Learn to Meditate, Reduce Stress

Meditation is an ancient form of contemplative practice that was developed as a crucial component of the world’s great spiritual traditions. From mindfulness meditation to creative visualization, the different forms of meditation that have developed throughout the world all aim to develop and enhance serenity, compassion, and wisdom. Only recently has modern science begun to recognize the positive impacts of meditation on the brain, including increased emotion regulation, decreased psychological distress, improved attention, and improved immune system functioning. As a result, people who are not necessarily connected to a spiritual tradition have begun to benefit from this ancient practice to improve their quality of life. The following is a brief introduction to a specific form of meditation called mindfulness. 

The purpose of mindfulness meditation is to bring your mind fully into the present moment, without being distracted by unrelated thoughts or unhelpful judgments. We are usually caught up in our thoughts, not realizing we are totally disconnected from what we are doing. This can have many negative consequences, the most important being we miss out on fully engaging in our lives, with our brains on autopilot. New research has shown that our mood takes a significant dip when we are caught up in our thoughts. Conversely, when our find is focused on the present moment, our mood is usually improved, even when we may be doing something unpleasant. 

There are many ways to practice mindfulness. Below are some instructions for developing a simple daily meditation practice of being mindful of the breath. 

Find a quiet place free of distractions. Your mind will offer enough distractions, so a place with noise or a lot of activity will make sustained attention significantly more difficult. 

Have a seat and close your eyes. There is no right way to sit. You can sit cross-legged, full lotus, or upright in a chair. The most important thing is that your sitting position is comfortable and not distracting itself.

Bring your mind to the sensation of your breath entering and exiting your nose. Just notice the tingling as cool air enters and warm air exits. This is a simple task in that there are not a lot of steps or complex visualizations to keep track of. However, you will find it is a difficult task. You will notice your mind wandering to all sorts of things: physical sensations, planning, daydreaming, rehashing past events. That is to be expected. In fact, the better you become at mindfulness, the more you notice how distracted you are when focusing your mind. 
All you have to do when you notice your mind leaving your breath, is gently bring it back. Again and again. If your mind wanders 100 times in one minute, bring it back 100 times in one minute. Sometimes, people become discouraged because their minds continually wander. In reality, you should congratulate yourself for noticing your mind drifting. This is a significant improvement over never noticing at all. 

Watch your breathing for about 5 minutes. Continually aware of when your mind leaves. Continually bringing it back. Afterward, you may notice an increased sense of calm that you can use to set the tone for the rest of the day.

As you become more acquainted with the practice, you can increase the time sitting to 10, 15, or 20 minutes. The most important point of developing a daily meditation practice is consistency, so 3 minutes every day is better than an hour once a week. 

Try this simple practice for yourself, and see what you notice. You may just find that taking a few minutes to be present is rewarding enough that you look for other opportunities throughout the day to be present. Just as this practice is focused on the breath, you mindfully focus on driving, eating, drinking your morning cup of coffee, chatting with a co-worker… There are endless opportunities to connect to the present moment. 

Cognitive Distortions Definition of Catastrophizing

The cognitive distortion of catastrophizing is pretty much what you might think it is: making something into a catastrophe when it's not. When we catastrophize, we tell ourselves that something is so awful, so terrible, that we won't be able to handle it. That we would fall apart or die. The more we tell ourselves the problem we are facing is a catastrophe, the more hopeless and helpless we will feel to effectively cope with it. Catastrophizing can result in increased anxiety and depression and can make difficult situations feel even worse than they already are. There are several ways of rethinking catastrophic thinking to help you better handle adversity.

When you recognize catastrophizing, first ask yourself what about this situation is so terrible? Have you dealt with similar situations in the past? If so, did you survive? If you did survive (and presumably you did), how?  What did you do to weather the difficulty?

How will you feel about this situation a month from now? Do you imagine your feelings will be just as strong? What do you think you will probably do to move on? How about a year from now? How do you think you will think and feel about the situation? Would your feelings be as intense? And two years from now? Challenges often lose their emotional intensity and perceived importance over time. Think back to what you were most worried about five years ago and how it turned out. Do you even remember what you were concerned about then?

