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11 Mental Health Podcasts Worth Checking Out

 

Podcasts are a great way to learn and stay on top of a variety of topics including everything from news, entertainment, sports, and comedy, to mental health and wellness information. Here we’ve selected a few podcasts on different aspects of mental health that we think are worth a listen.

 

The Mental Illness Happy Hour – Candid and humorous conversations about mental health. Hosted by Paul Gilmartin, former host of TBS’s Dinner and a Movie. Guest hosts include comedians and mental health professionals.

 

 

Anxiety Slayer – Hosted by Shann Vander Leek & Ananga Sivyer. This podcast is focused on meditation and relaxation-type activities such as breathing tools and self-affirmations.

 

 

The Dark Place – Hosted by Joel Kutz. Each episode is an open conversation about the guest host’s experiences of struggles with mental health. Joel is a young producer and crisis hotline volunteer who describes that no topic is “too taboo” for The Dark Place.

 

 

The Anxiety Guy – Hosted by Dennis Simsek. Dennis is a former professional tennis player and anxiety sufferer who now describes himself as a “happiness machine”. On the podcast he shares his experience with anxiety and tips for other sufferers.

 

 

The Hilarious World of Depression – Hosted by John Moe, comedian and former NPR correspondent. This podcast is a series of open and funny conversations about depression between Moe and various guest comedians including Peter Sagal, Andy Richter, and Paul F. Tompkins.

 

 

Not Another Anxiety Show – Hosted by Kelli Walker, who is a registered nurse, wellness coach, and previously suffered from agoraphobia. Some episodes are conversations with other experts, while in others Kelli offers information and practical tips about how to manage anxiety.

 

 

The Struggle Bus – Hosted by Sally Tamarkin and Katharine Heller. The hosts are quick to assert that they don’t have professional training other than “lots of feelings and opinions”. Listeners write in with questions or concerns and the hosts reply on air with tips and feedback

 

 

The One You Feed – Hosted by Eric Zimmer, The One You Feed is a podcast that describes itself as a discussion about habits, meditation, and various mental health topics. Guests on the show include many well-known writers and experts in meditation and psychology such as Sharon Salzberg, Stephen Hayes, and Tara Brach.

 

 

The Hardcore Self-Help Podcast – Hosted by Robert Duff, a psychologist in Southern California. Dr. Huff responds to listener questions on topics related to mental health such as anxiety, depression, and relationships. Dr. Huff tries to avoid jargon and be down-to-earth in his show.

 

 

ADHD ReWired – Hosted by Licensed Social Worker Eric Tivers, this podcast focuses on ADHD. The podcast shares stories, interviews individuals who have dealt with ADHD, and offers tips for those coping with ADHD to increase their productivity and functioning.

 

 

Happier – Hosted by Gretchen Rubin and co-hosted by her sister Elizabeth Craft. Rubin is the author of the book The Happiness Project and the podcast provides tips and tricks to “increase happiness”. These tips are often of the “life-hack” variety and provide listeners ideas on how to improve their quality of life.

Does Your Therapist Track Your Progress?

Due to the recent opioid crisis, the need for expanded mental health and addictions treatment in the United States is finally being broadly recognized by those outside of the medical community. Only the future can tell whether increased access to care will be a reality rather than just a hope. However, in the meantime, there are things that clinicians can do to improve the treatment they give their current clients. One of the most important things is to practice what’s known as Measurement-Based Care.

 Measurement-Based Care can be administered digitally.
What is Measurement-Based Care?

Measurement-Based Care is essentially the use of structured questionnaires to track patient symptoms. For example, someone with depression would regularly take a questionnaire to measure their mood and emotions, to determine whether they are improving or not. This is like your doctor taking your blood pressure or weight, to objectively measure how you are doing.

Why is Measurement-Based Care Important?

