EXERCISE 1 Look through this list and underline any of the habits that you have a tendency toward:

Transcription

1 Dealing with Reactive Habits: A CBT Primer One of the gifts of mindfulness training is helping us notice the myriad thoughts that arise in meditation just as they do in life, even if in life we often don t notice them. Some thoughts are useful, and some don t serve us well. During the training we will explore briefly how those thoughts that don t serve us come about. We will see the interconnection between the nature of the brain in survival mode and the neuroscience of how we can develop habits of thinking that seem rational, reasonable and right- but may not be, and how mindfulness is useful. We don t actively choose to have negative thoughts pop up in our minds, but we can actively choose to address them and prevent their negative impact on how we feel, think and behave both in our own life, and with others. Mindfulness is one of many tools we can use to understand and address those thoughts. There have also been 2 widely known and used psychological tools for this. In the 1950 s and 1960 s Albert Ellis and Aaron Beck were independently developing therapeutic models to explain and deal with this very issue of unhelpful thinking. Especially the unhelpful thought patterns that have become habitual, and we believe them to be true. Before you come to the course, please complete this worksheet exploring some of your own unhelpful thoughts. You may notice that some of these change over your life, and some stay for a long time. Even if you teach CBT to clients, we encourage to complete the worksheet and use this training to nourish and support your own personal development. Albert Ellis developed a model called Rational Emotive Therapy (RET) which uses disputation to amend what he called dysfunctional beliefs and thinking. RET addresses both the more profound schematic ways we understand the world, and the immediate, conscious, steam of thought. Aaron Beck developed Cognitive Behaviour Therapy (CBT) which adopts the Socratic method of questioning the validity of our thoughts. CBT focusses more the immediate conscious, steam of thought. EXERCISE 1 Look through this list and underline any of the habits that you have a tendency toward: 1. Exaggerating 12. Shoulds and musts 2. Over generalising 13. Misplacing responsibility - Blaming 3. Over simplifying 14. Focusing too narrowly 4. Extremism 15. Harmful judging 5. Over certainty 16. Asking unanswerable questions 6. Negative guessing 17. Seeking confirmation for your own bias 7. Self defeating conclusions 18. Using emotions as evidence 8. False implications 19. Dismissing alternatives 9. Choosing the worst possible scenario 20. Ignoring alternatives 10. False helplessness 21. Assuming 11. False hopelessness 22. Negative bias

2 When we re younger we believe what we think, so we might be habitually reacting in one of these ways, but not yet have the awareness that we are doing it. As we develop, repeated feedback from other wise, respected people, and our own insight helps us see that maybe we over generalise or repeatedly make decisions from some idea of what should be. RET and CBT both address these irrational thoughts. RET has a strong focus on the should/ musts/ demands that we expect of ourselves, others, and the world. These are considered as the core of our problems. Albert Ellis believes that our shoulds, musts and demands stem from three common core irrational cognitions about: 1. How I am: I must be competent at all times 2. How you are: You must treat me reasonably, considerately, and lovingly, or Everyone should love me 3. How the world is: Things and conditions must be just as I want them to be, and should never be too difficult or frustrating When we have some level of these core cognitions, then when things do not play out the way we think they should, we tend to develop core irrational beliefs, that over time, seem like truth, eg: 1. How I am: I must be competent at all times, or else I am not good enough or worthless! 2. How you are: You must treat me reasonably, considerately, and lovingly or you are a bad person and you should be blamed and damned for your poor treatment of me! Or Everyone should love me, or else I am unlovable. 4. How the world is: Things and conditions must be just as I want them to be, and should never be too difficult or frustrating, otherwise life is awful, terrible, catastrophic and unbearable! Or When things are scary, I should be able to cope. I shouldn t feel so shy and nervous - what s wrong with me? etc. EXERCISE 2 While you may or may not feel these irrational beliefs strongly, underline below the core irrational cognition you initially relate to most? 1. yourself 2. others 3. the world And what are the core irrational beliefs that has led you to have?

