Saturday, July 20, 2013
Lots of us here are fans of Dr, Judith S. Beck's great book, "The Beck Diet Solution: train your brain to think like a thin person". She applies techniques from cognitive therapy (originally developed by her father, Dr. Aaron Beck) to weight loss and weight loss maintenance. They work: there's a whole "Beck team" here which attests to their efficacy!
Beyond weight loss, I've also found techniques of cognitive therapy very helpful in dealing with "mood"; stress generally and of course just the anxiety and worry and sadness that arise from the situations we live through and the experiences we've had in the past.
Riffing on these Beck cognitive therapy techniques, Dennis Greenberger and Christine A. Padesky have written a great workbook called "Mind Over Mood: change how you feel by changing the way you think".
In a nutshell, Greenberger/Padesky set out a series of sequential exercises based upon the concept of the "thought record". The idea is to:
1. identify the situation giving rise to the mood (the who, what, where, when);
2. identify the mood itself (fear, anger, anxiety, sadness etc.) and rank the intensity of the mood (100% depressed? 40% irritable?)
3. identify the automatic thoughts triggered by the situation and the mood (what was going through my mind, what am I afraid might happen, what memories are triggered etc.) and in particular the "hot thought" that gives rise to the mood ("nobody cares about me", "the emotional pain is unbearable", "I'm having a heart attack" etc.)
4. consider the evidence that supports the "hot thought" (without "mind reading" by attributing the response of the non-caring person who may simply be preoccupied, and without subjective "interpretation" of facts such as "heart racing, sweaty" etc.)
5. consider the evidence that does NOT support the "hot thought" (what experiences have I had that don't support that "hot thought", what would my best friend tell me, what have I learned from prior experience in comparable situations etc.)
6. consider an alternative or more balanced thought, summarizing all the evidence both supporting the "hot thought" and not supporting that "hot thought", and taking into consideration what's the worst possible outcome, best possible outcome and most realistic or likely outcome; and finally
7. re-evaluate the mood (sadness, grief etc.) and its intensity after going through the exercise. If I was feeling 40% irritable before, is that now reduced to 20%? If the negative mood is not diminished, do I need to reconsider the evidence supporting the hot thought, both positive and negative? Is there a deeper-rooted "core thought" or assumption that I need to address? Will I need to change the situation before I can change the mood?
This is not a "power of positive thinking" Pollyanna type of exercise. It's not a willed suppression of all negative thoughts. At stage 6, it's an exercise in balancing the positive and the negative evidence supporting the "hot thought", and there's not an expectation at stage 7 that the negative mood will have been utterly vanquished and replaced with a mood of blissful euphoria.
It's more along the lines of strength training. One set of bicep curls doesn't produce Obama arms. Over a period of six weeks, with appropriate diet and cardio -- the guns begin to emerge! Reading about weight lifting doesn't have an effect: watching exercise videos doesn't have an effect. Lifting the weights -- yup.
And so too with the Mind over Mood exercise. First published in 1995, this book has been hugely popular, with over 800,000 copies in print. The sequential exercises sound a bit complicated but in fact it's like learning any new skill -- driving or keyboarding or public speaking. You get better with practice. And mood benefits accrue even if you don't practice the skills perfectly.
When I'm noticing a blip upwards in weight -- I reach for my Beck cards and take care to track nutrition and exercise with renewed vigilance.
When I'm dealing with stress, I reach for Mind Over Mood and give myself a refresher course!