Reducing Anxiety & Depression with Cognitive Behavior Therapy (CBT)

our OnLive uh and hello nine 2272 said hello and very dear friend hello my name is Dan Fox and I'm Brooks Witter let's take a deeper dive into what

cognitive

behavior

al

therapy

is all about and how you can help with your own

anxiety

and

depression

symptoms using some of these tools, yes, an intensive one-hour course will be enough. You will know everything at the end of an hour. So the picture here is just a brief look at the relationship between thoughts,

behavior

and feelings, and

cognitive

behavioral

therapy

. You've really looked at this and started to map out some of the ways that our brain relates to these different things and how they play a role in each other's experience, yeah, because we can see that they're all interdependent and intertwined in that. our behavior will influence our thoughts our feelings and our feelings will influence our behavior our thoughts and everything vice versa, so we will learn a little bit about the relationship between those things and, more importantly, some techniques that come from this research based approach in human behavior change about how we can actually change our thoughts, feelings and behaviors in a way to get more of what we want in life sounds good, that sounds great and, you know, just looking at the definition of CBT is one of the The most important thing about this approach is that we are really looking at how our cognitions, our thoughts, our cognitive framework or structuring, how we see the world, how we see ourselves, our beliefs, how that creates our thoughts, our emotions, our feelings and how can we, instead of just being unconsciously governed by that structure, um, how can we actually be more intentional about it and take more conscious control over how we want to behave and think and experience our world, just to point out that we're Let's go.

I'll go into this a little bit more in the presentation, but CBT at this point in the game is kind of an umbrella term that encompasses a whole family of therapeutic modalities and some different theories that basically come out of a tradition of cognitive and behavioral science. which looks at the interaction between our thoughts, feelings and behavior, so CBT is kind of generic and there are a lot of different things like DBT and BSR and we'll talk more about this later, but there is one name that, if not, I wake up by the tomorrow and I'm a little stressed, I take three breaths and say, "Okay, it's going to be a great day." Does that count as a CBT technique?

Could it be a technique found in many CBTs? Is it okay because I feel like it? a lot of the things that we do to psych ourselves up or see the positive side or, you know, focus on the positive or, you know, things that we might say to our kids, are things that could be seen as you know something as part of it. of the cognitive-behavioral toolkit and that interventions are not exclusive to cognitive-behavioral therapy, they are things that we often do anyway, but I think that cognitive-behavioral therapy gives us a map to really understand what it is doing and when these tools are the most useful, yes, and another indication of cognitive behavioral therapies and how CBT is different from many other treatments is how well proven it is in scientific research that CBT is generally taught in many psychology training programs, largely because The universities where this is taught are research-based and really dive into the science of our cognitions and behaviors and how to change them, so let's take a few minutes to go over some of the concepts.

Basics of how CBT works, the interventions are structured as the three waves of CBT and then we will delve into

anxiety

and

depression

and some of the strategies to alleviate those symptoms. This is your chance, if you have questions, you can type them into that chat and we will include them in the conversation and address them as they go so we can make sure that we really meet your needs and the reason you are tuning in today, if you don't write Your question now, can you do it at any time? Yes, you can do it at any time.

Well, I don't know how much we need to go into this slide, but I'm going to go into more detail about how our thoughts affect the way we act and how we feel affects our behavior. our emotions in our thoughts, etc. and what I think is important to me when I think about this is that usually a thought and a behavior end up tied together in our memory in our mind if we do it. "Wow, that happened yesterday. There's a kind of emotional connection to cognition and that seems quite automatic and one of the main things I think we're trying to do with cognitive therapy is to be aware of those automatic connections." kind of automatic thoughts and the emotions that kind of follow automatically and, um, kind of unleash that causal link, unleash that kind of automation and they can have a well-said choice because we'll often say well, of course, I had yelled at you that was. angry as if because there is anger the only rational course is to yell right, you had no choice because I did that to you mm-hm I made you angry and we can well justify our anger because you were yelling at me and calling me stupid as if that was simply the necessary precursor and obvious anger, but without recognizing that other people can have very different responses and therefore these relationships between thoughts, feelings and behaviors are not necessarily inherent but perhaps quite arbitrary and based on our own learning as individuals, create a la reality itself yeah yeah and that's okay so I pick up this comic I'm sure I left the gas on says these people stranded on the little desert island like an intrusive thought and I love this one in particular because my dad was great at this , when we were leaving for school in the morning, I was like 10 or 11, we were in the car backing down a driveway and he was going, maybe I left the stove on and I was saying dad, um, we had cereal for him. breakfast.

