Why doesn’t my husband share his emotions? This question, often whispered in the quiet corners of our minds or during heartfelt conversations, reflects a common yet deeply personal concern among many partners. The silence that greets us when we seek to connect on an emotional level can feel both puzzling and isolating. But beneath this silence lies a complex world of feelings, beliefs, and, most intriguingly, meta-emotions.
[Read more…] about Understanding Your Partner: Unveiling the Mystery of Unshared EmotionsSelf-Help
Understanding the Conflicted Parts of Ourselves (with IFS)
The primary tool I use to help people who struggle with internal conflict is known as Internal Family Systems (IFS). It has nothing to do with family therapy. More accurately, it’s not unlike being a wildlife observer. A really good one. Who has also read Clan of the Cave Bear. You’ll understand it all in a moment.
First, imagine a wildlife observer sitting down in a field, taking notes in his journal. He’s intent on learning more about the animal kingdom. After sitting still for a few hours, he notices a small squirrel innocently wandering around, looking for nuts. Without warning, a lion suddenly pounces out of the bushes in an attempt to eat the squirrel.
With a rush of adrenaline, The Poor Wildlife Observer immediately reacts. In a flash, he jumps up and tosses his clipboard and papers in the air as he rushes towards the lion in a panic. He waves frantically and yells at the top of his voice: “Bad lion! Shoo! Shoo! Go away!” He’s desperately trying to save the poor innocent squirrel. Startled by all of the commotion, the lion hesitates, and reluctantly backs off. The Poor Wildlife Observer picks up the little squirrel, cradles it in his arms and gives it a gentle caress as if to say that everything is going to be all right.
This is not the right approach to self-awareness.
Compare this with the behavior of The Good Wildlife Observer. He notices the squirrel and sees the lion pounce. However with this encounter, he does not react to what he sees. Instead, he allows the entire interaction to take place. Undeterred by the protests of the innocent little squirrel, the lion proceeds with his midday snack. The Good Wildlife Observer simply nods, picks up his clipboard, and with slow, deliberate action begins to write: “Lion exhibits squirrel-eating behavior. Interesting,” and shrugs.
The difference between the two wildlife observers is that one reacts, while the other one reflects. When we react to our thoughts and emotions, we don’t really notice what’s truly going on deep inside of ourselves. Reflection allows us to notice, observe and accept what is. You can’t change what you don’t notice, and over time, you’ll be able to choose to act rather than react. Acceptance and curiosity allows us to access a deeper, more complete picture of our emotional landscape.
This is one of the essential components in Internal Family Systems (IFS).
Introducing IFS
Internal Family Systems (IFS) is a type of therapy that helps people understand and manage their complex emotions, thoughts, and beliefs. An essential component of this is that each person is made up of different “parts”, all of whom may have different goals, objectives and motivations. Understanding how they work and not working against them is the first step towards healing emotional wounds.
All About this IFS “Part” Nonsense
A client once expressed her concern over exploring her various “parts”. She didn’t want to buy in to this “touchy feely nonsense” without some understanding of how it works. Which is perfect, as I love it when clients want to understand how to use these tools better.
I suggested that she look at it like the situation with Ayla doing mathematics in Clan of the Cave Bear. For Ayla, learning to count was simple; in fact, she could count past ten even though she only had ten fingers. Her peers were dumbfounded; they were still stuck on the literal concept of not comprehending what fingers had to do with numbers. However, Ayla knew that her fingers were representative of a concept, specifically mathematics.
In the end, it doesn’t really matter whether or not we actually have different “parts” of ourselves or if we’re just using this as a way to represent our conflicting feelings and thoughts. It’s effective and incredibly illuminating to understand ourselves in this new light.
Therapy Handouts
Here is a list of what I feel are the most important therapy and psychology handouts to have. This list ebbs and flows as more resources are added.
Generalized Anxiety Disorder
The key element behind this type of anxiety and worry is an intolerance of uncertainty. Over time, our excessive worry becomes persistent, repetitive and uncontrollable. We rush around trying to find solutions, yet we never end up finding any sort of relief.
