Archive for Depression

The Holiday Blues

It’s that time of year again… Michael Bublé playing on the radio, cool air blowing the leaves off the trees, twinkle lights all around. It is a common belief that people are supposed to be happy around the holidays. You see it all over social media – a newly engaged couple picking out their Christmas tree, a group of friends ice skating at the local rink, a family laughing together over dinner. All the posts consist of smiles and laughter, and everything is so bright and cheery. But is it really that way?

It is quite common for people to experience sadness and loneliness around the holidays. An elderly woman living alone in a nursing home, facing her first holiday season without her husband. A set of empty-nesters, with all their children spread out across the country. A young boy who lost his father last Christmas… there are many people that experience sadness around the holidays. For some, the holidays can be a reminder of negative past experiences and traumas. Social media only helps to reiterate this sense of loneliness, because people often compare their lives to the highlight reel of other’s lives. They place too high of an expectation on the holidays and often blame themselves for not feeling a certain way. As rock band 5 Seconds of Summer sings, “Why can’t we choose our emotions?”. If only it were that simple.

It’s important to set realistic expectations for yourself and know that your feelings are completely valid. You have a right to feel what you feel. Remember to be mindful and accept your feelings, but try not to linger on them too long. Take a break from social media, especially if you are not in a good mood. You may end up making yourself feel worse, especially if you compare yourself to everyone else. The large majority of social media users only post the highlights of their lives. Just because they have multiple photos of their expensive trip to the Maldives or their multiple social gatherings with friends, doesn’t mean they aren’t going through a rough time too. 

Remember that it’s okay to be sad around the holidays. It doesn’t make you any less of a person. Think about sharing these feelings with a loved one. They will want to do what they can to be there for you and support you. It is common for people who feel lonely to isolate themselves. Try to get out of the house if you can. Connect with a close friend, or try a new yoga class. It can be a healthy distraction and you may find yourself focusing less on those negative thoughts when you’re out doing something enjoyable. 

It is okay to not be okay, especially around the holidays. If you are feeling this way, reach out to someone to talk about it. Whether it be a significant other, a friend, a therapist… seek out support. You may be surprised to discover how many others feel exactly as you do.

How to Get Help in San Jose/Los Gatos

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Los Gatos) specializes in therapy and counseling with adults, children and teenagers. Click to send an email for more information on how we can help you or your family members improve your outlook.

Silicon Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety and Obsessive Compulsive Disorder near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

CONTACT US

Click to send an email

International Stress Awareness Day

International Stress Awareness Day

It’s International Stress Awareness Day. We wanted to highlight the types of stress, the effects of negative stress, and some ways to help cope with stress.

It is common for people to believe that all stress is negative, but that is not actually true. There is such a thing as positive stress, also known as eustress. Some positive examples of stress are starting a new job, having a baby, or graduating from college. Everyone comes face to face with stress; it is essential for survival and is a great motivator.

Negative stress, also known as distress, can be short term or long term. There are many situations that can cause us distress: loss of a loved one, a child struggling with school, or the loss of a job. When negative stress becomes long term, it can greatly impact you in many ways. You can experience brain fog, inability to focus, depression, anxiety, high blood pressure, low immune system, insomnia… the list goes on and on. That’s why it’s important to make time for yourself to de-stress!

What activities can you do to relax?

There are endless amounts of things you can do to relax and de-stress. We asked our therapists to share some ways that they de-stress.

Cindy, our Center Assistant, goes for a run and paints to Bob Ross videos. Exercise is a great way to cope with stress!

Laura Johnson, our Center Director, likes to pet her dogs and her cat. Studies show that petting your dog or cat can actually release beneficial hormones and lower cortisol, the primary stress hormone.

Caitlyn likes to take her dog for walk, and also enjoys drawing, listening to podcasts, and cooking.

Tamara goes for a run, or calls a good friend or family member. Surrounding yourself with loved ones is a great way to relax!

Jessica enjoys outdoor activities: yoga, going for a hike, tending to her garden. She likes to cook and surround herself with loved ones who can make her laugh. They say laughing is the best medicine… well, it can definitely help!

Melissa enjoys crafting. Photo projects, making greeting cards, etc. She also relaxes by food prepping, organizing, and being mindful with the family.

Erica unwinds by binge watching shows on Netflix and dancing.

Saryna enjoys fun projects, walking/exercising, talking to friends and family. Anything fun, relaxing, or nourishing.