You know the stove was going to be used but he had to go check it and if I pressed him on the matter he said well, you know, one time I went back in and the stove was on and the house was burning justification justification I'm there for everything the obsessed life, well, the house would have burned down. I think it's a joke to come to some conclusion, but it fueled it and I feel like the conclusion of this is not so much, you know, the gas. in which it's maybe a kind of trivial annoyance or someone we feel obligated to do, but the impact of that, hopefully, isn't too emotionally heavy;

However, many intrusive thoughts, many automatic thoughts that are negative, have a much more impactful experience on our daily mood our daily level of anxiety and depression and it may also be that our daily anxiety or depression may be informing which intrusive thoughts appear , it is good, so if we are already in that state of feeling, we intend to do it. but if we are in a certain feeling state, we are much more likely to have certain thoughts associated with that feeling and vice versa, so friends, I hope you understand as we do as we take some turns with this, the basics of CBT .

You must be because no one has asked questions yet, but I hope it raises some questions about anxiety, depression and how we can really work with that very negative thinking that is something we all do. In fact, I feel like there is a part of our brain that Its job is to scan the horizon of our life, figure out what there is to worry about and then start worrying about it and we do it automatically and many times it has this function. What prevents us from getting into trouble or missing a problem that could arise in the future, but many times it becomes an impediment because we cannot turn it off and it creates a state of biological stress that is not functional for us as a starting point, yes. , and we want to enter into the negativity bias that yes, yes, little, we are leaving a little bit here, but we, as an organism, as a living creature, have built in us a Survival Mechanism that prioritizes paying attention to threats.

It's a threat that will possibly kill us or make our lives really difficult, so we need to pay close attention to that to survive, as well as negative thoughts and when we get stuck. In negative thinking patterns we are often actually victims of a survival mechanism that has served a purpose in our evolution when those threats are outside of us it is going to be too cold we need to hunt we need to get food to hunt and to solve our hunger problems um, but now with a lot of the survival needs taken care of, that same mechanism of paying attention to threats is still active, but now it's becoming our cognitions and threats to the kind of abstract qualities of our social maybes. survival, these threats are for status, social cohesion, connection, prestige and all that, it is good to know that our nervous system is integrated into what prioritizes negative thoughts, true, it is not pathological per se, it is not bad when we have That's right, it's part of our DNA, so to speak, so one of the things that I really like about cognitive behavioral therapy is that we really dig into what our thoughts are and there's a framework to understand some of the ways in which we distort reality.

This is by David Burns, a great feel-good book and there are more cognitive distortions than this, but these are ten of them and it's really helpful to be able to look at our thoughts from the perspective of a being that has a thought so that we don't have to. feeling like we are our thoughts, but we are a person who is experiencing this mind that is constantly generating thoughts and sometimes that thought is really stable and steady and strong and kind of on time in terms of being connected. with reality and not with magical thinking and other times when we are anxious, distressed and depressed, cognitive distortions like the ones listed here come up more and we have to figure out how to deal with them, so one of the things that really bothers me I like this approach to anxiety and depression, and by the way, we won't get too deep into the research, but CBT strategies have been shown to be as effective as medications and the only therapy that's as effective that I've come across. as a medication for anxiety and depression and part of the reason I think it is so helpful is because we can all use these strategies day to day in the moment to work with our thoughts and be able to feel a sense of confidence and have strategies that actually work to help us influence our thoughts, behaviors and feelings rather than just feeling overwhelmed by them and it starts here being able to have a sort of meta framework to look at our thinking, particularly our distressed thoughts, so a task It could be if you are in therapy to write down during the week some of the things that are causing you great anxiety or feelings of depression, they may be on a scale of one to ten and you write down those thoughts and then go back to the ones that you observe.

Okay, so does this fit into any of these distorted categories of thinking and what might be a more functional, honest kind of authenticity in touch with the truth of reality? It's not that we're just trying to create some kind of arbitrarily positive worldview that's not connected to the world. but we also don't want to be in this arbitrarily negative, cognitively distorted worldview that we're trying to not allow that negative bias that we tend to have to really govern our thoughts, feelings and emotions, yeah, so I want to invite you now because I said we would do well some techniques and we just talked about some techniques, let's do it, that's right, so why don't you, if you have a piece of paper in a pen, write down some of the disturbing thoughts that you've had. today you can have some of these thoughts today is Wednesday November 9th do you want to put them in the chat or is it that oh um no you don't need to put them in the chat I just want you to write three three or four thoughts, if you had problems today, that's okay and now See if you can handle each of those thoughts, just identify if they fall into one of the categories of the ten that are in this slot, oh my goodness, I'm a great fortune teller.

