Cognitive behavioral therapy
The most common cause for stress I witness as a therapist is a refusal to adopt to change. Stress itself is not bad. We experience stress when we experience a heightened sense of arousal in response to negative experiences our brains have interpreted as worrisome or a potential threat.
For example, if you are experiencing a bad relationship with a supervisor at work, it is perfectly natural for you to experience stress, in response to your brain seeing this as a potential threat. After all, your supervisor is responsible for rating your performance on the job and in most cases a deciding factor for how long you keep your job. If you are in a position where your job is a sole source of income it is understandable that you may feel threatened if you suspect that your supervisor is not happy with you. If you lose your job, your ability to sustain yourself in regards to your basic needs will become inconvenienced until you find another job.
So what if you find yourself in this position? What do you do? Most people in this position would approach their supervisors and attempt to find out how to remedy the situation. I have counseled with people who have taken this route, only to continue to experience the same negative encounters with their supervisors.
In most cases like these I have dealt with, once the person runs out of options he or she continues to go through a sequence of activities they have traditionally done. Show up for work on time, remain courteous, to co workers and supervisors, address official issues with the supervisor all the while experiencing an emotional breakdown on the inside. In a few cases the person would have made an attempt to find a new job, but after one or two rejection letters they usually give up on this route. All the while, the primary stress-or he or she is experiencing continues unabated.
This post is not meant to discuss work issues per se, it is meant to address why some people deal so poorly with stress. The primary reason? Our beliefs. What we come to believe plays a primary role in how we deal with stress. Our beliefs are like doors to other realities, one belief can open your life up to multiple opportunities, while others can lead to dead ends. So if I were to use the example of an employee experiencing being emotionally stuck as a result of all his strategies to end the problems with his supervisor not working, I would say that the employee is operating on a set of limiting beliefs.
On the surface that belief could be that the current employment he has is the best he can do, and there are no more opportunities out there for him. When people make these statements with me, I dig deeper to learn if this is really what they believe, then the belief changes to people are just refusing to hire. Upon further investigation, once the person comes to realize how irrational this belief is, he later comes to the conclusion that he holds unto the belief that he should not suffer, which has lead him towards playing by a rigid set of rules in his work life and thus, his current situation.
So yes, I am writing in this post, that the common cause for stress is the belief that suffering is intolerable, and therefore should be avoided as often possible. When we come to believe this, we run into dead ends, in our professional and personal relationships. We avoid change because we want to avoid suffering.
Suffering is inevitable, I have found that when clients come to accept and make peace with this fact, they come up with surprisingly simply solutions to the problems they experience.
Ugo is a psychotherapist and life coach.
Driving to my office this morning, I listened to some broadcast information, I found disturbing. A happiness guru was giving giving advice on how to be happy.
He started out with an example of a retail worker, who was not happy with her job, and went to detail how she could immediately begin experiencing happiness, simply by changing her perceptions. Listening further, he appeared to state that she would be able to experience happiness by practicing a number of cognitive exercises simply geared towards looking at her situation in a different light. The problem I had with his message was that the change in perceptions where not tied to any follow through actions.
That line of thinking is based on the old glass half full or half empty analogy. That is to say, that you can either see a half glass of water as either half full or half empty. The issue I have with messages like these is that they are based on half truths. It is true that your thoughts influence your level of happiness, however if you find yourself experiencing unhappiness, who is to say that your thoughts are wrong? Take again the glass half empty or half full analogy, in reality a glass of water at any level is either on it’s way to being emptied or filled. It all depends on what decisions you intend on following through on. Are you going to empty the glass or refill it? Perhaps both.
Let’s explore a concrete example using the story of the retail worker who is unhappy with her job. What if she does not earn enough wages to get her basic needs met? Yet she believes that there are no immediate opportunities she can pursue where she is generating sufficient income. Telling someone in this situation to think happy thoughts is deceitful and insulting. It reminds me of a high school English teacher I was working with, who stated, “thank God I don’t live in India”. As she said this, I couldn’t help but notice the gaping hole in her right worn tennis shoe. I am not one to be materialistic, but I decided that based on her statement, her daily appearance was not one of self imposed frugality but one of impoverishment. Further, her comparison of her current situation at the time, to her perception of life in India, was meant to generate feelings of happiness about her situation. Which amounted to nothing but a false positive.
Back to our fictional retailer, if I knew someone in that situation, I would immediately share with that person that her unhappiness made sense. Further I would share with her that her feelings of unhappiness was her brains’ way of informing her that her current line of employment isn’t working out. If so, what is a retailer to do? I would introduce the retailer to cognitive exercises meant for her to brainstorm realistic alternatives for generating income. From my experience, such a process usually leads the person to come face to face with her fears generated by unhealthy beliefs she developed during her early life experiences.