Kimberly unwinds by watching something funny to get herself laughing.

There are many ways to unwind. Don’t be afraid to try something new! Take time for yourself, even if you have to schedule it into your calendar. It’s good for your health!

How to Get Help in San Jose/Los Gatos

The Cognitive Behavior Therapy Center in Silicon Valley specializes in therapy and counseling with adults, children and teenagers. Click to send an email for more information on how we can help you or your family members improve your outlook.

Silicon Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety and Obsessive Compulsive Disorder near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

CONTACT US

Click to send an email

Positive Outlook Is Good For Your Health

CBT Skills and Your Health

In A Positive Outlook May Be Good for Your Health, the New York Times reports that actively enhancing positive emotions can boost your immune system and reduce depression. Studies have shown a link between having a positive outlook and health benefits like lower blood pressure and heart disease, better weight control and healthier blood sugar levels.

CBT Skills that Work

In a research study, participants were encouraged to learn at least three of eight skills and practice one or more each day. The eight skills were:

  • Recognize a positive event each day.
  • Savor that event and log it in a journal or tell someone about it.
  • Start a daily gratitude journal.
  • List a personal strength and note how you used it.
  • Set an attainable goal and note your progress.
  • Report a relatively minor stress and list ways to reappraise the event positively.
  • Recognize and practice small acts of kindness daily.
  • Practice mindfulness, focusing on the here and now rather than the past or future.

How to Get Help for in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley (San Jose/Saratoga) and Sacramento Valley (Roseville) specializes in therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members improve your outlook.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

Does Halloween Make You Want to Hide?

Halloween’s Growing Popularity Can Lead to Social Anxiety

Halloween used to be primarily a kid’s holiday. In recent years, Halloween has transformed from a kid-centric holiday into an $8 billion a year industry for everyone. Two in three adults believe Halloween is a holiday for them and not just kids. Many companies allow, and even encourage employees to wear costumes. Halloween’s creep also extends to pets. Americans will spend $370 million on pet costumes this year, with pumpkin (13%), devil (7%), and hot dog (6%) among the most popular. Halloween is now the second-biggest decorating holiday of the year — right behind Christmas.

Common Worries About Halloween

All this pressure to celebrate Halloween can make some folks downright anxious, especially if you suffer from social anxiety. Besides the fear of ghosts, witches and goblins, adults with social anxiety may suffer from other fears such as:

  • Worry and indecision about whether to wear a costume and, if so, what to dress up as
  • Fear of being judged for the type of costume you choose
  • Depression about not being invited to a Halloween party and thinking that everyone else is having fun except you
  • Social awkwardness if you do go to a Halloween party, such as not knowing what to say, being uncomfortable with small talk or comparing your costume to others
  • Anxiety about opening the door for trick-r-treaters and having to interact with neighbors and strangers

Easing Your Social Anxiety About Halloween

Halloween Ghosts Social AnxietySo what can you do this year to help ease the Halloween jitters?

First, remember Halloween is about fun. No one really cares what you dress up as. Most people are more focused on showing off their own costume than what you are wearing. Since everyone is so focused on their own costumes and being spooky and silly, they are less likely to care whether you talk or what you say anyway.

Second, remember many people enjoy staying home and watching scary movies on Halloween or just doing nothing and relaxing. Take the pressure off yourself if you do end up spending the evening alone. Plan some fun and enjoyable activities for yourself.

Third, if you stay home and don’t feel like opening the door, you can leave a bowl of Halloween candy on your doorstep with a friendly message so your neighbors know you care. Or you can push yourself to face your anxiety, open the door, and hand out candy. You can say “trick-r-treat” and smile. Or just make a pleasant comment about the kids’ and adults’ costumes.

How to Get Help for Social Anxiety in San Jose/Saratoga and Sacramento/Roseville

The Cognitive Behavior Therapy Center in Silicon Valley and Sacramento Valley specializes in social anxiety therapy and counseling with adults, children and teenagers. Call us in Saratoga at (408) 384-8404 or in Roseville at (916) 778-0771 or Click to send an email for more information on how we can help you or your family members overcome your social anxiety.

