The Importance of Empathy 12/29/2011
 What’s your Favorite Color? Like many boys his age, my 3-year-old nephew loves dinosaurs. Time with “Aunt Bridgett” is usually spent hiding from a tyrannosaurus, searching for a lost brachiosaurus, and sketching various other dinosaurs. In addition to loving these extinct creatures, my nephew also loves the color green. We discussed his love of green in great depth while talking about our favorite colors. In that conversation, I disclosed that, while green is a wonderful color, my favorite is blue. We then engaged in an artistic game in which he played visionary and I created his visions. He suggested, “Draw a T-Rex.” I asked for instructions such as, “Should he smile? Where should I draw him? How many should I draw? What color should he be?” Based on his suggestions, I sketched a smiling, green tyrannosaurus in the center of the page. I also drew one behind a tree, another in the lower right corner of the page, another under a cloud, etc. In total, my nephew asked me to draw 6 tyrannosauruses, 2 brachiosauruses, 4 trees, a lake, 3 fish, 2 clouds, a pterodactyl, a sun, grass, a rabbit, a lion, 2 dogs, 2 cats, and every member of our family each equipped with our very own backpack. When asked what color to use for each item, animal, and person, guess what color he suggested… You guessed it! Green! And of course, I complied. I drew green dinosaurs, green fish, a green sun, etc. Furthermore, he insisted I draw every family member with a green crayon, except one. When it came to me, my nephew made the sweetest suggestion without any prompting: “draw you in blue, because you like blue.” My nephew revealed the ability to empathize with that statement. As a psychologist armed with the knowledge that empathy predicts success, happiness, and sophisticated moral development, I was delighted.  What is Empathy? According to John Medina, empathy requires three basic ingredients: 1. Affect Detection: sensing the emotional reaction of another person; using the example of my nephew, he sensed that the color the blue makes me feel happy 2. Imaginative Transposition: after detecting the emotion, the person essentially “tries on” the emotion to determine how he/she might react in a similar situation; my nephew determined that if he liked blue he would want to be drawn in that color instead of green 3. Boundary Formation: the empathizer realizes that the emotion belongs to the other person; instead of suddenly changing his favorite color to blue or requesting that all of the drawings be done in blue crayon, my nephew maintained his own preference while acknowledging mine Why Empathy? As aforementioned, empathy relates to success, happiness, and moral development. Children capable of empathy typically maintain healthier social relationships, perform better in school, and are generally happier than those with limited abilities. As they age and continue to develop the ability to empathize, such children typically grow into empathic adults. In adulthood, empathy directly links to greater marital satisfaction, satisfying social lives, occupational success, and highly effective parenting skills. In fact, the ability for spouses to empathize with one another protects the marriage from volatile arguments and prevents divorce. Furthermore, empathic parents can better teach their children to experience and express empathy in order to perpetuate the benefits of empathy for subsequent generations.  Empathy also leads to a deeper sense of morality that is based on an implicit sense of right/wrong rather than fear of punishment. To better understand the importance of moral development, consider the following vignette: Sally and Samantha are sisters. Sally feels jealous that Samantha received a new doll as a birthday gift. Out of jealousy, Sally is tempted to break the doll, but decides to leave the doll intact. If Sally was your daughter, for what reason would you rather she not break the doll? (a) Because it is against the rules and Sally does not want to be punished. (b) Because Sally wants parental approval and to be seen as a “good girl.” (c) Because Sally loves her sister and believes it is important for Samantha to enjoy her gift, despite feeling jealous.  Philosophers and psychologists have described the development of moral understanding and behavior in a number of ways. Psychologist Lawrence Kohlberg identified three levels of moral development: (a) preconventional, which is defined by obedience of rules, avoidance of punishment, and the service of personal needs, (b) conventional, which is marked the desire to be seen as a good person by peers and maintain social order, and (c) postconventional, which emphasizes the importance of consensus when determining rules and the individual determination of right/wrong regardless of societal laws. Postconventional moral development is more sophisticated than conventional, which is more advanced than preconventional. Empathic individuals tend to engage in moral reasoning at the postconventional (most advanced) level. Returning to the vignette in which Sally felt jealous over Samantha’s doll. Many parents would prefer if Sally chose to leave the doll intact because she wanted Samantha to enjoy her gift (postconventional level). Furthermore, most people would be more inclined to trust the adult version of Sally if she engaged in such moral reasoning. If Sally’s parents practice and teach empathy, she will most likely develop the more sophisticated, postconventional level of moral reasoning. It is important to note that most children begin at the preconventional level and need clear rules and consequences to behave appropriately; eventually, however, they can advance to a more sophisticated level with proper guidance. How to Develop Empathy? Knowing that empathy relates to increased success and happiness in all facets of life, you may wonder how to best develop this skill. The two main steps include: 1. Describing the emotion you think you see in the other person (“You sound angry, is that right?”) This step requires “affect detection” described above as well as a vocabulary to label feelings with words. To develop “affect detection,” practice noticing other people’s emotions and using a list of feelings words to label those sentiments. 