Tuesday, 4 May 2010

Relax With Ease (C) Michael Cohen 2010

Please Note These Articles are meant for information purposes only and are not a substitute for Medical or Psychological treatment.

Many people make the mistake of thinking that they do not have the time to relax. Others believe that relaxation is only for winding down at the end of a hard day. One of my clients believed that time spent following a relaxation procedure would impede his efficiency at work, but after a few weeks practice he felt more alert and better able to concentrate. Waiting for a stressful event to occur is not the best time to begin learning relaxation It is far better to set aside 20 minutes a day for practice. Once learnt you will be able to let go of your tension in virtually any situation. Relaxation produces a wonderful feeling of well being helping to relax tense muscles.

It can also -

Reduce your anxiety.

Eliminate fatigue.

Improve physical and mental performance.

Help you to get to sleep.

Manage pain

Lower your blood pressure.

Manage irritable bowel syndrome

PROGRESSIVE RELAXATION.

Progressive relaxation is a technique that focuses on deep muscle relaxation. It was first developed in the 1920s by Dr Edmund Jacobson and over the years has been refined and modified. This technique involves tightening different muscles groups. If you have neck or back problems you may wish to modify the procedure. Never practice while driving or when your concentration is needed elsewhere.

The procedure is as follows.

1. Sit or lie down in a quiet comfortable place. Remove contact lenses and any sharp objects such as jewellery. Uncross your arms and legs. Take in a deep breath and hold for as long as you find it comfortable. Breath out - letting all feelings of tension leave your body.

2. Clench your right fist, tighter and tighter. Notice the tension in your clenched fist, hand and arm. Now relax your fist and feel your right hand and arm go loose and limp. Notice the contrast with the tension. Repeat the procedure with your left fist and then with both fists.

3. Focus your attention on your forehead. Pull your eyebrows together as tightly as possible and hold. Now relax and let your forehead smooth out. Notice the contrast between tension and relaxation. Repeat the procedure and notice how relaxed your forehead can become.

4. Close your eyes together as tightly as possible, feel the tension, now relax your eyes letting your eyelids droop. Keeping your eyes closed repeat the procedure. Let your eyes remain closed for the rest of the exercise.

5. Clench your jaw biting your back teeth together. Feel the tension as it spreads throughout your jaw. Now relax your jaw. Once again notice the contrast between tension and relaxation, then repeat the procedure.

6. Pull your head back as far as is comfortable. Feel the tension in your neck, hold and then roll you're head slowly to the right and then to the left. Notice the tension. Then straighten your head and bring it forward, push your chin onto your chest. Feel the tension in the back of your neck. Relax and allow your head to return to a comfortable position. Repeat the procedure and allow the relaxation to deepen.

7. Hunch your shoulders and hold for as long as is comfortable. Feel the tension. Then let your shoulders relax. Feel the relaxation spreading. Repeat the procedure and see how relaxed your shoulders can become.

8. Focus on the rhythm of your breathing. the rising and the falling of your diaphragm and chest. Notice how heavy your body is becoming. With every breath that you take feel your body relax just that little bit more.

9. Pull in your stomach muscles. Hold for as long as is comfortable, feel the tension and then relax. Repeat the procedure.

10. Tighten your buttocks and thighs. Push your heels down as hard as you can. Feel the tension Hold for as long as is comfortable and then relax. Notice the contrast between the tension and relaxation. Then repeat the procedure.

11. Point your toes in a downward direction and notice your calves getting tense. Feel the tension and hold for as long as is comfortable. Then relax. Repeating the procedure.

12. Focus your attention on the comfortable feelings in your body. From the top of your head to the tips of your toes. Notice how relaxed you have become. You can now drift of to a relaxing place in your imagination. It can be somewhere familiar to you. Or it may be an imaginary place that only exists in your mind. When you are ready open your eyes.

For best results practice progressive relaxation on a daily basis for approximately 20 minutes.

It is important to take your time and not rush through the technique. After practicing the procedure you may notice tension in parts of your body that you thought did not exist. This is not an unusual experience and is an indication that you are becoming aware of the parts of your body where you hold on to tension. With practice this will pass. You may find it beneficial to make a tape recording of the procedure or have some one talk you through it.

THE BRIEF RELAXATION TECHNIQUE.