Mental and emotional health is, by its nature, more complex and “messy” than some other fields of medicine. Since there isn’t a blood test to determine how you’re doing emotionally, it’s important that your provider uses validated, objective measures to track your progress. While clinicians do their best, they aren’t always able to detect subtle changes in mood, and sometimes may forget to ask certain questions. Structured assessments can help in this area.

Does Measurement-Based Care Actually Help?

In a word, yes. Research on measurement-based care has shown:

  • Greater Improvement:  According to one study of individuals in a behavioral health clinic, patients whose clinicians were receiving patient-reported symptom rating scale data showed 28% greater improvement after 6 weeks compared to those whose clinicians weren’t receiving feedback.
  • Higher Response Rates:  Another study showed patients receiving psychiatric treatment for depression were able to achieve higher response rates and faster remission when treated with measurement-based care methods compared to usual care.
  • Better Outcomes:  In a literature review of 21 studies focused on various specific disorders (e.g. depression or anxiety), 76% showed better outcomes for patients receiving measurement-based care, compared to patients whose therapists did not receive symptom rating data.
So What Do I Do?

If you are currently in treatment with a therapist, you can simply ask your provider how they are tracking your symptoms and progress. Ask how you will know when you are getting “better” and how “better” is defined. If you have not yet started treatment or are considering starting to look for a provider, you can make it part of the questions you ask any prospective therapist. “How will you track my progress? How will we know if therapy is working?”. Often therapists are reluctant to use measures because they worry that clients will find them time-consuming, but if you clarify your preferences at the outset it can make for a more successful therapy relationship later on.

 

Ask your therapist about measurement-based care today.

Meditation and Mindfulness for Beginners: Getting your Mind in Shape

Starting a daily meditation and mindfulness practice is a lot like starting a fitness program for your mind. You know you want to do something good for your mind, but might not know where to get started. This simple guide will help explain meditation and mindfulness in plain English so you can find what works best for you.

Meditation vs. Mindfulness vs. Mindfulness Meditation: What’s the difference?

Meditation is a more overarching term that includes a broad range of activities, but generally involves engaging in concentrated thought, focus, or reflection. Mindfulness is the act of consciously directing your attention to the present moment, with non-judgmental awareness of your emotional state, thoughts, and physical sensations. You can be mindful without meditating (e.g. “everyday mindfulness” or simple mindfulness exercises you can do during day to day tasks). However, individuals often practice Mindfulness Meditation, which is designed to cultivate mindfulness. When practicing Mindfulness Meditation, you set aside time to purposefully focus yourself on the present moment, with awareness, and without judgment.

Meditation vs. Mindfulness vs. Mindfulness Meditation

How is mindfulness meditation helpful?

The practice of cultivating mindfulness can be helpful for a variety of mental and physical conditions. Many studies have demonstrated that the practice of mindfulness can actually change our brains and our emotional reactions to different experiences, particularly difficult emotions. We also become better at regulating our emotions. One key thing to consider is that while mindfulness won’t get rid of our problems, it allows us to react differently to them. Mindfulness allows us to step out of our tendency to be on auto-pilot and make more conscious decisions about how we want to respond. We are able to see our thoughts as thoughts and not become stuck on them. Additionally, mindfulness has been shown to improve our ability to focus and to relax. A regular mindfulness practice has even been shown to strengthen the immune system. In short, almost everyone will find some benefit from practicing mindfulness.

Meditation can be helpful wherever you are.

Tips for Getting Started

  1. Find Time: This might be the most challenging part of the process. Not surprisingly, it’s also one of the most helpful. People often get started with mindfulness meditation because they feel stressed or feel like their own self-care needs are being neglected. Therefore, the process of simply making time in your day for your own needs can often be the biggest hump to get over.

    Acknowledging that you are feeling run down, or wound up, or simply in need of some time to reflect is a big step.You’re making a declaration that your needs matter, and recognizing that until you take care of yourself, you won’t be able to be the best, healthiest, or happiest, version of yourself. Even if it’s only 5 minutes, deciding that you matter and that you need to just stop and breathe, is a big deal. Thank yourself for finding the time and making your own health and wellness a priority. Many people find it helpful to set a standard time each day to meditate, such as right when they wake up. Really, the best time to meditate is whatever time you can find that works for you.