When we worry, we tend to predict that bad things will happen to themselves or other people. These fears may even be based on real events. We try to figure out one or more solutions to what we fear will happen. However, since the “bad” event still hasn’t actually happened yet, we never end up being able to use our solution. As a result, we still continue to feel uncertain and anxious.
Adapting Cognitive-Behavioral Therapy (CBT)
Cognitive-Behavioral Therapy (CBT) uses a specific cognitive model in order to understand, interpret and effectively work with Generalized Anxiety Disorder (GAD). The cognitive model of GAD consists of four essential parts:
- Intolerance of uncertainty
- Beliefs about worry (positive & negative)
- Poor Problem Orientation
- Cognitive & Emotional Avoidance
Part 1: Intolerance of Uncertainty
When we can’t handle uncertainty, we tend to become intolerant of it. This intolerance tends to set us up for developing Generalized Anxiety Disorder (GAD) as well as maintaining the disorder once it starts.
People without GAD may not like uncertainty, but they generally tolerate it. They tend to believe that if bad things happen to them, they’ll be able to cope.
GAD clients have a different perspective! They believe it is unacceptable to have any uncertainty. They fear that experiencing any uncertainty or ambiguity will actually cause more problems. There is even a believe that they would be irresponsible of they don’t try to eliminate any uncertainty.
Part 2: Beliefs About Worry (Positive & Negative)
Generalized Anxiety Disorder (GAD) clients suffer from dysfunctional beliefs about how worry works. They tend to have extreme views on how helpful or harmful worry is.
People with GAD might feel that worrying ahead of time can prepare them for anything that happens to them (extreme positive belief). Or they might feel that it is dangerous to experience worry and that any worry is uncontrollable (extreme negative belief). It’s the extreme beliefs that are the actual danger themselves, as they add fuel to the fire to make us worry more.
Part 3: Poor Problem Orientation
Those with General Anxiety Disorder tend to view any problems as threats. They aren’t very confident in their ability to come up with any solutions. This mindset sets them up to always expect a negative outcome when they attempt to solve any problem. As a result, they overcompensate by trying to create a perfect solution.
But, when you combine a Poor Problem Solving Orientation with an Intolerance for Uncertainty, this is what happens:
- You’ll keep trying to come up with a solution that you are certain will work.
- Yet the problem is still in the future, so you won’t be able to implement the solution at the moment.
- The result is that you can’t be certain that your solution will work, so you’ll continue to worry and come up with more solutions without actually choosing one.
Part 4: Cognitive & Emotional Avoidance
Ironically, worry itself is a way for us to avoid certain things. We don’t want to think of what things will look like if something goes bad. We start to imagine “worst case scenarios” and experience very distressing feelings. As a result, clients with Generalized Anxiety Disorder use worry as a way to avoid these thoughts and emotions.
The Benefits of Cognitive-Behavioral Therapy (CBT)
I’ve had many other counselors over the years and I chose you because of your focus on CBT (Cognitive-Behavioral Therapy). I really relate to your more analytical, organized, solution focused approach verses just letting me talk and you listen. It feels more pragmatic.
– Client review
Cognitive-Behavioral Therapy (CBT) is one of the major tools used in psychotherapy. CBT assumes that the way that people perceive situations is more closely connected to their reaction than the situation itself.
Simply put, a therapist’s job when using CBT is to help clients identify the thoughts that pop up into their minds, evaluate, and respond to them. The assumption is that when clients are able to do this, they feel better and can act in accordance with their values and goals. One critical concept underlying all aspects of CBT is that just because you think something doesn’t necessarily mean it’s true.
Evidence-Based Treatment
CBT is evidence-based. This means that it is backed by research to be an effective treatment. However, it’s worth noting that any type of therapy (such as CBT) cannot be “evidence-based” without listing what disorder it is effective in treating. For example:
- CBT is an evidence-based treatment for Major Depressive Disorder. The therapist focuses specifically on the automatic thoughts that have to do with the self, the world, the future.
- CBT is an evidence-based treatment for Panic Disorder. The therapist focuses on the automatic thoughts that have to do with the catastrophe that the client is afraid will happen if a symptom gets worse.
