel At Life's apps if English is your second language or you have expertise in other languages. People the world over have requested translations saying that they do not have access to the type of information and help provided by Excel At Life. Help others get the help they need!
Excel At Life is using Crowdin to translate our android apps. Join our project here: Crowdin.com
. You can help as little or as much as you like. A "crowd" project means the more people who help translate, proofread, and vote on the translations will insure a good translation.
The Cognitive Diary app is the basis for many of the other apps so once it is translated much of it can be used for the translations of the other apps.
October 7, 2014
Announcing: Excel At Life's PsychNotes have been indexed!
Now it is easier to find PsychNotes according to topic of interest: Index
October 4, 2014
New Article: What to Expect from Mindfulness-based Cognitive-Behavioral Therapy (MCBT) When You Have Depression and Anxiety
When practicing the techniques described by Excel At Life, people want to know when they should feel better. This is a difficult question to answer because it requires an assessment of each situation which is why it is best to practice these techniques under the guidance of a MCBT therapist. However, in this article I will discuss what to expect and how to assess your practice.
What is Mindfulness-Based Cognitive-Behavioral Therapy (MCBT)?
1) Cognitive Therapy
. First, CBT is a type of treatment that focuses on how you think (cognitive) by examining the accuracy of your thoughts about yourself, others, and the problems you face. Then, when thoughts are found to be an inaccurate appraisal, cognitive therapy helps to change these thoughts by developing a more accurate (or rational) way to think or approach the situation. Once a believable rational has been developed, the idea is to frequently express this new thought to create the new pathway (connections) in the brain.
2) Behavioral Therapy
. CBT uses a variety of techniques to help change a person's behavior. These methods can include goal-setting, communication training, relaxation and biofeedback, behavior modification, and exposure methods as well as many others. The commonality of these methods is they are meant to affect the behavior.
. Although a technique that has often been included under the behavioral methods of CBT, mindfulness has taken a more prominent role due to its influence upon the other methods and its overall impact in the therapy. Mindfulness is an approach that is present-focused and teaches to refocus when engaged in the depressive or anxious thoughts.
4) Mindfulness-Based Cognitive-Behavioral Therapy
. CBT has a history of bringing under its umbrella any techniques that have been shown to be effective. Since cognitive therapy, behavioral therapy, and mindfulness have all been shown to be effective, they have been combined into MCBT. So MCBT isn't a new therapy, nor is it necessarily one specific treatment used for all similar cases, but it is the use of a variety of methods that are chosen based upon each individual's problem. Thus, MCBT may look very different for each client because it is specifically designed for each person and problem.
If you examine most self-help books you can see the influence of CBT running through them. Similarly, many specific therapies for certain types of problems are often just a set of methods chosen from CBT to address a certain problem. For example, when I have had discussions with DBT (Dialectical Behavioral Therapy) practitioners, I haven't been able to determine the difference between that therapy and MCBT except that DBT spells out certain specific techniques to use for treating trauma. Also, EMDR (eye movement desensitization and reprocessing) uses the CBT methods while adding in the eye movement component but has not been shown to be any more effective than CBT alone (Seidler and Wagner, 2006). I'm not saying that these methods aren't effective. I'm just saying that I would tend to categorize them under the umbrella of MCBT. Some people may swear by the differences they have experienced from these various therapies but I suspect it may be due to individual preference or a difference in the therapists seen by the individual (see my article: Does CBT Lack Compassion? It Depends Upon the Therapist
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