2. Guessing the cause of the emotional change (“Are you angry that I didn’t call to tell you I’d be late?”) In order to determine the cause of an emotion, it helps to engage in both “imaginative transposition” and “boundary formation” described above by “trying on” the other person’s emotional reaction and consider the possible causes. Bear in mind that your emotional reaction may be different than the person with whom you are trying to empathize. While great value lies in the ability to experience empathy, the most benefits arise when empathy is directly communicated. For example, a husband can understand the reason his wife is upset, but if he does not directly communicate that knowledge she will not know that he empathizes and she will likely remain upset. Lastly, once a person has communicated empathy, it is most helpful to then validate the emotion without getting defensive. When empathizing with children, it can also be helpful to teach them to label their emotions with words and, when appropriate, effectively express their feelings. Further Reading & References Ginott, H (2003). Between Parent and Child (Rev upd edition). Three Rivers Press Gottman, J (1997). Raising an Emotionally Intelligent Child: the Heart of Parenting. Simon & Schuster (NY) Gottman, J. M., Katz, L. F., Hooven, C. (1997). Meta-emotion: How families communicate emotionally. Hillsdale, NJ: Lawrence Erlbaum. 366 pp. Hoffman,M.L.(2000).Empathy and Moral Development: Implications for Caring and Justice. Cambridge, UK: Cambridge University Press. Izard, C. et al (2001). Emotion knowledge as a predictor of social behavior and academic competence in children at risk. Psychol Sci 12(1): 18 -23 Katz LF & Windecker-Nelson B (2004). Parental meta-emotion philosophy in families with conduct-problem children: links with peer relations. J Abnorm Child Psych 32(4): 385 – 398 Kohlberg, L. (1984). Essays on moral development: Vol 2. The psychology of moral development. Harper & Row (San Francisco) Levenson, RW (2003). Blood, sweat and fears: the autonomic architecture of emotion. Ann NY Acad Sci 1000: 348 – 366 Medina, J. (2010). Brain Rules for Baby: How to Raise a Smart and Happy Child from 0 to 5. Pear Press (Seattle, WA) Seal, R & Miller D. (2008). Why is it comforting to discuss problems with others? Scientific American Mind Gratitude 12/08/2011
 While attending a meditation class, the instructor asked “do you know how to change the energy of a room? List everything you are grateful for until you can’t think of anything else.” In response, each person expressed gratitude in various ways, and the energy of the room in fact became more positive. They began by naming the standards: · Family · Health · Friends · Opportunities · Faith · Happiness Eventually, the statements of gratitude became more specific: · “That I have a job that I enjoy, especially in this economy.” · “That my sister is coming into town for 3 days.” · “That my mother emerged from surgery alive and healthy.” Silly statements of gratitude sometimes arose: · “That the boots I have been wanting went on sale today.” · “That my butt doesn’t hurt as much as I thought it would from sitting on this cushion for this long.” · “That the cashier at the grocery store asked me how I was doing.” The list seemed exhaustive, but people continued searching: · “That the sun rose today.” · “That my car started.” · “That I am able to order food and have it delivered to my home.” · “For the tree I see every day on the way to work.” People even unexpectedly expressed gratitude for generally problematic events:’ · “That I got a speeding ticket today. Maybe I was driving too fast. I would have felt terrible if something happened.” · “That I had the flu last week; it reminded me to slow down.” · “That I could not afford that new car. I didn’t need it.”  Positive psychologists have found that expressing gratitude can change mental and emotional states. Gratitude can turn bad days into good ones and shift your perspective in almost every situation. In his book Spontaneous Happiness, Dr. Andrew Weil discussed recent research in which depressed individuals who maintained a daily gratitude journal for one week experienced mood improvement for the six months that followed. Imagine the impact engaging in a daily gratitude practice for the rest of your life could have! Clearly, experiencing and expressing gratitude can have a profound effect. Consider practicing gratitude in one of the following ways and notice whether it positively influences your life: Gratitude Journal As aforementioned, maintaining a gratitude journal can improve emotional functioning. To do so, keep a journal at your bedside. Each night, review the day and note everything for which you are grateful. The list can be brief or exhaustive. Morning Expression of Gratitude Similar to a gratitude journal, a morning expression of gratitude requires you to list everything for which you are grateful except that you perform the act upon waking rather than before going to bed. It can be done orally or in writing. A high minimum requirement of items to be listed can challenge you in a healthy way. If you decide to keep a gratitude journal or engage in a morning expression of gratitude, consider having a minimum requirement of 20 items. Gratitude Meditation As with all meditation, set aside some uninterrupted time during which you can relax. Before you start, decide to whom or what you would like to express gratitude. When you are ready, begin by inhaling and exhaling through your nose with your eyes closed. Spend several minutes relaxing your mind and body by inhaling into your abdomen for a count of four and then slowly exhaling. Pay attention to the physical sensation associated with relaxing your body and slowing down your breath. When your mind is calm, choose a person to whom or something for which you are grateful. As you meditate, recognize all the benefits you receive from that person, object, or activity. Notice the feelings of gratitude that arise, and focus your mind on that sensation. If your mind begins to wander, simply redirect your attention toward the feeling of gratitude. Deliberately Experience and Express Gratitude Throughout the Day A less formal way of practicing gratitude involves mentally noting moments as they occur. While the practice may seem the easiest to perform, it can also be the most difficult to remember to do. If you decide to engage in this practice and find that you are forgetting to mentally note grateful moments, consider trying one of the aforementioned suggestions instead. Thank you for reading this blog entry. I am grateful for your attention.  