At this point the goal would be in assisting the retailer to discard her old unhealthy beliefs and adopt new beliefs that steer her in the direction of practicing the courage to pursue her passions. So it is just not enough to think happy thoughts, instead happy thoughts are generated by decisions we make and intend to follow through on in either pursuing meaningful change in our lives or continue practicing habits to maintain a meaningful and fulfilling life style we are already living.
In my opinion, the key to happiness is the practice of courage. I will write more on this on the next post.
Ugo is a psychotherapist and a life coach.
Throwing it all away.
From time to time, I work with people who have either made an attempt at suicide and or expressed serious intent to do so. My first response to these people is to ask a standard question based on a ancient quote; “have you left all stones unturned?”
Often times when people contemplate on committing suicide, they are operating on limiting core beliefs, which they have repeatedly used towards getting their emotional needs met in a diverse number of situations. As a result they have experienced limited to no success, due to their lack of flexibility in their core beliefs and subsequently their behaviors.
For example, a common theme I observe with people who idealize suicide is an absence of love from their lives. Often these are people who still struggle with childhood trauma, where they experienced significant physical abuse and or emotional neglect under the watch of caregivers. They often feel unloved and unwanted by others in their lives and in their personal relationships they will resort to subservient roles in the hopes of gaining the approval of the other person.
During the course of these relationships, as the person with suicidal ideation gives more of themselves to the other person, the less value the other person sees in them, the more used, undervalued and unloved the person feels. Further, the more relationships the suicidal person engages in which they give the best of themselves with little to nothing in return, the more exhausted they are going to feel about themselves and life in general.
The good news is that people in this predicament with timely intervention can adopt a more optimistic view of themselves and life in general and start thriving. However before I get into what the turn around process will look life for suicidal people, I am going to get into the reasons why people with suicidal ideation, typically find themselves feeling exhausted about themselves, undervalued and unloved in their personal relationships.
Before I begin, I would like to state that the following reasons does not apply to everyone who experiences thoughts about suicide. Further, the following content is not meant to diagnosis and heal anyone who is experiencing suicidal ideation. The following content is being provided as helpful information , if you are experiencing thoughts of suicide or know someone who is experiencing thoughts of suicide, please seek consultation with a psychotherapist.
“A Corrupted Sub Conscious”
During the first two years of life, the right hemisphere of the brain is the first develop, in regards to the establishment of neurological connections. Not only is the right hemisphere the first to develop, it also a experiences a rapid growth sprout during those first two years.
In the field of neuroscience it is generally agreed upon that the right hemisphere is more closely connected to the primary and survivalistic needs of the body than the left hemisphere. As a result, the sensory information is usually interpreted by the right hemisphere from an emotional narrative while sensory information from the left hemisphere is usually interpreted from an analytical / problem solving narrative.
The type of emotional narrative used by the right hemisphere to interpret information is usually dependent of the person’s experiences in getting his or her emotional needs met as a child. If the person experienced a lot of success in getting his emotional needs met during childhood, his fundamental emotional narrative tends to be more optimistic. The right hemispheres of people who are more optimistic, tend to communicate easily with the left hemispheres. While the right hemispheres of people who are more pessimistic, tend to communicate less with the left hemispheres of those people. So people who had difficulty getting their needs met as children tend to have a more rigid and pessimistic emotional outlook on life. They are more likely to adopt narratives of helplessness and hopelessness when they encounter challenges in their lives.
The typical mindset of a person struggling with feelings of helplessness and hopelessness is such that if one type of solution does not work for the problem he is addressing, then no other solution will work for that problem. This is obviously not true and explains why people with suicidal ideation give up so easily after addressing the same types of problems with the same approach. repeatedly.
“The Devil You Know..”
Another reason why people with suicidal ideation experience limitation of ideas in addressing their challenges are the people they have grown accustomed to associating themselves with. We are accustomed to dealing with the same types of people we are raised with. This is because during the course of our lives we have developed neurological connections to enable us relate to specific types of people, which affords us a sense of predictability and consistency.
For the person who suffers from suicidal ideation, this presents a big problem, because chances are that you have grown accustomed to interacting with toxic people, and responding to such toxic persons with your own toxicity. This creates the illusion of de ja vu, were just about every relationship you are engaged in is a toxic relationship, which leads to feelings of inferiority, in that you begin to believe that something is wrong with you and that you are deserving of being on the receiving end of toxicity.