Are you the only one in the world to go through this? How many other people would you guess go through something similar? How many people do you think are facing something even worse? How do you think they manage to move beyond the negative event and go on to do positive things in their lives? What does that tell you about how you may be able to handle this situation?

Consider what you have going for you in your life. What positive experiences are you able to have? What steps can you take to improve your life? Consider the aspects of your life that you take for granted and are not catastrophes, and cultivate gratitude.  

Think of someone you know who seems to handle adversity pretty well. If this catastrophe befell them, how do you imagine they would cope? What do you think they would tell themselves to be able to pick themselves up and get back on the proverbial horse?

Do you think everybody would think this situation is as bad as you do? If not, why not? How would they be making sense of this not to see it as a catastrophe?

If ten years from now, you were to realize that this "catastrophe," although clearly not part of your plan, was actually the best thing for you at the time, how might this be the case? What positive things might come from this? What opportunities might this situation present that you might not otherwise have access to?

Recognizing catastrophizing and considering other perspectives can reduce your belief that the situation is terrible or hopeless. By feeling better and more confident, you can effectively manage the situation. You are more likely to respond to the challenge skillfully and with less emotional pain. The next time you hear yourself catastrophizing, try considering some of these other lines of reasoning and see what happens. 

Should I Trust Psychology Research?

A recent large-scale study that came out of the University of Virginia has made a lot of headlines of late. A group known as the Reproductability Project replicated 100 social psychology experiments and found that more than half failed to replicate, meaning that the new studies came up with different results. This gained a lot of attention in the popular media and has caused many people to question their trust in psychology research openly. As cognitive-behavioral therapists pride themselves on clinical practice supported by research, this is a relevant issue for those using CBT.

The primary issue concerns what to make of two identical studies with un-identical results. The insinuation in popular media is that there may be some fabrication of results.  This is an understandable conclusion, especially in light of notable incidences of this in the medical field in the recent past. However, this is not the only conclusion. Nor is it the most likely one.

The reality is that it is fairly common for replication studies to produce results different from the original study. This is expected because even when there are efforts to replicate a study such that the second study is identical to the first, some conditions are not controlled for and thus are different from those in the original. A slight change in the conditions of an experiment can yield widely divergent results. A different sample population, an updated psychometric measure, or even a change in temperature can result in a large degree of variability in the data.

In actuality, when replicated experiments result in inconsistent data, this is a cause for excitement in the scientific community. It means we do not understand something as well as we thought we did. In essence, the previous data was only true under certain conditions. If we can learn what was so influential about those conditions, we can have an even more sophisticated understanding of the phenomenon being observed and hone the experimental hypothesis. Divergent data are just as helpful, if not more so, than identical results.

This has certainly been the case with cognitive-behavioral clinical studies. Gold-standard treatments such as prolonged exposure for PTSD have been the source of numerous studies and replication studies. Through continual testing and re-examining, we have a better idea of how these treatments work and, when they don’t, what factors are responsible.  Most importantly, when a clinical practice is deemed evidence-based, it is not because of having merely one study to support it. Evidenced-based denotes having numerous studies evidencing the effectiveness or efficacy of a particular clinical practice. CBT has been the subject of hundreds of studies in the last two decades, and as a result, we know which practices are effective and under which conditions. 

Cognitive Distortions: Mind Reading

Living in a complicated world, we need a simple way of making sense of things so we can navigate our lives. One way we simplify is to take mental shortcuts, quick ways of sizing up a situation without having a lot of information. Usually, the shortcuts work pretty well, but sometimes they distort our thinking. These distorted shortcuts are what we in cognitive behavioral therapy call cognitive distortions. There are numerous cognitive distortions that we engage in all the time. One common distortion is mind reading. Mind reading is assuming what someone else is thinking without having much to go on. If we rely too much on mind reading, we can make mistakes about what others think of us, which can really wreak havoc with our mood. Mind reading often leads to depression and anxiety, especially social anxiety. Consequently, learning to recognize and respond to common cognitive distortions such as mind reading can be helpful.