You can benefit from learning a brief method of relaxation. This is especially helpful if you find yourself in a stressful situation that requires you to let go of tension immediately. For example, Lisa - who was studying for her degree in economics - came to see me because she was behind in her studies and under immense stress. Lisa told me that the harder she tried to study the more stress and anxiety she would experience. She was convinced that she would fail her exams. I spent some time with Lisa looking at how she approached her studies and how her irrational thinking might be contributing towards her distress. I suggested to her that she take regular breaks from her studies and practice the brief relaxation technique. She found this very helpful and reported that it reduced her anxiety and improved her concentration.

You can also benefit from learning a brief method of relaxation. This is especially helpful if you find yourself in a stressful situation that requires you to let go of tension immediately. . You can also practice the technique for a couple of minutes every two to three hours to keep distress at bay. All you need to do is:

1. Sit in a comfortable chair.

2. Relax and close your eyes.

3. Focus on the rhythm of your breathing.

4. Let your whole body become lose and limp.

5. Imagine a relaxing scene.

Many of my clients find this simple process very helpful in stressful working environments where taking regular breaks can sometimes prove difficult. This is equally true if you are a homemaker with demanding young children to take care of.

PICTURE YOUR STRESS AWAY.

You can use your mind to help you relax by creating pleasant images in your imagination.

This is called visualisation and can involve all of your senses. For example if you were to imagine yourself on a beach you could picture the sand, feel the warmth of the sun, hear the sound of the sea and smell the salt air. Imagery can also be used to create and recreate emotions.

For instance you could imagine a past experience when you felt very calm and relaxed.

Tom, another client of mine, told me how he used the power of visualisation to create his own imaginary safe place. Whenever he felt that stress was getting the better of him he would go to this place to "recharge his emotional battery". After going to his safe place for five to ten minutes he felt revitalised. This is how it is done:

1. Sit in a comfortable chair.

2. Close your eyes

3. Focus on the rhythm of your breathing.

4. In your mind paint a picture of a comfortable relaxing place.

5. Allow yourself to feel relaxed and safe in this place. Think of it, as somewhere you can just be yourself and let go of all your troubles.

6. Go to your safe place whenever you feel the need. You can use it as a place to resolve problems. To think things through or to just switch off, the more you practice the easier it will become.

BREATHE YOUR STRESS AWAY.

When we feel under threat our breathing rate increases in preparation for fight or flight, but if this response is inappropriate we can feel anxious and short of breath.

In order to achieve a good quality of relaxation, you need to learn how to breathe correctly. This may surprise you; after all you have been breathing since you were born. Many people who experience stress and anxiety are breathing in a shallow way from their chest. People who are relaxed are breathing slowly and deeply from their abdomen. One of the most effective ways of switching of stress and anxiety is to practice deep breathing. Here is the process:

1. Sit down in a comfortable place.

2. Tune into the rhythm of your breathing.

3. Put your hand on your stomach. As you breathe try and feel your stomach moving up and down. The aim is to breathe from your stomach instead of from your chest

4. When this has been achieved slow the rate of your breathing down.

At first you may find it difficult to breathe from your stomach .To get a comfortable rhythm you may find it helpful to say the word relax as you breathe out. One of my clients would imagine all her stress leaving in a black cloud. As you keep practicing you will find your body becoming more relaxed.

SCAN YOUR STRESS AWAY.

A fast and effective way to check for stress is to use a technique called scanning. The idea is to mentally scan through your body from the top of your head to the tips of your toes to discover where you are holding tension. Whether you are driving to work or waiting in a supermarket checkout, scanning is easy to practice. . The basic idea is to direct your attention throughout your body, find your tension then let it go.

This is how it is done:

1. Spend a few moments focusing on the rhythm of your breathing.

2. Breath in and mentally scan an area of your body for tension.

3. Breathe out relaxing the tense area.

4. Move on to the next area of your body repeating the process.

Scan your body at regular intervals throughout the day. You can remind yourself to do this by putting notes in your diary or around your home.

RELAX WITH SELF- HYPNOSIS.

Self-hypnosis is a straightforward, effective and non-mystical way of relaxing the mind and body. In a deeply relaxed state you can repeat to yourself autosuggestions that "I will feel calm and relaxed" in situations were you would normally feel distress.

Self hypnosis involves the following.

1. Make yourself comfortable, sitting or lying down.

2. Without moving your head, slowly roll your eyes up as high as you can.

3. Take a slow deep abdominal breath, hold momentarily and as you exhale close your eyes relaxing the muscles around the eyes.