“Reprograming Your Subconscious”
Your subconscious mind can be reprogrammed, intentionally or coincidentally. Intentionally by yourself or a third party and coincidentally by information you encounter which inspires you towards change, for better or for worse.
You can come to deeply believe yourself to be a worthwhile human being and come to unconditionally accept yourself.
This process involves creating a narrative and seeking real life evidence to test the effectiveness of the narrative. The first step towards creating this narrative is by understanding the law of opposites. The law of opposites states that everything in existence is a combination or unity of opposites, a common example would be electricity, which is defined by a positive or negative charge.
This means that if you are currently living your life based on a narrative where your worth is low and you reject yourself, there exists a narrative where you believe yourself to be a worthwhile human being and you unconditionally accept yourself.
This is not a narrative you simple make up, but one you base on evidence. First you explore evidence that supports your reasons for degrading your worth as human being. Imagine that your belief of low self worth is a table top, and the reasons you look down on your self are supported by the legs that hold up the table top.
Now write down on a sheet of paper the evidences you have gathered to support your issues with low self worth, each of these evidences will symbolically represent as a leg for the table. You can write down as many evidences as possible even though the standard table has four legs. Once you have written down your evidences, write down on a separate sheet of papers, the exact opposites of these evidences and how they will support the new worthwhile you.
For example, if you believe that you are surrounded by people who do not care about you, as evidenced by the current people in your life, then you write down what it would be like to be surrounded by people who do care about you and who in return you care about.
You will then write down what changes you can start taking in your life to be surrounded by people who do care about you. By doing so, you will be faced with the harsh reality of the things you do to attract uncaring people into your life. Whatever changes you write down, you will come to the realization that practicing these changes will change how you relate to others and subsequently how others relate to you.
A former client of mine, once began the practice of setting boundaries with family and friends anytime they made crude jokes he considered to be offensive. He would place these boundaries and follow through with his commitment to follow through on the boundaries if he was teased for being too sensitive. Much to his surprise he reported experiencing less conflicts with people, as he in turn had become more cognizant of the things he said to others.
This was all based on his new narrative that he would commit to being the most genuine and courageous person he could be, in all of his relationships with people.
In getting to this stage, there was on obstacle that he had to overcome, and that was learning to get past his difficult feelings.
In this previous post, I wrote about feelings, I discussed feelings being tools we use as human being to gage our accuracy of our perceptions of reality as compared to reality as is.
The most difficult part about implementing a new narrative, is getting past your difficult feelings, which usually consist of confusion, guilt, fear and shame. These feelings are false negatives that you become anchored to over the years to unhealthy narratives you formed during your early life experiences.
The most effective way to get past your difficult feelings is to do nothing. The process of doing nothing does take a lot of effort, as over the years you have developed strong neurological connections that fire in response to certain triggers to illicit certain reactions. The most effective way to do nothing is to practice deep breathing. Deep breathing exercises, invoke deep states of relaxation, leading you to become less reactive to certain triggers. A starter exercise I typically introduce clients to is the process of counting breaths from one through ten and then from back down from ten to one. After this process has been completed you will experience a deep state of relaxation, at which point you can focus on asking yourself why you are experiencing the difficult feelings you are experiencing.
With practice, you will experiencing progress in getting past your difficult feelings, making it more easier to implement your new narrative.
As effective as these techniques are, they are easier said/written than done. If you experience significant difficulty practicing these techniques, it is advisable that you see a therapist.
After all, you have one life to live. So leave no stone unturned.
Ugo is a psychotherapist and life coach.
During our first five years of life, our right hemisphere develops a narrative in accordance to what we have experienced in our immediate environment so far. This means that if our experiences so far have involved safety, compassion and affection, we develop core beliefs to reflect these narratives. If our experiences so far have evolved a scarcity of affection and compassion and a lack of safety, we develop core beliefs which prepare us to survive in a rough world. This is because on a primitive level we are hard wired to survive at all costs. An example of an unsafe environment would include physical abuse in which a person’s existence is threatened, or humiliation as a result of being on the receiving end of chronic emotional abuse. When these incidences occur during a person’s early life experience, it will most likely lead to the development of core beliefs which reside in his subconsciousness, beliefs which are geared towards protecting him from similar incidences in the future, and beliefs which habitually influence his decision making.
For example, when a child is habitually physically or emotionally abused, the child grows up to develop a sub conscious belief in which his safety and/standing with the community or any community is always at risk of being compromised. These beliefs leads to feelings of hyper arousal, where the person is subconsciously constantly on the look out of trouble, as a result everything he does will be limited by his threatening beliefs.
