Archive for CBT

Help! My life is out of control!

stressWe all know that life is stressful. In fact, without a certain amount of stress, life would be boring to most of us. We use certain internal stressors such as deadlines to make sure we stay on track with our responsibilities and appointments. Some stress comes from positive events in our lives such as a new marriage or birth of a baby. Other times, it is from a death in the family, financial worries, or too many demands at work. We live in a fast paced world that asks us to keep up a whirlwind speed that can become overwhelming at times. When we become overwhelmed by tasks, deadlines or commitments, we can move from stress to di-stress.

Stress and anxiety are the fight or flight instinct that is our body’s natural way of responding to emergencies. When there is an actual emergency, this instinct allows us to think clearly and quickly respond to what is needed. Hormones race through our body to speed up our heart and other physical processes. They help us to avoid or deal with the threat. However, because we have the ability to anticipate problems, many of us fall into chronic worry or planning for possible problems that never even materialize. Thoughts about these possibilities can trigger the same flood of hormones and stress. Chronic anxiety leads to impairment of the immune system and increases the risk of physical and mental problems. This can lead to increased physical problems such as autoimmune diseases, coronary artery disease and decreased satisfaction with life.

Signs of stress vary among individuals but may include:

  • Worry, anxiety, or panic attacks
  • Sadness or depression
  • Feeling pressured and hurried
  • Irritability and moodiness
  • Difficulty concentrating and making decisions
  • Physical symptoms, such as stomach problems, headaches, or chest pain
  • Allergic reactions, such as a skin rash or asthma
  • Problems sleeping
  • Drinking too much alcohol, smoking, or misusing drugs
  • Sexual dysfunction
  • Eating too much or not enough

Mindfulness is a great tool for coping with stress and anxiety. This practice involves stilling the mind by letting go of thoughts or emotions as they arise and tuning back into the present moment. Simply focusing on the breath or our body can do this. It is a practice of letting go of the thoughts that will, without a doubt, arise. The only definition of successful practice is that when we notice we are thinking or feeling, we name it and let it go, returning to the focus of the present moment. Practicing this type of stillness is best done as a routine before we are in the midst of an upsetting situation. Then when these situations occur, we can lean on our practice of letting go of anxious thoughts that are not helpful to solving the problem but just add stress. A great resource describing how to apply this technique specifically to anxiety is The Mindful Way through Anxiey: Break Free from Chronic Worry and Reclaim Your Life by Susan Orsillo, PhD & Lizabeth Roemer, PhD.

Cognitive Behavioral Therapy (CBT) is also another tool that can help to alleviate the anxiety we feel. There are several different techniques in this field that can be applied to anxiety. The first step is learning how to identify these thoughts and differentiating the rational from the irrational. A therapist can help us to isolate the thoughts that are causing the anxiety and teach us ways to challenge them to decrease anxiety. This type of therapy has been shown to be a very effective means of reigning in our chronic worry, anger or depression. A good resource to read to become familiar with this tool is When Panic Attacks by David Burns, MD.

It is also important to remember to take time for self-care in the form of spending time with friends and family and getting the proper nutrition, exercise and sleep. Participating in positive activities and having fun is an important stress reducer. Watch any negative self-talk about not being able to cope or being competent. Seek out people that are supportive and caring. View problems as challenges rather than insurmountable obstacles. Remember, stress is normal but anxiety can be met head on and decreased. Don’t be afraid to seek the help of a friend or therapist if life begins to feel overwhelming and nothing seems to help. We all need help at one time or another and no one needs to go it alone.

Don’t Worry, Be Happy

IMG_0508When Bobby McFarren first came out with the song, Don’t Worry, Be Happy, I thought he must just be high on something.  It sounded too pat an answer to life’s many difficulties.  It couldn’t be as easy as just telling yourself or someone not to worry and focus on being happy, could it?  Maybe he was a typical laid back man from the tropics who lazed around in the sun all day.  What did he have to be worried about?  Well, it turns out he was from the States and a world class musician to boot.  And what he had to say is true.  We can control the level of our worry by  focusing on being happy.

How can we do that?  Dr. Rick Hanson, a neuropsychologist, and Dr. Richard Mendius, a neurologist, havewritten a book called Buddha’s Brain: The practical neuroscience of happiness, Love & Wisdom.   This book outlines in detail how to decrease our stress and be happy. According to them, scientists have recently mapped out the neurotransmitters (chemicals in the brain) that are involved in emotions such as anxiety and depression.  These chemicals are key to firing parts of the brain that alert us to danger in our environment so that we have an increased chance of survival.  Over the thousands of years of human evolution, these pathways have developed to a level that our brains can make split second decisions whether to fight or flight or just relax.  Since these pathways are key to our survival,  they get the most traction in our brain.

We have evolved to pay greater attention to unpleasant experiences. This has created a negativity bias that overlooks good news and focuses on any possible dangers or threats in our environment.  With the development of our prefrontal cortex (the part of our brain that separates us from other animals), we have even been able to imagine possible scenarios, thus developing anticipatory anxiety about the danger we might meet in the future.  While this might serve us well if we were ever to meet such a circumstance, for the most part this tendency causes us to worry unnecessarily, even before something happens.  It causes unnecessary suffering more often than it prepares us for disaster.