4. Continue to breathe slowly and naturally as you allow the relaxed feeling to spread from the top of your head all the way down to the tips of your toes, letting go of any feelings of physical tension.

5. To deepen this state of relaxation count backwards from 5 down to 1, counting on each inhalation and as you exhale mentally repeat a word such as relax or peace or another word that has meaning to you.

6. When you feel completely relaxed Give your self auto-suggestions such as "I can remain calm and relaxed in this situation"

7. End the self-hypnosis by counting up from 1 to 5 opening your eyes at the count of five.

When working with self-hypnosis it is important to keep your autosuggestions realistic and positive. Refrain from using suggestions such as "I will try and relax" or "I must relax" The first implies a struggle and the second is a demand that may lead to more stress. Practice self- hypnosis unhurriedly 2 to 3 times a day. The whole self hypnosis exercise will take about five minutes to practice.

All of the above relaxation techniques can help reduce distress. Unlike alcohol and drugs the only side effects are an increased feeling of well being. However the techniques become more effective if you also work at changing your irrational thoughts. Keep practicing and build on each success. Persevere and above all do not be put off by setbacks.

(C) Michael Cohen 2010


So what's all this about stress? (C) Michael Cohen 2010

Please Note These Articles are meant for information purposes only and are not a substitute for Medical or Psychological treatment.


Stress is a word that is banded around a lot these days, usually in the negative. Most people view it as something that must be avoided. Your partner, friends and work colleagues all may say that they are under stress. But what is stress? How does it affect you? How do you recognise it?

When a person believes demands placed on them outweigh their ability to cope they will experience stress.

The technical name for these demands is “stressors “and the wear and tear on the body is the stress. You may think of stress as a relatively new phenomenon; in fact it has been with us for millions of years. Many years ago when men and woman lived in caves life-threatening situations occurred on a daily basis. Cave dwellers hunting for food were regularly exposed to physical dangers. Sabre tooth tigers, lions and other hostile predators might be just around the corner. Faced with one of these threats the body reacts immediately - there is a rush of adrenaline, heightened muscle tension, faster heart rate and raised blood pressure. Blood pumps to the muscles and brain causing the body become alert and as strong as possible, for in order to survive a hunter would have to respond by either fighting the threat or running away from it. This is called the “fight or flight response” and is activated whenever a person is faced with an emergency. Physiologist Walter B Cannon first described it over one hundred years ago.

The “fight or flight response” is still experienced by people today and is of course appropriate whenever we are faced by a real life emergency. However, unlike our ancestors, we are rarely faced with such life threatening situations. Screaming children, nagging bosses and work deadlines are very unpleasant but hardly life threatening. The problem is that nature does not know this and will produce the same fight or flight response. This leaves the body in a high state of arousal but unable to act.

So if everyday pressures mount up and a person is in this state for long periods of time the body soon suffers and the experience becomes distress.

THE THREE STAGES OF STRESS

The first scientist to carry out major research on stress was Doctor Hans Selye. Over fifty years ago he described a model of stress he termed the “General Adaptation Syndrome”. According to Dr Selye there are three stages to the syndrome a person will go through when experiencing a stressful event.

Stage one. Alarm
During this first stage the person experiences alarm, immediately a complex cascade of biochemical events occur and the stress hormones called adrenaline and cortisol are pumped into the bloodstream.

Stage Two. Resistance
At stage two the body’s heightened physical responses create an increase in activity so that the person either leaves the situation, or stays and attempts to cope by resisting or adapting to the stressful event.

Stage three. Exhaustion
By this stage the person has been reacting to the stressful event for so long that they have become overwhelmed, their energy is finally depleted and the result is exhaustion. It is then that people become vulnerable to the health problems that are associated with stress. When the alarm bell rings you need to take some action and learn to deal with stress before stress deals with you!

THE SIGNS AND SYMPTOMS OF STRESS

Stress can manifest itself in many different ways, so recognising the signs are an important first step in dealing with your problems. Generally the symptoms will manifest themselves in five different ways which we describe as emotional, mental, physical, behavioural and health problems. So without wishing to cause you too much stress lets take a look at them.

The emotional symptoms
The emotional symptoms include,

  • Anxiety. Nervousness. Worry.Depression.
  • Anger. Irritability. Guilt. Moodiness.
  • A loss of enjoyment in life. Loneliness.
  • Feeling tearful. A loss of humour...
  • A lack of confidence. Isolation.
  • A dissatisfaction with your job.