I'm already looking at five B's, I'm just really good at it, I'm just like oh, this is going to be a disaster, yeah, yeah. I like to call that guy as my meteorologist, your weatherman because he predicts the future, but he is often wrong, but Yes, yes, I lovingly take a proactive way to divide your mind and your personality different from something good, that is another technique that we could get into and then it's advanced, it's the best, yeah, I get into catastrophizing, but it's not there, maybe about Jim mm, yeah, maybe overgeneralization could be a version of catastrophizing well and This is not an exhaustive list.

I urge people to read that book.to feel good if you really like this as a practice. I think that's where the real strength of this comes in, it's not just some sort of intellectual truth that we touch on once, but it's more of a way of working day by day with our thoughts so that we're not subject to feeling overwhelmed by the ups and downs. One thing I often tell my clients is until I am myself your mind is not much of a friend, it can be quite fickle, especially when we are struggling with anxiety and depression, our mind can be quite intimidating and it can tell us and give us all kinds of stories, opinions and judgments. about ourselves in the world that are incredibly bad, unhelpful, rude and not really being a good friend, so one of the ways I see CBT practice is to develop a relationship with your mind in such a way that you are able of cultivating a discriminating awareness about when your mind offers you things that are useful and when your mind offers you things that are not useful and many of these things in the cognitive distortion table are not useful, some of them could be useful in certain contexts , but that is one of the things that we would be developing as a skill in CBT: our ability to take that perspective, discriminate our thought patterns and notice if it is useful or unhelpful, and if it is not useful, then we do other work. about developing some flexibility to get out of that stream of thought and into another one that may be more useful.

It is a good introduction to talk about the different types of interventions that are carried out in general. You certainly know that this is at The level of images and images is a great resource for us to think about and rehearse stressful situations or things where we might feel emotionally volatile and we try to imagine ourselves in a better place and in a better place. A lot of this is really trying to map out where our thinking patterns and our emotional patterns go and where these stressful experiences are here, of course, it's a mess with this trauma that he's maintaining, so I have to worry because it's happened. and now it's all consuming mm-hmm and if you're interested in more of this performance psychology thing, there's a lot of research into its performance ecology about mental rehearsals and visualizations and how effective it can be in achieving that. different outcomes in our lives can't delve into an example, yes, so often in high school there is a tremendous amount of anxiety that children begin to experience because their ability to think and experience emotions is greater and the school system encourages them. less in the same way.

An elementary classroom in the elementary school system is more about a nurturing community, so we create a lot of anxiety for high school students and it's really difficult, as a kind of new experience for them, to figure out how to work with it. I had great success having children and we can do this as adults. I certainly do this for myself. um, being able to think ahead about experiences that they've had in the past where they felt confident, excited, successful, and, um, you know. an example could be when someone is doing something sporty, I'm skiing down a mountain, maybe it's a specific moment, which is useful, the more sensorially rich we have the experience, the better so we can get the person to think about that moment in the moment. who were very successful in what the snow felt like in the sounds that they heard and in really bringing the emotional experience of that confidence and that success, and one option is something that I have used often with children who wake up stressed to go to school. the school.

It's coming up with three scenarios like that and spending a minute going through those scenarios where Rhian was seeing them in real time, then taking a few breaths, then taking the next one, taking a few breaths, then taking the last one and everything. What we're doing is trying to give our mind a script to follow to get out the door in a time that is classically difficult, where in fact they have a script to follow, it's just negative and they didn't decide on it intentionally, it's just kind. It started to form as a habit and we're trying to replace that kind of unconscious intrusive negative thinking with something that's going to be much more helpful to them and remind them that okay, here are these moments where I felt safe and successful.

I was in a social experience and I felt successful and I can imagine it and remember it and use that visualization as a way to feel the experience again and from that field and move forward into my day instead of feeling, oh this, you know the biological response. to anxiety I really like what you said about you know we have each other, we have scripts that we follow all the time and the question is do those scripts work for us and it sounds like what you're saying is if not, then it's a process in one that we can intentionally engage in to find some new scripts that can put us in a state of mind and frame of emotional experience that might be more conducive to facing the challenges in front of us.

I think that's great and I think that and I think it's really good to look at our kind of unconscious scripts and see if they're healthy or not, because I find that, as adults, most of us are good when we're stressed, when we get anxious, We tend to self-correct in the wrong direction, we don't care or take care of ourselves no matter how much we try to push ourselves harder and harder to a breaking point, so this slide is just about the classic CBT intervention steps, it's a kind of outlining like here, but the idea is that we're really trying to clarify what we're working on and trying to accomplish in therapy, so we're identifying the challenging behaviors that we're trying to figure out if the behavior is something that's happening in excess or in deficit and then we look for a baseline to evaluate, you know the frequency and the intensity and then we look for, what are the actual steps so that you know, decrease the intensity, the frequency, the duration or vice versa to increase it?

