Troubling thoughts by Mahboob


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Troubling thoughts gives us an insight of our deepest fears and ways how to overcome them...

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  • Stoicism is a school of Hellenistic philosophy, founded by Zeno of Citium in Athens in the early third century BC. It proved to be a popular and durable philosophy, with a following throughout Greece and the Roman Empire from its founding until all the schools of philosophy were ordered closed in AD 529 by the Emperor Justinian I, who perceived their Pagan character to be at odds with his Christian faith. Epictetus was a Greek Stoic philosopher. He was born a slave and lived in Rome until his exile to Nicopolis in north-western Greece, where he lived most of his life. So far as is known, Epictetus himself wrote nothing. All that remains of his work was transcribed by his pupil Arrian. The main work is The Discourses, four books of which have been preserved (out of an original eight). Psychologist Albert Ellis, the founder of Rational Emotive Behaviour Therapy, credited Epictetus with providing a foundation for his system of psychotherapy. Stoicism teaches the development of self-control and fortitude as a means of overcoming destructive emotions; the philosophy holds that becoming a clear and unbiased thinker allows one to understand the universal reason, or 'logos'. The word stoic has come to mean unemotional or indifferent to pain, because Stoic ethics taught freedom from passion by following reason. But the Stoics did not seek to extinguish emotions, only to avoid emotional troubles by developing clear judgment and inner calm through the practice of logic, reflection, and concentration. Marcus Aurelius was a student of the writings of epictetus: "Because your own strength is unequal to the task, do not assume that it is beyond the powers of man; but if anything is within the powers and province of man, believe that it is within your own compass also“. Other Stoic philosophers include: Antipater of Tarsus, Cato the Younger Diodotus (teacher of Cicero), Diogenes of Babylon, Marcus Aurelius, Musonius Rufus and Rubellius Plautus.
  • ‘ Constructivism’ is a perspective in philosophy that views all of our knowledge as "constructed", under the assumption that it does not necessarily reflect any external absolute realities; it is contingent on convention, human perception, and social experience. Therapists are mostly interested in how people construct their realities, rather than pursuing some absolute universal truth. In effect, we co-construct our realities in relation to one another! Constructivism in Psychology considers how human beings create systems for meaningfully understanding their experiences. In psychotherapy, for example, this may mean a therapist asking questions that help elucidate a client's world-view in an effort to make clear his or her meaning-making habits. The assumption here is that clients encounter problems not because life is inherently problematic, or because they have a ‘mental illness’, but because of the way the client languages their problems. Piaget served as Professor of Psychology at the University of Geneva from 1929 to 1975 and is best known for reorganizing cognitive development theory into a series of stages. These four stages of development correspond roughly to (1) infancy, (2) pre-school, (3) childhood, and (4) adolescence. Each stage is characterized by a general cognitive structure that affects all of the child's thinking. Each stage represents the child's understanding of reality during that period, and all but the last is an inadequate approximation of reality. The four development stages are described in Piaget's theory as: 1. Sensorimotor stage: from birth to age 2 years (children experience the world through movement and senses) 2. Preoperational stage: from ages 2 to 7 (acquisition of motor skills) 3. Concrete operational stage: from ages 7 to 11 (children begin to think logically about concrete events) 4. Formal operational stage: after age 11 (development of abstract reasoning).
  • Tom Borkovec, Professor of Psychology , University of Illinois. Worry does not reduce the likelihood of negative outcomes, increase the likelihood of effective coping (Borkovec, Hazlett-Stevens, & Diaz, 1999), or result in effective, concrete problem-solving (Stober, 1998). The strategy of avoidance utilized by GAD worriers is negatively reinforced in the short term by a reduction of psychological distress; and in the long term by the nonoccurrence of catastrophic events which precipitated the worrying.
  • Having positive beliefs about worry are a problem
  • Thought Replacement: when an unwanted thought enters, immediately replace the thought with a healthy, rational one. Yelling ‘Stop’ on thinking the unwanted thought, immediately yell STOP. The yell can be out loud or only in the mind. Continue to yell STOP until the unwanted thought ceases. Substituting a Healthy Thought Pattern: if you have a tendency to think irrationally due to irrational beliefs, you can develop a rational pattern of thinking by challenging every thought that comes to mind, asking: Is this a rational thought? If not, what is irrational about it? What would be a rational replacement for this thought? Replacement Visual Image: if you have a tendency to visualize negative images, replace these negative images by positive, healthy images.