The physical symptoms
The physical symptoms include,

  • Feeling restless. Feeling uptight. Jumpy.
  • High blood pressure. Palpitations.
  • Muscle tensions in the neck and back.
  • Headaches. Poor sleep. Fatigue. A lack of energy.
  • Pain. Dry mouth. Weakness. Dizziness. Trembling.
  • Grinding of the teeth. A frequent need to pass water
  • Diarrhoea and constipation. Butterflies in the stomach.
  • A loss or increase in appetite. Ringing in the ears. Cramp.

The behavioural symptoms
The behavioural symptoms include,

  • Impatience. Impulsiveness. Hyperactivity.
  • Short temper. Aggressiveness. Accident-prone.
  • Avoiding difficult situations. An increase in smoking.
  • The use of prescribed drugs. The use of illegal drugs.
  • Alcohol abuse. Absenteeism. Poor work performance.
  • Loss of sex drive. Uncooperative. Overworking.
  • Compulsions and obsessions.

The mental symptoms
The mental symptoms include,

  • Frequent lapses in memory. Constant negative thinking.
  • Being very critical of yourself. An inability to make decisions.
  • Difficulty getting things done. An increase in susceptibility to criticism.
  • Distorted ideas. Very ridged attitudes. Difficulty concentrating.

Health problems
Stress is often associated with an increase in physical heath problems including,

  • High blood pressure. A higher than usual susceptibility to colds and flu.
  • Migraines. Irritable bowl syndrome. Ulcers.
  • Stomach disorders. Heart attacks. Angina. Strokes. Asthma. Skin rashes.

HOW TO ASSESS YOUR STRESS

Read through the list of symptoms and make a note of those that you feel apply to you. Being aware of your symptoms can be a useful sign that stress is on the increase. By applying the stress reducing techniques described in other articles you will be able to monitor the reduction in your symptoms. It is not the purpose of this web site to diagnose mental health problems, however there are some conditions and symptoms that need to be taken seriously.

These include depression, anxiety, panic attacks, burnout, and post-traumatic stress disorder.

If you are are experiencing any of the following, for your own peace of mind consider seeing your doctor.

  • If you are feeling depressed.
  • Have lost your appetite.
  • Feel that life is not worth living.
  • Feel overwhelmed with anxiety.
  • If you have lost your energy.
  • Experience heart palpitations.

It is also important to seek advice about any physical symptoms such as weightloss, stomach pains, and blurred vision.

THE STRESS GAUGE

One of the most effective ways to measure the amount of stress you are experiencing is to use a “stress gage”. When you have a fever you take your temperature, it makes sense to do the same for your stress levels. The advantage of the stress gage is that it is fast and simple and can be used in virtually any situation.
As you can see from the diagram below zero stands for no stress everything is just fine. Thirty means that some stress is being experienced, fifty denotes a moderate amount, seventy is high and finally one hundred is extreme stress.

STRESS GAUGE
O 30 50 70 100

Whenever you are experiencing stress, for example if you are held up in a supermarket queue or have a pile of unfinished paper work, ask yourself the following, “How much stress am I experiencing now?” Is it thirty, fifty or one hundred percent? Once you have started to use the stress reducing exercises on this web site you will be able to take ”before” and “after” readings and become familiar with the techniques that are most effective for you in your particular situation.

WHAT IS TRIGGERING YOUR STRESS?

The events and circumstances that trigger stress are many and varied. They are caused by external events (such as noise and traffic) and also by our inner thoughts and attitudes about events. Listed below are some major courses of stress.

Work stress
It has been suggested that work is the biggest cause of stress in the western world today. The pace of change in the way we work has never been as great. People have to cope with new information technology longer working hours and short-term contracts. A job is no longer for life. As job insecurity increases people are more likely to remain in a job that is perhaps safe but not necessarily suited to them. It is important to examine the sources of stress at work and whenever possible improve your strategies for coping.

Family and relationship stress
People can experience high levels of stress in their relationships. From marital conflict and difficult children to alcoholism and violence the problems can be wide and varied. These issues need to be properly addressed otherwise the consequences can be serious and lead to separation and divorce.