- CBT is an evidence-based treatment for Obsessive-Compulsive Disorder. Here, a CBT therapist doesn’t focus on automatic thoughts; rather, the focus is on the beliefs that the client has about their obsessive thinking and about their ritualistic behavior.
Where Therapists Get CBT Wrong
Many therapists jump into CBT without understanding the fundamental concepts and techniques, and apply a scattered “try, try again” approach with techniques. In fact, when working with clients it is critical to delay introducing CBT techniques until they have demonstrated two essential things first:
- That your client believes and “buy in” to the cognitive model (that “thinking influences how we feel and what we do”) and that by evaluating their thinking, they can feel and act better.
- Clients should also be able to demonstrate to you that they can use the list of socratic questions (see below) and have filled out any related worksheets with you during/in-session. Otherwise, any assignments you give will be half-believed, half-accomplished and will be unlikely to make any material change in their cognition between sessions.
Action Plans (“Assignments” or “Homework”)
It’s just not enough to come in and talk for 50 minutes a week. The way that people get better is by making small changes in their thinking and behavior every day. That’s why action plans are so crucial. Research consistently demonstrates that CBT which includes action plans is more effective than CBT that doesn’t.
Most people don’t like homework, so “assignments” or “action plans” are used instead. However, I’ve found that the following question helps to identify clients who are more likely to follow through with CBT assignments (i.e, those who don’t choose the third answer):
- How do you prefer to spend your time in-between sessions?
- I prefer reading assignments
- I prefer written assignments
- I prefer to just reflect and think on what was discussed in session.
Assignments entail some kind of responding to the client’s negative thinking and behavioral change. If in doubt, you can ask your client, “What do you think is most important to remember this week? What would you like to do about it? What would you like to remember?” At a minimum, clients should be assigned the following activities in-between sessions:
- Read coping cards or therapy notes everyday
- Implement solutions to problems
- Monitor experiences so that they can notice important automatic thoughts
- Respond to their negative cognitions
- Practice new behavioral skills
Cognitive Conceptualization
To be an effective therapist, you have to continuously conceptualize clients’ experiences. You must understand what the client’s specific problem is and decide on a treatment technique, such as:
- Evaluating their thoughts
- Identifying and modifying their beliefs
- Doing problem solving
- Teaching skills to regulate emotions
- Change their behavior
- Decrease their physiological arousal
- Acceptance of the problem and changing their focus
In the end, people’s reactions always make sense once you understand what they were thinking. That’s the hallmark of CBT.
Understanding Thoughts, Emotions and Behaviors
For example, think of a recent situation in which you felt at least a little distressed. Or where you engaged in an unhelpful behavior, or noticed a change in your body. With CBT, we ask ourselves:
- What was the situation? Or what were you thinking about, remembering, experiencing or predicting?
- What went through your mind? (Automatic Thoughts)
- How did you feel emotionally? What was your reaction? (Emotions)
- Did your body react? If so, how? (Physiological)
- What did you do? (Behavior / Coping strategy)
The resulting behaviors can tell us what kind of strategies a person has developed to survive in life. These patterns tend to be consistent and, at times, dysfunctional.
Understanding Core Beliefs
Initially, your work with a client will focus on evaluating and modifying their thoughts and/or beliefs. As sessions progress, you might begin to focus on clients’ deeply held beliefs, which are referred to as Core Beliefs. Core beliefs prevent you from gathering evidence to contradict your analysis of a situation. You can identify these beliefs as they are always active (24 hours a day, 7 days a week) and act as a “lens” where whatever happens to you gets filtered through it.
There are three primary categories of Core Beliefs:
- Helplessness
- Ineffective in getting things done
- Ineffective in protecting ourselves
- Ineffective as compared to other people
- Unloveability
- Worthlessness (belief that you are morally bad)
How Client Cope with their Core Beliefs
People cope with their Core Beliefs by using Assumptions or “Rules for Living”, regardless of whether they create more problems than they solve. Coping Strategies are the characteristic ways that clients behave in order to protect themselves from the activation of their core beliefs.