  2. Find a Place: Ideally you will find somewhere quiet and calm to practice your meditation. It’s not necessary to have a dedicated space, though some people find it helpful. The most important thing is that you are able to disconnect from the hustle and busy-ness of the day. That might mean softer light or a location away from distractions. Some people like to get a meditation pillow or bench, while others simply use a comfortable chair.
  3. Set a Goal: identify why you want to start meditating, what you hope to get out of your practice, and why you think it might be helpful. You will feel motivated to continue your practice and stick with it if you have an idea of why you want to do it. You might find it helpful to write it down, or you might want to verbalize your goals to a friend.
  4. Strength in Numbers: When you start a physical fitness program, sometimes joining a class or finding a gym partner can make it easier to stay committed. Similarly, it can be helpful to have a meditation buddy or group. Such partnerships can help with accountability and sticking with your practice, and many people find it helpful to talk to someone about some of their experiences when starting a mindfulness routine. Having someone to ask questions, discuss successes, and exchange encouragement can be helpful.
  5. Be Kind with Yourself: There may be times you struggle to meditate, and sometimes you’ll have a better experience than others. That’s OK. Remember that having a nonjudgmental stance is a cornerstone of the practice, and that includes being nonjudgmental of yourself and your own successes and shortcomings.

You can find basic meditation instructions, guided meditations, and daily mindfulness exercises in the “Relax Now” section of Pacifica.

 

CBT & ACT: Help your clients give their thoughts a little space

Night sky, CBT and ACT teach us to gain distance from thoughts

One of the major premises of cognitive-behavioral therapy (CBT) is the idea that thoughts affect feelings, and that by changing our interpretations and thoughts about and interpretations of situations or events, we can change our emotional responses. Sometimes this can take the form of challenging the validity or accuracy of thoughts by questioning whether or not they’re true. This process is effective for many people and helps them to recognize that their interpretations, beliefs, and self-talk aren’t accurate or fair to them. By then generating more positive and true statements, they are able to feel differently about their experiences. For example, rather than feeling anxious by focusing on an unlikely worst-case scenario, individuals can acknowledge that the most likely outcome is something they can handle, and their concerns or worries become much more manageable. One of the essential tools for examining and challenging thoughts in cognitive therapy is the thought record. The thought record is used to help individuals see the relationship between their experiences, thoughts, and emotions. It also helps people to identify potential inaccuracies in their thinking, and provide an opportunity to change those thoughts to be more fair.

Despite CBT’s wide acceptance and demonstrated efficacy, for some individuals, the process of challenging their thoughts can feel invalidating. Some people find that they get stuck in what feels like an academic exercise of trying to find evidence for or against their thoughts. More recently, there has been a “third wave” of therapy (such as Acceptance and Commitment Therapy or ACT) which integrates concepts from mindfulness and acceptance to help individuals change their relationship to their thoughts. On first glance, some people (therapists and clients alike) have a difficult time reconciling CBT and acceptance-based approaches, because they appear to be in conflict (one aimed at changing thoughts while the other is focused on accepting them).

CBT & ACT: Integrating Different Approaches

However, both CBT and these newer therapies have the effect of helping people see their thoughts as more like “mental events”, being more objective, and giving their thoughts more space. CBT is more oriented towards challenging the content of the thoughts whereas acceptance- and mindfulness-based therapies are more focused on allowing oneself to co-exist with the thoughts, without necessarily believing or acting on them, or trying to change them. In both cases, the individual is changing their relationship to their thoughts; often this means putting some distance between themselves and their thoughts. One of the difficulties clients often face is taking their thoughts to be the truth and believing them. Often they have the same thoughts over and over, and that repetition makes the thoughts seem all the more true. Whether mindfulness, acceptance, or distancing by challenging validity ring most true for your clients, increasing their awareness of their thoughts and emotions will help them to disconnect and de-fuse from those thoughts.