Silicon Valley and Sacramento Valley Communities We Serve

Cognitive Behavior Therapy Center of Silicon Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder and Eating Disorders near the following Silicon Valley/San Jose communities:

San Jose Therapy CounselingSaratoga Therapy CounselingLos Gatos Therapy Counseling Monte Sereno Therapy Counseling • Cupertino Therapy CounselingCampbell Therapy CounselingMountain View Therapy CounselingLos Altos Therapy CounselingSunnyvale Therapy CounselingSanta Clara Therapy Counseling

Cognitive Behavior Therapy Center of Sacramento Valley offers evidence-based therapy for Anxiety, Obsessive Compulsive Disorder (OCD) and Eating Disorders near the following Sacramento Valley and Sierra communities:

Sacramento Therapy CounselingRoseville Therapy Counseling • Rocklin Therapy Counseling • Granite Bay Therapy Counseling • Lincoln Therapy CounselingFolsom Therapy Counseling • Citrus Heights Therapy Counseling •  El Dorado Hills Therapy Counseling • Loomis Therapy CounselingGrass Valley Therapy Counseling  • Auburn Therapy Counseling

CONTACT US
Saratoga: (408) 384-8404
Roseville: (916) 778-0771
Click to send an email

Impostor Syndrome: Are You Discounting Yourself and Your Successes?

In the Boston Globe, I read that four smart and talented students at MIT committed suicide within the past year. Among its efforts to help students cope with stress, MIT is encouraging students to talk about the psychological phenomenon called “impostor syndrome,” the feeling of being a failure despite a record of accomplishment.

What is Impostor Syndrome?

Impostor syndrome is common among high achievers, many of whom discount their successes. As a result, they do not feel confident or deserving inside of themselves even though they are objectively successful and perceived as such by other people. Psychological research done in the early 1980s estimated that two out of five successful people consider themselves impostors and other studies have found that 70 percent of all people feel like impostors at one time or another.

The impostor’s thoughts and feelings can be divided into several categories:

1. Feeling like a fake: You may believe that you do not deserve your success, academic standing or professional position. This is accompanied by a fear of being “found out”, “discovered” or “unmasked.” If you feel this way, you might identify with statements such as: “I have tricked other people into thinking that I am more competent than I really am” or “I am often afraid that others will discover I don’t really know what I am doing.”

2. Attributing success to luck: Another aspect of the impostor syndrome is the tendency to attribute success to luck or to other external reasons and not to your own internal abilities. You may refer to an achievement by saying, “I just got lucky this time” or “it was a fluke” and worry you will not be able to succeed next time. You may think you are just lucky, in the right place at the right time, and that’s why you were chosen for a particular job or role.

3. Discounting Success: The third aspect is a tendency to downplay success and discount it. You may discount an achievement by saying “it is not a big deal” or “it was not important.” For example, a student attending a prestigious university may discount the fact that they were accepted or feel like it was a mistake that they were accepted and that they don’t belong or they aren’t as smart as the other students. Or you may say “I did well because it is an easy class” or “I was promoted because my manager left” instead of attributing it to hard work or intelligence. You may also discount your accomplishments and have a hard time accepting compliments.

4. Dwelling on the Negative: You may notice every time where you think you should have done better or where you made a mistake. On the other hand, you overemphasize minor flaws in your performance. You fail to notice, or fail to put enough importance, on what you did well.

5. Unfair Comparisons: You compare yourself unfavorably to others. Frequently you pick out the most outstanding people in your school, company or field and judge your own performance as inadequate and inferior.

Women and Impostor Syndrome

Imposter Syndrome MaskThe term “impostor syndrome” first appeared in an article written by Pauline R. Clance and Suzanne A. Imes in the 1970s. They observed that many high-achieving women tended to believe they were not intelligent, and that they neither internalized nor accepted their own accomplishments. These individuals attributed their successes to luck rather than skill or talent, and were afraid others would realize they’d been deceived by a fraud.

While both men and women experience impostor syndrome, studies show that women are more often affected. According to Valerie Young, author of The Secret Thoughts of Successful Women, boys are raised to bluff and exaggerate. Girls, on the other hand, learn early to distrust their opinions and stifle their voices. Young women learn that they tend to be judged by the highest physical, behavioral and intellectual standards. Perfection becomes the goal, and every flaw, mistake or criticism is internalized—slowly reducing self-confidence.

“A real bias against female competence persists,” says Young. “Being female means you and your work automatically stand a greater chance of being ignored, discounted, trivialized, devalued or otherwise taken less seriously than a man’s.”