3 The theory is that actually life is random, sometimes unfair, sometimes difficult and frustrating and that s just how it is. Our aim therefore in RET is to replace should/musts/demands with preferences to restructure our irrational unhealthy thinking with rational healthy alternative thinking, using mental tasks and worksheets (homework!), until we have new hardwired thinking that respects and has unconditional acceptance of ourselves, others, and the world. Big job? It can be done! In an interview, Ellis explained how he gets himself out of an upset. 1. First he says to himself, I m creating this upset because of how I m thinking 2. Then he asks, What am I telling myself? 3. Finally he looks for commands and demands: Things should not be this way, the other person should not act that way, I should not feel this way, etc. Ellis suggests that if someone presents with a problem, looking for the shoulds or musts will go right to the heart of the problem. Once you recognise the shoulds, oughts, musts, demands, and commands you use on yourself, and once you realise they are merely preferences, it takes away the intensity of negative feelings and you are left with mild disappointment, simple frustration, or concern rather than sadness, anger, or fear. When we notice ourselves or others saying things like She should know better than that People should always keep their promises I can t believe they just cut in front of my car! They shouldn t drive like that! I should get things right I must never get upset with my partner I should always cook exquisite meals à People don t have to know everything à I prefer that, but sometimes they can t à That was scary à I like to get it right, but I won t always and that s normal and ok, if slightly disappointing à I didn t like what they did, we are never going to like everything about our partners, I may need to talk about it, or let it slide à I love cooking exquisite meals, it s a luxury I sometimes have the opportunity to do, and often not. We can choose a more balanced thought process. Like anything we learn, when it is new it might not feel right- not because it is wrong, but rather because it is unfamiliar. The more we practice a new thought, way of thinking or understanding, the more our brains learn it, we feel more emotionally familiar and then comfortable, and eventually we have developed a new way of thinking and responding that serves us well. And it to becomes a habit a useful habit.

4 EXERCISE 3 Look through these RET 12 Common Irrational Beliefs, and some of the thoughts that might dispute those statements. Underline any of the beliefs that you can be caught in. 1. It is a necessity for adults to be loved by significant others for almost everything they do Concentrate on your own self respect, on winning approval for practical purposes, and on loving rather than on being loved. 2. Certain acts are awful, and that people who perform such acts should be punished Certain acts are self-defeating or antisocial, and the people who perform them are behaving stupidly, ignorantly, or neurotically, and would be better helped to change. People's poor behaviors do not make them rotten individuals. 3.It is horrible when things are not the way we like them to be It is too bad, that we had better try to change or control bad conditions so that they become more satisfactory, and, if that is not possible, we had better temporarily accept and gracefully be with their existence. 4.Human misery is invariably externally caused and is forced on us by outside people and events Neurosis is largely caused by the view that we take of unfortunate conditions. 5.If something could be dangerous or fearsome we should be terribly upset and worry about it If possible we will face it and render it non dangerous, if not possible, accept the inevitable. 6.It is easier to avoid than to face life difficulties and self responsibilities The so called easy way is usually much harder in the long run- or, the only way around is through 7.We need to rely on something other or stronger or greater than our self We can benefit from taking risks of thinking and acting independently 8.We should be thoroughly competent, intelligent, and achieving in all possible respects We would prefer to do well rather than always need to do well, and accept our self as a quite imperfect creature, who has general human limitations and specific fallibilities. 9.Because something once strongly affected our life, it should indefinitely affect it We can learn from our past experiences and not be attached to or prejudiced by them. 10.We must have certain and perfect control over things The world is full of improbability and chance and that we can learn to embrace and enjoy life 11.Human happiness can be achieved by inertia and inaction We tend to be happiest when we are vitally absorbed in creative pursuits, or when we are devoting ourselves to people or projects, or things we love or care about 12.We have virtually no control over our emotions and can t help feeling disturbed about things We have real control over our destructive emotions if we choose to work at changing the must hypotheses which we often employ to create them

5 In CBT, rather than disputing the irrational beliefs, we can dispute what is being said, we might simply ask questions of ourselves in a more Socratic style like: Do you always have to be in control? Do you always have to be right? Do you always insist on being realistic? Is that always true? Is it never the case? The CBT model covers similar aspects to the RET, and additionally details some of the finer subtleties of the 3 core irrational cognitions and subsequent irrational beliefs, sub beliefs, and consequences that arise as a consequence. EXERCISE 4 Look over the Three Core Irrational Cognitions in detail. Underline those responses you recognise as familiar in yourself in the summary, sub beliefs, emotional consequences, and behavioural consequences of each. And at the end decide which one or two of the three of the three Core Irrational Cognitions do you get caught in? Remember, these are the more extreme versions, but you will know if the concept relates to you even if at a less intense level. I. I must do well and win the approval of others or else I am not good enough. A. Summary 1. Inflexible 2. Places unrealistic expectations on oneself 3. Over-concern with others' opinion of oneself 4. Self-worth measured by achievement and popularity 5. Non-self-accepting B. Sub-beliefs 1. I must have love and approval from everybody. a. I need someone to love me. b. I must not do anything that would cause others to think less of me. 2. I must be competent and successful. a. I must have an important skill or talent. 3. I must successfully avoid unpleasant or undesirable situations. a. Unpleasant and undesirable situations upset me. i. I can't control my emotions in difficult situations. 4. I must avoid dangerous or life-threatening situations. a. If I do encounter such situations, I must worry about them to make them go away. 5. I must think, feel and act the same as I always have. a. My past has such a strong influence on me that I cannot change. 6. I must find order, certainty, and predictability in life. a. If I don't find these things, I cannot feel comfortable or act competently.