So it's a way to really break it down almost into scientific experiments, as you know, this is the goal, try this intervention, see what happens in terms of our thoughts and emotions, and that approach is something that often makes CBT a practice in the office that can be more short-term, you know, we are not doing a kind of deep planting and remember the years and years of your childhood, it is common that you know how to discover some strategies to use, practice them in the office, do some tasks and then Going back and reporting how it worked in troubleshooting, now I think we can go ahead and address this.

We'll have more discussion time at the end, right, yeah, great, okay, then, okay. I love this slide because it's not really what we're trying to do with our cognitive restructuring. We're looking at a situation here where someone tells Pinocchio and I don't know what he is and Rudolph that um, there's nothing wrong. with your nose right so you don't have to feel bad or something that you're aware of and that's not what we're advocating therapeutically with cognitive behavioral therapy we're looking for something that's actually what I'm going to do. To feel authentically true is not just magical positive thinking, but something that passes the test of reality in our core beliefs, because if we are simply trying to convince ourselves of something that deep down we know is not true or that the world is reflects on us is not true, it doesn't really have the benefit that we are looking mm-hmm, so the cognitive restructuring in this might seem like a good thing, my nose may be unique and different, but it is how it is. saved Santa, saved Santa and helps me be honest and helps me be honest, my nose, otherwise I would be honest, very good, so I found a way to maybe put an area of ​​concern into a value framework , so let's look at this.

From the experience of depression and the thoughts we often see with depression, you know that nothing I try is going to matter, so why bother? This I feel is a little more challenging because someone who is anxious often has the energy to try a lot. of interventions, but when we're depressed it's like I know I could go for a run or I could clean my house, but I just don't feel like it, so I fix it, how do we fix it? Boy, I take this from a different approach that we'll get into later, but um, so here's this, this thought that keeps you in bed, nothing I do is going to matter, so why do anything anyway ?

Yes, this is inside and then you just throw the sheets away. and I'm just going to sleep the rest of the day to put on my Netflix and just wallow, just be here, my therapist tells me all I have to do is wake up and go to the gym for half an hour and then then I'll be fine, yeah, well , that therapist is making a lot of promises, it wasn't a win or a loss, more on that later, but what we're looking to do is actually fine, so let's say that going to the gym is actually a value for the client who wants to be healthy He wants to have vital vitae, it is important that he take care of his health, he is fine, but he is very depressed and feels that he is under the weight of the oppression of the thought that nothing he does is going to work.

It matters so why do anything? okay, let's do an experiment right here, right now, okay, because CBT says that there is a relationship between our thoughts and our behavior, right feelings on the Internet, yes, we feel depressed with low energy, we have thoughts that keep us low energy, nothing I haven't done. It matters, so why do anything? Just staying down and then we act, that's a fundamental reason, yes, okay, it makes sense, so what if instead of changing the thought we change the relationship we have with the thought, right? We talked before about part of Actually, this is developing a relationship with our mind where we can see what is useful and what is not useful and then we learn to disengage it, yes, so the thought is that nothing you do It's going to matter anyway, so I do anything if we want to have more health and vitality in life is that thought useful to achieve that end is not right, it keeps us depressed it keeps us away from activities that historically provide health and vitality they give us the opportunity to connect with people, that's all good, okay, it's so useless, so, um, traditional CBT might say Well, we need to replace thinking.

I'm going to take a different tack and say that we need to change the relationship with that thought. Alright. So it's not about never thinking about these automatics. Yes, I'm going to say that the thought is not the. The enemy here is the relationship with the thought that buys that thought and believes it and then follows it as a justification and a rationale for doing nothing, okay, okay, so everyone at home or at work, wherever If they are, hopefully, not driving, this won't work. It does not reside only if you are driving while driving so if you are sitting this will work very well so think I don't want to stand up standing is meaningless what's the point of not holding me up and keeping us upright ?

What's the use? Yes, keep that thought in your mind as if it were as clear as crystal. And this is a true thought. Ah, standing right now is pointless. Yeah, okay, my hip hurts. Okay, so now what I want you to do is try it. stand up while holding that thought do I really do this? Yes, I'm still ahead, yes, do it well, excellent, if Dan is now standing, I hope many of you at home are okay too, so this is a bit of a silly but profound exercise. in the sense that what he does is demonstrate that there is a you that can identify with your thoughts and that can do something different from you.

