by Ericka Martin, LMHC, LPC | CBT
Are you interested in learning more about Cognitive-Behavioral Therapy as a mode of counseling or self-help? Check out these 7 amazing online resources:
- https://llttf.com/ Living Life to the Full
Living Life to the Full is an interactive CBT website. This free online course incorporates audio and video clips throughout the learning modules. The site includes handouts for each course topic, a moderated discussion forum, assessments tools to track progress, and an array of other self-help materials. Users can also invite a mental health practitioner to view your progress and provide feedback.
- http://www.cci.health.wa.gov.au/ Centre for Clinical Interventions
The Centre for Clinical Interventions provides information on struggles (ex. Anxiety, Assertiveness, Depression, Panic, Perfectionism, Sleep, etc.) and gives access to free downloadable workbooks, customized to that area. Each topic includes 7-12 user-friendly chapters. It is an instantly practical resource. Click on “Resources” and “Looking After Yourself” to find the resource best suited to your needs.
- http://www.suffolkcognitivetherapy.com/web/resources/worksheets/ Suffolk Cognitive Therapy
This website provides free audio recordings of mindfulness instruction, including “Progressive Muscle Relaxation,” “Watching Thoughts Drift By,” “Acceptance of Anxiety,” and “Acceptance of Thoughts and Feelings.” They also provide clinical forms for practicing cognitive therapy, including a Thought Record, an Objective Thought Exercise & Worksheet, and a Values Exploration Worksheet.
- https://www.academyofct.org Academy of Cognitive Therapy
The Academy of Cognitive Therapy shares CBT outcome studies, describing conditions that are treatable with CBT, including a spectrum of anxiety and mood disorders, eating disorders, and a surprising amount of medically related disorders (including insomnia, IBS, chronic fatigue, and chronic pain).
- http://threeminutetherapy.com/ Three Minute Therapy
This website has an entire book online, free of cost. The book is “Three Minute Therapy: Change Your Thinking, Change Your Life” by Dr. Michael Edelstein. The book includes an explanation of cognitive therapy, CBT applications for a variety of topics (i.e. worry, self-esteem, anger, and overeating), and a three-minute exercise that walks users through the A-B-C-D-E-F approach to cognitive re-framing.
- http://www.rebtnetwork.org/ REBT Network
The REBT Network elaborates on Albert Ellis’ ABC Model of rational-emotive-behavioral therapy, explaining how beliefs are connected to our emotional and behavioral reactions. This website also includes forms for disputing irrational beliefs and walking yourself through REBT therapy. You can also download free copies of “How to Conquer Your Frustrations” by Dr. William J. Knaus and “Rational Emotive Education” by William J. Knaus.
- https://moodgym.com.au/ Mood Gym
Mood Gym is an interactive website that uses cognitive therapy to treat depression or anxiety. This low-cost site ($28.15 annual fee) incorporates quizzes, worksheets, animated demonstrations, and skill building into its program. It also tracks your progress through the workbook and helps you measure your results.
by Ericka Martin, LMHC, LPC | CBT, Counseling
Have you ever wondered how your feelings are generated? Do you understand what it is that triggers your emotions?
The fact is, there are many different answers to these questions in the field of psychology. Let’s take a look at just one of those approaches from the world of cognitive therapy. Cognitive-behavioral therapy (CBT) teaches that all moods are generated by our thoughts and reinforced by our behaviors.
Most thoughts that occur in the heat of an emotional moment are automatic. Often, these thoughts occur spontaneously, without conscious intent; hence the term “automatic.” Thoughts that are skewed negatively can lead to amplified emotional pain (ex. Sadness, anger, anxiety, or hopelessness), which is often what prompts people to come to counseling to begin with.
A cognitive approach to counseling helps people with uncovering and re-framing negative thoughts with the assumption that changing these thoughts changes the intensity of the feelings.
What happens in cognitive therapy?
- A counselor that uses cognitive therapy or CBT might start by asking you to describe the context in which particularly strong feelings are being triggered. What is happening? Where are you? Who are you with? What happened first?
- The counselor might prompt you to name the different emotions happening in that specific situation. Sometimes there is more than one emotion happening at the same time. You might even rate the intensity of the feelings (Example: Shame 90%; Anxiety 55%).