In small doses, mind reading can actually be a useful tool. We know that certain nonverbal behaviors and verbal reactions can give us clues about what someone is thinking. For instance, when we tell someone something and their jaw drops, we automatically assume the other person is surprised. This is a kind of mind reading that’s helpful in social encounters and not an example of a cognitive distortion. However, when used too much or without much evidence to go on, mind reading can be problematic. Take the example of someone eating alone in a cafeteria, thinking everyone thinks she is a loser for eating alone. Or if you get to work a few minutes late, and you think everyone else is thinking about your tardiness. Engage in enough distorted mind reading, and you can feel pretty miserable after a while.

Below are a few questions and different perspectives designed to help you think through mind-reading, and take on a more helpful way of thinking about difficult situations.

First, identify what exactly it is you predict the other person is thinking. Sometimes, just writing down or saying the prediction out loud can help you see the holes in logic and get you a little distance from the unhelpful thought.

What are the costs and benefits of believing this thought? Although we usually don’t think about thoughts in terms of their costs and benefits, they all have costs and benefits. With mind reading, you may think that you are protecting yourself from some bad outcome or some kind of surprise. These would be benefits. Costs are things like increased anxiety, more self-consciousness, and rumination. Now compare the potential benefits to the actual costs, and ask yourself, “Would you want to buy these thoughts given their price?”

What is the evidence for and against your thoughts? When we engage in a lot of mindreading, we usually only consider evidence that confirms our predictions. Rarely do we ever pit our assumptions against evidence that steers us away from our predictions. By collecting the evidence for and against our mind reading, you can determine which side has more evidence, and more importantly, consider the quality of the evidence you have. This is a more objective approach to testing your thoughts and can help you detect common cognitive distortions.

Imagine the thought were true. Would it mean more about you, or more about the other person? For instance, if the thought is that someone doesn’t like you because of the clothes you’re wearing, what does that mean about the other person? And do you expect everyone to like you? Is that a realistic expectation?

Can you test out the thought? What would need to happen for you to be absolutely convinced? Try it out as an experiment.

Try acting counter to the thought. If you feel like avoiding eye contact, approach the other person and introduce yourself. Their reaction may indicate your assumption was totally inaccurate. Our behavior often has a way of making self-fulfilling prophecies. Trying something new might get you a result you didn’t expect.

By learning to recognize and challenge the common cognitive distortion of mind reading, you can begin to reduce self-consciousness, shyness, and negative feelings such as anxiety and depression. This is one technique that comes from cognitive behavioral therapy for anxiety and depression. For more information about CBT, explore the links at the top of the page. 

Cognitive Behavioral Therapy Los Angeles is a therapy practice of expert psychologists with the highest level of training and experience in providing evidence-based treatment. Click the button below to ask a question or schedule a consultation to determine whether CBT is right for you.

Common Cognitive Distortions: Negative Filtering

Negative Filtering is a common cognitive distortion, and most of us do it from time to time. Simply, it is filtering out all of the positive information about a specific situation and only allowing in the negative information. In other words, negative filtering is focusing on negative things and discounting positive things. For instance, negative filtering occurs if you’re usually on time with deadlines but are late once and have thoughts about being incompetent. Or, if you generally make A’s and B’s in a class but make a lower grade on one assignment, having thoughts about being stupid or a poor student is evidence of negative filtering.

Negative filtering often accompanies unrealistically high expectations. Unrealistic expectations involve anticipating always doing something well or doing something perfectly. Perfection is the standard against which all effort is judged. If you reach it, it’s merely doing what is expected. But if you fall short occasionally, it is easy to ignore all of your past successes and focus entirely on the few instances that were not as successful.

Negative filtering can be harmful, as only focusing on negative things can result in a depressed mood, poor self-esteem, and unhealthy pessimism. Many people get caught in a cycle of negative filtering that results in poor mood, resulting in more negative filtering, etc. Negative filtering is one of the primary cognitive distortions in people with depression. As such, identifying negative filtering is one of the primary treatment targets in cognitive behavioral therapy for depression.