Most of these take the form of an “if…/then…” format. For example, “If I don’t trust people, then I’m going to be ok. But if I do trust them, I’m going to be hurt, and therefore proven unloveable.” Therapists help clients evaluate these conditional assumptions by exploring both the positive assumption that helped them cope with their core belief, as well as any negative counterparts to their assumptions.
Modifying Core Beliefs
Using what CBT therapists refer to as the “downward arrow approach”, you identify a core belief through automatic thoughts by asking, “If your automatic thought were true, what would that mean? And especially, what would that mean about you?” This can be time-consuming and challenging as clients often express their core beliefs as automatic thoughts. You can also explore how the client has coped with these core beliefs all their life, examine what kind of behavioral strategies they have developed to get along with in life, and identify some consistent patterns of behavior that are, at times, dysfunctional.
Core beliefs can’t be worked on during the initial steps of therapy until the client is in agreement with the critical concept above (thoughts are not necessarily true). Also, questioning one’s core beliefs questions a client’s core self, which can be very uncomfortable; this requires trust in the therapeutic relationship to be solid and established.
Cognitive Distortions
Cognitive distortions are often the blueprint with which we explain and comprehend what happens to us in life. With CBT, it’s not essential to label the cognitive distortion, but it can be helpful to give clients some cognitive distance from their emotionally charged thoughts. Some common distortions include:
- All-or-nothing thinking: You see things only in two categories. Things are black or white, with no shades of grey. “I have to do a great job on everything.”
- Fortune-Telling: You make negative predictions about what will happen when other outcomes are more likely. “I’ll always have trouble figuring out my thoughts.”
- Labeling: You put a globally negative label on yourself. “I’m a failure for making a mistake.”
- Emotional reasoning: You believe something must be true because it “feels” true. “I must be incompetent.”
- Selective abstraction: You pay attention only to the negative aspects of situations instead of considering the entire experience. “I made so many mistakes”.
- Overgeneralization: You draw a general conclusion based on a small amount of evidence. “I do everything wrong.”
- Mind reading: You are sure you know what others are thinking. “They probably think I’m foolish.”
- Personalization: You take others’ actions personally when they actually have other intentions. “They did that to me on purpose.”
- Imperatives: You have an unreasonably rigid idea about how you or others should or must behave. “I should always do my absolute best.”
- Magnification and minimization: You magnify the negatives or minimize the positives. “I’m no good at figuring out what to do.” “It doesn’t matter that I have good common sense.”
Adapted from Cognitive Behavior Therapy: Basics and Beyond (J. Beck, 2011)
Responding to Dysfunctional Cognitions
Cognitive-Behavioral therapists tend to challenge these thinking errors using a variety of techniques, including Socratic Questioning, Behavioral Experiments, Labeling of Cognitive Distortions, Cognitive Challenging/Refocusing/Reframing, Exploration of Coping Patterns, Exploration of Thoughts and Emotions, Interactive Feedback, Role-Play/Behavioral Rehearsal, and using Analogies and Metaphors.
Of these, the most important is Socratic Questioning, where clients learn how to evaluate thoughts and beliefs by gathering evidence, developing alternative explanations, de-catastrophizing, and using other Socratic questions, such as:
- What’s the evidence?
- What’s the evidence on the other side?
- What’s another way of looking at this situation?
- If the worst happens, how could you cope?
- What’s the best outcome?
- What’s the most realistic outcome?
- What’s the effect of changing your thinking about this?
- What would you tell a friend who was in the same situation?
- What do you think you should do?
How to End Every CBT Session
The single most important question to ask your client at the end of each CBT session is, “How likely are you to do your assignments (action plan) this week?”
- If your client responds saying 90-100%, you’re all set for success.
- If they say 75%, your client will do some of the assignment, but just before the session just to please you.
- If they say 50%, they’re not going to do it, but they don’t want to tell you.
To reach 90%, make certain the action plans are easier, or make parts of the action plan optional. You can ask yourself, “What are the practical problems (or automatic thoughts) that will get in my way?” Once you’ve addressed these and revised your action plan, you can then ask yourself, “NOW how likely am I to do the action plan this week?”
