A question for the thread: how do you motivate yourself to do CBT when you’re really depressed? As one of the characteristics of depression is inertia and a complete lack of motivation. I’m doing it now but I wish I’d done it in November and December, when I really felt like shit.
Part of my motivation was seeing that it actually works. First you have to take it on faith, that all those people telling you it works aren’t just bullshitting you. Then once you start seeing some results, you want more of that.
Pain itself can be a sufficient motivator. The beach meditation thing I described at the end of page 1 was something I had to do because I was feeling really down. Like almost in a panic down. I now see it as a really valuable tool. I turned pain into one of the most profound experiences of my life. Now I know I can draw on that whenever I want.
I have a really cool story about that.
The other day I was talking to someone on the phone. She geeks out on this stuff as much as I do. She asked how I get into a state of presence, and I described my beach experience. I don’t know what it was, maybe the sound of my voice was really hypnotic, maybe I was just feeling the experience – but she said that I put her into that state. I actually bestowed bliss over the phone. How cool is that? I should charge for this stuff…
And some people do! 
I got the questionnaire for my assessment today. Predictably, I worried that I wasn’t ‘getting it right’ whilst filling it out. Things like feelings are hard to put in ranked boxes, of course…
Seeing all the physical symptoms of anxiety laid out in a row was enlightening for one reason, at least. Most of my health anxiety-inducing symptoms are on that list, surprise surprise…
Hey all! I’m glad people are benefiting from this thread.
In the past couple weeks I’ve been really busy and absorbed in adopting a mindfulness practice. My husband and I did a weekend workshop related to mindfulness and weight loss, and I’m taking an eight-week class in Mindfulness Based Stress Reduction. So I’ve been working a lot on that, rather than CBT as such.
BUT I’m really struck by how mindfulness can help alleviate anxiety in particular, and how it is so wonderfully complementary to CBT. I never truly realized how busy my mind is, and how automatic my thoughts and reaction chains are, until I started mindfulness.
Also, some of the attitude cultivated in this practice are trust and acceptance, and I’ve found concentrating on those to be very helpful to my anxiety. Not only can I say to myself via CBT that a thought is catastrophizing, but I am working on leaving the catastrophe for when it actually arises, if it does, and trusting that I will endure it.
One thing about correcting distortions versus inserting falsely optimistic thoughts: there was a study that showed that displaying false positivity actually causes more stress in the body than honest negativity. So it is worth making the effort to zone in on reality, rather than just giving yourself a Stuart Smalley pep talk in the mirror that doesn’t ring true.
As to how to do CBT if you’re depressed and therefore have great difficulty accomplishing things - I have two ideas. One is to do the tiniest bit. Just carve out what seems a ridiculously small task, like correcting one thought a day, or only focusing on one distortion. As said above, it will probably help, and then you’ll find motivation to do more.
On the other hand, I have long referred to SSRIs as my “training wheels” that let me get up and running with a practice (CBT, exercise, and nutrition) that usually keeps my mood elevated without drugs. But sometimes I need the drugs to start up again after a lapse or something like an illness or surgery.
CBT and mindfulness really do work wonderfully together. I always recommend trying some mindful meditation in my anxiety group, but it seems like few people are willing to try it (and I can’t make them, dammit!). In some ways it really is as simple as just staying realistic, just staying in the moment. When you worry you’re in the future, and when you feel guilty or regretful, you’re in the past.
Doing one small thing is a great way to get motivated if you’re working on anxiety, too. Nothing succeeds like success.
So I had my assessment today. I was pretty happy with how it went – in particular, the therapist was not condescending to me and respected my intelligence.
My ‘job’ is to focus on short-circuiting the ruminations/cycles of anxiety. She’s not into ‘worksheets’ which is good because I’m not a huge fan of them either.
So this week I have to develop a few strategies on my own for ‘letting go’ of anxiety-provoking thought.
Anyone have any suggestions for distraction/short-circuiting strategies?