The key thing to do when you suspect you may be engaging in negative filtering is to examine the actual evidence. Look around to find instances in which things are not all bad and, more importantly, things to be grateful for. Ask yourself if other people you know would come to the same conclusion given the circumstances and if not, what would they be focusing on that you’re not? Is the evidence really all bad, or are there varying degrees? Try making the opposite case, for instance, that you will be able to pass the class or that you’re not incompetent. Is there more evidence for that argument? By probing and systematically looking at the way we think about things, we can come to more rational, less mood-dependent conclusions.

Being vigilant to negative filtering can help us learn to take on more effective, less pessimistic perspectives and consequently feel better about our situation. The next time you suspect you may be engaging in filtering, try taking on an alternate perspective by more closely examining your thoughts. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Cognitive Distortions: Labeling

Labeling is a cognitive distortion in which we generalize by taking one characteristic of a person and applying it to the whole person. Because I failed a test, I am a failure. Because she is frequently late to work, she is irresponsible.  If someone responds in a brusque way, he is a jerk. Rather than more objectively thinking about the behavior, when we engage in labeling, we globally describe the whole person. As a result, we view the entire person through the label, such as jerk, and filter out any information that doesn’t fit under the umbrella of the label. This results in the label feeling more apt as a descriptor of the person, and we believe it more.

So what’s wrong with labeling? Well, as it is a cognitive distortion, it is necessarily a distorted way of thinking about things. The person who spoke to us curtly may not be “a jerk” but instead could be in a hurry. Or they may be a very kind and generous person who speaks directly and to the point. Making one broad assumption about someone based on one isolated data point or just a few data points is almost always inaccurate.

Labeling as a cognitive distortion, in addition to causing inaccurate thinking, can fuel and maintain painful emotions. If you fail a test and come to the conclusion that this means you’re a failure, it will likely trigger feelings of sadness, despair, hopelessness, etc. Whereas recognizing that you merely failed a test would most probably result in more mild disappointment. Furthermore, if you believe the label, identifying as a failure, you won’t know what to do to solve the problem. Failing a test means you need to study more. Problem solved. Failing in life, however… What do you do to solve that?

Labeling also causes problems when we apply it to others. Labeling your husband as uncaring because he appears not to listen to you when you talk about your day can feel miserable. You’re married to an uncaring person. But if you consider the behavior as the problem rather than the person, it becomes easier to discuss with him and potentially solve it. For instance, it may be that he needs time to unwind at the end of the day or has difficulty concentrating in general.

When we notice ourselves engaging in the cognitive distortion of labeling, there is one simple solution: objectively describe the behavior we notice. That person is late to work. I failed the test. She spoke to me brusquely. You may find that fewer negative feelings are stirred by this more objective, more accurate language. Even better, problems that have felt unsolvable, or people who seem impossible, may become much more manageable. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Achieve Your Goals by Countering Automatic Thoughts

Many people who have anxiety and depression often feel hopeless about getting what they want in life. It’s not that they haven’t tried to achieve their goals. The problem is that what they have tried hasn’t worked as well as they would have liked. Over time, they conclude it is not worth the continued effort. As a result, they feel they are off track in their lives, and this feeling fuels and maintains their anxiety and depression.  The more depressed they become, the less effective their efforts seem. It can be a devastating cycle.

There is a technique from a form of CBT called Cognitive Behavioral Assessment System of Psychotherapy (CBASP) designed specifically for this dilemma. It involves looking at your goal and working backward to determine what has gotten in the way of achieving it. This may sound like something that most people do automatically. However, what is different about this technique is that it does not just require that you examine the actions you took to obtain your desired outcome. It also requires that you examine your interpretations of the situation as well. In other words, this model emphasizes that how you think about your goal is just as important strategically as the steps you take in going after it.

