Stop Worrying... Or at Least Postpone It.

If you are a worrier, you probably find that worry can sour your day. Incessant worry increases anxiety and can crowd out other, more pleasant thoughts in your mind. You have probably tried to distract from worry, but if you’re like most people, trying not to think about something brings it back into your mind with a vengeance. There’s a reason.

Worry can actually serve an adaptive function. A healthy dose of worry or concern can help you prepare for something important. Without worry, you probably wouldn’t do as well on tests, you might submit a resume without double-checking it, and you probably wouldn’t ever visit the doctor. Although it may feel unpleasant, worry actually does a lot for us. 

The problem arises when worry begins to take over and no longer helps us prepare for anything. As worry reaches a fever pitch, it can actually get in the way of our effectiveness. It might seem like the solution would be to think about something else, but that’s easier said than done. Oftentimes, we worry about something because it seems important, and important things need to be thought about. We need to prepare for important things, remember?

One solution to this problem is called worry scheduling. Worry scheduling is a well-researched strategy to limit worrying to a certain time every day. Choose a 15-20 minute period near the end of the day to devote to worrying about all of the important things you have to worry about. When you have a worrisome thought during the course of the day, remind yourself you have an appointment with this worry later on, and postpone it. Then, you can put your mind on whatever you were doing before the worry appeared. If you need to, you can even make a note of what the worry was about so you can focus on it later. 

When the scheduled worry time comes, devote as much time as you feel the worry deserves. Some people use the whole 30 minutes, but most people run out of steam after 5 or 10. Oftentimes, you might find that when the worry is postponed, it no longer seems as compelling. If that’s the case, you needn’t worry about it at all. This also means there was never any urgency to the worry in the first place. By setting the time, it’s easier to give yourself permission to not worry the rest of the day, and by limiting the duration of the worry, you significantly reduce its impact on your overall mood. 

For more information on this and other cognitive-behavioral approaches to anxiety, visit Cognitive Behavioral Therapy Los Angeles.

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. 

5 Tips To Curb Procrastination

We all procrastinate to some degree, putting off tasks because there is something aversive about what we have to do, or would rather be doing something else. When procrastination stands in the way of our being effective, however, it can cause serious problems at work, in our social lives, and with how confident we feel in our abilities. Below are some steps that, when implemented, may help you do what you need to do. These interventions come from the Cognitive Behavioral Therapy protocol for procrastination. 

Identify Small Goals
Small goals can help reduce feelings of being overwhelmed by large projects. A project that will take a full week of work is much easier to avoid than a task that can be completed in 20 minutes. These small tasks accumulate, ultimately turning into a completed project. Many people report that just setting a goal to work on something for 10 minutes makes it easier to sit down and do it. Even better, most people report that 10 minutes easily turns into several hours of focused work. 

Create a Prioritized To-Do List
One thing that gets in people’s way when it comes to completing tasks is finishing lower-priority items at the expense of more important tasks. Most people juggle numerous responsibilities, making it necessary to put some off. A to-do list separated into three categories, “urgent,” “moderately important,” and “put off until later,” can help you make an informed choice on what things to put off and when, rather than finishing the easier things first. 

Use Your Natural Patterns to Your Advantage
If you are more alert in the mornings, schedule more difficult tasks in the mornings. Do you feel more desire to interact with people after lunch? Schedule lunch meetings or phone calls then. Is there a time of day you prefer to be quiet and withdraw into yourself? That may be a good time for organizing your desk or filing system. Chances are, if you don’t like doing a particular task at a certain time, you are more likely to put it off.    

Complete Quick Tasks Immediately
Instead of waiting for a client to leave to email them a document, do it while the client is there. This applies to quick phone calls, filing, and small data entry tasks. If you add smaller tasks to your To-do list, they can add up and become overwhelming. 

Increase the Pressure
Use an egg timer or an alarm on your phone to limit yourself to a certain amount of time to complete a task. If you’re the type of person who can spend 30 minutes editing a document for which 15 minutes would be adequate, this strategy can be helpful. It may make some people anxious, but the feeling of working against a deadline can serve to increase the contingencies moving you toward the completion of the task. 

Because procrastination is often a habit created over decades, so it can be difficult to reverse on your own. Working with a cognitive behavioral therapist is the most effective way of ending your procrastination habits. There are cognitive-behavioral treatments for procrastination that can be completed in as few as four to ten individual therapy sessions. Click here for more information about cognitive behavioral therapy for procrastination and completing goals. 

