Friday, January 1, 2016

What is the Best Behavioral Approach to Overcome the Troubling #Emotions Associated with Episodes of #Anxiety, #Depression, #Grief, etc.

Now this may be the 64 million dollar question!  Please notice that I said what is the best behavioral approach.  I did not include medication because, in my view, there is widespread overuse of medication to “treat” psychological problems that are largely behavioral in nature. Many psychological problems are productively resolved when viewed as difficulties in emotional learning rather than “medical” disorders.  Although medication can help lessen some psychological symptoms, it does absolutely nothing to correct the behavioral deficits that may be causing them. So what is the best way to manage these negative emotions behaviorally?

Since a primary consideration is to respect and promote a person's autonomy,  we may want to resist categorizing so many people with emotional problems as patients .  Like the rest of us, most are just people who have things to learn. When a medical provider hands out a prescription that tells the "patient"  to take one dose in the AM and one in the PM for anxiety, they reinforce the impression that there is a medical disorder that lies beyond the “patient's” control.  Let's set the record straight here: not all, but probably most, emotional problems are behavioral rather medical in origin. Importantly, many of these emotional problems can be avoided or successfully overcome with appropriate emotional education.

The high costs and circumscribed benefits associated with mental health treatment entailing endless rounds of medication and talk therapy remind us all that there must be a better way forward. Our approach to mental health by way of "mental illness treatment" has been and still is uncertain, prolonged, and costly. Too much effort is expended trying to fix mental health symptoms and problems; far too little on providing the education that prevents their occurrence.  Developments in our understanding of the influence of cognition on emotion and behavior now offer promising and practical tools that will advance mental health through better informed emotional education and treatment.

Cognitive Behavioral Therapy (CBT) has several strategies to reduce the negative thinking that underlies worry and anxiety as well as many other emotional problems. These include thought stopping, thought shifting, and a technique initially formulated by Albert Ellis known as cognitive restructuring. Thought stopping is what the name implies, stopping a disturbing thought that generates a negative emotion. For example, if I have social anxiety I might try resisting thoughts that other people may be judging me negatively. Thought shifting goes a step further.  I stop worrying about what other people think by shifting my thoughts to something else like the garden I am planting.

Both of these techniques come up a little short. Although I might get some relief by stopping my anxious thinking, or by shifting my thoughts away from this thinking, the emotional relief lasts only as long as I continue to thought stop or shift my thoughts. Unfortunately, as long as I continue to endorse my disturbing beliefs that cause me to worry over what people think of me, I am not free from the social anxiety.  The anxiety evoking thoughts are still there, and every time I drift back to this line of thinking I will make myself feel anxious.

Cognitive restructuring works better. This technique entails correcting (restructuring) the problematic thought so that it no longer generates the negative emotion.  So, if I replace my worrisome thinking about how others see me with better ones, and encourage myself to accept this new way of thinking, I will be able to continue feeling less socially anxious.  An example of the new thinking might be, “Who cares, let them think whatever they think; they will anyway.”

Let's take a closer look at why this behavioral approach usually works best. To get rid of disturbing emotions (depression, anxiety, guilt, anger, etc.), you must also get rid of the thoughts that activate these negative feelings.  Repressing or trying to ignore negative thoughts doesn't make them go away.  They are still there and, because they are, the disturbing emotions will linger on.  Medication does not correct faulty emotional reasoning, nor do attempts to dodge negative emotions by thought stopping or avoidance behavior. The real solution is choosing to learn the emotionally correct ways to think about your world. Cognitive restructuring is an essential tool for reaching this goal and improving emotional health and well-being. 

With my new CBT self-help guide, Think Right, Feel Right, you can acquire these and other emotional tools my clients acquire to optimize emotional health and happiness.

No comments:

Post a Comment