What your thoughts tell you, your thoughts are not causative and it doesn't matter how much sense your thoughts make if they do. are not useful, so we have to find a way to step aside and act despite our thoughts, okay, so we are late, we are the being that has the thoughts instead of just the thoughts exactly exactly Well, here There is another type of this is not the right, right approach to an unkind restructuring. We're trying to figure out how to not just imagine ourselves feeling blissful, but also really connect with our lives and with our inner and outer world in a way that is effective I don't really want to do homework um, this slide is about how our core beliefs are tied to our thoughts about ourselves and our future and other people and one of the things that uh What we've discovered in some of the brain studies about what we do when we think is that a lot of times when we're just reflecting on ourselves in relation to other people and in relation to the future, this is not really the case. um functional, it stresses us out and we are not making plans, strategizing or reflecting as we would if we were activatingour frontal lobes, we're just in different parts of our brain where we're ruminating and worrying without any real problem to solve, so part of the cognitive behavioral therapy strategies is to try to figure out what those core beliefs about ourselves are. and other people in the future and how they serve us or not and how we can actually achieve it. in contact with them because some of them are so deep that it's like a fish in water where it's hard to really see how a belief affects us because it seems like such an obvious truth that it's not even questioned, yeah, and then do you think that some of them We can believe these fundamental beliefs, but sometimes we wish we didn't believe them?

We weak people do not want to believe that, as if it were a negative belief about ourselves, as if we were weak and nobody. He likes me, right, I'm never going to be in a relationship, I'm never, I'm never going to be in a relationship, maybe he believes that, but we can even have a relationship that disproves that belief, but the belief is still classified there, right? right, well, and I feel like beliefs are also very good at ruling out new information, so if I feel like I'm not going to get into a relationship and you say oh no, you know I've seen the way you talk to people. and you are very charismatic and I think you have many qualities that would attract people to you.

I'll be thinking Brooks in the back of my head, right? I know what you're talking about, you're just saying Let it be nice things like that that just discount your input and confirm my belief and that's often automatic, right, it's not even a choice I'm making, it's just my thoughts that align with what I feel like I know. To be true, if anyone has ever had an argument with someone you love and the argument became quite heated because you are quite committed to being right and you sacrificed being happy and kept making your point. I'm trying to force it.

For this person to see that you're right and that somehow undermines some of the trust in the relationship made it kind of gross to be there. You know how powerful the impulse is for us to be right, so if you can, do another little experiment here. Write one: a fundamental belief or fear. I call them core beliefs or fears about yourself, a judgment that is common and that you are aware of. To me it's like it's a little lazy, right? um, if you look at that belief. and if that belief were not true, who would be wrong?

Who would be wrong if that weren't true? You write so big. That is the case. I would be wrong if that weren't true. And yet, I often am. I've invested in being right at the expense of my own happiness because we don't really want to be wrong, it's pretty threatening to be wrong too, so we can start to see where you know these core beliefs can really back us into a corner when they're not serving us, but abandoning them means that We have to admit that we are wrong and that we are right, fallible. There was a book I read when I was 20 called You Can Heal Your Life by Louise Hay, I think so, and Asik and I. at least she can lose hey, I think it's hey hey um and at the end of each chapter she had this as a kind of verse or a saying that you could tell yourself to focus on the positive and it was a healthy way to start the day. , the idea was, you know, to come back to this almost as a prayer for your day, an affirmation, yes, an affirmation mantra and it was, um, I think one of the reasons why that book was published.

It was so successful that people used it and it worked like it was really helpful to find some kind of affirmation phrases that are personally meaningful to you and allow you to think about it and focus on it on a regular basis throughout the day. weeks, they will be an interesting experiment considering what you said earlier that we will discount competitive information that competes or that prevalidation validates a core belief, we also have a confirmation bias where we look for information that does validate. is correct and so if you are testing a different claim, it would be interesting to see if you were also looking for experiences, moments in the interactions of your day that you have that would affirm the claim and validate that information, in which case then getting a much better picture. fuller understanding of the complexity and multivalent nature of the self.