For example, let’s say that your goal is to get a raise at work. You go into your boss’ office, highlight your achievements, ask for the increase, and… rejected. After several instances of this, you might feel it is hopeless and give up. You did all the right things, right? Well, your interpretations of the situation might have weakened your strategy. While you were talking to your boss, did you have thoughts like “I don’t really deserve a raise” or “I’m not worth it?” How about, “I know she’s just going to say no anyway.” If these are the thoughts running through your mind, how do you think they impacted your body language or how assertively you went after the raise? How do you think these thoughts affected your commitment to the goal, i.e. your willingness to compromise? What about the impact of these thoughts on your nonverbal communication, such as eye contact, posture, etc.? Or the other extreme may be the case: Did you go in thinking, “I’ve worked here for so long they owe me a raise,” because how do you think this might come across?

Yes, our ineffective automatic thoughts can get in the way even when we have a solid strategy for getting what we want. In CBASP, the solution involves comparing your interpretations to your desired outcome, and deciding whether the interpretations moved you closer to your goal or further from it. If the thoughts were obstacles to your objective, you need to tweak them so they become assets. What would you have to think to get what you wanted? Or, what would someone else who consistently achieves their goals think in this situation? By identifying a more helpful mindset, you allow your thoughts to work for you rather than against you. This technique is akin to cognitive restructuring on traditional CBT. And like cognitive restructuring, it is more difficult than people first assume, mainly because you actually have to believe the alternate perspective.  Click here for more information about cognitive restructuring in CBT.

So, the next time you feel like your bulletproof strategy has fallen short, stop and consider whether you included your thoughts as part of your strategy. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

Get Back to Sleep!

There is much information on the internet about healthy sleeping habits, commonly called sleep hygiene. Behaviors such as maintaining a regular bedtime, making the bedroom comfortable, not watching TV in bed, etc. – all of these can be very helpful for helping people go to sleep. However, if you have difficulty waking up in the middle of the night, these tried-and-true interventions are probably not terribly helpful. You may, however, find the following techniques to get back to sleep helpful:

Once you realize you are awake, try to get back to sleep immediately. The lights stay off, and your head on the pillow. Rather than think about your day or plan the next day, go to sleep. There will be plenty of time to deliberate or plan tomorrow. If you find it difficult to turn off your mind once it gets going, try one of the other techniques mentioned below.

Let it go. Tell yourself to let it go and that if what you are thinking about is truly important, you will surely resume thinking about whatever it is tomorrow.

Do your planning before bedtime. If you have a good idea of what you will worry about once you are in bed, worry about it beforehand. Write out the source of the worry, and next to each worry, write the solution or the next step. When the worry occurs to you while you’re in bed, remember that you’ve already identified a solution, and postpone the worry until tomorrow. You may even find it helpful to have the piece of paper on your nightstand to use as a visual reminder that you’ve already done all the thinking you need about that topic.

Count your breaths as a way to distract your mind. Imagine you are becoming increasingly sleepy with each exhalation.

One mistake people make is staying in bed for hours when they are unable to fall back asleep. When you stay in bed while you are not sleeping, you are essentially training yourself to be awake, alert, and frustrated in bed, all of which are moving you in the opposite direction from sleep. The more you toss and turn, the more you teach yourself that this is what you do in bed, not sleep. You can undo this cycle by getting out of bed once you’ve been awake for 15 minutes. Stand beside the bed in the dark, counting your breaths, imagining that you’re feeling sleepier and heavier with each breath. Once you feel drowsier, return to bed.

You may find these exercises helpful the next time you have difficulty falling back asleep. They come from a cognitive behavioral treatment for insomnia. For severe insomnia, it is recommended you consult a mental health professional. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice. 

CBT Self-Help Books

People often ask me for recommendations for good, evidence-based books based on cognitive behavioral therapy and mindfulness. There are quite a number of good ones out there. Unfortunately, they are vastly outnumbered by self-help books that are poorly written, vague, unhelpful, and sometimes even harmful. The following is a list of self-help books based on contemporary psychological research and that my clients have found helpful through the years.

Feeling Good by David Burns An easy-to-read best-selling self-help guide using CBT principles. Well-researched interventions such as cognitive restructuring and behavioral activation are explained and discussed.

Mind Over Mood by Greenberger and Padesky: A self-help guide using primarily cognitive therapy techniques, it contains helpful interventions to assess the thought patterns that may be getting in the way of achieving your goals and provides clinically proven ways of addressing these patterns.

