Cognitive Behavioural Therapy Made Simple: 10 Strategies for Managing Anxiety, Depression, Anger, Panic and Worry (Sheldon Press)

by Seth J. Gillihan

CHAPTER ONE: Your CBT Starter Guide CHAPTER TWO: Goal Setting CHAPTER THREE: Activate Behaviour CHAPTER FOUR: Identify and Break Negative Thought Patterns CHAPTER FIVE: Identify and Change Your Core Beliefs CHAPTER SIX: Maintain Mindfulness CHAPTER SEVEN: Stay on Task: Push Through Procrastination CHAPTER EIGHT: Work Through Worry, Fear, and Anxiety CHAPTER NINE: Keep Calm: Manage Excessive Anger CHAPTER TEN: Be Kind to Yourself CONCLUSION: Keeping It Going

While I was there I learned that focusing our attention on the present with openness and curiosity is a powerful way to break the grip of anxiety and depression.

Do enjoyable activities. Think helpful thoughts. Face your fears. Be present. Take care of yourself.

I’ve learned that despite the simplicity of these effective treatments, they still require work.

In my previous book, Retrain Your Brain, I provided a structured seven-week plan to manage anxiety and depression in a workbook format.

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CBT includes both a cognitive component, which focuses on changing problematic patterns of thinking, and a behavioural component, which helps develop actions that serve us well.

mindfulness-based stress reduction (MBSR), based in practices that have been around for thousands of years. Mindfulness is grounded in the idea that we can relieve suffering by focusing our attention on our experiences in the present moment, as opposed to ruminating on the past or worrying about the future. Mindful awareness also includes a deliberate openness to our reality.

Just as cognitive and behavioural therapies were joined together, mindfulness-based therapy has been integrated into some CBT programs.

CBT emphasizes collaboration and active participation. CBT works best when you take an active role in defining treatment goals and deciding how to move toward them.

CBT is goal oriented and zeroes in on specific problems. A crucial part of the work in CBT is defining the problem, which then makes that problem feel more manageable.

CBT focuses on how one’s thoughts and actions in the present may be a part of ongoing struggles and how changing those patterns might be helpful.

CBT aims to teach you how to be your own therapist.

CBT emphasizes relapse prevention. Learning how to stay well is an integral part of CBT.

CBT is time-limited. CBT fulfills its goal of offering relief in a relatively short period of time.

CBT is structured. Treatment elements in CBT are presented in a predictable order, with later sessions building on earlier ones.

CBT helps you address negative automatic thoughts. At the heart of CBT is the recognition that our thoughts often lead us astray.

CBT involves a variety of techniques. An impressive array of techniques falls under the CBT heading, from relaxation training to cognitive restructuring to behavioural activation, exposure, and meditation.

I like to organize the techniques of CBT under the headings “Think” (cognitive), “Act” (behavioural), and “Be” (mindfulness).

CBT breaks down big challenges into smaller, more manageable pieces.

The systematic and structured training of CBT ensures we get an adequate “dose” of the techniques that can bring relief.

These medications can be as effective as CBT, but relapse tends to be more common if the person stops taking them. Many people benefit from a combination of CBT and psychiatric medication.

It’s not easy to build new habits, especially when we’re extremely well practiced in doing things that aren’t working for us. It takes repetition to reprogram our automatic responses to difficult situations.

Worry is the core feature of generalized anxiety disorder.

For this week, consider the following questions: • What is the number one issue you hope this book will help you with? • What have you tried so far to get some relief? • What has worked well and what hasn’t? • How does CBT as I’ve described it compare with what you’ve tried in the past? • Finally, how are you feeling after reading the first chapter? For subsequent chapters, you’ll need a journal that’s dedicated to your CBT work. If you

1 Take a few moments to review what you learned from this chapter. Did you discover anything about yourself and what’s important to you? 2 Be sure to write down your goals to make them more salient and easy to remember. 3 Think carefully about the goals you set. Are they inspiring? Specific enough? About the right level of difficulty? 4 I recommend keeping your goals somewhere visible and reviewing them several times over the coming days.

5 Also consider talking about your goals with a supportive loved one, both to get their insight and to provide some accountability for yourself. Simply telling someone our intentions can raise our motivation to follow through. 6 Finally, if you think of any additional goals, add them to your list.

In order to feel well, we need a balance of enjoyable and important things to do—or in the words of Dr. Aaron T. Beck, we need experiences of “pleasure and mastery.”

Two powerful factors drive avoidance of activities: 1 An immediate sense of relief from dodging what we think will be difficult 2 Not experiencing the reward from engaging in the activity, thereby further diminishing our motivation for it Behavioural activation is designed to break these patterns.

to gradually start doing rewarding activities, even if we don’t feel like it. The interest in the activities will follow. This approach is the foundation of behavioural activation for depression.

STEP 1: CLARIFY VALUES FOR EACH LIFE DOMAIN

VALUES & ACTIVITIES FORM

You can find a copy of this form online at CallistoMediaBooks.com/CBTMadeSimple.

STEP 2: IDENTIFY LIFE-GIVING ACTIVITIES

STEP 3: RATE THE DIFFICULTY OF EACH ACTIVITY

STEP 4: PLAN THE ORDER OF COMPLETION

STEP 5: SCHEDULE ACTIVITIES INTO A CALENDAR

STEP 6: COMPLETE THE ACTIVITIES

You can use the Daily Activities form here

1 Track your activities using the Daily Activities form. 2 Follow the six-step plan to build valued activities into your days. It may be enough to do steps 1 through 4 this week, and to schedule activities for the following week. 3 Choose one to two activities to complete per day, starting with the easier ones. 4 Use the strategies offered to raise the odds of following through. 5 Continue choosing activities from your list and scheduling them in your calendar. Check periodically that the activities are aligning with your values. 6 Add activities and values to your list as they occur to you. 7 Have fun! This is for you.

DAILY ACTIVITIES

You can find a copy of this form online at CallistoMediaBooks.com/CBTMadeSimple.

Just as our thoughts can cause us unnecessary pain, they can also help us heal if we harness them to work in our favor. The word harness is perfect in this context because it means to control something in order to make use of it.

we have to be cleverer than our thoughts.

THINKING ERRORS

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1 Keep in mind that the thoughts may be about the past, present, or future.

2 Give yourself the space you need to identify what’s on your mind, which might include:

3 Be aware that thoughts might come as impressions or images rather than words.

You can find a blank form online at CallistoMediaBooks.com/CBTMadeSimple.

THEMES THOUGHT FEELING BEHAVIOUR Hopelessness “I’ll never feel well again.” Depression Worthlessness Inadequacy Loss Withdrawal Threat “I’m going to fail this exam.” Anxiety Danger Uncertainty Self-protection Injustice “She treated me unfairly.” Anxiety Mistreatment Rule violation Retaliation