Don’t go in thinking that these are the only methods. I found the counting doesn’t work, and mindfulness is more likely to cause anxiety in me. I just use the stay in bed thing, and refuse to move around if I wake up in the middle of the night. As long as I don’t move around, I don’t really get woken up. The rest is just getting into a routine.
Oh, that and the opposite of believing it is so dadgommed important–that’s what will make you catastrophize if you start having problems. A lot of people in the world have survived a few nights of not sleeping. I’m actually to the point where I say “So what if it takes a few years off my life? Why is that more important than not being afraid? Is it worth worrying about that and not getting to sleep?”
ETA: Also, I wish my fears were the more practical like olives’s and could have been so easily refuted. All I ever worry about with not sleeping is how I won’t be able to handle the way I feel. For me, the irrational like a burglar coming in is easy to dismiss.
I hope you didn’t mean it this way, but this comes across as very dismissive of olives’ post. For you, it might be easy to dismiss a fear such as a burglar coming in. For others, not so much.
When recalling the more ‘fearful’ kinds of thoughts that get me worked up, my mental processes are the kind that say, “You have to get eight hours of sleep!” A lot of the time, because I start off already tired, I also get frustrated when I can’t sleep. Maybe that is something to work on.
If the sleep restriction keeps up the way it is, I might not even have a chance to do CBT. As soon as my head hits the pillow, I’m out. My body is supposed to adapt, though; even if it didn’t, this is no way to live life in the long term. I really hope that the sleep restriction puts me in a good subconscious frame of mind to practice the CBT.
One last question…with some of the CBT being about mindfulness, is it something that could be adapted to mindless eating? I’m on Weight Watchers right now, but a big chunk of my weight problem is because of eating while bored, emotional, etc. If CBT can be applied to help me out in that way, I would stand a much better chance of maintaining my weight loss in the long term.
Thanks for the information, everyone. This has been very helpful!
Aaand, I just figured out that you two are married. Sounds like you and my hubby would get along great.
Different techniques are going to work better for different people. In your case you’re still addressing the distressing thoughts with rational refutations. There is something of a friendly rivalry between behavioral and cognitive psychologists, as some recent evidence indicates that behavioral therapy does the same thing as cognitive therapy better and more efficiently, but for me personally, confronting and analyzing the thoughts is pretty crucial to successfully overcoming depression, whereas behavioral methods are best for overcoming anxiety. The key is to find what works for you in different contexts and stick with it.
I never meant to give the impression my beliefs were easy to refute. I would never want to give the impression that any of this is easy – because it’s hard work. It’s hard and uncomfortable work, which is why some people reject it without really giving it a chance.
My journey was also made easier by the fact that I’ve done prolonged exposure multiple times and I believe STRONGLY in the power of CBT. There is no problem in my life I have ever had that didn’t respond to applied CBT. I’m particularly a fan and veteran of exposure… I did prolonged exposure for severe PTSD last year and it worked very well. After 10 years of trying to ‘‘talk it out’’ with no success, a simple but intense 3-month regimen of prolonged exposure resolved 80% of my PTSD problems (treatment consisted of 3 months two hours daily of hyperventilation, crying, and reliving past trauma… this is no joke. The ‘‘night terror’’ issue described in this thread was one of those lingering symptoms of my PTSD that had be dealt with in vivo.) So this axe-murderer stuff was really small potatoes compared to what I went through last Fall.
BigT, I get the impression from your posting history that you believe your anxiety is special and abnormal and therefore Very Hard to Treat. The reality is that anxiety disorders are predictable, universal, and highly treatable. My PTSD flashbacks may be superficially different than your panic attacks, but anxiety is anxiety. It is triggered by a stimulus, it is accompanied by frightening physical sensations (such as heart palpitations, shaking, sweaty palms, dizziness, nausea, etc.), it is often accompanied and exacerbated by distorted thinking (‘‘I’m gonna die,’’ ‘‘I can’t take this,’’ etc.) it peaks after a certain period of time, and it is extremely unpleasant and undesirable for anyone who goes through it.
The good news is, all anxiety disorders are perpetuated and reinforced by certain behaviors and attitudes and are diminished and extinguished by others. Those particular behaviors and attitudes have been researched exhaustively through randomized controlled trials and solidified into the theoretical framework now recognized as ‘‘CBT.’’ There is no other treatment that can even compare in terms of scientific validity. If something isn’t ‘‘clicking’’ for you, I guarantee you there are at least 50,000 research papers explaining why and proposing corrective solutions. Any good therapist should be able to summarize that research and help you correct whatever is holding you back.
