CBT podcast

The hour-long radio program on CBT that aired May 6 is now available for listening as a podcast. Host Jeff Frey, MD and I discuss topics such as how CBT works, automatic thoughts, mindfulness, medication vs. talk therapy, and similarities and differences between various types of mental health professionals (licensed clinical social workers, psychologists and psychiatrists). The show is called Your Health Matters, and it airs every Wednesday, 6-7 p.m. Central on KOPN 89.5 fm in Columbia, MO.

Mindfulness and options

Mindfulness has found its way into the work of many cognitive-behavioral therapists, and for good reason. Any practice that has the potential to increase awareness, improve focus and reduce harmful judging deserves our consideration.

Someone practicing mindfulness is noticing their inner experiences (thoughts, feelings, urges and body sensations, for example), without necessarily acting upon them. The practice is designed to enrich whatever one chooses to focus upon, by allowing them to fully participate.

In my last post I wrote about how black-and-white thinking occurs when someone is limited in their ability to see good options for themselves. In her book, Mindfulness, Ellen J. Langer describes how the practice of mindfulness can serve as an antidote to this type of thinking. She writes:

A model of mindful receptivity is the inertial navigation system in modern aircraft. This device is constantly receiving new information, constantly letting the pilot know where the plane is at any particular moment. We have a similar mechanism operating within us as we walk or balance ourselves in other ways. Our minds, however, have a tendency to block out small, inconsistent signals (p. 67).

The inconsistent signals Langer mentions can be any bit of information or alternative point of view that we don't normally consider. Many times, we limit our own options by the way we think, which means only considering the options that come to us readily. Being mindfully aware of all information available allows us to see possibilities that we'd either dismissed or never considered. As Langer points out, the results can be liberating.

Anger: The guest that won't leave

Say you’re waiting in your car at a red light. It turns green. You start to go, when another car zips through the intersection, running their red light and nearly taking off your front end. Now you’re angry. How long does it take for you to cool down?

If you take a long time to cool off from anger, you may be doing one of two things: rehearsing or elaborating.

Rehearsing refers to playing out situations in your mind in which you act upon your anger. You tell the person off. You make cutting remarks. You scream. You might even exact revenge in creative ways. None of this actually happens, but it’s all very real inside your head.

What happens to your anger level while you’re imagining these elaborate scenes? Most likely, it’s on the way up. It’s only natural for your anger to intensify, or at least gain staying power, if you’re keeping it around in your thoughts. After all, you’re rehearsing for anger, and we tend to get better at what we rehearse.

Another mental activity that keeps anger around is elaborating. After getting angry at someone you know, have you ever found yourself thinking of every thing you don’t like about that person? Or you might make a mental list of every time they made you mad in the past. The current issue may even be forgotten by the time you’re through. In any case, you’ve just given yourself a lot more reasons to be angry.

Trying to stop rehearsing or elaborating altogether is a lofty goal, but there are ways to cut back. Using ideas from anger management self-help books, working with a therapist, and practicing mindfulness can all make a big difference. Just becoming aware of when you’re engaging in either of these activities can help. And when you’re able to shorten your cool-off time, just think of the extra time and energy you can devote to things that matter more to you than that person who just ran a red light.

From zero to 100 in a heartbeat

The last time you found yourself getting seriously angry, how long did it take? A lot of people say they go from feeling perfectly fine to feeling really angry in about two seconds. Some people even report feeling “blinded” by their anger. They do or say things they later regret.

How is it possible for something so powerful to sneak up on you so quickly? The answer may lie in self-awareness.

Self-awareness is knowing what’s going on in your mind and body at any given moment. When you react to a situation—like that driver who just cut you off on the freeway—changes happen in your body and mind. These are your anger cues. They tell you that unless you do something different quick, you might be headed for trouble.

There are at least four different types of anger cues to look for—body sensations (rapid heartbeat, for example), behaviors (such as slamming objects), emotions (embarrassment, fear, etc.), and thoughts (“Here we go again!”). Everyone’s cues are different. If anger is a problem for you, it’s important to become intimately familiar with your own unique anger cues.

This idea fits well with CBT, which can help people heighten their awareness of their own inner experience. This is often a first step toward managing moods and behaviors. When coupled with mindfulness practice, CBT can be used to foster tolerance of anger cues without necessarily acting on them.

For a lot more information on anger, check out AngerManagementExpert.