Sheryl Sandberg, COO of Facebook, spoke of her own feelings of insecurity in her best-selling book, Lean In: Women, Work, and the Will to Lead. When Sandberg attended her Phi Beta Kappa induction at Harvard, a woman gave a speech called “Feeling Like a Fraud.” During the talk, Sandberg looked around the room and saw people nodding. “I thought it was the best speech I’d ever heard,” she recalls. “I felt like that (an impostor) my whole life.” At school, Sandberg thought, “I really fooled them.”

Sandberg says, “Many people, but especially women, feel fraudulent when they are praised for their accomplishments. Instead of feeling worthy of recognition, they feel undeserving and guilty, as if a mistake has been made. Despite being high achievers, even experts in their fields, women can’t seem to shake the sense that it is only a matter of time until they are found out for who they really are – impostors with limited skills or abilities.”

Originally thought to be more common among women, men, too, can be victims of the imposter style of thinking. Even Albert Einstein suffered from impostor syndrome near the end of his life. A month before his death, he reportedly confided in a friend: “the exaggerated esteem in which my lifework is held makes me very ill at ease. I feel compelled to think of myself as an involuntary swindler.”

Do I have Impostor Syndrome?

Imposter Syndrome DogDr. Valerie Young developed the Impostor Syndrome Quiz (reprinted below). If you answer yes to many of these questions, you may have impostor syndrome:

  • Do you secretly worry that others will find out that you’re not as bright and capable as they think you are?
  • Do you sometimes shy away from challenges because of nagging self-doubt?
  • Do you tend to chalk your accomplishments up to being a “fluke,” “no big deal” or the fact that people just “like” you?
  • Do you hate making a mistake, being less than fully prepared or not doing things perfectly?
  • Do you tend to feel crushed by even constructive criticism, seeing it as evidence of your “ineptness?”
  • When you do succeed, do you think, “Phew, I fooled ‘em this time but I may not be so lucky next time.”
  • Do you believe that other people (students, colleagues, competitors) are smarter and more capable than you are?
  • Do you live in fear of being found out, discovered, unmasked?

Strategies for Overcoming Impostor Syndrome

1) Become aware of your thoughts. Automatic thoughts can be defined as underlying, unquestioned thoughts, which affect how you perceive an event or situation. Realize them for what they are: negative self-talk that has become a habit. Be aware when you engage in thoughts and feelings of an impostor. Awareness is the first step to change and many times we are not aware of our automatic thoughts.

2) Do a reality check. Question your automatic “impostor” thoughts and feelings and try to come up with more balanced thoughts. Understand the difference between your negative thoughts and reality. Identify the critical voice that is doubting your authenticity. It’s not You. Separate yourself from the critical and self-limiting “impostor” voice.

3) Understand the difference between feelings and reality. Some people believe that if they feel something strongly it must be right. “If I feel so stupid, it must mean that I really am stupid.” When you catch yourself thinking in this way, change it to a coping statement of “the fact that I feel stupid does not mean that I really am. It’s a feeling and not reality.”

4) Write down the steps you took to earn the success you achieved. In one column, make a list of what you accomplished on a particular task or project, and in a second column, write the names of people who helped contribute to the success. Come up with realistic responses that give you credit, but also share praise with others who contributed. For example, you could say to yourself, “I’m proud of what I did on that job, and I had the help of a great team.”

4) Replace your negative “impostor” thinking habit by practicing more realistic and helpful self-talk. Remind yourself of how you contributed to your success with thoughts like “I have proven I am capable by…” or “I prepared for this by…” Give yourself credit throughout the day for both major and minor successes. Notice and reframe “yes, but” statement such as “I brought in accounts but she brought in more” to “Even though she brought in more accounts, I brought in many myself.” Focus on your strengths. When you finish a task, you can ask yourself, “What positive qualities do I have that allowed me to do accomplish this?”

5) Be on the lookout for unhelpful coping strategies you engage in to prevent others from evaluating you negatively. For example, if you tend to hold back from sharing your opinions in meetings, take a risk and speak up in a calm and confident way.

6) Celebrate! Give yourself permission to be proud. Let your friends and family praise you. Take some of it in. Let it touch your heart. Being proud of an accomplishment is not the same as being self-centered. After you celebrate, you will probably remember that no matter what you achieved, chances are there is more to do. This can be humbling and healthy, and important to distinguish from the unhealthy internal put-downs.