I like multi-balanced, that's a big word. Do you want to give three waves? Because, oh yeah, all we have is we can get into this. Brooks is like an expert on Act that we'll hear from in the third wave, so I think you know a lot about the history of what's happening with cognitive behavioral thinking, yeah, so cognitive behavioral therapy is situated in the family of behavioral therapy and we can analyze it. Of three main waves, big kinds of paradigm shifts in the evolution of behavior therapy, one wave was a kind of classical behaviorism that really looked at the type of animal behavior and really only looked at the observable phenomena that could be measured by an outside observer. . the scientist, so no thoughts or feelings were relevant to learning theories in the first wave of honest behaviorism and then, but they were presented with a problem where humans were quite different from animals in the laboratory, we responded differently, We had different vulnerabilities, we had different strengths, obviously, and there was this kind of question about how do we incorporate what we know influences human behavior, which is our thoughts and feelings, that inner life, how do we incorporate that into a science of understanding the phenomena? that we can observe empirically.

Anyway, Aaron Beck brought a whole stream of cognitive science into the behavioral therapy literature and under the ambit of behavioral therapy and created cognitive-behavioral therapies, his point of view is quite dominant for about thirty years, forty years, it's still very, very prevalent and, uh, but what's happening now in the field of CBT is a third wave in the sense that you can see that there is a mindfulness-based cognitive therapy DBT where the third wave says "hey, maybe it's not so much that the thoughts we have are causing our behaviors and we're traditional CBT or the second wave says, come on." just change the bad thoughts, dispute it, we will get rid of them and put the good thoughts in the third wave, it says, well, we can't really get rid of the thoughts, but what we can do is change our relationship with the thought. so that we can establish an alliance with an aspect of ourselves that is able to step out of the stream of thought and feeling and take perspective that this is like what we did with these blows.

I can't get up, but you really can. arise, yes, so that there is a part of you that can observe the thought and act independently of what the thought tells you to do. You don't need to change thinking to change behavior, you just need to change your relationship with thinking the feeling in order and then behaving differently, so we should apply that to the question of one of our viewers, Jan Hillman, who is experiencing post-election depression and anxiety and now your relationship with your thoughts is that your thoughts are actually logical, so it's for example how to get more functional thinking if you feel like your thoughts are already correct, this becomes problematic because in CBT Second wave is about whether it is logical or illogical.

Well, in second wave CBT, I would say Jan just thinks about a time when you were boogieboarding in the ocean and just visualize that constantly and find the location of your happiness whenever you have anxiety or depression and you notice it, you know. , go for a trigger that will get you into a better state of mind, right? it's seeing depression and anxiety as an enemy that we must subdue and turn away from, so in a third wave, let's look at this from a third wave perspective and I'll just look at it from an act perspective, okay, from an act perspective.

Jay and I ask you well, what is this, what are these thoughts, what is the challenge here, telling you what is important and may it be that some of your anxiety and depression about the election is knowing that you have values ​​that you feel are valid? threatened and there is a fear of a society that treats people differently than you would want them to be treated and so from this perspective we can see what is really important here in terms of living your best life, living a good life. that is aligned. with your core values ​​and let's find those thoughts and let's find those strategies that will be useful in developing a more value-rich repertoire of behavior because in our post-election depression and anxiety a response to that is like the world is going to do it. marijuana and there's nothing I can do about it and I'm just going to watch Netflix for the next four years and wake up when the next national election happens, that would be one of the responses we might have to fearing that when we look outward. in the world is going to give us a reflection that we do not want to see, it is going to give us all kinds of pain and fear in anguish and, yet, that would not be an answer that would lead us to really connect with a meaning. of vitality and purpose and a sense of agency that you can really respond functionally to the challenges of the world and if you can really respond functionally to the challenges you will be in a much better place and we know that there is a lot of behavioral about this that if you have a sense of control and agency then your experience of distress is significantly diminished, so although your thoughts may be logical, the question now is what do we do, where does it fit, tell Janux to go away. on a bike ride for like 20 miles oh, I think I think then I think Jan should definitely go for a bike ride, okay every morning and then it'll be here, well, will it be the door that goes back to our previous one?

They are angry? interventions, the results of the elections will still be valid, yes, so the question is, Jan, what do you want in your life and what will be useful for you to move in that direction and what does this anxiety in this depression tell you about what which is more important. Does it make sense for what you care about: the values ​​you have, the vision you have for our society, for your loved ones for the next generation, and is there a way we can develop strategies that take those newly clarified values ​​and set some goals in some cases? developing activities so that you can get more of that value in your life ah, the polygraph talks about anxiety right, right, um, very good, one of the really interesting things about the third wave of cognitive behavioral therapy is that not looking at our experience, whether it's thoughts or feelings as an enemy that we need to subdue and get rid of, more like, you know, what we're talking about before, it's more like, it's like this process that we need to befriend. to get familiar and we also need to learn to open up, so let's do a thought experiment here to give you an idea of ​​why we would take this different approach.

