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Showing posts with label cognitive behavioral therapy. Show all posts
Showing posts with label cognitive behavioral therapy. Show all posts

Thursday, September 21, 2023

Emotional Content

Thursday, Sept 21, 2023


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It is always rewarding to see progress, no matter how small.


I recently picked up my kids for a short visitation. Pickup was 5:30 PM on Friday and drop-off was noon the next day. It’s not a lot of time, but I cherish it.


Something happened just as I was supposed to pick them up. It slammed my mood sideways, took over my thoughts, and threatened to ruin my time with the kids. They could tell I was in a bad mood, and they gave me the space and understanding that they shouldn’t HAVE to know how to give me.


Here’s the good part. I saw what was happening. I did a check in and did my best to change both my thoughts and my behavior. It wasn’t perfect, but I managed to savor the time I had with them. They responded to the change, and I think they recognized that I had swerved away from a potentially gloomy visit.


This is a small victory for me. But my kids know I am going to therapy and working on myself. I hope this example has planted seeds that will help them avoid the same problems in the future. A change in the system affects the whole system.


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In going over Mind Over Mood with my therapist, I shared with him a realization with him. I have told him story after story about life events that have affected me. He has even, on occasion, praised me for telling the stories in a way that doesn’t make me out to be a victim, or place blame on other people.


I mistook this praise as a sign that my storytelling was good. I hoped so, after all, since I am a writer. It turns out I had blind spots that I wasn’t aware of.


Go figure.


In doing the mood check-ins that I described in an earlier post, I kept uncovering moods that I hadn’t realized were part of the situations I’d been through. Sometimes these were subtle, easy to miss. Other times they were pretty massive, to the point where I was stunned that I had missed them at all.


Like humiliation.


I had described a massive event that I had gone through. One that left me shaken and off balance for some time. I had gone over everything in detail with my therapist, making sure that I was telling things as they were, to the best of my ability to do so, and leaving nothing important out. I knew there would be continual fallout from the experience for years to come, but I didn’t think I was leaving out anything so major as humiliation.


It wasn’t until I stopped to ask what my moods were during and after the event that I noticed that it was there. Frustration. Fear. Anger. And humiliation.


What my therapist told me struck me so hard that I stopped taking notes and just stared at my hand for some time. He said that I was very good at recounting the details of events that happened. I was like a journalist, or recounting a blow-by-blow in a movie. Nothing was left out.


Except emotion. 


My understanding of the situations I had been through lacked emotional content. A part of me was morbidly amused by this, because as a writer I know that storytelling without emotional content will bore the reader. Yet somehow, IN THERAPY, I had missed that crucial point.


He went on to say that in order to process emotions, I have to include them in my own story. They will linger, hidden behind things, polluting my thoughts and behavior unless I allow them to have a place in the narrative.


Somewhere along the way, I learned that telling THIS kind of story needed to be emotionless. I don’t know if it was out of a desire to be as correct as possible, without emotions clouding the facts. Or maybe my security reporting background steered my words, trying to make sure that I said only what happened, without putting opinion or feeling on the events - like an amateur journalist.

In therapy - especially emotionally-based or cognitive-behavioral therapy - that doesn’t work.


Well. What we’re good at can often hinder what we are bad at. It’s time for me to tell stories badly for a while, get it wrong, and flex that emotional content muscle until I get it right once more.


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What are my qualifications? None, except for my own experience and a desire to help. Going back to Doctor Who, “I am an idiot … passing through, helping out.” I hope my own struggle with my darkness can help you with yours, or understand the struggle of someone you love.


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Life before death

Strength before weakness

Journey before destination



Thursday, September 7, 2023

A Change In the System

Thursday, Sep 07, 2023



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I’ve been very ill with a respiratory illness for a while now. It’s wreaking havoc on work, sleep, and daily function, and has comorbid interactions (fun!) with my diabetes. It sucks.


And yet I’m doing much better, mentally and emotionally. I always feel weird when people ask me how I am, because I tell them all the awful stuff happening with my body and then say I’m doing really well.


I guess it goes to show that you don’t have to feel well to do well.


Buckle up. This one’s a bit longer than normal. Also no proof-reading, so judge me if you will. But if I edit this, I won’t post it.


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As part of the work that I’m doing on myself, I’m reading Mind Over Mood (Dennis Greenberger, Christine A. Padesky). It focuses on cognitive-behavioral therapy approaches (CBT), and while I knew about them in theory, I haven’t really practiced it in my daily life. I’m still learning, so these are just my thoughts as I read.


The principles of CBT say that how we feel can be changed by the way we think, and the way we feel has an impact on everything else in our lives. 