Pacifica is a digital implementation of an integrated approach, which is to say, it includes elements of cognitive-behavioral therapy and mindfulness-based approaches. Pacifica includes several different types of thought records with different foci, some delving more deeply into cognitive distortions, with another more focused on guiding the user to generate alternative thoughts, etc. Additionally, there are guided meditations focused on awareness and acceptance of thoughts and emotions, and psychoeducational content which guides users through the process of using the various tools. Pacifica users are able to select which approaches and tools are most effective for them and which fit their needs and personality best.

"The most effective solution is the one you are willing to implement", ACT or CBT


 

Lessons from HIMSS: How mental health tech can advance population health

Last week Dale and I had the opportunity to attend the Health Information and Management Systems Society (HIMSS) Conference in Orlando, Florida. Here are some thoughts and reflections I’ve had since then.

One view of the HIMSS conference
One view of the HIMSS conference

Technology and Progress in Mental Health

The 1990s were the “Decade of the Brain”. Though many advances and discoveries were made during this time, the experience for mental health patients today is still challenging. Finding providers (particularly those which are covered by insurance), understanding different models of care, and integrating mental and physical health can all be difficult. Despite the high rates of mental illness in our society, stigma is still a problem and a barrier for many people trying to seek treatment. Recently, pharmaceutical companies drastically reduced budgets to research medications for psychiatric conditions.

So what can we do? The first step should be working to improve mental health outcomes through measurement-based care and evidence-based practice using proven behavioral/psychosocial treatments. In order to do this, we can harness the power of the Internet and mobile apps and use technology to advance the state of this sector of health care.

While there are a number of connected-health tools available, few of them are geared towards people with mental health problems, and even fewer are achieving traction or widespread adoption. There could be several reasons for this, but employers and health insurers are increasingly looking for innovations in this space. Health care providers and insurers on a broader scale are beginning to realize that without solid mental health, patients struggle to manage their chronic health conditions and costs can increase dramatically. Employers, too, are motivated to help keep their workforce feeling mentally well. Depression, for example, is as costly as heart disease or AIDS in terms of lost productivity, costing over $43B annually in the U.S. and mental illness is a leading cause of absenteeism in the workplace.

One of the biggest things that investors, providers, and health insurers are looking for is engagement: Getting folks interested and involved in managing their mental health. Apps like Pacifica can help people do just that, either on their own through guided self-help tools, or by connecting to an in-person provider and enhancing their between-session work. Rather than offering an alternative to an in-person provider, Pacifica’s goal is to work in concert with clinicians to improve outcomes and help users achieve longer-term behavior change and wellness.

HIMSS Lessons: The State of the Field

We attended HIMSS to announce our recent funding round and new product launch as well as a big update to the existing Pacifica app. Additionally, I participated in a panel discussion about women in mental health tech. It was clear from our experience in that conversation and the conference more broadly that while there has been a lot of innovation in this area, the field still has a long way to go.

At the conference, we attended a talk that included the CEO of Omada Health, which has developed an electronic diabetes prevention program. Their method is based on a well-validated, in-person program that they adapted to work virtually. They use objective outcomes to measure progress and bill for reimbursement. While this is slightly more challenging when applied to mental health, Pacifica follows the same basic principle of creating engaging, interactive tools based on empirically-supported best practices.

The Health IT Chicks panel participants at the HIMSS conference
The Health IT Chicks panel participants at the HIMSS conference

We left the HIMSS conference feeling exhausted but also excited about the opportunities that lay ahead as we continue to innovate and work to improve mental health care. The use of objective measures has been called for by the Kennedy Forum for years and will continue to be important as mental health care providers adapt to changes to reimbursement models and the introduction of value-based care. Everyone seems to agree that health care costs need to come down, and the use of objective measures to improve treatment monitoring and adjustment is a good first step. As we move forward, attention to issues of privacy and information security will continue to be important, as will integration into existing electronic health records. These are all challenges, but exciting ones, which hold the promise of improving health care for all.