Measure Your Baseline Happiness
If your goal is to be happy, it’s useful to know how far you’ve come.
As the old saying goes, if you don’t know where you’re going, you’ll probably end up somewhere else. With happiness, it’s important to know what your current level of happiness is so that you can measure how effective therapy is over time.
The first time you take the assessment, you’ll get a score that will serve as a “baseline” of your current happiness level. As you make changes in your life, you should see this number change over time. The goal is to see if your happiness and overall mood have changed after a period of time in therapy.
To measure your happiness, you can take the University of Pennsylvania’s Authentic Happiness Inventory. This survey contains 24 questions that provide an overall measure of your happiness levels. Note: I am not affiliated with the happiness website.
When you complete your survey, you’ll be given a “happiness score” ranging from 0.00 (no happiness) to 5.00 (maximum happiness). Once you get your score, write it down and keep track of it.
NOTE ON DATA COLLECTION: The Authentic Happiness website is supported by the Positive Psychology Center at the University of Pennsylvania under the leadership of Dr. Martin E. P. Seligman. Dr. Seligman is often cited as the father of Positive Psychology. While the data is used anonymously, you can also consider using a fake name and/or email to participate (although using your real email may be helpful to log back into to the site to take your post-tests). More information about what information is collected, how it is used, and how it is shared can be found on the Authentic Happiness Website’s Privacy Policy.
An alternative to taking the test is to take the Oxford Happiness Questionnaire and score it yourself. Your resulting score from this questionnaire can also act as your baseline happiness score.
6 Reasons Why We Don’t Implement Changes In Our Lives, and What Can Be Done About It
Why is it so difficult to make changes in our lives? We all talk about it, and some of us will start work on it, but in the end we seem to get stuck in remaining the same. This happens even when we know that it would be best to make certain changes in our lives. Why is this?
[Read more…] about 6 Reasons Why We Don’t Implement Changes In Our Lives, and What Can Be Done About ItHow Not to be Blocked When Doing an Intervention
A.K.A, “Handling Questions Designed to Put You On the Spot and Them Out of the Spot”.
Interventions are extremely uncomfortable to do. Your main job is to try to help them to see that they can no longer continue to live in “the denial of the present reality.” Chances are they will get upset and object – this is designed to put you on the defensive and to take the focus off of themselves. Remember, the person you are confronting has had years of practice in avoiding dealing with their problems. A few ideas might help you in this process.
[Read more…] about How Not to be Blocked When Doing an InterventionWhy Emotionally-Based Reasoning Fails
The reason that many people don’t solve problems is that they “personalize” everything that is said to them. They relate what is happening to some fear, some event, past memory, problem, or so forth, from the past that is “evoked” in the present by what another person says. As a result, discussions with people like this are never easy as they are always personalized based on fears and emotions, without any real future focus.
[Read more…] about Why Emotionally-Based Reasoning FailsHow to want what you can’t have and keep getting what you don’t want
We tend to have expectations that others should meet our needs or treat us in a certain way. Yet we act surprised when they continually disappoint us. The reality is we need to start paying attention to other people’s patterns of behavior. Acknowledge that everyone has limitations.
[Read more…] about How to want what you can’t have and keep getting what you don’t wantHow to Make Sure That No One Can Ever Get Close to You
Why do some people verbally “attack” others in a relationship? When someone’s behavior changes like this to the irrational and bizarre, it is often not due to some unexplained physical or emotional cause. In fact, the real reason is more surprising than you’d think.
[Read more…] about How to Make Sure That No One Can Ever Get Close to YouHow to Keep Yourself So Busy That There is no Time Left to Face Your Problems
There is nothing wrong with wanting to be comfortable and safe in life. However, when we find ourselves devoting much of our efforts into finding ways to avoid our feelings or to always be comfortable, then something may be wrong. Understanding a few issues might be of some help.