Get Out of Your Mind and Into Your Life by Stephen Hayes is A mindfulness-based self-help book using principles of Acceptance and Commitment Therapy. This is a good book for learning how to work toward big life goals while overcoming the emotional obstacles that generally get in the way.

Dialectical Behavior Therapy Skills Workbook by McKay, Wood, & Brantley A workbook providing instruction and exercises for people who have difficulty regulating intense emotions. This workbook contains exercises designed to teach mindfulness skills, distress tolerance, emotion regulation, and interpersonal effectiveness.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn: A self-help guide to mindfulness for a variety of problems.

The Mindful Way through Depression by Williams, Teasdale, Segal, and Kabat-Zinn: A self-help guide for using mindfulness-based cognitive therapy to cope with depression and stop a relapse before it starts.

These books can provide helpful guidance on dealing with difficult emotional problems. They are, however, no substitute for working with a licensed psychologist. If you have a significant psychological problem or are in significant distress, seeking treatment with a mental health professional is important.

Acceptance Techniques to Reduce Anxiety and Worry

People who have difficulty controlling their anxiety generally worry a lot about a lot of things. This is known as generalized anxiety. One factor that often fuels generalized anxiety is difficulty accepting the absence of certainty. For most people, uncertainty about important areas of life is unpleasant. It may seem as though life would be easier if you knew how everything would turn out in advance. Unfortunately, this is not a realistic expectation. With life comes uncertainty. People who struggle with this often end up needlessly worrying about things they have very little control over, causing undue anxiety and stress. 

The solution to fighting uncertainty is accepting uncertainty. By choosing to tolerate not knowing how situations will turn out willingly, we expend less energy fighting unnecessary battles, getting tied up in knots about things in unhelpful ways. Acceptance does not necessarily mean enjoying uncertainty. It merely means acknowledging that there is a degree of the unknown in everything we do and letting go of the fight with reality. Following are ways you can learn to turn your mind toward acceptance of uncertainty:

Weigh the pros and cons of accepting uncertainty: Identify the reasons fighting uncertainty feels helpful or safe, as well as the ways in which it is ineffective. Chances are the cons outweigh the pros. Being mindful of this can help you drop the struggle and embrace the unknown. 

Identify areas of your life in which you’re already accepting of uncertainty: You’re already doing this in some situations, either with traffic jams along your commute, visiting a new restaurant, or meeting new people. Take a moment to consider how accepting some degree of uncertainty is helpful in these situations, and take the same attitude with more difficult areas of your life. 

Analyze what underlying meaning uncertainty has for you: Sometimes, without awareness, we automatically associate uncertainty with a negative outcome. If you do this, take a step back from this thinking pattern and ascertain whether there’s any evidence. Take another moment and identify the evidence against this assumption. Chances are by thinking about uncertainty from this new perspective, it may seem less threatening. 

Imagine what life would look like without uncertainty: Although a sense of certainty may be helpful for planning, it’s likely that too much certainty would make life pretty dull. How enjoyable would movies be if you knew exactly what was going to happen every step of the way? And with absolute certainty, there would be no pleasant surprises. Envisioning what would happen if we really got our wish and everything was more certain may cause us to think twice and consider that uncertainty comes with some benefits we normally overlook. 

The next time you tense up when you encounter a feeling of uncertainty, bring to mind these different ways of relating to the situation and see what happens. You may find that you can more calmly handle whatever it is that’s on your plate, and you may just be able to appreciate some of the benefits of uncertainty. 

This technique for reducing anxiety comes from a cognitive behavioral treatment for anxiety disorders that has been shown to be highly effective (see effectiveness rates for CBT) in significantly reducing symptoms of anxiety in 70-80% of patients. Compared that to traditional talk therapy, which helps about 30% of patients with generalized anxiety. Click here for more information about cognitive behavioral therapy for anxiety disorders. 

All material provided on this website is for informational purposes only. Direct consultation with a qualified provider should be sought for any specific questions or problems.  Use of this website in no way constitutes professional service or advice.