7) Give yourself a little time to grow into your success, especially if success seemed to come rather easily or quickly. Sometimes you just need time for a new promotion or status to settle in so you can feel like you deserved it and earned it. However, if you think impostor syndrome is keeping you from getting the most out of your life, then you might want to find a therapist to help you work through your thoughts and feelings.

How To Get Help for Impostor Syndrome

The Cognitive Behavior Therapy Center of Silicon Valley offers counseling and therapy for women and men suffering from Impostor Syndrome. We are located in Saratoga on the border of San Jose and Saratoga just 1/2 mile from Highway 85. With our convenient location near highway 85, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Cupertino and Campbell, CA. Contact us at (408) 384-8404 for more information on how we can help you savor your accomplishments and reduce your feelings of being an impostor at school or work.

Radically-Open Dialectical Behavior Therapy (RO-DBT)

RO-DBT: Your Path to a More Flexible Life and Joyful Experiences

Laura Johnson, LMFT, LPCC, Center Director, attended a two-day workshop on Radically-Open Dialectical Behavior Therapy (RO-DBT) led by its founder, Thomas Lynch, PhD, Professor of Clinical Psychology at the University of Southampton, UK. RO-DBT is an evidence-based approach to help individuals become more flexible in their thinking and responding, more open to life experiences that create joy and happiness, and build intimacy and social connections. RO-DBT can be particularly helpful for individuals with inflexible, rigid personality styles who are susceptible to certain types of anxiety disorders, depression, OCD, perfectionism, anorexia and autism. RO-DBT includes many of the skills taught in traditional DBT but also teaches an entirely new set of skills to increase flexibility and reduce rigidity.

RO-DBT Theory

The theory behind RO-DBT is that children with an “over controlled” temperament are more likely to develop internalizing disorders such as anxiety and depression and become socially isolated as adults. “Overcontrol” is defined as an emotionally constricted, shy and risk averse temperament. In appropriate amounts, overcontrol is a positive trait. You may desire to exceed expectations and perform well, value rules and fairness, delay gratification to achieve goals, and have a high sense of duty, obligation and self-sacrifice.

On the other hand, individuals who develop a excessively overcontrolled style may have a need to appear perfect (planning ahead, being right, stressing orderliness and structure), follow rules (always doing the right thing, being prepared, smiling even when unhappy) and have high pain tolerance (able to work really hard and delay or minimize joy and fun).

Goals of RO-DBT

The goal in RO-DBT is to help individuals develop optimal control that is neither over- or under-controlled.

RO-DBT starts with defining what’s healthy and what’s not. Its interventions strive to build these positive traits including:

  • Receptivity and Openness to new experiences (as opposed to high risk aversion, hypervigilance for threat, avoidance of novelty and discounting of constructive feedback)
  • Flexible Responding to adapt to changes in the environment (instead of compulsive needs for structure and order, hyper-perfectionism, compulsive planning/rehearsal, and rigid rule-governed behavior)
  • Emotional Expression and Awareness to have genuine emotional experiences (as opposed to inhibited expressions or fake expressions and low self-awareness or minimizing of feelings)
  • Intimacy and Connection to form long-lasting bonds (instead of aloof/distant relationships, excessive social comparison, envy and bitterness, and low empathy and validation skills)

Ways to Build Flexibility, Openness and Social Connection

In addition to most of the traditional DBT skills, RO-DBT also teaches additional new skills  to build the qualities of flexibility, openness and social connection including:

Radical Oppenness Skills LegosRadical Openness Skills Module is a completely new skills module where you will learn to change your physiology, engage in new behaviors, learn from constructive feedback, validation skills, build compassion and forgiveness, stimulate positive emotions toward yourself and social connectedness with others through loving kindness meditation,verbal and non-verbal skills to signal openness and friendliness, and communication of emotions to increase social connection and reduce social isolation and loneliness.

Mindfulness Skills to recognize when you are in fixed mind vs. fatalistic mind and how to get to flexible mind and to teach self inquiry.

Emotion Regulation Skills to reduce envy, bitterness, resentment and revenge.