Rock climbing offers wisdom that can generalize to life with great ease. Combining my primary pastime with my career, the current blog entry will highlight the rock climbing wisdom I have gleaned from experience, friends, and professionals over the years. A visit to a local climbing gym can present many opportunities to consider the following life lessons regardless of experience and/or type of climbing. Lesson #1: Growth Sometimes Requires Discomfort Climbers sometimes find themselves unwilling to move from a “good” hold, one in which the hand grips easily or the foot stands comfortably, to a “bad” one. Eyeing the painful rock feature, they may linger in the luxury of an effortless position at the expense of completing the climb. In order to ascend, however, climbers must at times endure discomfort and use undesirable holds. Stepping into uncomfortable arenas is sometimes necessary to pursue the life you desire; growth often requires some level of discomfort. For instance, to pursue higher education, students must often leave home to live with strangers. The move to college can be awfully uncomfortable, but usually results in tremendous growth. Furthermore, those “strangers” often times become friends. A previous blog entry highlighted the importance of leaving the comfort zone in the pursuit of growth as inspired by Ilgner’s The Rock Warrior’s Way. Lesson #2: You Have to Let Go to Move On If climbers refuse to release their hands or move their feet, they will not reach the top of the rock climb. Climbers must let go of the rock to move on to the next handhold and lift their feet to continue stepping up the climb. Many times climbers find comfortable rest spots that they do not want to leave. If wanting to scale the wall, however, the climber will have no choice but to let go and continue up the difficult part of the climb. Similarly, fear can cause climbers to rigidly cling to a rock face or stubbornly refuse to remove their hands. Again, in order to move upward, even the most terrified climber must let go. Many life experiences provide opportunities to practice this lesson. For instance, one must often let go of fears, insecurities, regrets, present comforts, etc. to move onto the next chapter of life. Consider divorce. In order to heal from the relationship, one must let go of the possibility of reconciliation and engage in the grief process.  Lesson #3: Holds are neither “Good” nor “Bad” Climbers often make declarations like “this hold is horrible!” when faced with an impossibly small sliver of rock on which to place a foot or pull on with a hand. Similarly, one might hear a climber celebrate with a sigh of relief by commenting that “this hold is great!” In reality, holds are neither “good” nor “bad,” they exist as part of the rock. Holds just are. One may produce comfort whereas another may cause pain, but qualitatively neither is truly better than the other. Good, ethical climbers do not alter the rock to change the nature of a climb but instead practice acceptance of an unchangeable attribute of the topography. Such acceptance of rock features not only allows climbers to connect with nature, but also helps climbers move past difficult sections. Skilled climbers attempt to acknowledge the nature of the rock without judgment and adjust accordingly. Parenting offers many opportunities to accept unchangeable environmental circumstances. For example, new parents face acceptance each time their babies cry in the night. The new parent may want more sleep, but accepts that babies wake when they do and provides them with needed nurturance. What unchangeable environmental circumstances could you benefit from accepting? Lesson #4: Breathing is Key Good climbers relax through intimidating sections by slowing down their breath. Commonly, folks on the ground yell “relax” or “breathe” to climbers stiffening with hesitation as they approach difficult moves. Beginners may argue then fall (“it’s impossible to relax!”); whereas experienced climbers may heed the advice, take a breath, and ascend. Of course, it does not work every time and not every experienced climber remembers to control their breath in the face of fear, but generally speaking, breathing under stress will improve your ability. Deeply inhaling while slowly exhaling will cause your heart rate to decrease, which can help with fear and/or anxiety be you on the ground or on the rock.  Lesson #5: Self-Talk is also Key Self-talk refers to the language we use when thinking about ourselves, the world, and the future. It is a common concept used in cognitive theory that Ilgner explores with specific regard to climbing in The Rock Warrior’s Way. The author emphasizes the impact of the way we engage in self-talk. Consequently, when climbers think “I don’t want to” or “I can’t,” a fall can easily result, because such negative self-talk generally results in disadvantageous actions. Furthermore, certain questions perpetuate cycles of self-talk that often impede problem-solving; thinking something like “why can’t I do this” often results in a series of circular, negative self-talk. While Ilgner does not overemphasize blind positivity, he does suggest moving away from negative self-talk and thinking in “how” and “what” questions. For instance, it does not benefit a short person to think “I can’t do this, I’m too short” or “why is that handhold so far away?” A more effective thought might include “how can I climb this route given my height” or my personal favorite “Lynn Hill can do it. There must be a way.” (For a blog I once wrote focused on a excerpt from Lynn Hill's