Power of Positive Thinking versus CBT


I met someone recently at a party who asked what I do for work.  When I responded that I’m a cognitive behavioral therapist, she questioned, “Oh, isn’t that the power of positive thinking?  Like if you’re sad, tell yourself, ‘don’t feel that way, just think positive!'”  This is a common misconception and I’d like to offer some insight on the matter.

CBT is about learning to think realistically, which is not to be confused with ‘positive thinking.’

CBT involves recognizing the irrational and dysfunctional nature of many negative thoughts that occur when people are experiencing a mood disorder, like clinical anxiety or depression.
For example, let’s say you are feeling depressed.  The 1st step is to identify why you feel this way, in other words, what causes this emotion?  The secret is in your thoughts, what you say to yourself.  Just as you start to notice your mood sink, ask yourself, “What is going thru my mind right now?”
So let’s say you identified the thought, “I’m unlovable.”  If you believe this thought to be 100% true it makes sense you would feel depressed!  Anyone would feel depressed if they believed this thought.  The problem is NOT your emotions (because they are quite logical here) but the problem lies in your faulty thinking.  (Important: this does not mean you’re ‘bad’ for having these thoughts. Faulty thinking is a symptom of psychological problems, just like a cough is a symptom of the flu.  These thoughts are not intentional – they occur rapidly and are often outside our immediate awareness.  The good news is that you can learn to change these thoughts and therefore feel better!)
A cognitive therapist does NOT tell you, “Oh come off it!  You’re the best thing since sliced bread!”  Instead, a good cognitive therapist helps you examine your thoughts and consider how accurate and useful they are.  The therapist will help guide you to recognize distorted thoughts, see yourself in a more balanced way, and build self-compassion.  So we might pursue the following lines of inquiry: How do you define ‘unlovable’?  Does everyone define the term ‘unlovable’ in this way?  If no, why not?  What is the evidence that you’re unlovable?  What is the evidence this label is not true about you, or not completely true all the time?  If you conclude there are things about yourself you don’t like, what can you do to improve?
‘Positive thinking’ on the other hand would be telling yourself, “I’m not unlovable, I’m perfect in every way at every moment!!”  This is an exercise in futility because you know it is not true.  No one is perfect all the time!  This kind of positive thinking is ineffective and illogical.

The point of CBT is to help people examine negative thoughts, identify cognitive distortions or errors, and replace distorted thoughts with more accurate thoughts, so they can feel better.

Just wanted to offer some clarification here!


Define your terms


I often observe that when people are depressed, they describe themselves in perjorative, highly-charged words – e.g., “I’m unlovable; ugly; a failure; or worthless.”  In essence, they are labeling themselves.  Here is some advice for this problem:

When you use a word, especially if you fall into labeling yourself, ask “what does that word/label really mean—what is its definition?”  Totally forget about yourself for a minute and define the word/label in terms of real behavior—what does that word/label look like when someone totally other than yourself or anyone you know does it/is it?  Write that definition down and then ask yourself, does that really apply to me, 100% of the time?

Example: “I’m a loser”. OK, if you want to affix a global, permanent label like that to yourself you had better know what it means, right?  So define “loser” WITHOUT thinking in terms of you, your life, your situation, your mood.  What does “loser” mean?  What would a “loser” say, do, and think?  BE SPECIFIC!

A “loser” is someone who:

– Fails at everything they do or have ever done, 100% of the time.