Environment, physical reactions, mood, behavior, thoughts

Within us, there are four interconnected things: physical reactions, mood, behavior, and thoughts. Any change in one will influence the other three. A head cold will make me feel stuffy and gross, which puts me in a bad mood, which makes me grumpy, which makes me think things like, “I just can’t stand people”, “I’m disgusting”, and “No one wants to be near me.


On top of that, external forces have an impact on each of the four. These are the environment around you, the situations you are in, and life changes. Our environment is the place we live and the people that surround us. The situations are short term, like an argument, or long term, like a relationship or job. Life changes can be anything that alters the course of your life. It could be positive or negative, as small as meeting someone new, or as big as getting a new job, or the birth of a child.


A big life change, like divorce, illness, the death of a loved one, job loss, and so on, all have an impact on us. The impact can be on any or all of the four interconnected internal parts. And any change to one of those four will have an impact on the other three.


Years ago, I received a big blow to my health. I was diagnosed with type one diabetes, a life-altering condition that I will have for the rest of my life. This was a life change and a change in situation. My external reality had been altered drastically.


My physical reactions included all the side effects of high blood glucose. Headaches, thirst, hunger, tiredness, lack of focus, restlessness, etc. As my care plan developed, the reactions expanded to include the symptoms of low glucose, and all the physical reactions to daily insulin injections and blood glucose checks.


My mood changed, too. I became melancholic and gloomy, for obvious reasons. And to be honest, I was always afraid.


My behavior changed, as well. I became more cautious, avoiding certain activities and food because I feared a disastrous low glucose event. I began exercising less for the same reason, having experienced several frightening lows. This was a major change for someone who used to train martial arts several nights a week.


My thinking changed as well. “I am limited.” “I am fragile.” “I will die from this condition.”


Each of these things began to influence the others. My limiting thinking changed my mood, making me feel lesser than I used to be, fueling my depression. My exercise avoidance sabotaged my mood. My mood made me think less and less of myself. “I’m not a martial artist any more.” “I will never be healthy anymore.”


This is obviously an example of a major, negative life change and the way it devastated my interior life. It felt hopeless. It still does, sometimes.


But the problem - that a change in the system has an impact on the entire system - is also the solution. A positive change in the system will have a positive impact on the rest of the system.


I remembered, for example, that one of my heroes at the dojo I was a part of was type one diabetic as well. She was tough, fearsome, and no-nonsense. She was a force to be reckoned with. I trained alongside her for more than a decade, and NOT ONCE did she let her condition limit her potential. This helped me change my thinking.


I can enjoy my life, no matter what my life situation is. This changes my mood.


I can exercise, even a little. I can walk and swim and practice my martial arts. I can eat lots of good, tasty food that isn’t that bad for my condition (and occasionally have a treat.) This changes my behavior.


All of these positively affect my physical reactions. Over the years my diabetes has become easier to manage, although there are always challenges.


So there is hope. And it is hard work, especially when I’ve been immersed in a certain internal pattern, to correct my course.


Because while a change in the system can break down the entire system, it can also improve it as well.


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What are my qualifications? None, except for my own experience and a desire to help. Going back to Doctor Who, “I am an idiot … passing through, helping out.” I hope my own struggle with my darkness can help you with yours, or understand the struggle of someone you love.


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Life before death

Strength before weakness

Journey before destination


Thursday, August 24, 2023

Writing Memories

Thursday, Aug 24, 2023



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I’m doing more than just surviving these days. Nothing’s perfect. There are lots of shadows cast over my life, but they’re just part of the landscape, not warnings of impending doom. More than just getting by, I’m also doing things that I find fulfilling, and have moments of sincere joy.


I’ve started things up again with my therapist and will be doing more than just telling him what’s happened to me each week. We’re going to start exposing the roots of my feelings and figuring out how to create better, more appropriate reactions to my triggers. I’m looking forward to this.


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Something very unfortunate happened a few weeks ago. I can’t get into specifics, but there was a complicated, dangerous situation with multiple different parties, each with their own version of what happened. In the end the danger was resolved and no one was hurt, although most of us were badly shaken.


I spent time wrestling with what happened. I reviewed the sequence of events, trying to see if I missed something important. Did I do the right thing? Was there something I could have reasonably done that would have nipped the incident in the bud? Were there signs I missed? I lost sleep, playing it over and over in my head, and at every turn I questioned things.


There were times where I felt like a monster. Self doubt and his nasty cousin, self loathing, were close at hand. But after some hard work, I was able to put them in their place. This time, I was able to see the lie my dark side was selling me and discarded it as such.


In the end I realized that while yes, there were things I could have done better, what I did was reasonable considering everything that was happening. It was a messy, complicated situation, and I was doing the best I could at the moment. 


