Issue # 9 

A Fork in the Road 

by Andrew John Tucker, LCSW, CASAC

Last week, we spoke about negative self-talk and how it comes without warning. We’re doing great, and boom – self-doubt slips in to tell us the accomplishment we just enjoyed somehow isn’t real or doesn’t count. Intellectually we know it’s not true, but……it could be….can’t it? It certainly feels like it’s true…..so…..what now?

This cognitive distortion is literally called “Discounting the Positive” in the Cognitive Behavioral Therapy World. Distortion is a harsh word, but it’s not a judgment; it’s an observation because our thinking can get off track when emotions heighten, and noticing can help begin the process of regulating. Another is when we don’t succeed at something (as people sometimes don’t), and a little voice tells us we are incompetent or stupid because of it. That one is called Emotional Reasoning. There are more, Overgeneralizing, All-or-Nothing Thinking, and Should Statements – the list goes on. It can feel like a Cheetah is chasing us, and all the serpentining is getting exhausting. We are promptly reminded our brains need moderation.

What is terribly interesting to me is how these thoughts fall upon us seemingly out of the sky. We didn’t ask for them. They just appear, and now we’re the ones who have to deal with them. My patients will tell you we talk about these occurrences regularly. We know it’s a response (conscious or unconscious) to all sorts of past experiences, heredity, trauma, and a desire to stay safe. Our brains have made a valiant attempt to manage it all, only to discover that some thoughts are helpful and some are not. And the ones that are not will only grow and fester if they are not adequately processed. One of our people once said in a moment of clarity, “I have to deal with it, or it’s going to deal with me, and I don’t like its way of handling things”…..indeed….

The good news is that we can absolutely change this dynamic with awareness and practice. I have witnessed seemingly impossible change as people discover more helpful thinking patterns enjoying a far more proactive, less reactionary life. They have reached a fork in the road and picked a better direction based on knowledge, experience, and acceptance. This particular brand of help is called Cognitive (thinking), Behavioral (what we do) Therapy (Education & Support), and they are all connected. 

What is Cognitive Behavioral Therapy?

Short answer? We have a thought that gives us a feeling that influences our behavior, not necessarily in that order. It’s tricky like that. However, if you can change one, you can change the other two, and we’ll get back to that idea later. But let us start from the beginning, from the moment we recognize something has gone awry. The clock starts ticking as we progress through time in a typical scenario of unhelpful thoughts and the actions we can take to deal with them.

12 PM – THE AUTOMATIC THOUGHT

An event stimulates us. Something happens, like a negative outcome, bad news, or even a depressive malaise. As an immediate reaction to the stimulation, we have “The Automatic Thought.” It can be a whisper or a general feeling articulated into our consciousness; it is the voice of fear, doubt, shame, and guilt. If you’ve experienced any of the following, sing along if you know the lyrics:  

1. “I can’t handle this stress.”
2. “I’ll never be successful.”
3. “I know I’m going to fail the interview, so there’s no point in preparing.”
4. “I always mess things up.”
5. “I feel stupid, so I must be stupid.”

If you’re relating, know these thoughts come for us all, and you’re not alone. They are automatic, after all. We don’t have a choice – it is a judgment that pops into our consciousness without our consent. I would also draw your attention to the phrases “never,” “can’t,” “no one,” and “not.” Strong feelings….but accurate accounting? Can we tell the difference in the heat of battle? 

What are some of your self-judging automatic thoughts?

3 PM – THE FEELINGS

As we venture through time after the automatic thought, I would ask a simple question; How would anyone feel after being judged like that? Sad, angry, frustrated, hopeless? “Never” is a long time and doesn’t leave much room for growth. “Always” seems to permeate everything. Left unprocessed, these ideas can settle in like cigarette smoke on an old couch. If we keep saying “never” and “always” and speak to ourselves in a manner that isn’t befitting of the way we would speak to a 5-year-old, we are at risk of creating an entire belief system that turns away from reason and what we have the power to control. It’s like traveling in space and being .00002 off on the trajectory calculations – it doesn’t seem like much at first, but after a while, we find ourselves alone and far from home. As the pressure builds, fight or flight kicks in, and action is at hand. But what to do now, feeling like we do?

6 PM – THE BEHAVIOR

Feelings can influence our next action. It has been called many things over the years – “cornering the bear,” / “draining the options,” / “escaping the fire”…. it’s all relevant. We can feel a desperation to escape the intense feelings, and we will do just about anything to get out of there. Here are five ways we have been known to react to these intense negative thoughts, feelings, and belief systems; 

1. Avoidance: This involves avoiding situations or activities that trigger negative emotions. Avoidance may provide short-term relief, but it can also reinforce the fear or anxiety in the long term and disconnect us from things that are in our best interest. Our world begins to shrink. 

2. Substance Misuse: involves using drugs or alcohol to cope with negative emotions, which can worsen the underlying emotional difficulties. Our people always talk about regretting using because they wake up with all the same problems they had before, plus all the new ones they acquired from using. Also, we deny ourselves the healthy opportunity to learn we are strong enough to manage difficult situations. 

3. Compulsive behaviors: This involves engaging in repetitive behaviors, such as checking, cleaning, or counting, to manage anxiety or other negative feelings. This is a mental and psychological attempt to control our immediate experience when our lives feel out of control. 

4. Rumination involves dwelling on negative thoughts and feelings, which can worsen anxiety and depression. We repeat the same sentences over and over – asking ourselves why again and again. We get stuck in a loop. 