– Has never been able to keep any relationship going for even a day

– Says “I’ll never succeed” AND then makes that true by never attempting anything

– Thinks “why try?” AND then makes that true by never attempting anything

– Shirks every (100%) of his/her responsibilities

– Is neither loved not respected, not even a fraction, by anyone

– Will not be missed by anyone at all (not even 1 person) if they leave or even die

– Loves no one even the least bit


How to succeed with failure


Failure tends to strike fear in our hearts like nothing else.  There is so little tolerance for it in our culture and tremendous pressure to get it right every time, to be in control, and to succeed and win.
But because we are human, we cannot help but fail.  We suffer from failed relationships, failed marriages, failed parenting, failure at work, failure in health.  And when we do fail, the wounds may penetrate so deeply into our psyche that we begin to think, “I AM a failure,” rather than, “I failed.” We might begin to make overly safe choices, to settle for less than we really want, out of fear of failure.
What would it be like to cast failure in a different light, to take it out of the darkness of disgrace and guilt, to remove the feelings of “disaster” associated with failure, to look for what it tells us about our well-being and our conduct in life?  What enormous amounts of energy would be freed up?  And for what?

Here are a few suggestions for working constructively (succeeding!) with failure:

Acknowledge your feelings of pain, humiliation and/or inadequacy.
Acknowledge your responsibility.  Don’t deny the importance of failure, but neither let it overwhelm you with guilt.  Guilt isn’t helpful; taking responsibility is.
Forgive yourself.  Forgiveness doesn’t take away the consequences or the memory of the failure, but it does soften the fall and clear a path for the next step.
Build a base of supportive people. Share the reality of your life.  When you stop hiding shame and denying negative feelings, issues are quickly surfaced and resolved.
No self-recrimination.  Replace “If only…” with “Next time…” to keep focused on the future.
Reflect.  Seek not to blame but to search for the wisdom beneath the failure. With real curiosity, ask yourself these questions:
How can this failure serve me?
What have I learned and gained?
How can I use this failure?
How can I see it in a different way?
What is positive here?
Expect to make mistakes again. Ultimately, failure is not about loss, deficiency and flaws.  It’s about learning lessons and courageously moving on.  It’s about retaining hope and the instinct for joy.  The lessons of failure make us wiser, stronger, and more prepared for the rest of our journey, if we take them with us.


Self blame or self-inquiry?


This is an article written by one of my favorite authors and colleagues, Dr. Richard Joelson, on the risks associated with making overly negative interpretations/jumping to conclusions.
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In the course of one’s life, many positive and negative things will occur that are unexpected and may be unexplained. We are, of course, delighted when the positive event comes our way that contributes something to our welfare, e.g. the unexpected raise or promotion at work,  or a personal success like a new romantic partnership. The negative events or developments, not surprisingly, are more difficult to process and for some, require considerable effort to accept.
Diane was stunned when abruptly informed that she was being fired from her high-level executive position. She had enjoyed two successful years at her job, seemed well liked by senior colleagues and her subordinates, and so could not understand why she was being let go and without clear cause.

Ed, a divorced father of two young sons and a self-proclaimed “veteran of the dating wars” was thrilled to have met Kathy through a mutual friend and was thoroughly enjoying the positive progression of their new relationship. Unexpectedly, Kathy seemed to cool to Ed’s further overtures and weeks later declared her wish to end their relationship. Ed’s pursuit of an explanation for this sudden change seemed to fall on deaf ears as Kathy virtually disappeared from his life.
It is very understandable for people in both Diane’s and Ed’s life situations to want to make sense of what occurred and to fill in the many blanks left open by the surprising actions of others. Arguably, occurrences like these are among the most difficult people face, for in addition to being shocked and bewildered, there may be nothing one can do other than cope with the event in the best possible way.

Many people become self-critical or self-blaming in the course of their efforts to understand things that make no sense to them. People with self-esteem difficulties are especially vulnerable to self-blame and may develop ways of explaining negative events that inevitably make them feel even worse. This is best typified by beliefs like “It must be me,” “I must have done something wrong,” or “maybe I was never adequate to begin with.”

While self-blame is something to avoid, an inquiry by the injured person into what they might have done to contribute to their unfortunate circumstance might prove extremely helpful.  Diane might wonder whether or not there was anything she did that resulted in her dismissal, so that she might learn something from which she could benefit in the future. It is also possible that through thoughtful inquiry, she might discover that her firing had little, if anything, to do with her.  In Ed’s case, similarly, rather than lick his wounds and disparage himself, he might discover something that would provide useful information for future romantic adventures. He may also come to realize that Kathy’s abrupt ending of their relationship had a great deal to do with Kathy and little, if anything, to do with him.