It seemed that CBT works as well as medication. Why change it? Here's a little thought experiment, so imagine you're hooked up to the world's most sensitive polygraph machine. This will measure any changes in your initial level of anxiety and I will know. Imagine you are sitting on this. room with me I'm there with you connect to this polygraph I'm going to give you a job in a job just to do and this job is to not make you anxious it's super important that you learn to control your anxiety here because we all know what happens if you don't, so to motivate you to learn this simple thing, if you get anxious I will shoot you with a gun, that's great motivation, sure, it's a horrible setup. just go there, it's a horrible setup and yet this is a setup that actually happens in many of the ways that we normally very reasonably address problematic feelings like depression and anxiety, the setup is okay, anxiety it's a problem yeah I shouldn't have it I should be able to control it if it comes up and I can't control it that's a really big problem and even worse things are going to happen yeah right so if I get anxious I'll get shot.

I'm going to lose my I'm going to lose my job I'm going to fail this presentation and it's just going to be proof that I'm just a worthless idiot, right, it's going to get worse, so in this situation in this scenario. what we have control over is that we don't actually have control over our anxiety and the problem is that the more we try to control it, the more there is at stake in our need to control it, the less likely we are to do it. have it under safe control at the moment. I'm totally with you, but couldn't we do some Becky thing and reach out and say? um you know, think happy thoughts and run a lot before your stressful activity to reduce anxiety like Can't we learn techniques to reduce our anxiety and then use them instead of just going well?

It is inevitable that we have no control, so yes, we can definitely learn how to do things that will be helpful in controlling our anxiety, but at the same time. At the basic level, we have tobeing willing to tolerate anxiety and recognize it as a natural process of living a meaningful life so that it doesn't become so problematic that it paralyzes our ability to move toward something meaningful because anxiety will show up in such a significant way. If we have the belief that anxiety cannot appear anxiety cannot be here if so it is going to be a problem it is going to be a big problem for me that is a problematic framework that is a recipe for creating anxiety so If Erin answers: “Oh, I know how to fix this anxiety,” the implicit message is that anxiety is a problem, but if the message is “you know what,” before doing something very anxiety-inducing, it might be interesting to see if your feet feel firmly. planted on the ground taking a few slow, measured breaths going for a run, let's experience how you can become flexible with anxiety instead of how you can become an anxiety exterminator hmm, I like that, okay, I still feel my inherent biases complain to get rid of it because it feels more comfortable I feel more comfortable when I'm not anxious right, we all do it well anxiety is an activated and excited state that prepared us to take some protective measures right, it's like it's not comfortable so We want to do something we can do to deal with the threat so we can get back to a comfortable place, so it's completely reasonable, the problem is that when all the threats are internal, we can have a kind of intrusive thought that then makes us anxious. . and then if we see the danger that anxiety is a problem, we become anxious about our anxiety, in which case it's this feedback loop that just gets out of control.

I see that makes sense, so let's say I'm going into an exam that I feel a lot of stress about because there are, you know, consequences, yeah, um, and I have the belief that if I'm anxious, my performance will be worse because the anxiety prevents so the brain can access its functions.problem solving and logical thinking parts um, what do I do, right? I want to have some kind of visualization, some affirmations to go into, like I have this, like everything is okay, you know, I've studied or whatever. I know just a few things to psych myself up, yeah, so I think I think, so you're asking how I deal with it, there's the feeling and then there's the thinking, yeah, and then there's a behavioral thing, what's going to happen?

How can I relate to my thoughts and feelings so I can have optimal behavior in this context? I think the research shows that yes, it can be really helpful to have other thoughts that we can turn to. that might give us more flexibility so that we can focus on our performance instead of focusing on our anxiety because often what happens is when we get anxious and we see anxiety as a problem, our resources are going to turn inward and we're Let's gather our resources to get rid of the anxiety, yes, and if we spend 50 minutes doing that and we don't take the exam well, then suddenly our anxiety has created the result that we feared, so if we can really identify the core belief that is operating in that situation, like my anxieties, my anxiety is a problem and it will prevent me from getting a good grade, and if I don't get a good grade, I'm going to be a failure, I'm a failure, right, if we can identify which you might want to write it down, we'll have done a little bit of work on this in our CBT session, identifying those beliefs and then looking at some other beliefs that may be more helpful so you can start to recognize oh, this isn't a really unhelpful belief, it causes many feelings, it is powerful and I am aware of it.

