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Build Your Own Mental Wellbeing
Author's note:
This is not intended as psychological consultation or a replacement for therapy.
This particular blog post is a work in progress. I will be back with more links and resources, but wanted to make the content available in its current form in the interest of time.
If you feel like you are having a psychological emergency, particularly if you are having thoughts of harming yourself or someone else, call 911 or go to the nearest hospital emergency room.
The crisis state of mental health has led to a national shortage of access to psychotherapy.
Those who have the financial means and flexibility of schedule are able to access therapy, but many are left unhelped, struggling with their distress and impairment of functioning, which in turn makes it harder to keep up the momentum of pursuing mental wellbeing for themselves and their families.
Even before the current crisis, a market has begun to emerge for brief therapies, a raft of cell phone apps, self-help and support groups, and the like. There's nothing wrong with that if it works for you. And if you are in therapy, doing part of the work yourself helps you live better, sooner – and that is important. The more of life you live at improved functioning levels and with less distress is related to how you care for your mental wellbeing.
Whether you want to go it on your own or move your work with a therapist ahead more quickly or deeply, you are in charge of yourself. And there are some specific things you can do to take charge effectively.
A big part of that pursuit of living well – whether in your individual quest or with a therapist – is engaging distortions in thoughts and ineffective or destructive behavior which stems from distorted beliefs and negative habits of thought and being, and overwhelming feelings which we believe ourselves to be at the mercy of.
A recipe for my model of self-assessment, which is one path to mental wellbeing, is at the bottom of this blog post, but you'll need some background first. First, we have to have an agreed definition of the purposes of therapy and self-analysis. For our purposes, we will say that therapy has the goals of:
Reducing distress,
Improving functioning – removing impairments and/or realizing potential, and
Living authentically in self-acceptance and self-awareness
Background: By using therapeutic tools to develop our own capacities and skills for observing ourselves neutrally and accurately in situations and evaluating how we want to respond that is in our best self-interest, we improve our lives, relationships, and outcomes.
Let's take a slightly deeper dive on each of these aspects of self-assessment.
Thought Distortions: Thought distortions are mistaken beliefs or ideas that become an integral part of our way of understanding ourselves, the world, relationships, and feelings.
All of us have some thought distortions, most of which come from a primitive part of the brain called the amygdala. There are particular categories of thought distortions, including catastrophizing (imagining it to be worse than it is), generalizing (assuming that one bad thing means that everything is bad), and personalization ("It's about me... Or this is happening because I'm unlucky or because 'they' don't like me.")
You aren't alone. Our habits of thought and underlying beliefs are part of the uniqueness that makes us who we are.
One thought distortion is that we are 'smaller," less capable than we actually are. Another is general negativity bias, which makes us less optimistic than is realistic or helpful. These two biases have the impact of making us less likely to take positive, calculated risks and less able to enjoy positive results when we achieve them because we chalk it up to not being an actual victory, but an anomaly which will soon correct itself via some negative consequences.
A patient reported to me that she felt devastated because a coworker had publicly, sarcastically suggested that she has a pervasive habit of pointing out what people are doing wrong. She worried that the relationship with this coworker, and other coworkers was poisoned by this perception – that they must not like her, and that she'd be best off looking for another job where she could start with a clean slate. She might have done that, and who knows with what results.
Instead, she brought the concern into therapy and was very upset about it, short of breath and tearful. Some of the underlying assumptions she was making included:
That the statement was both true of her (she felt bad about it), and that other people shared disdain of her as a result.
That the person who said that intended it to hurt her and push her away.
That it is imperative that (all) coworkers like her.
That if people don't like one thing about you, they don't like you in general.
That one example of a behavior causes all people to come to a pervasive negative conclusion that overall, you are a certain kind of person.
When the patient evaluated the first belief – that it's true that she often tells people they are doing something wrong, she was able to identify many examples where that was true. She related that her social media posts were often about what people were doing wrong politically, how they had the "wrong" attitudes, and were being reckless and selfish about responding to COVID. Interestingly, acknowledging that the belief was true made her feel better because she could look at it with neutral, benign curiosity instead of judging herself negatively about it. Upon reflection, she decided that this pattern of behavior generally made her feel worse, and that it was something she wanted to, and could change – not for anyone else's benefit, but rather because it wasn't producing the results she wanted. Her critique wasn't changing anyone else's beliefs or behavior, and was alienating people, and possibly galvanizing those beliefs and behaviors she felt were wrong. She realized that it wasn't in her long-term self-interest to be so critical of others, even if it felt satisfying sometimes in the moment.
The patient looked at the second belief – that her coworker made the observation to be hurtful. She concluded based on the evidence that she and the coworker had enjoyed a long friendship, and that the coworker has a tendency toward friendly joshing in a sarcastic manner, that he may not have meant it to hurt her, but ultimately decided that his motivation of the moment needn't be so important to her – it was just a few words that came out at a particular moment and didn't merit much of her energy and attention. She also decided that the evidence of her many friends and good relationships negated the idea that people don't like her, and that even if people don't like everything about her, they can still find enough to like about her that relationships stay intact. She reflected on some relationships she maintains where a friend has a characteristic she doesn't care for, but that she still likes them overall. On further reflection, she evaluated that it is unlikely and also unnecessary to be liked by everyone.
She felt much calmer and, behaviorally, eased back into normal friendly relationships at work and didn't feel any further need to leave. She would leave only if/when it suited her desire for career and personal growth.
Ineffective Behavior: Emotional intelligence, in large measure, is the ability to perceive, manage, and evaluate situations and emotions and make strategic decisions about how to behave (that is, choose behaviors that lead to the results we want, rather than responding impulsively). This method of self-assessment teaches us how to stay more aware of what is happening around and within us, to choose behavior that is effective and aligned with our values, and respond instead of reacting in situations. Ineffective behavior is usually driven by a distorted belief.