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. 

Reduce Stress One Piece of Pie at a Time

Today, more than ever, there is intense pressure to be productive, multitask, and perform. All of this pressure can be a fertile breeding ground for feeling overwhelmed by stress and anxiety. Unfortunately, the more overwhelmed we feel, the less productive we are. Sometimes, juggling numerous responsibilities can leave us feeling helplessly paralyzed, avoiding what needs to be done rather than tackling it head-on.

There are numerous ways Cognitive Behavioral Therapy can address this all-too-common problem. One simple way is the pie-chart technique. Here's how it works:

1. Identify all the things causing you to feel overwhelmed. They can be projects, errands, or even difficult people.

2. Create a pie chart using each of the items you listed as pieces of the pie. For this, you'll need to rank which things are the greatest contributors to your stress. Then assign each one a percentage based on how much of your stress you can attribute to it. For example, if your pie chart has three items: returning phone calls, preparing for a presentation, and a difficult co-worker, they might be assigned percentages of 60%, 25%, and 15%, respectively. Make sure that it all adds up to 100%.

3. Identify the most stress-inducing problem and prepare to tackle it. Although this may seem like common sense, when overwhelmed, most people feel there are so many problems that it would be hopeless to solve. Consequently, they end up avoiding their problems while the problems get bigger. Focusing on only one problem at a time makes feeling overwhelmed and giving up less likely. By solving the problem that is responsible for the most stress, people generally feel much less anxious and more empowered to solve the rest of the items on the pie chart.

4. Break the identified item into steps. Oftentimes, one project or problem all on its own can trigger feelings of hopelessness and worry. Identifying all of the steps needed to solve the problem is a way of seeing in a concrete way how the problem does have a solution.

5. Complete each step one at a time. Focusing on one small step rather than ten or more steps makes the task feel more manageable. It works the same way as focusing on one problem from the pie chart rather than all of the problems at once. Additionally, because one step is easier to complete, it promotes confidence and mastery, making the rest of the project feel less difficult. With each step completed, solving the entire problem seems more likely. After completing one step, move on to the next.

6. Continue this process for the rest of the items from the pie chart. You can continue to work in this fashion until all of the identified problems are solved or at least more manageable. However, after completing the first few items from the pie chart, most people find they no longer need this approach, as they feel much more confident in actively solving problems.

For more information about how Cognitive Behavioral Therapy Works, visit Cognitive Behavioral Therapy in Los Angeles

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. 

Reduce Anxiety Quickly with Square Breathing

Cognitive behavioral therapy has hundreds of research articles in support of it as the most effective treatment for numerous psychological problems. It is helpful for everything from depression to relationship problems. One thing the research has shown time and again is that cognitive behavioral therapy is especially effective at treating anxiety disorders. Numerous CBT interventions target anxiety, including systematic exposure, cognitive restructuring, and mindfulness training. The following technique is a form of relaxation training that can be used in conjunction with one of the aforementioned interventions or all on its own. 

Cognitive behavioral therapy (CBT) helps people reduce the intensity of negative emotions. However, we cannot change our emotions by focusing on them directly. Otherwise, it would work when people told us to "calm down." What we can change, however, is our thoughts, behaviors, and, to some extent, our physiology. Because all of these components affect one another, CBT helps us to change emotions by changing the things that feed the emotions.

One emotion that CBT has been proven to be helpful for time and again is anxiety. As human beings, we all experience anxiety from time to time. It's natural. It's normal. And if we didn't, we'd probably get into a lot of trouble. Unfortunately, sometimes anxiety can become too intense and hinder our effectiveness (think going blank during a final exam). Cognitive behavioral therapy has numerous treatments for anxiety, and most of them are among the most effective psychological treatments studied by scientists. One that is easy to learn is square breathing, also known as relaxation breathing.

A note of caution: If you have any medical condition that might be adversely affected by slowing down your breathing or holding your breath, please consult with your doctor first. This can include cardiovascular problems, epilepsy, and asthma.

Steps for Square Breathing:

STEP 1: Find a quiet place where you can sit for ten to fifteen minutes without distraction.

STEP 2: Take note of your normal breathing pattern, and count how many seconds each inhale and exhale takes. 

STEP 3: Once you have a baseline measurement, increase the length of the inhalation and exhalation by one second, in essence slowing down each in-breath and out-breath. Once you have acclimated to the new, slower rate, increase the inhalation and exhalation by another second. If you feel uncomfortable or out of breath, it probably means you're slowing down too fast. Continue gradually slowing down your breath until you are breathing as slowly as you can without ANY difficulty. 