I'm having the thought rather than the thought having me, so if we can identify it, see it for what it is, which is a thought that comes from our own history of having perfectionist parents or whatever, and then really see which ones might be more useful thoughts, it could be to feel your feet on the ground and do your best. You can, well, pay attention to what the question is asking, look, we could generate a lot of more adaptive thoughts that we can then shift our attention to and see if it actually holds those thoughts, they are more useful, yes, and this is something that I Like you said, you know in therapy we would work on that because it's definitely a practice that's best done outside of the intensity of the moment right once we're in crisis mode taking the test or in a socially anxious situation.

Developing at that moment your cognitive strategies, the thoughts that you are going to resort to, is a heroic task, which is why we want you to know that you have done that work in advance and practice it in similar but less intense situations so that we can really have it in our minds. bones as a strategy, yes, and a lot of times I think signs of anxiety are signs of more anxiety, but you feel the anxiety come on and then you get anxious, so a lot of times what would be working and I would recommend it.

This for people in the audience is that when we recognize a signal, one of the feelings associated with a problematic core belief, when we feel those signals, it can be really helpful to develop a new relationship with those signals, where instead of just shooting up . in our heads and where we've been involved in a lot of cognitive distortions rather than just bringing conscious awareness to the feelings themselves, where we can then develop a sort of larger container for the anxious feelings. run their course instead of keeping them in an echo chamber where every sign just triggers more and more anxiety, so we have a big question here that I can totally relate to: You know, this is what dealing with depression is, right?

We have some strategies that we recommend that have this level of energy that needs to be in place to be able to do these strategies, how do we overcome that feeling of boredom that we just can't dig out to get out of bed or to do the word, you know, exercise Or make a list of things I'm going to do today to make you feel better. I'm so wondering about this question because I feel like that's why anxiety feels like there's this kind of potential energy that's ready to arise, we have energy and depression often feels like there's a void of that energy and if someone tells me oh, action is the antidote to depression, it's like, well, why us, but like I said, yeah, that's not happening, yeah, you did.

To your point, with depression there's a lot of inertia and energy that sticks around and it's hard to get moving and one of the gold standards of depression research is behavioral activation, but it's the chicken and the egg in terms of classification. the energy needed to walk out the door, put on the shoes to do it, and from the language of behavior, it's an exit process of shaping and one of the things that by shaping I mean starting with small steps and moving toward the goal. which could be going to the gym for half an hour a day, but it could start with going for a run, putting on your running shoes and that's it, but one of the things that is problematic and maintaining depression is the way we relate to our depression. thinking errors thinking strategies we engage in that serve to reinforce a state of depression in which we are accepting the type of toxic thoughts our minds give us about ourselves, about the world, about the futility of hope, while We buy all the things. that we tend to notice that our energy gets more depressed and one of the things about depression is that it's always like this, it's always just this numb fog, blah, which is an eternalization, so one thing that's really helpful is getting out. of that.

Think about it and question it with your experience and look for slight variations in the texture of the experience and be curious about Oh, after I shower I have a little more energy and that could be a sign or a way to develop some strategies that will help me. To be looking at how we increase the line of that upward curve in terms of our energy, does that make sense? Yeah, okay, umm, final thought on a job we're in at the same time, but I feel like you're the Netflix solution, right? I'm depressed, I'm going to watch Netflix, there's kind of a short-term and long-term vision for relieving the symptoms of depression or anxiety and a lot of times there's short-term escapes with technology or whatever someone knows. addictive options that provide temporary relief and sometimes I'm all for that.

I think if you can do it without too much negative, whatever the behavioral downsides or really the long-term downsides, a lot of times our short-term escapes from uncomfortable feelings, difficult thoughts and emotions are behaviors that create long-term problems, probably bigger in the future, so you know something like Netflix. I think, although there is research that shows that the more I am doing. Things like that online reach a threshold where it starts to feel depressing and we have less motivation and that sort of thing, in terms of short-term benefit, is often quite good as it offsets the long-term cost, where there are much more. extreme escapes that are more dangerous in the long term, yes, but we just got a question when ringing a follow-up for adolescents and CBT interventions that are effective for high school kids, please, I think one thing we can say about that is that um, in the last webinar there was also a request to address high school students and the social stress and social challenges that they face, so we're going to do that in the spring and we can look to incorporate a lot of the things from the We've been talking through the lens. of teenagers during that workshop and just the one that you did with an example earlier in the webinar about morning and developing a new script based on moments of facing challenges with confidence, so yeah, I think it's a good time to start delve into CBT strategies that people can use on their own in early adolescence because there is the ability to start to metacognate and really conceptualize our own experience anyway.

I hope this has been really helpful to you. Thank you very much for joining us and there will be an email sent with a link on how to find us if you want to do UM, please check back later. Thank you very much, hello guys.