Pacifica for Clinicians: Bring Measurement-Based Care to Your Practice

As demand increases for healthcare providers to transition from a fee-for-service to a value-based model, the need to implement measurement-based care is greater than ever. Although measurement-based care practices are commonplace in the medical and surgical fields (testing cholesterol levels or A1C level for diabetes, for example), they tend to be less widespread within the behavioral health community. According to a report published by the Kennedy Forum, only 18% of psychiatrists and 11% of psychologists regularly use measurement methods to monitor their patients’ progress.

What is Measurement-Based Care?

A report in the journal Cognitive Behavior and Practice defines measurement-based care as the practice of basing clinical care on client data collected throughout treatment. Aside from working well with a value-based reimbursement model, measurement-based care can be very beneficial to both clinicians and their patients. Studies have shown that patients receiving measurement-based care are more likely to achieve greater response and remission rates than those receiving standard care. Measurement-based care allows providers to create measurable, data-driven treatment plans that can be amended and reassessed if patients are not responding to a course of treatment. Additionally, when patients are involved in providing ratings of their symptoms, they can feel more actively involved in their treatment and more aware of potential symptomatic patterns.

While it may sound appealing to bring measurement-based care methods to your practice, knowing where to start can be difficult. Creating a symptom rating and tracking system on your own can be cumbersome, and potentially become a roadblock to offering more effective care. Though prebuilt solutions exist, many products on the market often don’t equally address the needs of the clinician as well as the needs of the patient.

Introducing Pacifica for Clinicians

Screenshot of Pacifica's Clinician Dashboard, bringing measurement-based care to your practice
A preview of Pacifica’s Clinician Dashboard.

Pacifica for Clinicians is a first-of-its-kind, web-based dashboard tool that mental health care providers can use to easily bring measurement-based care to their own practice. Using Pacifica’s popular consumer-facing mobile app, which has over 1.25 million registered users and counting, Pacifica for Clinicians makes it easy for you to track your patients’ progress, and use data to inform treatment decisions.

How Does It Work?

The goal of Pacifica for Clinicians is to help facilitate measurement-based care without disrupting your existing practice.

With a subscription to Pacifica for Clinicians, all of your patients will receive a Premium subscription to Pacifica’s mobile application. The app includes a variety of tools based on cognitive-behavioral therapy and mindfulness:

  • Mood and Health Tracking: Users can enter mood ratings and attach feelings or include notes on each rating. The Health tool allows users to select specific habits (such as sleep, exercise, alcohol, caffeine, etc.) and track them each day. Together, these tools can help users identify patterns in their mood based on different health activities.
  • Thoughts and Goals: Using one of Pacifica’s nine psychologist-designed thought recording tools, users can keep track of their thoughts and learn to challenge negative thinking patterns. By setting daily challenges, users can reach their long-term goals one step at a time.
  • Relaxation Techniques: Pacifica offers over 25 audio activities including deep breathing, muscle relaxation, and a variety of  mindfulness exercises.
  • Community and Hope Board: The peer-support community in Pacifica allows users to connect with others for encouragement. Based on the dialectical behavior therapy (DBT) concept of a “Distress Tolerance Box”, the Hope Board is a place for users to save and review inspiring content, including photos, quotes, completed Pacifica activities and community content.
  • Guided Self-Help Paths: Designed by psychologists, Paths include an audio lesson and accompanying activity. Topics include CBT and mindfulness, with more to be added in the future.
  • Progress Data: View daily, weekly and monthly progress reports so users can see improvement over time and notice patterns in their moods.

Using Pacifica for Clinicians, you will get full access to the Clinician Dashboard, which offers you oversight of your patients’ progress all in one place.