STEP 4: Once you are comfortable with a slower breath, experiment by pausing after each exhalation and each inhalation. These pauses can be short, lasting one or two seconds, or long, lasting up to ten seconds. However long the pauses last, just note you will probably have to adjust your rate of inhalation and exhalation to continue breathing comfortably without feeling the need to gasp for air. The technique is called square breathing because originally, the in-breath, out-breath, and both pauses were designed to be the same length; in the same way each side of a square is the same length. However, the ratio doesn't matter, as long as fewer breaths are taken each minute. 

STEP 5: Set an alarm and continue this for ten to fifteen minutes. Afterward, you will most likely experience an increase in relaxation and a significant decrease in anxiety. AMAZING.

This works in the same way that the half-smile technique works: Normally, when we are anxious, the result in our body is that our breathing rate increases, and we take shorter, shallower breaths. When we are relaxed, the opposite happens. By slowing down the breath, we trick our brain into thinking we are relaxed, releasing all of the relaxation neurochemicals. 

Research has shown engaging in this technique has immediate effects on the brain. More importantly, studies have proven that engaging in square breathing twice daily lowers overall anxiety levels long-term in people prone to excessive worry. 

Try it out to see how it works. If it's helpful, the next time you're freaking out in a doctor's waiting room, or biting your nails before a job interview, pull out your square breathing and take things down a few notches.

For more information on this and other cognitive-behavioral approaches to anxiety and depression, visit Cognitive Behavioral Therapy Los Angeles.

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. 

Opposite to Emotion Behavior

Opposite to emotion behavior is a technique that comes from traditional behaviorism, but has been adapted to treat emotion dysregulation in newer science-based therapies such as CBT and DBT. The goal of the intervention is to cut the cycle of behaviors, thoughts, and feelings that maintain negative mood states. By ceasing behaviors that fuel negative emotions, you can reduce the intensity and duration of the emotion. 

Emotions love themselves. The more we feel an emotion, the more we engage in behavior that makes us feel that emotion even stronger. When we're sad, all we want to do is curl up in bed for hours on end, usually not eating, not talking to anyone, listening to sad music... Sound familiar? The problem with this is the more we lie in bed, not doing anything, the more physiologically depressed we become. This then leads to us feeling even sadder, and eventually, we can be pretty demoralized when we look around and realize we've wasted the whole day.

To break this feedback loop, we need to engage in a behavior inconsistent with the emotion we're trying to manage. This is a technique called opposite-to-emotion behavior. To do this, identify the emotion (sadness), identify the mood-dependent behavior (inaction/isolation), and then do the opposite of that (exercise, social interaction, productive behavior). After a while, the feedback loop is broken, and you have successfully managed that painful emotion. This works for any emotion:

Anger: Instead of engaging in conflict, act opposite to that emotion by gently withdrawing, or even better, doing something nice for someone else.
Fear/Anxiety: Instead of hiding or avoiding, approach what you are afraid of with full commitment.
Unjustified guilt or shame: Instead of trying to keep something (that is not shameworthy or morally wrong) a secret, expose it with the spirit of acceptance.
Justified guilt or shame:  If you did something that was out of line with your values, do something in line with your values that overshadows that other thing.

Please note this is not intended to be a way of not feeling your feelings. Emotions are important cues that something important is happening. This technique is merely a way of managing emotions if you're afraid they might become too intense or last a little too long. Give it a try the next time you have an urge to hide in bed and listen to sad music. You might be surprised at how you can turn around what might have otherwise been a day wasted!

For more information on cognitive behavioral treatment of mood disorders and anxiety, visit Cognitive Behavioral Therapy in Los Angeles.

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

Treating Pain with Mindfulness Meditation

Chronic pain affects approximately 116 million Americans. Often, chronic pain is debilitating, both physically and psychologically. The typical treatment for chronic pain is pain medication, many of which can be addictive and lose their potency as our bodies develop a tolerance to them. While pharmacological treatment helps a significant number of people, for enduring pain, psychological treatments have begun to emerge as the treatment of choice, as numerous studies have come out showing new psychological treatments to be effective. The most researched of these treatments is mindfulness-based therapy. 

