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January 2013

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contents.

A message from Matt our

Clinical

Director, An extract from the clinics new book written by Matt and Brian

Chapter 5

in the Dummies series Managing Depression using CBT

from the book


CBT London and the Home Counties Our head office is based in at the

Harley Street, London, while we also hold London CBT Clinics

Healix Wellbeing Centre

London. Highbury and Islington

in Southgate, North

Brixton

, Dulwich,

Camberwell and Walthamstowe. In the home counties we have CBT Therapists available on Norwich,

the network in Berkshire, Buckinghamshire, Essex,

St Albans in Hertfordshire

, Kent , Surrey and Sussex. For more

information, book an appointment or enrol in a Group CBT Programs you will need to contact us, register

online or telephone

0207 467 1508

Message From the Clinical Director Happy new year! Welcome to 2013! Another opportunity to enjoy new challenges and test out how strong we are. But strength does not mean wearing a mask but rather allowing self to be weak at times. There is a time to be sad, cry, strong, weak, happy, joyful,.......a time and season for everything. I hope that 2013 brings you all that you wish for and tolerance for times when tough. And remember to view problems as an opportunity for growth! • Website: www.cbtinthecity.com
 • Join Our Facebook Groups: CBT in the City - CBT in the City for Schools - Mindfulness and the City
 • Follow us on Twitter: CBTDaily  -  SchoolsCBT  -  MindfulnessCB


Facing your feelings * * * * * * * *

extract from book

Revisit the thought/feeling connection The attitude effect Feelings aren’t Facts managing Emotions Beating self Berating Self resilience / Self comforting What to say when you talk to yourself Developing emotional intelligence and responsibility

This chapter aims to help you to develop knowledge about emotions. Once You understand these emotions then you are half way to dealing appropriately with your emotions..

The other half is then understanding how to recognize the message the emotion holds for you, and how to use it to make your life better. By changing the way you think and respond to your emotions you will find that you can experience any human emotion and use it in a positive manner.

Perhaps for some personal change and growth. Perhaps to motivate you to do something different in your life. Lets start by describing 2 types of emotion, unhelpful negative emotions and helpful negative emotions

Unhelpful negative emotions play a big part in Depression and can feel overwhelming and are certainly more problematic than helpful negative emotions.

It may be best to think of Depression as a warehouse term and within the warehouse there can be different emotions like Hurt, Unhelpful Anger, Guilt, Shame, unhelpful Jealousy to name but a few of the emotions common in depression.

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Example of helpful disappointment. Scenario 1-

I am 30 minutes late meeting my brother and he is disappointed. However believing that I did not intended to be late and being flexible enough to understand that ‘life happens’ and the fact that I was not punctual does not mean I don’t care but instead I am just stuck in traffic.

This then can be an emotion that brings about a discussion and an understanding is developed which helps us to trust each other better.This leads to feeling accepted and supported.

But if….

The unhelpful emotion of Hurt- Scenario 2-

I am 30 minutes late and my brother is Hurt and believes that I intended to be not punctual and therefore attributes the ideas that I did not care and therefore dwell on past hurts.

Then this emotion has the potential to spiral out of control as Sulking is the main self defeating behaviour which leads to isolation and withdrawal.

No discussion takes place and this leads to a distancing in our relationship.

It is important to know about the helpful negative emotions as when your depressed there is a tendency to think all negative emotions are unhelpful.

For example feeling guilty can be really useful if you use it to motivate yourself to respond differently the next time you find yourself in a similar situation.

Recognizing that negative emotions can have positive benefits helps you to accept and tolerate them better .when you recognize this you will discover that helpful negative emotions are normal and natural to feel and can be productive if you allow them to be.

Revisit the thought feeling connection.

Remember the motto ‘you don’t feel anything without thinking something to make you feel that way'.

This will help you to recognize and name your feelings. These can usually be described in one word such as hurt, angry, happy sad etc. and naming your emotions is the first step in learning to respond appropriately.

It is the meaning that you attach to events that lead to your emotional responses to the event, so you may have a positive meaning that you place on the event which then leads to happiness and contentment but a negative meaning attached to an event will lead to unhelpful negative emotions and self defeating behaviours.


The feeling behavior connection.

For example:

You feel scared you run away

You feel hungry you eat

You feel upset you cry

You feel tired you sleep.

In depression the examples might be:

You feel hopeless you give up trying

You feel stuck you do nothing

You feel fatigued you lay around

You feel unwanted / unappreciated you withdraw and avoid people.