[Read more…] about How to Keep Yourself So Busy That There is no Time Left to Face Your ProblemsHow to Spend Your Life with the Wrong Person by Being Afraid to be Alone
Have you ever wondered why you seem to make “poor choices” in relationships? Why your life is not working out the best? In order to have a healthy and more positive romance with someone, it’s urgent that you learn some critical relationship concepts regarding quick solutions, dependency and the fear of “being alone”.
[Read more…] about How to Spend Your Life with the Wrong Person by Being Afraid to be AloneAssertiveness & Boundaries
At first, I was afraid of conflict. I always assumed other people know more than me and that if we disagreed on something, they would leave me. After working with Dave, I learned to trust my opinions enough to voice them and how to stop worrying about saying something wrong. I can now be uncomfortable during conflict without being overwhelmed or waiting for it to pass or for someone else to resolve it. It’s so much more comfortable a feeling than what I’ve been living with up until now.”
– Client Review
Assertiveness is a crucial interpersonal skill that involves expressing your thoughts, feelings, needs, and opinions in a respectful and direct manner, while also respecting the rights and boundaries of others. It’s finding a balance between being passive (not expressing yourself) and aggressive (expressing yourself at the expense of others).
What Does Assertiveness Look Like?
- Clear Communication: Assertive individuals are able to communicate their thoughts and feelings clearly and directly. They use “I” statements to express their needs and emotions.
- Respect for Others: Assertiveness involves respecting the thoughts, feelings, and boundaries of others. It’s not about dominating or belittling others.
- Self-Advocacy: It’s about advocating for yourself and your needs. This means speaking up for what you want or need in a given situation.
- Conflict Resolution: Assertive individuals are skilled at resolving conflicts in a constructive manner. They seek compromise and win-win solutions.
- Emotional Regulation: Assertiveness requires emotional self-regulation. It’s about expressing yourself without losing control of your emotions.
What Do Healthy Boundaries Look Like?
Boundaries are the psychological, emotional, and physical limits we set to protect ourselves and define our personal space. They help us maintain our individuality, self-respect, and well-being. Boundaries can be physical (personal space), emotional (communicating when something bothers you), or interpersonal (setting limits on what behavior you find acceptable).
Key aspects of boundaries include:
- Identification: Knowing your own limits and what is acceptable or unacceptable to you.
- Communication: Clearly communicating your boundaries to others. This involves using assertive communication.
- Respect: Respecting the boundaries of others. It’s a two-way street; you expect others to respect your boundaries, and you must respect theirs.
- Consistency: Maintaining your boundaries consistently, even when it’s challenging. This helps establish trust and predictability in relationships.
Why People Struggle with Assertiveness and Boundaries
- Fear of Rejection: Many people fear that asserting themselves or setting boundaries will lead to rejection or conflict. They prioritize avoiding discomfort over their own needs.
- Low Self-Esteem: People with low self-esteem may not feel worthy of asserting themselves or setting boundaries. They may fear that others won’t value their needs.
- Cultural and Gender Norms: Societal and cultural norms can discourage assertiveness, especially in certain cultures or for individuals who identify with traditionally non-assertive gender roles.
- Lack of Skill: Assertiveness is a skill that needs to be developed. Some individuals may simply not have learned how to communicate assertively.
- Avoidance of Conflict: Conflict avoidance can lead to a lack of assertiveness. People may avoid difficult conversations to keep the peace, even when it’s detrimental to them.
- People-Pleasing: Some individuals have a strong tendency to please others at their own expense. They prioritize others’ needs and feelings over their own.
- Boundary Violation in the Past: Those who have experienced boundary violations in the past may struggle to set healthy boundaries because they may not trust that they will be respected.
It’s important to note that both assertiveness and boundaries can be developed and improved through practice and self-awareness. Cognitive-Behavioral Therapy (CBT) can be a valuable resource for addressing these issues and building healthier relationships.
The Martyr Complex & Psychological Drama
Drama, suffering, self-defeating statements, living in and for crises, upsets and problems can make it difficult to change and grow. When everything is part of the “Soap Opera of Life” we get trapped in the “never ending drama” of responding.
[Read more…] about The Martyr Complex & Psychological Drama