  • Troubling thoughts by Mahboob

    1. 1. DEALING WITHTROUBLINGTHOUGHTSLearning to deal with distressingthoughtsBY: Mahboob Ali Khan MHA,CPHQUSA Harvard
    2. 2. Section Contents Understand why attempts to control our emotions fail Learn about ‘willingness to experience’ Learn about ‘thinking about thinking’ Understand the link between thoughts and symptoms Identify ways we can deal with ‘troubling thoughts’
    3. 3. Background - Stoic Philosophy ‘Man is disturbed not by things, but by the views he takes of them’ pictetus, about 55 - 135 AD
    4. 4. Background - Constructivism ‘Constructivism’ is a perspective in philosophy that views all of our knowledge as ‘constructed’, i.e. it doesn’t necessarily reflect any external absolute realities; rather depending on convention, human perception and social experience Experiment with the views in this section, take and use what seems right or useful for you There is no ‘one size fits all’ solution!
    5. 5. Individual Differences The way we perceive things is determined in part by the ‘map’ of the world we carry inside our heads Our ‘map’ is drawn up in childhood - it tells us about ourselves, life, and about other people Our ‘map’ is a rough guide to life Sometimes our maps are inaccurate!
    6. 6. To Deny the Map is to Follow the Map omplete the following en are ... omen are ...
    7. 7. Thoughts are both Consequences & Causesur thoughts are triggered by events around us, by our behaviour and by ourfeelings and emotions, as well as by other thoughtse all have thoughts of which we’re unaware (unconscious)e have relatively little control over thoughts which enter our minds
    8. 8. Which Comes First - Thoughts or Feelings? What’s important, from a purely practical point of view, is that it’s usually much easier to change our thinking (what we think) and our behaviour (what we do), than it is to change our emotions Therefore we can make useful changes simply by assuming that thoughts come first!
    9. 9. Some Anxiety is Useful - Yerkes-Dodson ur abilities improve with anxiety, up to a point nxiety interferes with complex tasks more than simple ones
    10. 10. In Summary... Our minds are sensitive danger warning systems Some of our thoughts are inaccurate, unhelpful or ‘out of time’ Negative and inaccurate thoughts often seem as though they’re true They also ‘feel’ true, so we tend to give them a high ‘credibility rating’ Negative thoughts can give rise to painful moods, emotions and physical sensations Relational Frame theory (RFT) suggests that one reason for human suffering is the development of language!
    11. 11. Caution! ou might want to look away if you have arachnophobia
    12. 12. PIDER
    13. 13. Conscious Thoughts are Lexical Lexical means ‘made of words’ If we’re afraid of spiders, the word SPIDER can evoke thoughts, emotions and physical feelings Thoughts (words) evoke emotions - to a greater or lesser degree, just as though a real spider were actually present There’s a picture of a spider on the next slide ...
    14. 14. Careful What You Say! Why taking about horrible things at dinner time isn’t a good idea The word ‘vomit’ can have similar stimulus effects as real vomit
    15. 15. Transfer of Stimulus Functions Relational Frame Theory (RFT) talks about the way that the stimulus function of an object or an event tends to get transferred to the word used to describe it If you’re afraid of spiders, the fear, the urge to run away and the physical effects of seeing a spider can all be evoked just by the word ‘spider’
    16. 16. Words as ‘Noxious Stimulants’ Our use of language can underlie a great deal of suffering as a result of the transfer of stimulus functions from referents to the language used to describe them Words can become noxious stimulants
    17. 17. Words as Sources of Pain Hearing someone talk about their relationship break-up, or about a bereavement can be very painful, especially if we have suffered something similar ourselves All we are exposed to is words, yet the words can evoke thoughts and feelings, as though a relationship break-up or bereavement were happening here and now
    18. 18. ‘Telescoping’ When I remember past events which went badly, or when I anticipate things that make me scared, I ‘telescope’ the past and the future into the present Without language, could we evoke a negative past or anticipate a negative future?