I once had a client who was struggling with his studies, he was a freshman at the University of Arizona and he was on the verge of dropping out of school. The primary reason for his failing grades was that he was simply not doing the work. My client would later reveal his struggle with a learning disability and the habitual shaming language he received from his parents at home in regards to their fears that he would amount to nothing. During our course of treatment, we determined that at his core, he believed himself to be worthless, and lived in fear of being discovered by others, so throughout his life, he would perform the bare minimum and avoid engaging in challenging work in the presence of others, least he was “discovered”.
Consider another story, of a client raised by a single mother, he shared that she was emotionally abusive towards him and some of her male partners were just as abusive. As a teenager, when my client finally demanded to be informed about whom his father was, his mother sent him to go live with his father for the summer. His father whom he had not had contact with since his second birthday, was now married with three children. My client reported that both his father and step mother where physically abusive towards him, and that he and his siblings struggled to get along. It was at this time he fell into a deep depression as he had always romanticized reuniting with his father and being rescued from his mother.
Fast forward to his mid thirties, where he experiences high stress and conflict in his relationships with others. He feels bullied by the mother of his child, he feels bullied by his supervisor at work and by another co worker. His response to these incidents of bullying is to become extra accommodating to the people he is experiencing conflicts with. The typical response to his accommodating behavior is that the bullying he is receiving from others becomes worse, leading him to experience bouts of panic attacks as a result of his feelings of being emotionally stuck.
Treatment for both clients were successful in which they were both able to develop new narratives to begin the process of replacing their core beliefs. These were accomplished through the process and combination of cognitive behavioral therapy and eye movement desensitization reprocessing. My first client transitioned from an academic probation status, to thriving in his studies during his second year at the University, while my second client reported how his practice of assertiveness had led to favorably changes in his relationships with others.
Our core beliefs resides in our subconsciousness and were formed during our early life experiences to meet the demands of our immediate and respective environments. However, given that change is constant, in the event we find ourselves in a new environment or competence enough to put ourselves in a new environment, it is important to know that we are fully capable of change.
We are the authors of our future.
Ugo is a psychotherapist and life coach.
A young client relayed to me an experience with bullying. The bully accompanied by a few other peers with one of them armed with a cell phone camera, began poking fun at my client. At first my client tried to ignore him, but then he allowed his anger to get the best of him. This was when he lunged at his tormentor, the fight ended quickly with the bully being the victor. What made matters worse was that everyone who witnessed the incident stated that he (my client) started the fight, which was true.
By the time my client had been brought in by his parents to see me, he was knee deep in a state of helplessness. From his perspective, even when he was most angry he was still helpless in response to being bullied. Even in the adult world, I learn about adult versions of what my client went through. One person being on the receiving end of unfair treatment from others, and decides he is not going to take it anymore and lashes out. The result being a series of natural and logical consequences the person cannot manage.
You see, the real culprit is the belief that anger is somehow a motivator for overcoming unfair treatment from others or life challenges. I have read about this myth of anger in blogs, magazine articles and witnessed it being said in video logs. Anger does not inspire courage, anger is a natural occurring emotion that arises when we have come to believe that our humanity is being disregarded by someone or others. The process of using courage to stand up for one’s self actually comes the belief that you are confidence in practicing necessary acquired skills to stand up for yourself. Such a belief comes from the evidence of you practicing those acquired skills in similar situations.
So when the bully got the best of my client, it was because he was in better shape to do so. Or in the second example, where the person is unable to use his words to state his boundaries, it’s because he lacks the practice of having to assert himself in situations with high conflict.
Anger is a natural occurring emotion, that is most useful for infants and children. This is because all infants and children know are their needs and that their parents and guardians are responsible for getting those needs met. As the child matures, the parents teach him that he is responsible for getting his needs met and managing his emotions. This is where the traits of competency, confidence and courage from acquiring and practicing skills start to emerge.
In this video I discuss my professional opinion on the subject of anger and courage.
I recently came across a two year article about the popularity of Xanax, and it reminded me of the number of patients I have worked with who had already been taking medication for months and sometimes years, before they decided to try the therapeutic route. I suspect that most people who stick with their medication, even past the point of diminishing returns are unaware about the specifics of how anxiety and panic attacks are typically addressed in therapy.
When treating anxiety, there are three therapeutic models, I use interchangeably , the cognitive behavioral model, the exposure model and the hidden emotion model.