- A cognitive counselor will be especially interested in helping you identify the automatic thoughts that happened before, during, or after the situation you’re discussing. To help with this, they might ask questions like: What was running through your mind when you started feeling ashamed/anxious/sad/guilty? Sometimes there are several automatic thoughts related to a particular situation. Maybe you’ve experienced a flood of negative thoughts one after another. Sometimes thoughts can swirl around so quickly that they feel like a hurricane of negativity. When that happens, the therapist can help you address them one at a time. You might start with the thought that evokes the most painful or intense emotions.
- You might be asked to identify and confront any distortions in your thought process. For example, noticing thoughts that are all-or-nothing, overly catastrophic, attempt to tell the future, attempt to read someone’s mind, or overly personalize things.
- You might be asked to examine evidence that your automatic thought is not 100% true. The workbook, “Mind Over Mood,” has a wonderful Thought Record worksheet that can help with challenging those emotionally heated thoughts.
- After examining the thought (and the evidence for/against the thought), you might be asked to try out a new thought. The new thought might not be all rainbows, unicorns, and false positivity. Instead, the new thought might be experienced as neutral, balanced, fair, and more reflective of a truth apart from emotional reasoning.
- After trying out the new line of thinking, a cognitive counselor might check in to see how the intensity of the emotions changed as a result of changing thinking.
- Perhaps, then, you might begin to explore how you would behave differently if the new thought were to take root.
Cognitive theory teaches that long-term thought change requires a re-examination of core beliefs.
After evaluating automatic thoughts over a period of time, many people find patterns in their thinking that reflect deeper beliefs that are at the center of their distress. Once exposed, you can dispute those beliefs and act against them. This is when “schema” change takes place. According to Dobson & Shaw (1995), cognitive schemas reside in the long-term memory, serving as a “vulnerability factor” for their negative thinking. In order for enduring change to take place, individuals must create new lenses from which to see themselves, others, and their environment.
Cognitive counseling helps people develop an awareness of the unhelpful thoughts that are contributing to intense feelings. People really can learn to replace destructive thoughts with more functional thinking. In cognitive therapy, there is hope for a new perspective on life.
Interested in learning more? Check out the resources listed below or read additional articles on our Cognitive Behavioral Therapy page.
References
Burns, D. (1980). Feeling Good. New York: Signet.
Dobson, K. & Shaw, B. (1995). Cognitive therapies in practice. Comprehensive Textbook of Psychotherapy: Theory and Practice. New York: Oxford University Press.
Dozios, D., et al (2009). Changes in self-schema structure in cognitive therapy for major depressive disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77 (6).
Froggatt, W. (2005). A brief introduction to rational emotive behaviour therapy. Handout.
Greenberger, D. & Padesky, C. (1995). Mind Over Mood: Change How You Feel by Changing the Way You Think. New York: Guilford Press.
Jones, S. & Butman, R. Modern Psychotherapies: A Comprehensive Christian Appraisal. Illinois: InterVarsity Press.
Wenzel, A, et al (2009). Cognitive Therapy for Suicidal Patients. Chapter: Cognitive therapy: General principles. Washington, DC: American Psychological Association.
by Ericka Martin, LMHC, LPC | Counseling
1. How does confidentiality work in therapy?
Seeing a counselor is sort of like being in the witness protection program. Even the fact that the counselor knows you is kept private and confidential. That means that when they run into you out in public, the counselor does not flag you down and say– “Hey! It’s me, your therapist! Remember me from counseling?” (How awkward would that be!?)
Instead, therapists wait for you to initiate “hellos” and are usually glad to say “hi” right back. Counselors don’t ever want to put you in that uncomfortable position where you have to explain how you know them to the people you are with.
As you may have heard, there are some exceptions to confidentiality, especially when safety is at risk.
- If you talk about children, elderly people, or disabled people that are being abused or neglected, your counselor is considered a mandatory reporter.
- Your counselor would also break confidentiality if you disclosed plans to harm someone else. Counselors really don’t want anyone to be murdered! (That’s a good thing, right?!)
- Counselors often see clients with thoughts of suicide. That really doesn’t freak us out. It’s more common than you’d think! When we DO break confidentiality is when that person is losing the ability to keep themselves safe. Because teens are a high risk population when they have thoughts of suicide, it’s common for therapists to seek coordination with family supports whenever risks of harm are involved.