  • Review Client Data: Using the Clinician Dashboard, you can see your clients’ mood and health history, goal tracking information, completed thought records and relaxation activities. This can both help your patient feel more involved in treatment decisions and give you more insight between sessions.
  • Assign Assessments: Beyond gathering data from app usage, Pacifica for Clinicians allows you to assign recurring assessments (e.g. GAD-7, PHQ-9) to your clients and review and export their response data from the Clinician Dashboard.

    Screenshot of assigning an assessment, an excellent measurement-based care technique
    Assign assessments to your clients and view their responses through the dashboard.
  • Data-Driven Decision Making: Put measurement-based care in action by using insights from the Clinician Dashboard to assess treatment effectiveness and inform clinical decisions
  • Coming Soon – We’re expanding the features of the Clinician Dashboard rapidly. Some upcoming features include:
    • Teletherapy: Projected for release in April 2017, the Clinician Dashboard will soon include a teletherapy feature that will allow you to perform virtual text or video sessions with your clients.

      Screenshot of teletherapy feature to continue measurement-based care between sessions
      Coming Soon: Text and video teletherapy options to conduct virtual sessions with your clients.
    • Client Assignments and Reminders: Give your clients assignments to complete activities within Pacifica and send push notification reminders to their phones.
    • EHR Integration: Integrate patient data from Pacifica into your electronic health record system.

Security: HIPAA Compliance

Pacifica for Clinicians is fully HIPAA compliant, with all necessary physical, technical and administrative safeguards in place to maintain data security.

The Science Behind Pacifica

All of the tools and activities in the Pacifica app are designed by psychologists based on the scientifically-backed principles of cognitive-behavioral therapy and mindfulness.

Additionally, Pacifica has partnered with the University of Minnesota on an ongoing Randomized Control Trial. The results have yet to be published, but the initial pilot has shown impressive effect sizes across multiple measures, including the NIH PROMIS scale for global mental health, and the DASS-21.

Try Pacifica for Clinicians Free for 30 Days

Ready to put measurement-based care to work for your clients? With your 30 day free trial of Pacifica for Clinicians, you’ll get Premium subscriptions to the Pacifica mobile app for you and your clients and full access to the Clinician Dashboard. You can request a one on one demonstration, or get started right away by clicking the button below.




Request a Demo




Pacifica 5.0 Update: Paths, Hope Board, Clinician Dashboard

New Features in Pacifica 5.0!

We are delighted to announce the newest release of the Pacifica mental health app for iOS, Android and web. This release includes a number of new features that we want to talk about here.

 

Guided Paths

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This version of the app includes the debut of “Paths” which are psychologist-designed self-help programs comprised of audio lessons and accompanying activities. Guided Paths have been requested by our users and we are very excited to have them ready. These first four Paths include “The First Week”, an introductory Path, “A New Approach” and “Digging Deeper”, two Paths which focus on Cognitive-Behavioral Therapy, and “Mindfulness”, which teaches a variety of mindfulness practices and meditations.

The two Paths on cognitive-behavioral therapy, “A New Approach” and “Digging Deeper”, include in-depth psychoeducation to explain how CBT works and how to use the different tools within Pacifica. The activities in these Paths include a number of tools, many of which are new, like thought records or behavioral challenges. The activities build on each other and teach users how to look closely at their thoughts and behaviors to start seeing things in a new, more adaptive way. Changing one’s perspective on their thoughts can help them to feel differently and reduce anxiety and depression. Users might realize that their interpretations contribute to how they feel, and that changing how they think about things can make them feel better. Building a list of small challenges to conquer every day can help people break out of their negative patterns of avoidance and feel more accomplished and capable.

The “Mindfulness” Path activities include three new meditations to help users be more mindfully aware of their thoughts and feelings. Mindfulness has been shown to be effective for a variety of conditions including stress, anxiety, and depression.

In the future we will continue to build our paths library with more specialized tools including insomnia, interpersonal skills, and tools to pursue one’s goals and values.