memoir click here.) Applying self-talk to a job interview, to think “I can’t get this job” or “why do I bother” will likely result in an unproductive interview. On the other hand, to think “I have a chance of getting this job” or “how can I best prepare for the interview” will more likely lead you down a road to success. Lesson #6: Fear Produces Limits In climbing and life, people often avoid reasonable risks as a result of fear. Because of fear, climbers sometimes do not try climbs within their range or avoid learning new techniques despite desires to do so. In life, numerous fears cause people to remain stagnant and avoid risks that could help them grow. Fear of rejection keeps people single. Fear of failure keeps people from pursuing more fulfilling jobs. Fear of pain causes people to avoid important emotional processes. Fear of things getting worse can keep people from trying to make things better. By recognizing the fears that limit your life, you take an important first step in pursuing goals and living a value-based life.  Lesson #7: Meet Yourself Where You Are Self-acceptance is a colossal lesson climbers are forced to learn repeatedly. When on a climb, if you are not strong enough, flexible enough, or tall enough to do a move, nothing in that moment will fix it. Training may help you gain strength and/or agility. Effective problem-solving will help you compensate for height. In that moment, all you can do is accept your body and skill level and try to adjust. Using height as an example again, if a handhold is out of reach by 5 inches, no amount of reaching will change that. Everyone you know may be able to complete the climb with their feet exactly where your feet are, but you are not as tall as everyone you know. Eventually, you must accept your height and ask the question “how can I do this climb being the height that I am?” When you figure it out, you will be a better climber for it…and you will likely impress all those tall folk! Outside of climbing, acceptance of personal characteristics also allows for growth. If you are trying to lose weight, it will only hurt you to hate your body until you attain a desirable weight. If you perform poorly in math, it will not benefit you to grow angry with your brain for making errors. If you are depressed, you will not heal simply because you wish you were not depressed anymore. There must be a certain amount of acceptance in order for you to start figuring out how to move on: “I am this weight and I will work toward being healthier by exercising and eating right,” “How can I set aside extra time to do my math homework given that this is a difficult subject for me?” and “I’m depressed. It sometimes helps to get out of bed and go for a walk even though I don’t want to. I’ll give it a try.” What are some ways you could meet yourself where you are? Lesson #8: Look Down! Ignore people who say “never look down.” Once the risk of falling minimizes, I find great beauty in looking down and recognizing my distance from the ground. The literal and metaphorical act of looking down allows one to embrace the risk and appreciate a new perspective. A beautiful viewpoint can be ascertained when taking a moment to fully engage in risk, as the risk is part of the climb. We too often appreciate moments in retrospect (e.g., “I’m so glad I did that!”) without realizing their value as they occur. Consider a difficult obstacle you overcame, a goal you achieved, or a beautiful moment. Did you engage fully in the experience or did you recognize the good of it in retrospect? Rock climbing allows for a plethora of “life lessons,” and those listed above are only a few. Consider visiting a local climbing gym and contemplating the above points; you may even glean some lessons of your own. The Rock Warrior’s Way by Arno Ilgner highlights many of the aforementioned points as well as many others. San Diego climbing gyms to consider using when bearing in mind the above “wisdom”: · Solid Rock Climbing Gym · Mesa Rim · Vertical Hold If you do not live in San Diego, you can visit the following website to find a gym near you: · Indoorclimbing.com Disappointment: A Universal Pain 09/29/2011
 People often go to great lengths to avoid disappointment. Some maintain unhealthy relationships to avoid disappointing their partners or family members. Others pursue partnerships doomed for failure to avoid the disappointment of heartbreak or rejection. Self-disappointment may cause people to avoid taking risks, abuse substances, or continue dissatisfying life paths. The act of pretending may also allow people to evade disappointment; people often pretend to be happy, satisfied, successful, etc. in order to avoid disappointing themselves and/or others. What might you do to avoid disappointment? Expectations can breed disappointment. In fact, when experiencing the feeling of disappointment, it can be helpful to ask “what expectation was not met in this situation and why?” Consider that question when pondering the last situation that caused you to feel disappointment. Was the expectation realistic? Did you acknowledge the expectation or express it to another person? Often times, unreasonable and unspoken expectations cause disproportionate amounts of disappointment. For example, imagine that Sean expects his girlfriend to attend a networking event put on by his employer. Before knowing of the event, his girlfriend already planned to have dinner with her sister. In disappointment, Sean grows angry until he and his girlfriend end up in an argument. He accuses her of being unappreciative, uncaring, and “always putting your family over me!” Clearly, Sean had an unspoken expectation: that his girlfriend attends the networking event. Unreasonable expectations often result in disappointment as well. For instance, Toni expects to receive perfect scores on all exams. Often times, she does. Throughout high school, she achieved perfect scores on almost all homework assignments and tests. At graduation, her parents commend her “perfect” performance, but she seems displeased. Toni recalls the three tests in which she did not receive a perfect score and labels herself an imposter. Dismissive of