The cognitive behavioral model approaches anxiety from the idea that it is the beliefs and subsequent actions of the person that is making the person anxious. So when the person holds unto beliefs that create anxiety, that person becomes sensitized to situations that can arose anxious thoughts, with the anxious thoughts being a product of what he believes. Take for example, if a person believes that all dogs are dangerous and vicious. This person then becomes aroused by concerns for his safety whenever he finds himself in the presence of a dog, or when he learns that there is a dog close by. Furthermore this person’s anxiety might become even more amplified if he engages in behavior he believes will keep him safe from the dog. So in this situation, we can say that the person’s anxious thoughts are caused by his beliefs about dogs. So in order to help the person get past his fear of dogs, we have to work on helping him adopt a more healthier belief about dogs. In the short term we will get him to practice healthier behaviors to cope with his anxious thoughts about dogs, when he is in the presence of dogs.
The exposure model approaches anxiety from the idea that the anxiety is being caused by the person’s decision to avoid her identified stimuli for the anxiety. An example would be a fear of negotiating one’s way through a crowd of people. So the person’s anxiety would be triggered every time she encounters what she considers a crowd. Using the exposure model, the person would be encouraged to gradually immerse herself into crowed situations, during which she will go through the process becoming desensitized to crowds.
The hidden emotion model approaches anxiety from the idea that anxiety is caused by a fear of confrontation with others. As a result, people who fear confrontation mask their emotions through a facade of being nice. The hidden emotion model posits that through the chronic process of forcing niceness, people sweep their true feelings “under the rug.” Which leads to the repressed feelings being expressed through chronic anxiety and in worse cases, panic attacks. The hidden emotion model addresses anxiety through a process of helping the person become more aware of his feelings, alongside strategies for helping him become more assertive through the practice of assertive building strategies.
In practice what I have learned is that regardless of which model I use to address a client’s needs, it all comes down to identifying maladaptive beliefs the person holds unto and helping the person adopt and practice healthier beliefs. Anxiety is treatable, and in worse cases such as recurring panic attacks, a person can learn to bring the episodes of panic attacks to an end.
Ugo is a psychotherapist and life coach.
So what is an impossible reality? An impossible realities can be best described as an experience that you have determined to be detrimental to your well being. However this is an experience you have actively pursued, and quite possibly prepared for your entire life. An example would be an abusive relationship or a toxic work place.
What makes experiences like these impossible realities is that you will most likely have strong beliefs and values that encourage you to continue with the experience despite the fact that in the long run you will not benefit from the experience. In the video below I discuss more about impossible realities, how they lead to mental health issues such as panic attacks and how to get past impossible realities.
Ugo is a psychotherapist and author of
How to end your panic attacks is now published and available for download as an ebook at the following ebook retailers:
Barnes & Noble
Baker & Taylor
In this video I briefly discuss what to expect when reading this book.
Ugo is a psychotherapist and life coach.
One of the things that makes cognitive behavioral therapy so rewarding is the numerous examples that one can draw from which lends more evidence to the power of believing.
There is a new drug, call zohydro and according to this article, it is the most important frightening potent drug recently approved by the FDA, when it comes to opiate drugs on the market today. Concerned advocacy groups indicate that once made available to the general population, that there will be high incidents of deaths due to the potency of the drug.
Times like this, members of the public have two choices, you can depend on others to fight your battles for you, or you can take the initiative to protect yourself.
Some years ago, I underwent emergency surgery to remove an appendix, after the surgery, I was offered by my doctor some vicodin, to which I refused. My doctor seemed surprised and repeatedly asked me if I was sure. I told him I would be fine. Out of what I determined to be genuine concern, he wrote me a prescription for tylenol, a prescription I never filled.
Yes, I was in pain, but it wasn’t crippling. I took an extra day off work for bed rest, and limited my movements. After about four days I had started to feel again like my old self. How was I able to pull this off? By practicing the art of mind over matter.
You see mind over matter is not the stereotypical machismo nonsense, you will hear in a movie line, or perhaps your local gym. From my experience most people who often use that phrase don’t understand the concept.
Instead mind over matter, refers to the a initial of readdressing our beliefs around certain circumstances we will typically find unpleasant, certain circumstances like pain for example.
While my doctor at the time had the best intentions, what he didn’t realize he was telling me was that I wasn’t not supposed to feel any pain after coming out of surgery, so therefore he had arranged for me to take some pain medication which would be helpful in reducing my pain.
However since I had just been cut open and a piece of organ had been removed from my body, it stands to reason that my body should experience pain as it healed itself. It was with this idea that I was able to accept the pain I was experiencing as a good thing. It meant that my nerves where functioning as they should and that my body was healing itself.
This is the kind of attitude through the practice of cognitive behavioral strategies I encourage people who suffer from addiction issues to take. Whether it’s pain, unresolved issues with abandonment and rejection, it doesn’t matter. What we choose to believe plays a role in influencing our ability to deal with psychological and physiological discomfort.