Some Examples of RO-DBT Skills

There are three steps involved in building the skill of Radical Openness:

  1. Acknowledge the presence of unwanted or uncomfortable feelings such as irritation, tension in the body, negative emotions or feelings of uncertainty
  2. Turn toward the discomfort and use Self-Inquiry to ask yourself, “What do I need to learn from this?” instead of automatically distracting or accepting
  3. Flexibly Respond by doing what’s needed in the moment

Practicing being open to feedback from others includes the following steps:

  1. Acknowledge the feedback
  2. Describe your emotions, sensations, thoughts and images
  3. Be Open to new information by cheerleading yourself, adopting an open body stance, and fully listening to the feedback
  4. Pinpoint what the new behavior is and confirm
  5. Try out the new behavior
  6. Self-soothe and reward yourself
How To Get Help in Building Flexibility and Other Positive Traits

The Cognitive Behavior Therapy Center of Silicon Valley specializes in helping individuals change unhelpful thinking and coping styles and build flexibility, openness and social connection. With our convenient location just a half mile from Highway 85 and the Saratoga Avenue exit, we serve the Silicon Valley communities of San Jose, Saratoga, Mountain View, Santa Clara, Sunnyvale, Los Gatos, Los Altos, Cupertino and Campbell, CA. We also have a CBT Online Video Therapy Program for clients in California who live to far away to drive for our specialized therapy in person. Contact us at (408) 384-8404 for more information on how we can help you manage you become more flexible, open and joyful.

Beck Institute on Depression

Beck Institute Group Photo

Erica Russell, Dr. Judith Beck and the workshop participants

I recently attended the Beck Institute’s training on Cognitive Therapy for Depression and Suicidality in San Francisco. The Beck Institute was established by Dr. Aaron Beck, the father of CBT, and his daughter, Dr. Judith Beck. As a world-renowned resource for training in CBT, I felt extremely lucky to attend this event and receive training from some of the CBT field’s most prominent members. The three-day training was host to professionals from all over the world and was led by Dr. Judith Beck and Dr. Daniella Cavanaugh, the Beck Institute’s Director of Education.

The CBT treatment for depression focuses on building awareness of and shifting these negative automatic thoughts and core beliefs, as well as developing a plan to increase a client’s daily activities. The training began by reviewing the basics of the cognitive model and then went on to provide specific information on the conceptualization and treatment of depression and suicidality. The Beck Institute conceptualizes depression as a combination of negative core beliefs (which we formulate early in life based on our experiences), negative automatic thoughts (which are typically linked to our core beliefs, but are activated more immediately), and maladaptive coping behaviors (which may involve social isolation, a lack of physical activity, or avoiding previous activities or interests).

Dr. Beck delved into the most common core beliefs held by depressed individuals and then discussed how these beliefs influence negative automatic thoughts. Common core beliefs center around a negative view of the self, the world, and the future. Clients typically express thoughts about themselves related to being “helpless”, “hopeless” or “worthless”.

Through role plays, Dr. Beck demonstrated how to uncover core beliefs and shift negative automatic thoughts toward more realistic alternative thoughts. She utilized socratic questioning, which involves assisting the client in evaluating and clarifying his or her statements, to uncover and shift negative automatic thoughts. Examples of socratic questions include: “What evidence do I have that this thought is true?” and “what’s an alternative viewpoint?” To assist with uncovering the deeper core beliefs, Dr. Beck utilized the downward arrow technique, which involves asking questions to elicit the meaning behind an automatic thought, such as “what would it mean to you if that was true?” This segment of the training involved time for those in attendance to pair up and practice interventions in role plays together. As a therapist, getting to witness Dr. Beck in action was like getting to watch a favorite rockstar on stage!

Erica and Dr Cavanaugh

Erica and Dr Cavanaugh

After covering cognitive interventions, Dr. Beck spent time discussing the most helpful behavioral strategies for depression, including scheduling pleasant activities, teaching problem solving and interpersonal skills, and encouraging adaptive behaviors, such as exercise and relaxation.

The final day of the training was led by Dr. Cavanaugh and focused on the treatment of suicidal clients. I found the information about practicing coping skills to prevent relapses into suicidal thinking to be particularly helpful. One of my favorite new ideas for coping with suicidal thoughts is a free app called “Virtual Hope Box”. The app includes the ability to add pictures or music that help you to feel hopeful, play games or access relaxation excesses for distraction, and create coping cards with positive responses to your most common negative thoughts. Dr. Beck also recommended creating a physical hope box (an actual collection of photos or items that help you to feel hopeful), but I loved the idea of having this electronic option that you can always carry with you.