Overwhelming Feelings: Difficult emotions are usually triggered by, or triggered with, thoughts. Some of those thoughts may be distorted and some may be helpful. The emotions that come with life and relationships and work often have wisdom to offer us. They alert us to when something is good or bad for us and push us toward making changes that will improve our lives. To live authentically, it is necessary to be aware of and express the full range of feelings, rather than stifling or avoiding them.
To live with self-acceptance, we must remember that we are not our feelings. We are capable of choosing how to express feelings that will most likely get us the results we want, instead of behaving in knee-jerk, impulse-driven ways that we regret later.
Distorted beliefs and emotions have a chicken-and-egg, mutually reinforcing relationship with each other. For instance, if a child has grown up with a feeling of rejection and learned that the way to avoid that feeling is to keep a low profile and not ask for much or assert oneself, they will get less of what they need or want, and more of the rejection feeling.
In future blog posts, we will explore the three aspects of self-assessment more deeply. For now, here is the first of three parts of my model for self-assessment that is directed toward our thoughts.
Part I – Mindfulness: The first part of this model has to do with mindfulness. This is the capacity to observe ourselves neutrally. It is a complex skill to develop, but a very important one. Before we can consider the content of our thoughts, or feelings, we need to be able to step back and look at them as if we were a camera, without the need to control them or make them go away. That is what is meant by neutral observation.
Sometimes the awareness of our thoughts and feelings is overwhelming, and so we have to build capacity for it over time. For now, I'm going to give you just a taste of how it can work.
Notice your body. Where is your body? Are you warm? Cold? Is there tension? Is your stomach tight? What is the temperature of your body? If your body were a landscape, what would the topography be? If you are sitting, what are the places where your body touches the chair? Are there places where it doesn't touch the chair? If you have tension in your back, is it on the right, left, or in the middle? Low or high? Or do you have tension in your stomach or shoulders? It may be possible to have tension in multiple places at once. Do you feel any places where your body feels relaxed, where you don't notice tension? Start at your feet and notice tension, tightness, tingling, sensation, or any other feeling. Notice each toe, the tops and the bottoms of the feet, the ankles, the calves, the knees, thighs, hips, pelvis, lower back, abdomen, chest, the back of the neck, throat, the back and front of your head, your forehead, your scalp. Maybe you have a sensation of tingling or tension inside the head.
Now, bring your awareness to the space where your body touches the chair or the floor, and listen for sounds. Maybe you hear the hum of a heater, or the sound of children playing in the background, or the sound of the computer. Or maybe you notice a smell – coffee, or food, or a candle, or an unpleasant smell. As you sit, or lie, notice any movement you feel – perhaps your own breathing or the beating of your heart, or the pulse in your fingertips or neck.
The point here isn't to change or fix anything, but just to observe what is happening. You are gathering data. And as you do that, you might notice a particular thought or image that comes up, a judgment or concern about the future or past, a self-critique, or some other thought.
All of this data – your body, your environment, your thoughts – are connected. We are going to use this information to observe our thoughts as neutrally as possible, like we are standing in front of a movie screen and watching the images go by. The observer and the observed are different from each other. The observer doesn't try to change the images on the screen. It just watches. The observer is the curious part of you, the part that asks "What's that?" "What happens if I do this?" "What happens next?" without judging the answers. If there's a mistake, the observer just wants to understand how it happened so the information can be used in the future.
You might want to notice a thought that is fleeting, or is persistently reoccurring. You might want to notice a thought that is associated with an uncomfortable feeling. If you do notice such a thought, you might want to give it a name, like "I'm not good enough" or "This is too hard," or "I'll never be happy," or "I should be further ahead," or "They don't like me," or "I'm not important." Notice if you don't like the thought or feeling, or are in some other way critical of it. Notice if you feel that the thought is true and that there's no use trying to dispute it. Maybe you think you are wasting your time right now, or that you are just too smart to do this. Maybe you want to blow off this work and check out. Or, maybe you just notice the thought and then it's gone, and you can't remember it anymore. Maybe, as you look at your thoughts, you find yourself falling asleep.
It's all okay. The observer just watches. The observer will come to recognize that some thoughts are just habits, conditioned responses, thought distortions, and that they may not be true. They may have been true once, or only in part, but that doesn't mean they will always be true.
For this exercise, you don't need to judge the thought. Just name it. Maybe write it down. Maybe make a note about how it makes you feel. You don't need to do anything with it. You don't need to change it. You don't need to dispute it. In fact, don't try to do those things, at least right now. Let the observer just observe and gather data. There will be time for other things later.
As you get more practice observing thoughts and not judging them, the observer will also observe that thoughts come and go. They may change a little, or a lot. They may be associated with changes in the body – increased heart rate, tension, or relaxation. They may have a lot of emotion or just a little. They may go by slowly or quickly.
Try practicing this when you are in various moods – when you are sad, happy, angry, anxious, numb, or calm. You might notice that your thoughts vary with your mood. In fact, this practice can help you become aware of your moods, how they affect your thinking, and how your thinking affects your mood.
It's worth noting that our attention span is limited, and so sometimes we need to put our focus on one thought or image, or emotion at a time, and sometimes we can take in a wider view and notice many things at once. When we notice that we have been distracted from our focus, we gently bring our attention back to it, without judging ourselves.
Remember, it's important not to judge the thoughts or feelings that come up during this exercise. The goal is simply to observe and gather data without trying to change or suppress anything. Over time, this practice can help you become more aware of your thought patterns and emotions, which is the first step towards making more conscious and intentional choices in your behavior and responses to life's challenges.
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