- Counselors are required to provide you with a copy of their privacy practices where you can read in more detail about how confidentiality works in this unique setting.
2. Why can’t I be Facebook friends with my counselor?
Counselors have to abide by professional standards and ethical guidelines. The 2014 ACA Code of Ethics introduced a requirement asking counselors to separate their professional and personal social media profiles. Those ethical guidelines do not permit counselors to communicate with clients via personal social media accounts. Counseling is unlike other relationships in your life, different from friendships and different from family connections. Part of what makes it effective is that separation and neutrality. Those boundaries help make therapy a safe place to express yourself without worrying about what your therapist is going to think, which can be triggered by social media comparisons. It’s for these reasons that your counselor cannot connect on Facebook or similar platforms.
3. What should I get my counselor for Christmas?
Okay, this was a trick question. Please don’t get your counselor anything for Christmas (or any other special occasion). Our ethical codes discourage counselors from receiving gifts from clients. We see some very generous people come through the door who love to show appreciation and gratitude by gift giving. When counselors decline your gift, know that it is not a personal rejection. It is instead another one of those professional boundaries drawn from the ACA Code of Ethics, which advises counselors to remain mindful of putting the therapeutic relationship first. More than anything, your counselor wants to avoid any situations that may cause a conflict of interest.
by Ericka Martin, LMHC, LPC | Body Image, Depression, Self Acceptance, Self Worth
The feeling of shame has a reputation of being the vampire of emotions–the feeling that will suck the life right out of you. Because it comes with it a very physical discomfort, heat, and pain, it’s probably on your list of emotions to be avoided at all costs.
In this blog, I’m going to ask (and attempt to answer) the hard questions: Why do we experience shame? What utility does it have for us? What’s a person to do when they’re feeling trapped in a shame spiral?
First, to understand why we experience shame, we have to explore what triggers it.
Shame happens when you’ve broken an agreement that you’ve made with yourself. It is a faithful (and loud) reminder that you’ve strayed out of bounds and broken an internal “rule.” Sometimes shame goes ahead of you, before you’ve actually done the “wrong” deed, preventing you from taking an action that would be out of alignment with your values.
Our internal “rules” are a mixture of AUTHENTIC and INAUTHENTIC shame, a concept pioneered by Karla McLaren in her book, “The Language of Emotions.”
AUTHENTIC SHAME:
AUTHENTIC shame happens when you’ve broken the code of your character or integrity. These “rules” are the moral code that you would apply NOT ONLY to yourself but to other people as well. For example, a part of my moral code is to not gossip. Every single time I find myself participating in gossip with a friend, a feeling of shame creeps up, informing me with its icky feeling that I’m out of line. My “rule” about gossip is one I would teach my children and one I’d hope all people would embrace.
AUTHENTIC shame helps you live a value-drive life. It acts like a curb, nudging you back to alignment with your deepest sense of integrity.
INAUTHENTIC SHAME:
On the other hand, INAUTHENTIC shame happens when you’ve broken internalized rules that apply ONLY to you. Here are several examples:
- A student to has to get all A’s and feels shame for that lone B+ on their transcript.
- A teen girl feels shameful disgust for the fat on her body because she’s taken in messages that fat is abnormal/wrong/shameful
- A woman has a miscarriage and feels shame, believing this wouldn’t have happened to her unless there was something bad/wrong with her.
- A man looks in the mirror at his receding hairline and feels a twinge of shame, as if he’s broken the rule that a man must have a full head of hair.
- A professional’s voice shakes while giving a presentation at work, feeling shame because they believe it’s bad/wrong to display any form of anxiety in public.
INAUTHENTIC shame is triggered by breaking the “rules” you have for yourself that you would NEVER intentionally pass on to other people.
With INAUTHENTIC shame, there is likely a part of you that recognizes the harmful nature of your “rules.” You might recognize that it contributes to your experience of depression, low self-esteem, poor body image, or toxic perfectionism. AND, you might still feel stuck, buying into those “rules” despite your recognition of the double standard at play.
HOW DOES INAUTHENTIC SHAME DEVELOP?
INAUTHENTIC shame springs forth from messages you’ve received from the outside (a critical comment from someone or maybe even messages from the media about what an ideal person is like). It’s as if you’ve taken someone else’s garbage home with you, accepted it as your own, and lived with its stench day after day.