Mindfulness is a practice borrowed from Buddhism by cognitive psychologists due to its many beneficial effects on the mind and body, including reducing pain. How does it work, you ask? The short version is that mindfulness works by helping people simply notice their pain rather than get caught up in trying to eliminate it, which causes frustration and paradoxically, increased pain.

Usually, we try to distract from it, which is very, very difficult to do. When we're not distracting, we're spending all of our energy struggling with it - wishing it weren't there, getting angry at it, etc. None of this is helpful. It just adds additional suffering to what is already a painful experience.

The mindful approach is to allow the pain to be there. Rather than trying (somehow) to make it go away through sheer will, just notice it and make space for it. Dropping the struggle with the pain can provide a lot of relief.

While you're allowing the pain to be there, just sit with it, and notice it. Put words to the experience. Where is the pain? Is it tingling? Is there pressure? Where does it begin and end in your body? Are there warm parts? Cool parts? By describing the experience without adding a lot of catastrophizing and negative judgment, we experience the pain in a new way. A lot of people report that just the mere act of sitting with pain and describing it, eliminates the pain entirely. A friend recently used this approach when he was having his wisdom teeth extracted... without anesthesia. He reported he noticed pain, but relating to it in this way made it tolerable. Just another event in his body that he was noticing, like the hiccups or a yawn.

It definitely takes practice, but with a little effort, you can transform pain into something that is much more tolerable and creates much less suffering.

Click here to learn more about CBT for Chronic Pain. For more information about mindfulness-based interventions, visit Cognitive Behavioral Therapy in Los Angeles.

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. 

Would You Really Tell THAT to a Friend?

This article is an introduction to cognitive restructuring. Cognitive restructuring is a tool cognitive behavioral therapists use to alleviate symptoms of depression, anxiety, and other psychological problems. We generally believe everything we think, which can sometimes cause real problems when those thoughts are distorted or we're filling in the gaps in our knowledge with misinformation.

We are constantly telling ourselves things all the time, a running commentary buzzing around in our minds. It's how we make sense of and interact with the world. Unfortunately, not everything we tell ourselves is necessarily helpful or even true. "I'm too fat..." or "I'll never get this job," "Why bother..." - Sound familiar? Cognitive therapy, developed by Aaron Beck in the middle of the last century, identified this problem and developed a very straightforward solution: to look at our thoughts rather than looking from our thoughts. It's a process cognitive scientists term metacognition. It refers to the ability to examine our thinking process rather than assume every thought we have is true. It is the foundation of cognitive therapy.

To illustrate how dysfunctional thoughts cause problems, let's use an example. Peter, a college freshman, has a crush on a young woman he sits next to in class, Kim. Peter has wanted to ask her out all semester, and now he only has one class left with her before summer break. Committed, he decided he would ask immediately after class. While trying to pay attention in class, Peter had an onslaught of self-defeating thoughts, such as "She'll probably turn me down," and had lots of images in his mind of her laughing at him and ridiculing him in front of the whole class. This heightened his anxiety to a fever pitch, so much so that his mind "froze" and when he approached Kim. His mind went blank, and she gave him an uncomfortable smile and wished him a nice summer vacation.

Had Peter used a little metacognition, he probably would have noticed that his thoughts were mood-dependent, meaning that they were thoughts triggered by anxiety rather than by the actual evidence around him, which is that Kim seemed too nice to try to humiliate him. In reality, it would probably have been highly unlikely for Kim to try to hurt his feelings by ridiculing him. But his thoughts triggered more and more anxiety until he couldn't think straight.

One tool to accessing that elusive metacognition is to ask yourself, "What would I tell a friend if he were in this situation?" It's very simple, but it helps to take all of the emotions we have wrapped up in our own situations and de-personalize them a bit. Here's how it might go:

Friend: If I ask her out, she'll probably turn me down and laugh at me in front of everyone. That would be humiliating.

Peter: Well, you don't know if she'd turn you down, but what I do know is that you really don't stand a chance with her if you never try. And do you really think she would laugh at you? I don't think that happens very often. She'd probably politely make up some excuse, and it wouldn't be great, but it certainly wouldn't be humiliating.

A simple method, yes. But it is a very effective one at helping us to take a more realistic perspective. It's interesting how we have more access to our own wisdom when we remove ourselves from the situation. The next time you notice an inner monologue of self-defeating thoughts, ask yourself, "What would I tell a friend if she were in my shoes?"

For more information on cognitive behavioral therapy, visit Cognitive Behavioral Therapy in Los Angeles.

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.