I realize I may sound like an evangelist, BigT, but I do it out of love. I’ve been through this on an epic scale. I’ve been diagnosed with no fewer than six anxiety disorders over the last 10 years - not all at once, but due to the nebulous nature of my PTSD (#1), I have been successively diagnosed, I shit you not, with panic disorder (#2), agoraphobia (#3), social anxiety disorder (#4), generalized anxiety disorder (#5) and, finally and most sensibly, anxiety disorder NOS (#6.) They were all variations on the same theme, when I finally, out of pure desperation, switched to CBT, my life changed immediately and forever. I can’t force anyone to see my POV, but I can testify my heart out and hope that someone who has suffered enough finally decides this is the day they are going to take charge of their own mental health.
What does sleep restriction involve? I haven’t heard of it before. Is it basically deprive you of sleep until you have no choice but to sleep?
CBT can definitely be applied to improved physical health. If you’re interested in the neuropsychology of overreating and how CBT can help, there’s a book called The End of Overeating which is pretty eye-opening. I also strongly recommend the free nutrition and exercise website www.sparkpeople.com. It’s an extremely positive and supportive and action-focused environment. My handle is RACINGSLUG if you wanna add me. I’ve maintained a 50 pound weight-loss thanks to their website. Part of it is getting past the belief that weight-loss is an all-or-nothing deal. It’s something you falter at, you backslide, you have to pick yourself up and carry on. I backslid this summer and gained 10 pounds, oh well, I know how to lose it, I just have to make it a priority. The idea that we can all achieve this perfect physical ideal is a cognitive distortion. Even at my healthiest I never looked like a supermodel. Health looks different on every person, and for some people achieving a perfect BMI is never a realistic goal, but you know when you are healthy because every cell in your body sings.
It’s funny you started this thread, because some nights when I go to bed I feel for no apparent reason that someone just injected me with massive doses of stimulant. It’s that ‘‘I just drank a 2-litre of mountain dew’’ feeling even though I don’t do caffeine. Last night was one of those nights. I was just wired.
I kept thinking about crap beyond my control. The topic du jour was actually this thread. I spent about 30 minutes trying to figure out the best way to respond to BigT. This might be comparable to your ruminations about how important sleep is – just some thought that distracts you from the business of sleeping.
Then I remembered the counting. One thing I didn’t add above is that it helps to visualize the numbers when you count – try to see them in your head. That way your visual cortex is occupied too. Anyway, I made it from 50 to 35 and I was out like a light. Even with all that adrenaline, the counting bored me to sleep.
Mithril - The primary issue I have dealt with in therapy is eating/weight, and it has been extremely successful, to the point where not only am I maintaining a good healthy weight, but I also don’t really need to think about weight or eating at all. It can definitely work.
I’ll let Mithril expand further, but olivesmarch4th (BTW just got your username), the sleep restriction is basically where she can’t go to sleep until midnight, and must get up at 6am. There are other rules regarding curtailing stimuli during certain hours, but thats essentially it - 6 hours of sleep. No more.
I’ve noticed what Mithril said - she’s asleep as soon as her head hits the pillow. After noticing that trend for a couple days, it occured to me that one of the benefits of sleep restriction might be to help train the mind into thinking ‘oh, a nice soft pillow. Time to go to…’ and then its out. After a few weeks of that, maybe it breaks the minds cycle of fretting about going to sleep and the anxiety associated with not falling asleep in a normal period of time. Sort of a pre-amble to CBT.
It’s funny - one of the running jokes between men and women is that women will ask a guy what he’s thinking, and a guy will respond with ‘nothing’ and totally mean it. There ain’t much going on up there at that moment. That notion always seems to confuse women. So when it comes time to think of nothing and bore yourself to sleep, do men have an advantage in that department? Maybe that explains why women tend to be insomniacs more often? (or so I’ve read).
BigT, I truly don’t mean this as a pile-on of you, but from what you’ve been posting here in the last six months or so, it doesn’t sound to me like you are really using CBT. I think you’re still in “victim” mode, and still getting too much out of your anxiety to let it go yet - you’ve got a lot of knot left to still untangle.
As for using CBT for mindless eating, I use CBT for EVERYTHING! In it’s simplest form, it’s just a way of looking at the world as it actually is, stripped of as many of the distortions your mind creates as you can manage - in other words, you learn to call yourself on your own bullshit.
I’ve been taught a different way of counting that works better for me. Starting at 100 count backwards by three. The theory is that it engages your brain just that little bit so that it’s not free to wander. It’s harder than normal counting, but not too hard.