The stress of bereavement
The loss of a loved one is a devastating life experience. When we lose someone close it is natural to go though a process of mourning. The emotions and stages of the grieving process will vary from person to person. First there is the initial shock of the loss and at this time it is common to experience a feeling of numbness. Anger, guilt, and despair follow as the reality of the loss deepens. This is followed by recovery as the person accepts the bereavement and begins to rebuild their life. It is important to acknowledge the grief and talk to someone close.

The stress of financial problems
Financial problems obviously cause an enormous amount of stress. The loss of a job, an addiction to gambling or mounting bills can lead to family tensions. Ignoring the problem will only make matters worse. When faced with money worries it is important not to panic. Instead talk to your debtors and set a realistic budget.

The stress of change
Changes in your life however big or small whether positive or negative can create stress. Major life changes such as starting a new job, getting married or moving house can challenge our abilities to cope. This is particularly true if we experience too many changes in a short period of time. Although change is an inevitable part of life it makes sense to plan ahead. Whenever possible do not take on too much at once.

Environmental stress
Our environment can be a big factor in the cause of stress. We have to contend with crowded trains, noisy traffic and polluted cities. These conditions can lead to health-related problems such as asthma, allergies and migraine headaches. We cannot easily escape the environment we live in. However healthy eating, exercise and regular breaks can help us to better cope with the stresses and strains of city life.
Although I have listed some of the major triggers of stress you may want to think about other causes that are are specific to you.

YOUR ATTITUDE COUNTS

It is genuinely believed that problems are caused by external stressful events, and to a large extent this is true. As we have seen from the triggers listed previously external events do play a part in the stress we experience. However, it is important to take into consideration our attitude towards these events. The way we think about a situation can have a direct bearing on the amount of stress we experience.

Let us consider the common experience of being stuck in traffic. As we observe the different drivers in their cars we may notice many of them getting very worked up. Some are sounding their car horns and even shouting at the traffic, as if that would magically move it on. Others remain calm taking the time to listen to some music or chat to their passengers. This is an example of people reacting to the same event in opposite ways with different emotions and behaviours. The drivers who became upset are interpreting and labelling the experience of the traffic hold up in a way that is certain to cause distress. It is a fact that our negative thinking causes a large part of the stress we experience. In other articles on my site you will be able to learn how to change your thinking.

(C) Michael Cohen 2010

HOW TO CHANGE UNHELPFUL THINKING (C) Michael Cohen 2010

Please Note These Articles are meant for information purposes only and are not a substitute for Medical or Psychological treatment.

Do you believe that upsetting events in your life are responsible for your negative feelings? If so, you’re not alone; this is a popular idea, but not strictly true. Adverse events do not cause our upsetting emotions, but our beliefs about those events do.

Let me explain: We all experience the frustration of waiting for a late train from time to time. If you look at the commuters on the platform, you may notice some of them getting very worked up. A few may be pacing up and down the platform as though this will magically make the train arrive. Others remain calm, taking their time to listen to their iPods or read their newspapers.

This is an example of people reacting to the same event in opposite ways, with different emotions and behaviours. The passengers who become upset are reacting to the delay in a way that is sure to cause them distress. Most people would assume that their anger is due to the late train, and to a large extent, this makes sense – after all, who likes to be kept waiting? However, this fails to explain why other passengers faced with exactly the same situation remain calm.

To understand the differences in the passenger’s attitudes and reactions, we need to look at a model of emotional upset first described by the American psychologist Dr Albert Ellis, the pioneer of Rational Emotive Behavior Therapy. He calls this the A.B.C. model. ‘A’ is the activating event, meaning any potentially stressful situation. ‘B’ stands for beliefs – in other words, a person’s thoughts and attitudes about ‘A’, and ‘C’ stands for the consequence, i.e., a person’s feelings and actions.

The theory behind the A.B.C. model is simple: Feelings are caused more by our thoughts about events than by the events themselves. According to the model, it is not being kept waiting for a train that is responsible for the passengers’ different feelings, but the way they are thinking about the situation.

A commuter remaining calm is probably thinking:

“This is a nuisance but not the end of the world.”
“There is not a lot I can do, so I shall have to grin and bear it.”
“I might as well relax and make the best of things.”

A commuter getting angry is likely to be thinking:

“This train must arrive immediately. This is terrible. I can’t stand being late for work.”