Unfortunately following these urges when you are depressed will only make things worse. Thus the “feeling / behavior connection becomes a trap that keeps you depressed and maintains your negative feelings

The attitude effect

The good news is that once you are aware of this you can use this knowledge to change your attitude and response to negative emotions.

In this way you will begin to tackle your depression and start to lift your mood. This awareness and ability to take conscious decisions about your response to negative emotions is called emotional intelligence.

Let’s take a look at Joe’s journey of self discovery with his problem with Unhelpful Anger and how he moves towards experiencing Annoyance and some contentment.

The unhelpful emotion of Anger Scenario 3- Joe is Queuing up at ATM and someone pushes in front of the queue


Here Joe is thinking that the other man has deliberately been rude and dismissive towards him and believes that if I am walked over then I am an idiot and I will not allow others to see that I am being treated like an idiot or they will think I’m weak and useless (not a real man)

These thoughts lead to Joe feeling angry and threatened. (Thought / feeling connection) then Joe experiences an urge to react The feeling behavior connection is anger + threat leads to an urge to attack.

In this scenario we can see that if Joe acts on his feelings he may get into an argument or even a fight with the man causing him further problems and negative emotions such as guilt or regret.

However if he doesn’t act on these urges, being depressed he is likely to interpret his non action in a negative way. Feeling like a failure telling himself he’s a wimp and let’s people walk all over him

This “dammed if I do dammed if I don’t” scenario is called a double bind situation and is very common in depression. Leading to a sense of hopelessness and thoughts of “I can’t win.”

However once you become aware of this problem you have the choice to change your attitude about it. Consider the following scenario.

The helpful emotion of Annoyance Scenario 4- Joe is queuing up at ATM and again someone pushes in front but instead he reminds the individual that he has pushed in front and maybe the man may listen and move to the right place in the queue

But lets look at the possibility that he may not listen and therefore Joe acknowledges to himself through his self talk that ‘this is a misguided individual but the fact that he chooses to not listen to me does not mean I am a door mat or a walk over but instead it has no relevance to my self esteem.

This change of attitude therefore leads to a change in emotions and behavioural urge.

Feelings are not Facts

As can be seen from the above when someone’s depressed it becomes all too easy to interpret every situation through a depressive attitude leading to depressive thoughts, feelings and behaviours.

One stumbling block people encounter when tackling their depression is the delay that usually occurs between beginning to change your thoughts and behaviours and beginning to feel better.

It can be very disheartening to be working on your thoughts and behaviours and to realize that you still feel depressed, but Don’t give up because with a little perseverance you will start to see that your depressive emotions will start to change it just takes time.

Tip for dealing with anger Top tip Follow a Anger 4 step approach

1. walk away-decide to come back to situation in one hour and then make an excusee.g. need to make a call or I am late for an appointment must dash!


make a call or I am late for an appointment must dash!

2.

Get calm- go for a slow walk or another activity which slows you down

3. Rethink- How do you want others to think about you? How do `I want to think of myself? Am I fostering/nurturing (looking after) the relationship with myself and the other person

4. Come back with a response- this can be a response to self ‘I am annoyed about……but now it’s ok and life goes on’ or a response to the other person to say “lets agree to disagree” or “ I am sorry”

The Anger 4 step approach is tapping into the idea of hindsight is golden and “I wished I had acted differently and if so then I would act like this…..”

Well the 4 step just helps to create a pause button while you collect your thoughts and decide a course of action. Pause and rewind can cause you to feel hot with anger and Pause and fast forward can help you see the potential consequences before they occur and help you to salvage the situation before it becomes a problem.

Managing Emotions

It is difficult to know what to do with emotions if you do not have emotional intelligence. This is a term used by Psychologist to refer to having knowledge about emotions and being self aware. To develop emotional intelligence then let’s look at some common references to some emotions.

Describe what you notice

Anxious-vexed, worried, agitated, apprehensive, edgy, crabby, concerned, fearful, scared, troublesome, jumpy, nervous

Anger- annoyed, irritated, bad-tempered, aggressive, cross, displeasure, furious, hostile, touchy, livid,

Ashamed-humiliated, mortified, dishonored, disgraced, disrespected,

Jealous- green-eyed monster, suspicious, wary, paranoid, anxious,

Hurt-gutted, offended, rejected, broken-hearted, aggrieved, down-hearted

Guilt-blame, at fault, sinned, unforgiveable, punishable, answerable,

Joy-euphoric, estatic, wow, cup filled to overflowing,


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 10 Harley Street, Central London, W1G 9P 
 


for more information contact +44 (0) 207 467 1508 
 
 
 • Website: www.cbtinthecity.com
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CBT in the City Newsletter 27