Hope Board

The Hope Board is a place for users to put inspirational and uplifting content to help celebrate wins and work through challenging moments. In addition to photos and quotes, users can also add links to completed Pacifica activities to remind themselves of what they’ve done well. Additionally, users can save inspiring content found in Pacifica’s peer-support community.

hope-board

Link to In-Person Clinicians

In addition to the biggest update to the app in Pacifica’s history, we are also announcing the release of Pacifica for Clinicians. Pacifica for Clinicians is a dashboard tool designed to bring measurement based care techniques to any clinician’s practice. The dashboard provides a HIPAA-compliant platform for in-person providers to view their patients’ activities in Pacifica, assign assessments (e.g. PHQ-9, GAD-7), and monitor progress. This connection can help make therapy more efficient and effective and increase engagement and between-session carryover.

“As Pacifica continues to resonate with consumers, the missing piece has been the ability for clinicians to leverage data to provide better informed treatment,” said Dale Beermann, CEO and co-founder of Pacifica Labs. “These releases advance the state of measurement-based care in the industry, while continuing to innovate on self-care with our biggest app update yet.”

Future releases will include teletherapy and electronic medical record integration. Are you a mental health care provider and want to learn more about Pacifica for Clinicians? You can read more here, or request a demonstration here.

Cognitive Distortions are All Black and White

My favorite color is grey.

OK, not really. But perhaps it should be, considering what I’m about to say.

I believe that we live life in the grey area. That nothing is black and white, right and wrong, cut and dry. I’ve been working on writing new content for Pacifica (look for exciting stuff soon!) and have found myself coming back to this idea several times. Often when we are struggling it’s because we’re looking for things to fit into boxes, to be neat and clean, and they aren’t. Life is full of exceptions to rules, qualifiers, maybes, and “that depends”.

One of the key points of Cognitive-behavioral therapy, upon which Pacifica is largely based, is that our thoughts have a major role in determining our emotions and behaviors. CBT holds that negative thoughts or cognitive distortions are one of the most important factors in maintaining mental illness.

A cognitive distortion is an error in thinking which can lead you to perceive the world inaccurately. Cognitive distortions are often negative self-statements and typically reinforce negative beliefs you have about yourself, others, or the world. One example would be telling yourself “I’m a loser. No one likes me.” You probably don’t have evidence that this is true, and this thinking trap will undoubtedly make you feel worse about yourself. If you are able to recognize that telling yourself “I’m a loser” is an exaggerated negative thought, you might then be inclined to try to convince yourself of the opposite: “I’m fantastic. I’m great. I’m the best.” But you may or may not have evidence for that either.

The fact is that, for most of life, we are in the grey area. Sometimes we are great, other times, not so much. Everybody has off days and makes mistakes. We also all have days where we feel like we’re doing well and things are going our way. The sum total of all this up-and-down is that we are all somewhere in the middle. In the grey.

gray

The key to accurate, non-distorted thinking is to recognize that nothing in life is simple or absolute (there’s probably even an exception to this!).

Finding Balance

One of the most innovative and helpful aspects of CBT that we’ve integrated into Pacifica is the ability to identify and challenge your thoughts. Once you notice that you are engaging in black-and-white thinking, you can take a step back and start to question whether the event or issue you are thinking about is really all one way or the other, or if perhaps you’ve made an inaccurate interpretation. Reframing or restating those extreme thoughts can be very helpful when trying to find emotional balance. It’s not always easy, but with practice you will get into the habit of seeing your thoughts and recognizing when you’ve fallen victim to a distortion. This often decreases the intensity of negative emotions and makes it possible to move forward.

So the next time you are trying to swing your views of yourself strongly one way or the other, remember that, probably, the truth is somewhere in the middle. An excellent goal would be to identify those balanced, realistic views.

New Year’s Resolutions

The winter holidays and beginning of the new year are a good time for reflection. Many people choose to make a New Year’s resolution, something that they want to do differently or better in the coming year. Losing weight and paying down debt are common choices. I have a few things I want to work on. One goal for the coming year will be to live more purposefully, being more mindful of how I spend my time.