their compliments, she tells her parents, “It wasn’t perfect.” Consequently, her disappointment turns to depression because Toni has set unreasonably high expectations. The following acts can help a person better deal with disappointment: (a) communicate expectations, (b) set realistic expectations, and (c) express/acknowledge disappointment. In the first example, if Sean explicitly communicated the importance of his girlfriend attending the networking event, she likely would have attended. In the second example, Toni would have benefited from adjusting her expectations to something more realistic, such as “I hope I receive perfect scores, but nobody can always be perfect.” Of course, disappointment is a naturally occurring emotion as it is quite difficult to live a life void of expectations. Furthermore, it is difficult for everyone and everything to meet our expectations even when they are both clearly communicated and reasonable. For instance, it may have been very important for Sean’s girlfriend to have dinner with her sister despite his expectation that she attend the networking event. Naturally, Sean may have felt disappointed. The next healthy step would be to acknowledge that disappointment to himself and possibly to his girlfriend. Similarly, even with more reasonable expectations, Toni will likely feel disappointed when she does not perform perfectly; however, her disappointment will likely not turn to self-deprecating depression if she acknowledges and validates the emotion. Considering the last time you felt disappointment, how might one of the above techniques helped you manage the feeling? Remember, the techniques include (a) communicate expectations, (b) set realistic expectations, and (c) acknowledge/validate disappointment. Lastly, the acknowledgement of disappointment can do more than assuage the unpleasant emotion. Disappointment provides information about the way we view ourselves, the world, and others. For instance, by acknowledging disappointment and examining the cause, you may better understand what is important to you.  This is the fourth and last entry in a series on Cognitive Therapy. Once people begin challenging cognitions that lead to unpleasant emotions, they also naturally arrive at new conclusions. Often times, cognitive therapists refer to this step as “developing alternative thoughts.” Unfortunately, people can abuse this step by trying to develop new conclusions too early in the therapeutic process. Consequently, they may identify new beliefs that they think they should wholeheartedly believe without doing the work to actually arrive at the new conclusions. In a way, people attempt to jump from A to Z without doing the important work of B through Y. Furthermore, people often arrive at beliefs that are erroneously over-positive or too simplistic; as a result, the thoughts become unbelievable and are often dismissed. While the term “identifying alternative thoughts” is often used in cognitive therapy, I prefer the phrase “arriving at new conclusions” because it implies the work it takes to change your way of thinking. Consider the following example. Arthur believes “I am a failure.” He decides to experiment with cognitive therapy by connecting situations, thoughts, and emotions. Arthur makes the following connections: Situation: He is late to week and misses a meeting. Thought: “I am a failure” Emotions: Depressed, disgusted, anxious Situation: He gets his daughter a gift she doesn’t like. Thought: “I’m a failure” Emotions: Severely disappointed, depressed Upon using Socratic questions and identifying cognitive distortions, Arthur realizes that thought “I am a failure” is unrealistic, unbalanced, and oversimplistic. He then attempts arrive at new conclusions. At first, he misunderstands the assignment and attempts to force conclusions like “I’m not a failure” or “I’m a success” into his mind. While seeming along the right track, the overly simplistic nature of such thoughts may put Arthur near where he started. To attempt to think the opposite or merely “think positive” after years of automatically assuming an identity epitomized by failure, it would be quite difficult for Arthur to wholeheartedly believe either thought. In other words, Arthur attempts to jump from A to Z by skipping B through Y. He did not arrive at the conclusion that he is “not a failure” through logic and consideration of reality, but instead Arthur attempted to assume a belief that he thinks he should believe. Furthermore, while the thought “I am a success” is wonderfully positive, the notion itself is still erroneously oversimplistic and in turn unrealistic and unbalanced. Sometimes other maladaptive thoughts may arise when people move too quickly to overly positive conclusions and the following connection may ensue: Situation: Arthur thinks he is a failure after his daughter doesn’t like the gift Thought: “I shouldn’t think I’m a failure” Emotions: Ashamed, disappointed, disgusted, hopeless The layers of thought can get complicated and confusing, but if you follow the process, you can see how they also deepen the layers of unpleasant emotion. Once engaging in Socratic questioning, identifying cognitive distortions, and accepting reality while committing to change, Arthur may develop more complicated conclusions that eventually lead him to truly believe he “is not a failure.” For instance, he may think, “I’m having the thought that I’m a failure, which is not necessarily true. What’s my next step to commit to change?” Such a notion is more realistic and integrates acceptance that the initial belief exists so that Arthur does not “beat himself up” for having habitual, automatic thoughts in difficult situations. Furthermore, by acknowledging the thought and then challenging it, Arthur is actually moving from A to Z through reasonable steps, rather than trying to “fake it ‘til he makes it.” Another, equally effective, thought process may include “I did not perform according to my expectations, but that doesn’t mean that I’m a failure on the whole. While it is disappointing, I can move on and learn from this.” Again, such a notion offers a more balanced, realistic alternative thought, and is much more likely to lead Arthur to eventually believe that he is not a failure. What other directions could Arthur take in challenging the thought “I am a failure”?  