I also had to tell the story many times, to people I care about and to people who had a right to know. It wasn’t something I wanted to do, but it was the right thing to do.


I told the story one more time the other day, and I received some unexpected feedback. To paraphrase what they said, I could have told the story with me being a victim, or beating myself up over not responding perfectly to a volatile situation. I could have been upset at the people present during the incident and what they said, did, or how they reacted.


My friend reminded me that every time we retell a story we are helping our brains reorganize the memory so we can understand and store the memory more effectively. The way we tell the story to ourselves writes and rewrites the memory. It changes the way we see the events that happened, and how we relate to them. It’s one of the slippery ways that our memories aren’t reliable, and why the way we think about our past is incredibly important.


Not wanting to put words in my friend’s mouth, it sounds like I did a good job of owning my part in the unfortunate incident. I accepted responsibility for what I did without overreaching and blaming myself for everything going wrong. I didn’t blame anyone else, either, but expressed understanding and compassion.


Hearing this was a breath of fresh air. It showed me that the work I’ve been doing on myself is paying off, and the results are noticeable to those who know me well. It also underscored to me the importance of being as honest and clear as possible with myself and others when dealing with the hardships of life. Because the way we tell ourselves these stories changes the memories we write.


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What are my qualifications? None, except for my own experience and a desire to help. Going back to Doctor Who, “I am an idiot … passing through, helping out.” I hope my own struggle with my darkness can help you with yours, or understand the struggle of someone you love.


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Life before death

Strength before weakness

Journey before destination


Thursday, August 3, 2023

Shifting Gears

 Thursday, Aug 03, 2023



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I am limping along. Emotionally I am well, but physically and mentally I am exhausted. I have trouble telling if this is some kind of burnout, or lingering effects of long COVID, or even a side effect of my fluctuating blood glucose. There always seems to be another round of illness, from strep to dangerously low glucose levels to horrible aches and pains all over my body.


And yet I feel pretty good inside. Not healthy, but more centered. Not tidy, but like I can see a pattern in the mess and understand what I need to do to start cleaning up - with permission from myself to take my time in doing so.


So, I take that as a plus. Direction over velocity. Journey before destination.


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After a long time away, I had my first therapy session in months. I hit a wall, mentally and emotionally, back in January and needed to take a break from it. It took a lot of consideration, but I realized that I had become frustrated with a lack of progress. I was spending my sessions updating my therapist on what had been happening, and I didn’t feel like I was actually improving.


I sought out the same therapist, and thankfully he was still available. I explained why I stopped the sessions, and he understood. In fact, he likened it to a shift in my growth. The way I expressed it to him months ago was not ideal, but it was an understandable reaction to my changing needs.


He described my previous sessions as relational therapy, which focused on my relationships with other people. My spouse, my kids, my parents, my inlaws, my boss, my friends, you name it. Looking back, that is 100% correct. I was drowning in stories I had to get off my chest about interactions that left me frustrated.


Occasionally I was able to dig below the surface of that, identifying a question, a cause, or a trigger. Something that intellectually I understood, from all my consumption of therapy material, but had trouble noticing in myself. But because I was still drowning in stories and their consequences, I didn’t have the space to investigate these seeds and see what they grew into.


Shifting gears, we will focus on goal-oriented therapy, emotion-focused therapy, and cognitive behavioral therapy - which brings me full circle. When I first started researching depression I read a wonderful book on CBT that I can’t remember the name of. I read it in an attempt to better understand the suffering of someone close to me, and stumbled into an understanding of my own depression. However, never having done the actual work of CBT, I never learned the tools I needed to apply it to myself.


I am excited, and a little worried. This isn’t just going to be me talking to someone about my problems. This is going to be me trying to figure out exactly what those problems are, why they affect me the way they do, and how I can reprogram my own responses.


I told my therapist today that my long term goal is to be able to be angry and to respond to everyone involved - including myself - with calmness and kindness. Not to ignore the anger, which will make me sick, but to integrate it and reclaim it, teaching myself how to take the gift of my anger and take away the potential harm, turning it into a useful response.


He also said that, from our conversation, it was clear that I had done a lot of work on myself in the past few months. It was good to hear that, because sometimes it’s hard to recognize our own progress. Especially when things have been dark.


So. It’s time to shift gears and focus on fixing the problem, not just talking about it. Time to do the work. Time to be better.


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What are my qualifications? None, except for my own experience and a desire to help. Going back to Doctor Who, “I am an idiot … passing through, helping out.” I hope my own struggle with my darkness can help you with yours, or understand the struggle of someone you love.


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Life before death

Strength before weakness

Journey before destination


You Don't Need to Carry All the Heavy Things

I've been thinking about the burdens we carry when we don't need to. Something may have served us in the past, but we hold on to it ...