A Mindful Approach for Chronic Depression

Chronic Unhappiness is Hard to Change

It’s challenging to try to help people change who have had a lifetime of mental suffering and hold deeply-entrenched negative beliefs about themselves and the world. The other day I was working with a client who yelled out in pain, “There’s nothing positive about my situation!”  I sat there feeling helpless because I could see his strengths, but my words fell on deaf ears.

Cycles

Cycles

One type of therapy I am exploring for clients with chronic depression is Mindfulness-Based Cognitive Therapy (MBCT), which was developed by Segal, Williams, and Teasdale. They found that people who hold depressive thinking styles are more easily triggered into depressive episodes. The more times this happens, the stronger the neurological connections become and the more likely they are to experience another depressive cycle.

What is MBCT?

MBCT combines mindfulness and cognitive therapy. It is generally taught in an eight-week class of two hours each plus one full-day session. Participants learn mindfulness techniques like the three-minute breathing space, which helps them to call upon mindfulness in stressful moments.

The cognitive therapy component includes learning about negative thinking styles and your own automatic thought patterns, reframing negative thoughts as part of the landscape of depression, recognizing that thoughts aren’t facts and asking yourself questions to help you see reality more clearly. Homework includes using CDs with guided meditations at home.

Crouching Tiger

MBCT in Action

Let’s say you have just gotten chewed out by your boss for turning in a report with several mistakes. Your normal mode of responding might be to defend yourself and argue, “You didn’t give me enough time.” Or maybe it’s to passively listen and then sulk at your desk with thoughts like “I’m no good at this job” and “He’s always such a jerk.” For someone with a strong negative thinking style, this could be enough to trigger depression.

Instead, you can use the three-minute mindful breathing meditation to become aware of the thoughts, feelings, and bodily sensations that arise in the moment of a challenging situation. The goal of the three-minute breathing space isn’t to take away negative feelings. It’s to help you access a clearer frame of mind so you can respond to stressful situations more skillfully and use different approaches to relate to your thoughts.

Promise

Promise

Promising Research for MBCT

The National Institute for Health and Clinical Excellence in the United Kingdom recommends MBCT for people who are currently well but have experienced three or more depressive episodes. In 2000, a research study found that 66% of participants in MBCT remained relapse-free vs. 34% in the control group. Another study in 2004 replicated the results and found the rate of relapse to be 36% in MBCT group vs. 78% in the control group. MBCT was not found to be effective in people with one or two depressive episodes.

MBCT and Positive Psychology

MBCT has some strategies in common with positive psychology. MBCT helps participants to:

  • Observe their negative thoughts with curiosity and kindness
  • To accept themselves and stop wishing things were different
  • To let go of old habits and choose a different way of being
  • To be present in the moment and notice small beauties and pleasures in the world

Appreciating Beauty

Appreciating Beauty

Just Notice

MBCT is intriguing because the goal isn’t to analyze and change your negative thoughts, but instead to simply be aware of your thoughts and learn to regard them as events of the mind. MBCT teaches people to notice their thought patterns and to change their relationship to their thoughts. Instead of believing the things your mind tells you like, “I am loser because I’ll never get a date,” you might instead just notice, “There’s that thought again that I’m a loser,” without having to react to it.

By noticing when you are at risk of getting caught in the negative habits of your mind, you will be more able to prevent sadness from spiraling into full-blown depression.


References:

Ma, S.H., & Teasdale, J.D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31-40.

Mindfulness Based Cognitive Therapy sites:

www.mbct.com
www.mbct.co.uk

National Institute for Health and Clinical Excellence, United Kingdom. Depression: The treatment and management of depression in adults (see page 10)

Segal, Williams & Teasdale. (2001). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing RelapseGuilford Press.

Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V., Soulsby, J., & Lau, M. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy.. Journal of Consulting and Clinical Psychology, 68, 615-623.

Williams, M., Teasdale, J., Segal, Z. & Kabat-Zinn, J. (2007). The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness. Guilford Press.

Images
Cycles courtesy of Mike Cattell
Crouching Tiger (butterfly) courtesy of Ajith U
Colorful World of Things Natural (flower) courtesy of sling@flickr
Batur Volcano and Lake (Appreciating Beauty) courtesy of tropicalLiving

 

Note: This article originally appeared on Positive Psychology News Daily on October 25, 2010. Reprinted with permission of the editors at PPND.