In the A.B.C. format, the angry driver’s situation looks like this:

A. Event: Commuter waiting for a late train.

B. Beliefs: “This train must arrive immediately.”
“This is terrible.”
“I can’t stand being late for work.”

C. Consequence: Anger. Body feeling tense – pacing up and down the platform.

The above beliefs are an example of what Dr Ellis has called irrational thinking and would lead anyone who thinks in this way to become angry. Many people would question the idea that these beliefs are irrational. Given the circumstances, wouldn’t anyone who is delayed for work think in this way? This is a good question, and in order to answer it, we need to take a close look at the make-up of irrational thinking.


WHAT MAKES THINKING IRRATIONAL?

The characteristics of irrational beliefs are:

  • They are unrealistic
  • They are rigid
  • They blow events way out of proportion
  • They lead to unhealthy feelings that cause distress

When we hold an irrational belief, we are demanding that events and circumstances be different from the way they actually are by using words such as ‘must’ and ‘should’.

E.g. “I must do well.”
“You should treat me well.”
“Life must go the way I demand.”

It is not the words in themselves, but the attitude behind the words that causes the problem. By making such inflexible demands, we set ourselves up for distress, if – as inevitably happens – life doesn’t go quite the way we’d planned.

Many of us also exaggerate the severity of events by using words such as ‘awful’, ‘terrible’ and ‘I can’t stand it’. Whenever we think in this unhelpful way, we will experience emotional pain such as anger, anxiety, guilt depression and feelings of inferiority – all emotions that lead to distress.

In the late train example, the angry commuter is holding the rigid belief, “This train must arrive immediately.” In reality, will demanding that the train arrive immediately make it arrive? Secondly, the commuter is exaggerating the badness of the event by describing it as awful. It is certainly annoying if your train fails to arrive on time, but can it truly be described as awful? Finally, why can’t he stand being late for work? In reality, people can stand almost anything.


HOW TO CHANGE IRRATIONAL THINKING

To change unhealthy feelings and actions, we need to challenge the way we think by adding ‘D’ to our A.B.C. model. ‘D’ stands for disputing and involves vigorously questioning the validity of our irrational beliefs.

We can do this by asking a number of questions:

What is the evidence for my must/should?
E.g. why must the train arrive immediately?
Why is it terrible?
Why is it awful?
Why can’t I stand it

The following example illustrates how to challenge irrational beliefs.

Clair is a secretary who recently lost her job at an advertising company. When she came to see me for counselling, she was feeling depressed and felt it was not worth looking for new employment.

Clair was thinking:

“I should not have lost my job. I can’t stand it. I am totally incompetent and will never get another job like that one again.”

A. Event: Clair loses her job.

B. Beliefs: “I should not have lost my job.”
“I can’t bear it!”
“I am totally useless.”
“Another job like that will never come along again.”

C. Consequence: Feeling depressed and unable to look for a new job.

After Clair talked the situation though with me, she was able to see that her depression had more to do with her irrational thinking than the job loss itself. In particular, she was doing a first-class job at running herself down. Once she was aware of this, Clair was ready to challenge her irrational beliefs.

Here’s how she did it:

D. Why should I have kept my job?
“Although I would strongly prefer to still be in my job, there is no law that states I should not have lost it.”

D. Why can’t I stand losing my job?
“In reality, I can stand losing my job. I have faced difficult situations before and coped. I can cope with this challenge too.”

D. What evidence exists that I am totally incompetent?
“No evidence exists for this idea. I made a number of mistakes while in the job, but that doesn’t prove that I am totally flawed – just human. I have done well in past jobs and I can do well again.”

D. What evidence exists that I will never get another job?
“There is no evidence; I am a competent woman with a lot of skills and work experience to offer. I have found other jobs before and I can do so again.”


RATIONAL BELIEFS

The characteristics of rational beliefs are:

  • They are realistic
  • They are flexible
  • They do not blow events out of proportion
  • They lead to healthy, appropriate feelings

Challenging irrational beliefs helps us form rational beliefs and change the way we feel about an event. By disputing her ideas about the job loss, Clair was able to change her demand that she should not have lost her job into a healthy preference for not losing it. Being unemployed was a setback, but by reminding herself that she had a lot of skills to offer, Clair was able to see that the situation was not awful. She had been in similar situations before and she could find another job again.

Clair was now ready to add ‘E’ – which stands for Effective new thinking – to the A.B.C. model. ‘E’ looked like this: “Although I would have strongly preferred not to have lost my job, I did. I have experienced difficult situations before and managed. I can get through this, too. I succeeded in past jobs and will do so again.”