6 7. I must depend on other people because I can't depend on myself. a. I must rely on superstition and religion especially in difficult times. 8. I must understand the secrets of the universe. a. I cannot be happy unless I understand the nature and secrets of the universe. 9. I must rate myself as either "good" and "worthy," or "bad" and "worthless." a. To be "good," and "worthy," I must be competent, successful and popular. b. If I am not competent, successful or popular then I am "bad" and "worthless." 10. I must never feel depressed, anxious or enraged. C. Emotional Consequences 1. Depression 2. Anxiety and/or panic 3. Self Downing D. Behavioural Consequences 1. Risk-avoidance 2. Shyness 3. Procrastination 4. Unassertiveness 5. Workaholism II. Other people must do "the right thing" or else they are no good and deserve to be punished. A. Summary 1. Inflexible and unrealistic 2. Assumes one's authority over others 3. Assumes a clear-cut difference between right and wrong 4. Assumes one's ability to inherently differentiate between right and wrong 5. Places oneself at the centre of the universe with others catering to one's needs and wants 6. Leads to conflict with others who also see themselves as the centre of the universe 7. Non-accepting of human fallibility B. Sub-beliefs 1. Everybody should treat everyone else (especially me) in a fair and considerate manner. a. If they act unfairly or inconsiderately, they are no good. b. If they act unfairly or inconsiderately, they deserve to be punished. i. Society or the universe must ensure that they get the punishment they deserve. 2. Other people must not act incompetently or unwisely. a. If they act incompetently or unwisely, they are worthless idiots. b. If they act incompetently or unwisely, they should be ashamed of themselves. c. If they act incompetently or unwisely, they should expect none of the good things in life. 3. Talented people must use their talent. a. Everyone must reach their potential.

7 b. People who don't live up to their potential have little or no value as human beings. 4. Other people must not criticise me. a. If they unjustly criticise me, they are no good and don't deserve anything good to happen to them. C. Emotional Consequences 1. Anger, rage or fury 2. Impatience 3. Bitterness 4. Resentment D. Behavioural Consequences 1. Aggression and violence 2. Bigotry and intolerance 3. Bullying 4. Nagging III. Life must be easy, without discomfort or inconvenience. A. Summary 1. Inflexible and unrealistic 2. Over-estimates one's right to a trouble-free life 3. Under-estimates one's ability to cope with adversity 4. Non-accepting of life's vagaries B. Sub-beliefs 1. Things must go the way I want them to go. a. I need what I want. i. It's awful if I don't get what I want. 2. I must constantly worry about life's predicaments. a. I must control, avoid or change life's predicaments. b. I must make myself upset over life's predicaments. i. Making myself upset gives me the power to control, avoid or change life's predicaments. 3. I must avoid, rather than face and deal with, life's difficulties and responsibilities. a. I must not be inconvenienced or be made uncomfortable. b. I cannot discipline myself. c. I can't stand the present pain that is necessary for future gain. 4. It must be easy to change things that I don't like. a. Difficulties must not exist. b. I am powerless to change my circumstances. i. Any effort to change my circumstances is pointless because it is doomed to fail. 5. Justice, fairness, equality, democracy and other "right" values must prevail. a. I can't stand it when my values are trodden on. 6. All problems must have a perfect solution. a. The perfect solution to all problems must be found. i. It's awful if a perfect solution can't be found to my problems (or those of people I care about).

8 7. I must not die prematurely. a. I should be able to live forever. b. It's terrible that I will one day die and no longer exist. c. It's terrible that people I love will one day die and no longer exist. 8. My life must have meaning and purpose. a. a. If I can't create meaning or purpose for myself, the universe or something supernatural must provide it for me. 9. I must not experience depression, rage or anxiety. a. I must not have psychological problems. i. I must not be institutionalised. ii. I couldn't stand to be institutionalised. iii. I could never recover if I went "crazy. C. Emotional Consequences 1. Low frustration tolerance 2. Self-pity 3. Depression 4. Discomfort anxiety D. Behavioural Consequences 1. Procrastination 2. Shirking 3. Drug and alcohol abuse 4. Overindulgence in "feel good" behaviours (e.g., overeating) Which one or two of the three of the three Core Irrational Cognitions do you get caught in the most?

9 Cognitive Model Situation Event Thoughts/Beliefs Interpretations Physiological reactions Emotions Mood Behaviours Conclusions we can draw from the schema: Ä Situations trigger a range of responses inside us (thoughts, emotions, etc.) Ä Thoughts, emotions, behaviours and bodily reactions are all linked Ä Therefore, by modifying our relationship to our thoughts, our emotional and bodily states, behaviours and responses tend to change, and visa versa.