What works for me (mostly) is thinking to myself, “That isn’t happening now, so I’m not going to think about it now.” or “I’m not interested in thinking about that now.” It doesn’t work for, oh, the first 50 or so times you try it, but after awhile, your brain gets used to the idea that your conscious mind is calling the shots now. I also use visualizations; I’ll visualize kicking my worry out of my brain, or putting it in my hand and blowing it away like dandelion fluff. Part of what you’re doing is regaining your perspective on these things; so much of what we worry on really doesn’t matter; it’s just busywork for your brain.
Sometimes it really helps to write things down, regardless of how big a fan of worksheets you are. We have many paths to learning something; seeing, hearing, reading and writing are all paths, and the more paths you use, the better you learn something.
At some point, your therapist might get into “what if” versus “so what” (at least, she should). The what if thoughts are the ones that cause us problems - what if my car breaks down? what if my kid gets hurt? what if I have a panic attack in the movie? The so what thoughts are reassuring by putting things in perspective - so what if my car breaks down? I’ll call the auto club/my husband/my friend and get a tow and a ride. So what if I have a panic attack in the movie? I’ll get up and go out in the lobby to get a drink of water. So what if my kid gets hurt is a little harder; it’s more like, “I can’t control every circumstance in the world; I truly hope my kid doesn’t get hurt, but if he does, we’ll deal with it if it happens.”
It also helps to recognize your what if thoughts - when I’m ruminating and worrying, I’ll catch myself having what if thoughts and stop myself right there - “What kind of thought is that? Oh yeah, that’s a what if thought and can therefore be disregarded as the baseless worry it is.”
My therapist gave me an exercise once that I found amazingly helpful, though silly: Carry a brown paper bag everywhere you go. Whenever you find yourself thinking “should’s” or “ought to’s”, write it on a piece of paper and put it in the bag. End of the day, dump the contents of the bag into the trash. I loved this exercise, because for one thing it made me aware of how badly I was "should"ing myself to pieces, and then I loved the silliness of it (this thing must not be so terribly serious if it’s this ridiculous, if you know what I mean). You can’t really catastrophize something that silly, right?
That’s great, kayT. Dragging these worries out of our heads and into the light of day goes a long way to dispelling their power, I believe.
The paper bag thing is great! When I was a kid my father put paper bags next to our beds if we were having nighmares. If a monster tried to get us in our dreams, we were to grab the monster and put it in the bag. In the morning we were to throw the bag away. It worked!
And speaking of silly – You know those voices of the inner judges that you here? “You’re not enough.” “You’ll fail.” “The worst is going to happen.” Recast those voices in a silly way. I suggest making them sound like Disney’s Goofy. How much power can they have over you if they sound like Goofy?
All of these sound like good ideas. I will try them.
Thanks!
For immediate distraction, I go on random counting sprees - how many letters in a paragraph, how many steps until I reach a destination, and so on. I’ve never been terribly good at visualizing removing an anxiety source, but setting my mind into a more logical working-type mode helps greatly.
Funny, I do the exact opposite. I’ll notice things around me and just name them with out judgement, without labels. “That’s a tree. Nice tree. That’s a car. Nice car. That’s a river. Nice river.” Far from making me more logical, it takes me out of my head and puts me more into my body. Then whatever problems I might be facing seem really petty.
To put yourself more in your body (and more in the moment), you can also do an inventory of your senses - “What am I smelling now? What am I hearing now? What am I seeing now? What am I touching now? What is the temperature around me?” It sounds too simple to work, but I think I mentioned it earlier; when you’re worrying and fretting, you’re not in the moment. Chances are extremely good that the moment you’re actually in is not one worth getting upset over - you’re safe, you’re comfortable - nothing bad is happening to you.
Yes, you’re right. I was talking about what I was seeing, but I meant engaging all of my senses. Here’s a weird one: What does the inside of your mouth taste like right now?
Do you suddenly have the urge to have a mint? 
Well, since I just had a container of yogurt, I’m about to brush my teeth.