Actual outcomes: Diane’s boss felt that while her work was superior, her role in the organization needed to be filled by someone who was a more aggressive person. While no one else agreed, he was the boss and did as he pleased. Clearly, Diane was helped to discover this information following both her internal and external inquiry, and walked away with both her self-esteem and her dignity intact.

Once Ed moved away from self-blaming to a meaningful self-inquiry, he discovered the possibility that his own growing ambivalence about Kathy may have led him to behave differently in the relationship. This perhaps prompted her to find him less appealing than earlier when he was very enthused and eager to be with her. It was helpful, too, to learn by chance that she had been having a hard time with her strong positive feelings and that had made it difficult for her to continue with him.


How to be successful in therapy


When people come to therapy they are often unsure of what to expect and sometimes ask about how to get the most out of our meetings. There are several important things that you can do to increase your chances for success in therapy.

I define “successful therapy” as achieving one’s desired results in the most comfortable and efficient way possible. This article will briefly lay out my recommendations on how clients can be successful in therapy.

Honesty

This is one of the most important aspects to successful therapy. When clients are forthright about their current struggles and fully disclose what has been going on, it makes the therapy move that much faster. Although it may seem obvious to be truthful to your counselor, it is often harder than you think. Depending on your situation, feelings of shame and guilt may get in the way of your ability to be open and honest. If clients allow these feelings to prevent them from sharing freely, it limits their chances to move forward and to make substantial progress.

Courage

To tell a total stranger about how you are feeling, whether it be sadness, anxiety, nervousness, shame, guilt etc. can be difficult and somewhat painful. It takes internal strength and courage to be vulnerable in this way, as it puts trust in someone else’s hands. Although most clients reveal themselves slowly as they build trust with their counselor, it can still be anxiety provoking. Courage is also needed when it comes to speaking directly to your therapist about your progress. This can feel quite unnerving, but good therapists should always be open to feedback. Clients that avoid this type of discussion may end up feeling resentful or prematurely end their therapy. When clients are unhappy with a certain aspect of the therapy and they have the courage to share this, it can substantially accelerate the progress and improve their treatment. This courage can tremendously benefit the client in reaching their goals and in my experience clearly improves the results of their therapy.

Diligence

The American Heritage Dictionary defines diligence as an: Earnest and persistent application to an undertaking; a steady effort. I see this motivation and willingness to follow through as a very important aspect to successful therapy.

Although I understand clients will have various levels of enthusiasm when they first enter therapy, clients who end up being the most successful have the greatest diligence. They are active in our face-to-face meetings, and they work to remember and utilize the skills that are discussed. Some take notes as we speak, where others are fully engaged by asking questions and intently discussing the concepts. To be successful in therapy, one needs to practice the skills that are discussed not only during the therapy meetings, but throughout the week. The most successful are also those who consistently complete their therapy “homework” assignments. Without this follow through, commitment, and diligence, the therapy is much less effective and slower in achieving the desired results.


Overcoming barriers to seeking therapy


One of the barriers you may encounter when considering counseling are your feelings of shame or embarrassment.  You may believe that your anxiety, depression, or low self-esteem is some sort of personal weakness that should be hidden from view.  This mindset often leads to further isolation and sometimes hopelessness.
As counselors, we see this quite regularly and sometimes experience this in our own personal lives.  On the other hand, we also experience what happens when you share this part of yourself with others.
One of my colleagues, David Burns, M.D., the author of the best-selling book, “Feeling Good,” often talks about how discussing your personal hurdles is what brings people closer together.  Not only do I find this to be true, but when you speak about your struggles in counseling you also open yourself up to the proven solutions to resolve them.
There is no doubt that it does require courage, but the payoff is worth it!
Call me at 973-768-7552 to schedule an appointment or to request a free telephone consultation.