This blog entry is the third in a series on cognitive therapy. Techniques to identify the maladaptive thoughts that influence behaviors and emotions were discussed in the two previous blog entries. Mere awareness of such thoughts can reduce unpleasant emotions and redirect unhealthy behaviors. Often times, people require more than just identifying these maladaptive thoughts in order to change them. Numerous ways exist to challenge thoughts. The current blog entry will focus on three: (a) Socratic questioning, (b) identifying cognitive distortions, and (c) accepting reality while committing to change. Each one of these techniques takes time to master, so consider focusing on one at a time. Socratic Questioning Socrates used questions to encourage his students to arrive at the answers they sought. Instead of simply responding to students’ questions or providing lectures, he systematically asked questions that encouraged deep thought which allowed students to gain knowledge through critical thinking. Cognitive therapists often use Socratic questioning to help people challenge maladaptive, unrealistic, and/or unbalanced thoughts. People can learn to challenge their own thoughts through Socratic questioning as well. At times, clients and students find the technique frustrating because they “just want an answer.” With maladaptive thoughts, most people need to do some work to believe new thoughts. For instance, a person who thinks “I’m a failure” will likely not believe the thought “I’m good just as I am” because a therapist told him/her it is truer than “I’m a failure.” Socratic questions encourage people to apply logic to their thoughts in order to understand that the ways they think of themselves and others may not actually be true. Eventually through Socratic questioning a person can arrive at adaptive, more realistic beliefs. Examples of questions that can be used to challenge thoughts include:  · Is this thought realistic? · What is the evidence for and against this idea? · Might this belief be a habit, rather than something based on facts? · How long have I been thinking this? · What possible misinterpretations might I be making? · Am I thinking in all-or-none/black-and-white terms? o Is there any room for “grey” with this thought? · Am I using words or phrases that are extreme or exaggerated (i.e., always, forever, never, need, should, must, can’t, ever time, etc.)? · Is extreme and/or exaggerated language implied in this thought? · In what way might I be focusing only on one aspect of the event (possibly negative)? · Who has given me this message before? o Other people in my life? o A younger version of myself? o Is that person a reliable source of information when it comes to this thought? · What are the odds that this thought is true? Am I overestimating the likelihood that this thought is true? Am I overestimating the odds that something bad will happen? · Are my judgments based on feelings rather than facts? · In what way might I be focused on irrelevant factors? · What are the costs and benefits of this thought? o How might I arrive at similar benefits with different thoughts? Attempt to answer each question as fully as possible with a specific thought in mind. If you are still having difficulty identifying the beliefs that influence your emotions and behaviors, consider looking at the previous blog entry and selecting a thought that most resembles how you view yourself and/or others. Click here to read an example of the way Socratic questioning can be applied to the thought “I’m a failure.”  Cognitive Distortions Remembering that the word “cognitive” refers to thoughts, “cognitive distortions” reflect distorted patterns of thought. Generally speaking, when a thought fits the pattern(s) of any of the cognitive distortions listed below, it is likely unrealistic. If you notice yourself using any of these patterns, it may be useful to employ the Socratic questioning technique discussed above. The cognitive distortions and examples listed below come from The Worry Cure: Seven Steps to Stop Worry from Stopping You by Robert L. Leahy. Mind Reading: Future-Telling: You predict the future – that things will get worse or that there’s danger ahead. “I won’t get that job.” Catastrophizing: You believe that what happened or will happen will be so awful and unbearable that you won’t be able to stand it. “It would be terrible if I failed.” Labeling: You assign global negative traits to yourself and others. “I’m disgusting.” “He’s horrible.” Discounting Positives: You claim that the positives that you or others attain are trivial. “That’s what I’m supposed to do, so it doesn’t count.” “Those successes were easy so they don’t matter.” Negative Filter: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all the terrible things on the news.” Overgeneralizing: You perceive a global pattern of negatives on the basis of a single incident. “I fail all the time.” All-or-None Thinking: You view events or people in all-or-none/black-and-white terms. “It was a waste of time.” “I get rejected by everyone.” Shoulds: You interpret events in terms of how things should be rather than simply focusing on what is. “I should do well; if I don’t, I’m a failure.” Personalizing: You attribute a disproportionate amount of the blame to yourself for negative events and fail to see that certain events are also caused by others. “The marriage ended because I failed.” Blaming: You focus on the other person as the source of your negative feelings and refuse to take responsibility for changing yourself. “She’s to blame for the way I feel.” “My parents caused all my problems.” Unfair Comparisons: You interpret events in terms of standards that are unrealistic. “Others did better than I did on the test.” “People my age are more successful than I am.” Regret Orientation: You focus on the idea that you could have done better in the past, rather than on what you can do better now. “I could have had a better job if I had tried harder.” “I