The good news is that we also have the ability to retrain our brains to focus on more pleasant experiences which can increase the neural pathways that are devoted to feeling good.  You can actually change the “wiring in your brain” by using some simple, easy remedies.  Drs. Hanson and Mendius suggests first of all that we look consciously for and take in positive experiences, letting them sink into our awareness by actually savoring them.  This helps them to be consolidated in our memories. We can then use the positive memories to counteract a painful one that is occurring in the present.  For example, during the birth of my second child, I was able to use the memory of how good it was to hold my first child after he was born to help me cope with the pain of labor.

Their book is full of many other helpful suggestions that help us cool the fires of the sympathetic nervous system which is the one that produces the stress-related hormones.Instead, we use these techniques to activate the parasympathetic nervous system which allows calming, soothing and healing hormones to spread throughout your body.  Some of these techniques are familiar to many of us, such as progressive relaxation, deep breathing, mindfulness, meditation and imagery.   Cognitive behavioral therapy techniques can be of help in this area as well, challenging negative thoughts with realistic challenges.  The authors’ suggestions are too many to cover in this brief article.  I would recommend that you read their book.  Don’t be scared off by all the technical terms for the brain and its wiring.  The authors really explain this in a way that we all can understand.  Dr. Hanson also has a website that is worth visiting .  (

So Bobby McFerrin was on to something in 1988 with his catchy tune.  I even can catch myself these days humming a few bars as I take his advise and let go of the negative filters. Instead, I choose to focus on the blessings and gratitude I feel for all that is positive in my life.  I would suggest the same for you.  Don’t Worry, Be Happy–it will change the way your brain works!


Imagination: a Blessing and a Curse

Imagination: a Blessing and a Curse 

 “It is said that when the heavenly powers gathered at their huge conference table and considered the evolution of humans on the planet Earth, they had great concerns over the erratic behavior of these particular beings. On the one hand, the courage and occasional unselfish love that humans demonstrated clearly called for a reward from heaven.  On the other hand, their tendency to behave with fearful selfishness indicated that they merited heaven’s punishment.

The powers debated for long hours trying to decide which course of action was most appropriate. Finally one junior member cut through the debate and said, ‘Let’s begin with reward.  I suggest that we bless them with a mind that is capable of remembering and imagining.  That way they can learn from the past and anticipate the future.  Therefore they will be able to plan and create great wonders.’ They all agreed that this reward was fitting so they caused it to be.

Then they turned their attention to the appropriate punishment. ‘How shall we punish them?’ they asked.  The junior member spoke quietly with a trace of sadness. ‘ We already have,’ he said, ‘the blessing will also be the punishment.’ *


     Our imagination is a wonderful gift.  With it we are able to plan great projects such as a city that will allow for access to all the essentials within walking distance, eliminating the use of cars and lessening the emission of green house gases.  We can think about a loved one and plan a party that will make them feel loved and appreciated.  Or just remember a special time we enjoyed together and bring a smile to our faces. We can close our eyes and imagine walking along a sunlight beach, enjoying the sounds of the waves, without ever having to get on an airplane.  We can use it to relax, to practice a sport, to dream about our future.

    Unfortunately, that same imagination can cause us countless hours of worry and anxiety as we imagine the worse possible outcomes that might occur.  We see a story about an earthquake in Japan and our imagination creates for us a picture of that same disaster in our town.  What would we do?  How would we cope?  We begin to lose sleep, feeling like we would not be prepared.  Or when our loved one is late coming home from work we imagine that they are killed in a car accident or have arranged a clandestine meeting with another lover.

     It is when the imagine “runs away” with our mind that we develop anxiety patterns that begin to cripple us.  Rather than using our anxietyimagination to develop a “plan B” that would be helpful, such as a survival kit for an earthquake, we spin our wheels in worry, thinking more and more devastating thoughts.  As the fear and anxiety increases we find ourselves unable to think clearly and respond appropriately to the actual reality.  We create such a complete picture of “reality” in our imagination that we fail to stop and question the validity of it.  Instead our physiological response system reacts our “imagined reality” as if it were true.  Adrenaline and cortisol flood our system until we are overloaded and stressed out.

      Cognitive behavioral therapy is beneficial in dealing with a runaway imagination.  A trained therapist can help isolate the thoughts that are causing the anxiety and teach us ways to challenge our thoughts to decrease anxiety.  Research has shown this therapy to be a very effective means of reigning in an overact imagination to combat anxiety, anger and depression.  For most people, it is more effective than medication alone.

If you are interested in learning more about this treatment modality, click on the link Cognitive Behavioral Therapy .   Guided imagery can also be beneficial in dealing with chronic pain and relaxation. For more information on this approach, click on the link Guided Imagery .  Learning to decrease the negative effect of imagination frees up energy to use it to benefit our overall joy in life. It facilitates tapping into the reward while diminishing the punishment aspect of imagination.

   The story at the beginning spoke of two aspects of the mind that were given as reward and punishment: remembering and imagination.  This newsletter only addressed the imagination.  Next month, we will look at “remembering” to see how this can be a reward and punishment as well.

*Story taken from The Tao of Forgiveness, by William Martin.


When Panic Attacks, David Barnes, MD

The Feeling Good Handbook, David Barnes, MD

Guided Imagery for Self-Healing, Martin L Rossman, MD