Oftentimes I get most of the way through the workday and look at the clock in surprise, not realizing where the time has gone. I don’t think I’m alone in this. Our lives are so full of demands for our time and attention that it’s easy to lose track of things, to get drawn off our path. I don’t have data to back this up, but I have a hunch that one reason we (well, some of us) get pulled off task so easily is that we need moments to decompress. We need to have short mindless breaks to just breathe and not keep hammering away on the NEXTBIGTHING, so we pull up Facebook or some other thing like a video game or YouTube clip.

This is not to say that I think we need to completely eliminate these distractions from our lives. In fact, I think we need them. My hope is that I can schedule these moments a bit, and try to be purposeful about when I take these breaks. There is good evidence that a similar approach can work for scheduling “worry time” (instead of just worrying intermittently throughout the day) or rewarding ourselves for completing difficult projects (instead of just miserably grinding away). It may also be useful to take little “distraction” breaks between tasks as a bit of a transition.

Iain Thomas - “And every day, the world will drag you by the hand, yelling, “This is important! And this is important! And this is important! You need to worry about this! And this! And this!” And each day, it’s up to you to yank your hand back, put it on your heart and say, “No. This is what’s important.”

There are different ways that I think I could implement this new approach: to-do lists, reminders, even asking for more accountability from others. In addition to planning out little breaks during my day, I think I’m going to try to practice mindfulness on a more regular basis. I want to improve my ability to know what I’ve been doing, when, and why. Mindfulness is intentional, conscious attention to the current moment. It’s not being on autopilot. Mindfulness can be helpful for a wide range of things, from chronic pain to depression, to addiction and ADHD. We’ll have more on this in the future, but for now, wish me luck on my resolution.

Opposite Action

“Sorry Doc, I was too stressed out to make it in last week.” This sentence was said to me by a therapy client, letting me know why they’d missed the previous session. Often times in life, we experience periods of increased stress. Times when we aren’t sleeping as well, or when we’re in a funk at work. Or maybe having frequent arguments with a spouse. Sometimes when we are dealing with greater stress, we feel an urge to withdraw, to pull into ourselves, and stop doing the things that have helped us in the past–like going to therapy and talking about what’s stressing us out, and getting some help with it.

Recently a friend of mine, who has been meditating and using mindfulness regularly, experienced a health scare. This left him with a lot of unknowns and unanswered questions. As I spoke to him about how he is handling it and how he’s feeling, I mentioned that this would be a great opportunity for him to take advantage of all the work he has been doing on his ability to accept his emotions and really use the skills he’s developed. His reaction to my suggestion wasn’t super positive. And I have to say, I’m not that surprised.

Emotions have accompanying “action tendencies” and when we are feeling anxious or feeling like life is uncertain, one common tendency is to go back to what is familiar and what has been comforting in the past. For him, it’s (I’m making an assumption here) worrying. For someone who is feeling overwhelmed by life in general, the action urge might be to stay in bed and pull the covers up. But one thing we know from Dialectical Behavior Therapy (DBT) (a cognitive-behavioral treatment developed by Marsha Linehan, PhD, and heavily influenced by mindfulness and acceptance approaches) is that “Opposite Action” can be what’s most effective. So that, for example, when you have the urge to give up and stay in bed, what might be most helpful is get out there and interact with the world. Will it be hard? Certainly. But it can really help to combat those feelings. It can also give you a sense of mastery for being able to set a goal and accomplish it.

To my friend I would suggest that even though the anxiety about this unknown in his life might be justified, he should do what’s most effective, what will bring him closer to his goals. And so rather than allow his worries to pile up and dominate his thoughts, and then spend effort trying to fight those worries, he should take a nice deep, slow breath, and remember that he can only control what he can control. And that might not be his thoughts, or necessarily what happens with this health issue. But he can control how he reacts to those thoughts: whether he gets stuck on them, or whether he notices them, labels them, and lets them go.