shouldn’t have said that.” What if? You keep asking a series of questions about what if something happens, and fail to be satisfied with any of the answers. “Yeah, but what if I get anxious, and I can’t catch my breath.” Emotional Reasoning: You let your feelings guide your interpretation of reality. “I feel depressed, therefore my marriage isn’t working.” “I feel anxious, therefore I must be in danger.” Inability to Disconfirm: You reject any evidence or arguments that might contradict your negative thoughts. “I’m unlovable – my friends hang out with me only because they must feel sorry for me.” “I’m a bad person – I only help others because it makes me feel better about myself.” Judgment Focus: You view yourself, others, and events in terms of evaluations of “good” and “bad” or “right” and “wrong” or “superior” and “inferior,” rather than simply describing, accepting, or understanding. “I didn’t perform well.” “I tried it, and I just kept doing it wrong.” “Look how successful she is, I’m not that successful.”  Acceptance In The Worry Cure, Leahy titles one of the chapters “Accept Reality, Commit to Change.” The contents of this chapter seem to epitomize the power of acceptance, and the title serves as a good reminder to practice. Acceptance refers to seeing things as they really are, and not as you think they are or as you think they should be. In Dialectical Behavior Therapy, Marsha Linehan speaks of “radical acceptance,” which refers to recognizing reality so that you identify the place from where you must start in order to change. For instance, consider a person who recently lost his job and believes “I’m a failure.” He may initially think, “I lost my job, I’m such a failure. I’m never going to get another job. This is horrible.” Consequently, he may find himself thinking in circles and feeling hopeless. Radical acceptance may appear as follows: “I lost my job. That is the reality. I don’t like it. I feel sad because of it. The thought about me being a failure keeps entering my head. That’s where I have to start from.” By practicing radical acceptance, a person can recognize reality and then commit to the next step in order to move in a desired direction. Reality includes external as well as internal events (i.e., thoughts and feelings). When the man in the example above practices radical acceptance, he acknowledges and accepts the fact he lost his job just as he acknowledges and accepts the fact that he does not like it, that he feels sad about it, and that he has thoughts about failure. He does not treat the thoughts as true or conclude he can do nothing as result of his feelings; he merely acknowledges their existence. Emotions and thoughts are part of reality in that they exist. Emotions are important to feel, but they do not have to dictate behavior. Regarding thoughts, we can think anything; the mere act of having a thought does not make it true. If the man thinks “I will never get another job” he is not predicting the future, he is having a thought. The reality is that he thinks he will never get another job, not that he will be unemployed forever. Consider another example. I can have the thought that “someone will call me in five seconds to tell me that I’ve won $1,000,000.00.” 5….4….3…2…1 I am not a million dollars richer. The fact remains that I had the thought that I would win the money, and if I truly believed that thought you could imagine my disappointment when the phone did not ring. The man in the example faces a dilemma when he believes the thought “I am a failure” rather than acknowledging it as an event that occurred in his mind. Committing to change often requires people to take difficult steps in the presence of contradictory thoughts or feelings. It also involves recognizing the values by which a person wants to live. The ability to commit to change arises when a person can gain distance from the thoughts or feelings that impede growth. Gaining distance means recognizing that thoughts are merely thoughts and do not dictate behavior. Many times, the distance allows people to realize their maladaptive thoughts about reality have been wrong. As previously mentioned, the man above may at times have the thought “I will never get another job,” and later realize the prediction was false when he actually receives an offer. When people gain distance from their thoughts, they can recognize that thoughts can be experiences they observe and then let go. The man above can recognize “I just had the thought that I’m a failure,” and then continue applying for jobs in the presence of that thought. As long as he has some idea about what he wants and/or what he values, that man can make decisions in the presence of any thought. The skill of gaining distance can be harder to develop than Socratic questioning or identifying cognitive distortions. It takes practice and patience. One way of gaining distance involves labeling internal experiences so that instead of thinking a thought, one identifies I am having a thought. The internal experience people generally label include: · I am having the thought that · I am having the feeling that · I am having the memory that · I am having the urge to · I am just noticing To start gaining distance, it may help to experiment with the above statements. Cognitive Therapy 101: Core Beliefs 06/01/2011