5. Aggression or anger involves lashing out at others or becoming angry in response to perceived slights or challenges, which can contribute to relationship problems and increase negative feelings. Someone has to pay for our pain, and it’s usually the ones closest to us. 

If you’re feeling a bit down by now, that’s ok. It’s always darkest before the dawn. Some would argue this is precisely the moment where significant change is born, and besides, we’ve arrived at the part of the program where we snap the shades up and let the light shine in. As the British philosopher Alan Watts said, “The only way to make sense out of change is to plunge into it, move with it, and join the dance.” (Don’t worry – I didn’t know who he was either – I looked it up). But what I DO know is a phrase we use in group all the time that speaks to how we must learn to deal with things instead of avoiding them. It says – “the only way around is through,” and if we’re going through, we better suit up.  

Personally, I like bringing a gun to a knife fight. I like to hedge my bets for my patients as much as possible. Stack the deck, tip the scales, be the house, whatever you want to call it. CBT does just that because, as we’ve discussed in the past – feelings aren’t facts – and any light you shed on them at all starts to melt away their power. By merely making the decision to confront this stuff, you begin to get stronger. We have spoken in session about putting the thought on trial. Does the thought hold up in court once examined? Of course, we want to acknowledge the power of the feeling, but that is all the more reason to challenge it towards a more balanced, less emotional reality. 

But first things first. Take a breath and acknowledge this difficulty and validate yourself. Allow yourself to feel and express your emotions, even if they are negative or uncomfortable. Avoid suppressing or denying your feelings. And before we practice CBT, consider surrounding yourself with supportive people: seek out friends and loved ones who accept and validate you for who you are. Talk with a trained therapist. They can also help you gain a clearer perspective. 

9 PM – TAKING BACK CONTROL

This is the best part of what started out to be a really challenging day. We get to write our own ending by acquiring the knowledge that we can manage and harness the power of our thoughts and feelings. They are you, after all, and are like a beautiful horse that starts off wild and ends up one of your best friends. Animals can react to a storm coming before humans can, and you can get to a place where you feel one brewing and manage it early, then ride off into the sunset. 

Here are six steps to help manage unhelpful thoughts so you can intervene before taking an action that is not in your best interest:

1. Identifying and Challenging Negative Thoughts:  This is the court where you get to switch parts from being the victim to being the prosecution. Remember, when we are upset, our thoughts can create extreme feelings that can create more extreme thoughts that result in a reaction action or vice versa. It feeds on itself and can feel like being tossed around in a washing machine. But…..remember, if you can change one, you can change the other two. You might start by examining and disputing irrational or distorted thoughts contributing to negative emotions and behaviors. This process can help you to identify and replace them with more balanced and accurate ones. Take a breath, and ask yourself, “is that really true?” And if you say (perhaps lovingly petulantly) “no – but it feels that way”, congratulations, you have just taken a step forward towards feeling your feelings and mitigating them. 

2. Reframing Negative Thoughts: The goal of reframing is to shift the focus from negative or unhelpful thoughts to more balanced and constructive ones, which can help to reduce stress, anxiety, and negative emotions. A great way to practice it is to focus on what you can control instead of dwelling on things you cannot. Take the unhelpful thought and re-write it into a more helpful statement. The best part is that it’s actually more accurate. It may be uncomfortable, but that’s ok. Keep practicing.  

3. Mindfulness: The goal of mindfulness is to develop greater awareness and insight into one’s thoughts, emotions, and behaviors and to cultivate a more accepting, non-judgmental attitude toward one’s experiences. Mindfulness can give you a break from the past or future by focusing awareness on the present moment while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations. The app Insight Timer has great meditations to guide you through difficult times. 

4. Relaxation Techniques: This involves learning and practicing techniques such as deep breathing, progressive muscle relaxation, and meditation to manage stress and anxiety. Relaxation can oxygenate the brain and lower levels of the stress hormone cortisol, as well as alleviate headaches and incubate creativity and planning toward more productive thinking. Get out of your environment – take a walk. This is an excellent example of how changing behavior can change our mood. Perhaps you’ve heard the phrase, “move a muscle, change a thought.” We can activate new ways of thinking and change perspective by stimulating our senses. 

5. Distraction: This involves engaging in activities that distract from negative thoughts and emotions, which can break the cycle of rumination and give your brain and tension a break. Listen to music that validates your experience. Watch a movie. Exercise, call a friend. Do a chore. Do something that not only takes your mind off the intensity of the emotions but also has a positive outcome. 

6. Positive Self-Talk: Remember that five-year-old we were talking about before? How would you speak to them? What if they looked up at you and told you they felt worthless or didn’t believe they could change? What would you say to them? Can you give yourself the same courtesy and dignity? Speaking to oneself positively and encouragingly, reframing negative thoughts, builds self-esteem. Positive self-talk can help individuals overcome challenges by promoting resilience and determination and providing a sense of control and empowerment.

Wow – what a day! Are you tired yet? Ready to crash? You’ve worked hard today and can rest your head knowing you’ve done your best. You went from feeling emotional and stuck to discovering strength and options. It takes practice, so be kind to yourself and allow yourself to learn, make mistakes, and regroup. Progress comes in many forms but always equals moving forward, so keep at it. Now close your eyes, and take a breath, knowing you can be grateful for the good things in your life that, includes your own empowerment. Sweet dreams. 

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If you or a loved one would like guidance in practicing these techniques or is experiencing substance misuse, depression, or anxiety  – call or text for a free 15-minute consultation. 646-504-6212.