THE REALITY IS: Whether your experience of shame is AUTHENTIC or INAUTHENTIC, 100% of the time it is informing you about internal rules that you are breaking.
4 STEPS FOR BREAKING OUT OF INAUTHENTIC SHAME
- Start by labeling the shame as INAUTHENTIC, as something that has been applied to you and caused you harm.
- Identify clearly what “rule” you are breaking. What are the specific details of the rule? For example: The rule that I’m not allowed to make mistakes OR The rule that I have to do X, Y, and Z by the time I’m 30 or else I’m a failure.
- Ask yourself: Where did this rule come from? What has allowed this rule to take root in you over time? Whose garbage is this?
- Try out Karla McLaren’s CONTRACT BURNING visualization skill for a powerful and effective way of releasing that old “rule.”
If you’d like help shifting out of INAUTHENTIC shame, a counselor may be able to help. The counselors with Star Meadow Counseling love helping clients explore and alter the “rules” that have kept them stuck.
References:
Alexander, S. (2018). Mind Body Connections.
McLaren, K. (2010). Language of emotions. [United States]: Sounds True.
by Ericka Martin, LMHC, LPC | Anxiety, Coping, Depression, Obsession
Do your thoughts ever end up stuck in the past, replaying a conversation or event in your head?
Susan Nolen-Hoeksema from Yale University describes ruminating as “a mode of responding to distress that involves repetitively and passively focusing on symptoms of distress and on the possible causes and consequences of these symptoms.”
You’ll know you are ruminating when:
- You replay the same old memory over and over, like watching a video on a loop
- You examine the memory in detail, play-by-play
- You think (and re-think) about what you could have said or done differently to cause a different result
- You try to remember exactly how another person reacted in order to evaluate yourself
Most people do not enter into ruminating thoughts on purpose. Instead, ruminating tends to be an automatic response and force of habit. You might even ruminate without realizing it consciously until you start feeling slightly (or a lot) embarrassed, anxious, disappointed in yourself, or guilty. Because the thoughts operate on auto-pilot, they are often unproductive. The thoughts can leave you with hyper-judgmental inner thoughts that have gone nowhere to propel you forward.
Have you ever paused to wonder: WHY ARE THESE THOUGHTS HAPPENING TO ME? WHAT’S THE POINT?
In her book, “The Language of Emotions,” Karla McClaren suggests ruminating might not only be replaying the past, but is in fact is the brain looking for NEW information. This new information might be of help to you in future, similar circumstances.
What if ruminating thoughts bring with them a powerful GIFT? What if you could channel their efforts into something that DOES help and DOES move you forward?
Here are some tips for ruminating more effectively and purposefully:
- Notice when you are ruminating and name it: “I’m ruminating.” This will help you shift into on-purpose self-reflection and away from a spiral into automatic negative thinking.
- Reflect back looking for learning points. What would I have done or said differently if I had a do-over? What did I miss that I’d want to watch for in the future?
- Avoid judging yourself. Labeling yourself harshly (Example: “failure”) serves no practical purpose and only causes you harm. In fact, rumination that is laden with negativity about yourself amplifies your experience of depression or anxiety.
- Be kind to yourself and intentional about practicing self-compassion. That means assuming the best about why you did or said what you did in those moments. In that moment, you probably did the best with what you knew. If practicing self-compassion is difficult for you, a counselor may be able to help.
- Some events we ruminate on were not in our control. Don’t take ownership of stuff that’s not yours, especially if it’s related to an experience of abuse.
- Know when to stop. The moment you realize that reflecting back is not helpful (HINT: You’re finding no further learning points), call it quits. There are a number of different strategies you can take to help you let go of unhelpful intrusive thoughts. Try out a cognitive defusion technique, prayer, or confirm to yourself out-loud: “These are just thoughts. They’re not helping anymore. I’m letting them go.” Some intrusive thoughts are harder to shake than others, especially if they’ve been around for a long time or if there’s trauma involved. Be patient with yourself and don’t be afraid to ask a counselor for help.
If you’d like assistance shifting out of a destructive pattern of rumination, a therapist at Star Meadow Counseling might be able to help. We love to see clients shift ruminations into something more constructive, useful, healing, and less self-critical.