 This blog entry is the second in a series on Cognitive Therapy. Core beliefs underlie many of the automatic thoughts discussed in the previous blog entry. Identifying and then challenging such core beliefs can not only change feelings but can also transform a person’s approach to life. Assumed to be true, core beliefs often go unnoticed and unchallenged. Through identifying automatic thoughts, we can sometimes uncover the main beliefs that underlie our personalities. Core beliefs can arise from childhood experiences, innate dispositions, cultural influence, and/or any combination of the three. Consequently, they can be difficult perceive and/or change. When reading the following descriptions of typical core beliefs, determine whether any seem characteristic of your personality and/or notice any childhood experiences or other environmental factors that may have contributed to the belief. Defectiveness Beliefs about defectiveness reflect a general sense that one is inherently flawed, incompetent, or inferior. Often times, people who maintain thoughts characteristic of a defective core belief withdraw from close relationships in fear that others may discover that they are inherently bad. Examples of thoughts patterns characteristic of defectiveness include: · I’m not good enough · I can’t get anything right · I’m stupid · I’m inferior · I’m nothing · I’m worthless · I’m insignificant · I’m a bad person · I’m unattractive (ugly, fat, etc.) · I’m useless · I’m a failure · I don’t deserve anything good · There’s something wrong with me · I do not measure up to others · I’m always wrong · I’ve done things wrong · I’m abnormal  Unlovable Those who uphold beliefs about being unlovable often make assumptions about the extent to which they belong and question whether they deserve love or can be loved. Individuals who believe they are unlovable may withdraw from relationships or maintain superficial companionships to avoid the suspected pain that will arise when they are inevitably rejected. Furthermore, the belief that one is unlovable can lead to significant feelings of loneliness even in the presence of others. Some thoughts related to an unlovable core belief include: · I’m not lovable · I’m unacceptable · I’m always left out · I don’t matter · I’m not wanted · I’m alone · I’m unwelcome · I don’t fit in anywhere · I’m uninteresting · Nobody loves me · Nobody wants me · I’m unlikeable · I’m bound to be rejected Abandonment Individuals who maintain core beliefs rooted in abandonment often assume they will lose anyone to whom they form an emotional attachment. Abandonment and unlovable core beliefs can often be related or even one and the same. Often times, those concerned with abandonment believe that people will ultimately leave, which will result in misery and loneliness. Consequently, people with abandonment beliefs often seek reassurance and silence opinions out of fear that others will desert them in the presence of differing viewpoints. Examples of thoughts related to abandonment can include: · People I love will leave me · I will be abandoned if I love or care for something/someone · I am uninteresting (and people will leave me because of it) · I’m unimportant · If I assert myself, people will leave me · I can’t be happy if I’m on my own · I’m not as good as other people · My partner is no longer interested in me · I’m bound to be rejected/abandoned/alone  Helplessness/Powerlessness Helplessness or powerlessness beliefs generally result in people assuming they lack control and cannot handle anything effectively or independently. Individuals who believe they are helpless often face difficulties making changes. Furthermore, a sense of powerlessness can cause people to try to overcontrol their environment or completely give up control. Some common thoughts reflecting helplessness/powerlessness core beliefs include: · I’m helpless/powerless · I’m out of control · I must have control to be okay · I’m weak · I’m vulnerable · I’m trapped · I’m needy · I’m ineffective · I do not measure up to others · I’m unsuccessful · I can’t achieve · I can’t change · I can’t handle anything · There’s no way out · Other people will manipulate me and control my life · I am trapped and can’t escape · If I experience emotions, I will lose control · I can’t do it · I’m always number two · I finish last · I can’t stand up for myself · I’m a loser · I can’t say ‘no’ Entitlement Entitlement core beliefs are sometimes not entirely apparent. Generally, they reflect a belief related to specialness that causes individuals to make demands or engage in behaviors regardless of the effect on others. Those who maintain an entitlement core belief assume they are superior and deserve a lot of attention or praise. Often times, people develop an entitlement core belief to compensate for feeling defective or socially undesirable. Entitlement beliefs can lead to unreasonable demands that others meet your needs, rule-breaking, and resentment of successful others. Some entitlement-related beliefs include: · If people don’t respect me, I can’t stand it · I deserve a lot of attention and praise · I’m superior (and am entitled to special treatment and privileges) · If I don’t excel, then I’m inferior and worthless · If I don’t excel, I’ll just end up ordinary · I am a very special person (and other people should treat me that way) · I don’t have to be bound by the rules that apply to other people · If others don’t respect me, they should be punished · Other people should satisfy my needs · People have no right to criticize me · Other people don’t deserve the good things that they get · People should go out of their way for me · People don’t understand/get me (because I am special/brilliant/etc.) · I can do no wrong Caretaking/Responsibility/Self-Sacrifice Caretaking, responsibility, and self-sacrifice could be separated into independent categories, but they reflect similar beliefs and can be addressed as a group. Self-sacrifice beliefs refer to the excessive forfeit of one’s own needs in the service of others. Individuals often feel guilty, and compensate by putting the needs of others ahead of their own. Such people often believe they are responsible for the happiness of others and apologize excessively. Responsible individuals may take pride in their diligence and dependability, without necessarily feeling a need to care for others or engage in self-sacrifice. People who maintain core beliefs rooted in caretaking, responsibility, or self-sacrifice may have felt overly responsible for family members in their youth. Related thoughts include: · I have to do everything perfectly · If I make a mistake, it means I’m careless/a failure/etc. · I’ve done something wrong · It’s not okay to ask for help · I have to do everything myself · If I don’t do it, no one will · I’m responsible for everyone and everything · If I care enough, I can fix him/her/this · I can’t trust or rely on another person · If I trust people, they may hurt me (and I won’t survive) · People will betray me |