After changing her thinking, Clair felt sad but no longer depressed. To feel sadness after a job loss is healthy. It would be unrealistic to expect her to feel over the moon given the circumstances. Depression, on the other hand, is an unhealthy emotion and is often an indication that a person is thinking in an irrational way.


THE SPEECH THAT NEVER WAS

Katie is a successful 28-year-old physiotherapist working in a large practice in London. Liked by her patients and co-workers, Katie has recently been promoted. However, when it comes to socialising, Katie is very shy. She is often asked out to parties by her flatmates and co-workers but more often than not declines. Instead, she spends most weekday evenings watching television and at the weekends goes home to her family in Somerset.

Katie told me about an incident that occurred at a party a number of years ago. It was a good friend’s graduation party and Katie had been asked to make a small speech to congratulate her. Being shy, Katie had always avoided these kinds of situations however small the crowd. But during her time at university, Deborah had become a friend she relied on and backing out of the speech didn’t seem like an option. Katie had written down everything she wanted to say and had rehearsed it about 10 times.

When the time came for Katie to give the speech, her heart started to pound. She opened her mouth to speak but couldn’t seem to focus on the words she had written down. She felt herself going bright red, her hands started shaking and her heart was racing. The next thing Katie realised was that she had run out of the room. Katie told me that everyone was very worried and extremely kind to her, but as far as she was concerned, one of her worst nightmares had become a reality.

Since that party, Katie has felt like a total failure; she is still friends with Deborah but rarely goes out to socialise with her.

Katie believed that she had to give a perfect speech and that if she didn’t, then she wouldn’t be able to cope. The unrealistic belief Kate held was:
“I must give a perfect speech – if I don’t, it’ll be awful and I won’t be able to stand it.”

She also believed that her friends wouldn’t accept her if the speech wasn’t flawless. Katie was terrified of what others might think or even say about her if her speech wasn’t good enough. The demand Katie placed on others was:
“People must think well of my performance; if they don’t that proves I am worthless.”

Let’s join Katie in the middle of her therapy session with me:

Katie: “I can now see that the belief that I must give a perfect speech led to my anxiety.”

Michael: “That’s correct; when we hold dogmatic, inflexible beliefs, we can quickly develop negative emotions. The problem was your idea was not based on reality. You were asking for a guarantee that you wouldn’t make any mistakes, yet who can guarantee that? It would have been far better to keep your beliefs flexible with a rational idea such as, ‘I would really like to give a perfect speech, but it’s not the end of the world if I don’t”

Katie: “Oh, I couldn’t possibly have done that – I wouldn’t want my friends thinking I was worthless.”

Michael: “Who thinks that you are worthless, you or your friends? Have they told you that you are worthless?”

Katie: “No, they haven’t.”

Michael: “Perhaps you believe you’re worthless and that you must prove to others and to yourself that you are not. That is why you demanded that you MUST give a perfect speech. A lot of people think they have to prove they are not worthless instead of starting out with the belief that they are okay. Someone thinking rationally may have thought, ‘Well, I messed that up; what can I do to rectify the situation?” rather than irrationally thinking, ‘I messed that one up; that proves I am useless.’”

Katie: “OK, I see that but how could I have stopped myself messing up in the first place?”

Michael: “By giving up your irrational belief; when you demand that you absolutely must give a perfect speech, with no mistakes at all, you put yourself under so much pressure that you virtually guarantee that mistakes will occur. A belief is rational when you accept that you’re human and allow for the possibility of errors. That way you take a lot of the pressure off yourself and paradoxically you are more likely to make a far more relaxed, genuine speech and to enjoy it, too.”

I taught Katie how to use a self-help form to identify, challenge and then change her irrational thinking.

SELF-HELP FORM

Get a sheet of paper and a pen and at the top of the page write:
A. The event
Describe the situation – try to be specific.

B. Irrational beliefs
Identify and write down your irrational beliefs about the event. Remember, irrational beliefs are rigid and contain words such as ‘should’ and ‘must’, e.g., things must go the way I demand. They exaggerate the badness of an event, turning a nuisance into a horror, e.g., it’s awful/terrible/I can’t stand it.

C. Consequences.
Write down how you felt and acted in relation to the event.

D. Disputing
Vigorously question the validity of your irrational beliefs by asking the questions outlined in Clair’s example.

E. Effective new thinking
Write down your new rational beliefs.

F. New feelings and actions
Write down how you now feel and act.

Here is how Katie used a self-help form:

  • The event

Giving a speech to congratulate my friend on her graduation.

  • Irrational beliefs

I must give a perfect speech—if I don’t, it’ll be awful and I won’t be able to stand it.

  • Consequences

High anxiety; running out of the room.

  • Disputing

Why must I give a perfect speech?
I would highly prefer to give a perfect speech, however there is no law that states I must.

What evidence exists that I wouldn’t be able to stand it if the speech went wrong?
None—in fact, I have had many things go wrong in my life. I felt very uncomfortable but I am still alive and kicking.

What evidence exists that my friends would think any less of me if my speech wasn’t perfect, say for instance, I slipped up on a few words?
No evidence exists for this idea. I have said things that I considered stupid in the past and not been rejected.

Even if some of my friends did reject me, would that really be the end of the world?
No, I would strongly prefer not to be rejected – then again, I wouldn’t want to remain friends with people that were so shallow.

  • Effective new thinking

I would strongly prefer to give a perfect speech, but I don’t have to. If it’s less than perfect, it won’t be the end of the world. If my friends reject me that would be upsetting but I wouldn’t want to remain friends with such shallow people.

  • New feelings and actions

Feeling apprehensive, but not anxious and worthless. Believe I can talk to my friends about my anxiety in a constructive way.

THIS IS NOT JUST POSITIVE THINKING

You may be familiar with the many books that are available on how to think positively. Positive thinking is a very good idea. In fact, there is now a significant amount of research showing that optimism is an important component of psychological health. However, there is a big difference between rational optimism and the “everything in the garden is rosy” brand of positive thinking. It can be self-defeating and potentially damaging to chant “every day in every way I’m getting better and better” while overlooking real problems and issues that need to be addressed. Rational Emotive Behaviour Therapy avoids this potentially damaging form of Pollyanna thinking. Instead of offering positive platitudes, it gets right to the heart of your faulty thinking, helping you to challenge and change unhelpful thoughts with positive but rational thoughts. This changes the way you feel and helps you achieve your goals.

NEGATIVE EMOTIONS CAN BE HEALTHY

There are two types of negative emotions, unhealthy negative emotions and healthy negative emotions. Earlier in the chapter, we saw how when Clair lost her job she felt depressed and lacked the motivation to look for another job. Depression is an unhealthy negative emotion and is usually the result of irrational thinking. After Clair challenged her negative beliefs about losing her job, she felt appropriately sad and decided to look for another job.

Sadness is a healthy negative emotion because it is appropriate to feel sad after an unexpected job loss. When filling out your own self-help form, don’t make the mistake of trying to feel good about a negative situation.

Instead, aim to change your feelings appropriately.Here are some other examples of unhealthy negative emotions and healthy negative alternatives:

Unhealthy-------------------------------------------Healthy

Anxiety-----------------------------------------------Concern

Damming anger-------------------------------------Anger or annoyance

Shame-----------------------------------------------Regret

Guilt------------------------------------------------- Remorse

Jealousy ------------------------------------------- Concern

Hurt------------------------------------------------- Disappointment

You may be thinking, “Is it really that easy? Do I only have to identify and change my irrational thinking to make such a big difference in how I feel?” The process of filling in a self-help form is indeed quite easy. With some practice, you will soon get the hang of it. Changing the way you feel will take a little longer and, to quote Dr Ellis, requires “work and practice.” You may have to go over your new thinking several times a day, like Katie did. Take into account that, when under stress, most people have difficulty thinking rationally. You have probably been thinking in irrational ways for a long time. However, by putting in the effort, you will soon find yourself getting less upset.

MAJOR POINTS

  • Adverse events do not cause our upsetting emotions, but our beliefs about those events do.
  • When we hold an irrational belief, we are demanding that events and circumstances be different from the way they actually are.
  • Irrational beliefs are unrealistic, rigid and blow events way out of proportion. They lead to unhealthy feelings that cause distress.
  • Challenging irrational beliefs helps us form rational beliefs and change the way we feel about an event.
  • Rational beliefs are realistic, flexible and do not blow events out of proportion. They lead to healthy, appropriate feelings.
Changing the way you think and feel takes work and practice; however, the change in the way you react and behave makes it worthwhile.

Article © 2009-2010 Michael Cohen