    19. 19. Why Worry? Worry primarily involves thinking or self-talk (Borkovec & Inz, 1990) This kind of internal verbal behaviour is one of the most highly evolved systems characterising human beings, allowing us to experiment with ideas, consider alternative choices, evaluate our motives and consider the likely consequences of each possible choice before acting on one of them, without fearing that the environment might, in some way, punish us for considering them
    20. 20. Chronic Worry However, chronic worry has an avoidant function (Borkovec, 1994; Borkovec, Alcaine, & Behar, 2004). Chronic worriers often believe worrying will help them prepare for, problem-solve, or superstitiously avoid negative future events (Davey, Tallis, & Capuzzo, 1996) despite evidence to the contrary Borkovec and Roemer (1995) found that GAD worriers reported engaging in worry to distract themselves from ‘even more emotional things.’ The next few slides show common unhelpful thoughts and beliefs
    21. 21. Difficulty Tolerating Doubt &Uncertaintyroblems can arise if we believe...hat uncertainty is stressful and upsettinghat uncertainty is unfairhat unexpected events are to be avoided
    22. 22. Cognitive Style 2 - Unhelpful Beliefsroblems can arise if we believe...hat worry helps us find solutions to problemshat worry increases our motivationhat worrying in advance helps us feel better if bad things happen
    23. 23. Cognitive Style 3 – Problem Avoidanceolving problems gives us a sense of mastery and pleasure roblem solving = problem orientation + problem solving skillsroblem orientation = (perceptions of problems) + (perception of self as effective)+ (realistic expectations)roblem solving skills = (defining the problem) + (identifying goals) + (identifyingalternative solutions) + (choosing a solution) + (implementing a solution)
    24. 24. Cognitive Style 4 – Ineffective Self-Soothing Worry is lexical – there’s often little imagery involved, worry dampens our autonomic arousal and emotional processing – without ‘emotional richness’ we can’t identify our needs GAD worry reduces hyperventilation and tachycardia – a form of self-soothing which is painful and only partially effective Worry reduces the likelihood of ‘full network activation’ i.e. behavioural, cognitive, emotional and physiological arousal (which is required for panic response)
    25. 25. Common Characteristics Early role-reversed or caretaking relationships Insecure attachments Predominance of overly-nurturing personality style Conscientiousness Positive social evaluation preoccupation – ‘people pleasing’ style
    26. 26. Avoiding Problems Although acting directly on painful things in the outside world can work well (it helps us feel effective), focussing on negative thoughts and feelings doesn’t help in the same way Avoiding things which make us afraid means we continue to fear fear itself Our ‘willingness to experience’ reduces the likelihood of panic
    27. 27. An example... A person with a fear of heights wants to take her family up the Eiffel tower, and she’s not willing to experience anxiety She thinks: “I hope I don’t have a panic attack” “I’m not even going to think about having a panic attack”
    28. 28. The anxiety spiral The very phrase “I’m not even going to think about having a panic attack”, whether spoken aloud or thought, can be a noxious stimulus for feelings of anxiety The thoughts “I must not feel X” contain the very words likely to evoke feelings associated with “X” Try this - shut all thoughts of Uri Geller out of your mind...
    29. 29. How Do You Get Out of a Chinese Finger Trap?
    30. 30. ‘Getting Rid’ of Feelings Doesn’t Work When we struggle to ‘get rid of’ a thought, emotion or feeling, we end up with the original pain, plus more caused by our failing attempts to ‘get rid of’ the experience (more suffering) We sometimes call this the anxiety spiral – fear and anxiety breed even more fear, which can, in turn, lead to panic In a sense, we get (intensify) what we notice So – we need to notice what we want to get!
    31. 31. What can happen if we feed one stray cat?
    32. 32. Thinking positively, negatively When we think a negative thought and try to get rid of it, we are thinking positively, negatively Thinking is like breathing: It goes on night and day and you can’t stop it. But you can change it. You can breathe slowly and deeply or shallowly and quickly. You can breathe any way you want. But you can’t stop. ‘Getting rid of’ fails because we are intensifying the experience by attending to it
    33. 33. What’s the Best Thing to do in Quicksand?
    34. 34. Emotions Come in Waves Recognise that an emotion begins, peaks, then ebbs Think about how long horrible feelings and emotions usually last Don’t become preoccupied by the time though... Think about how confident swimmers deal with waves Don’t ‘splash about’!
    35. 35. Intrusive Thoughts Intrusive thoughts - thoughts which just seems to ‘pop’ into our mind without warning and which are upsetting or which stop us from getting on with things. Thought suppression studies, (Wegner, Schneider, Carter & White, 1987) show that the very act of trying to suppress a thought only results in more unwanted thoughts. This has been termed the ‘rebound effect’. The more you try to suppress a thought, the more the thought keeps popping up (‘rebounding’)
    36. 36. Dealing with Intrusive Thoughtsf you are troubled by thoughts which intrude, try the following techniques:hought stoppingreative fantasies – ‘boxing’ your worriesaking worry time
    37. 37. Thought Stopping Thought Replacement Yelling ‘Stop’ Thought disputation
    38. 38. Creative Fantasies - ‘Boxing’
    39. 39. Paradox - ‘Worry Time’ Put aside time each day to worry incessantly Paradoxically, it can be very difficult to consciously ‘hold’ a worry
    40. 40. Surreal Visualisation Re-voicing our worries to disempower them ... Give your worries a different voice Click the speaker icon above
    41. 41. Distraction Thoughts have ‘charm’ – that which draws our attention to them The challenge is to find something more ‘charming’ than our worries What can you think of that is more attractive or interesting than worry?
    42. 42. Guilt and Regret – a Special Case? Consider your values and personal philosophy, would most people with your philosophical outlook feel guilt or regret in your circumstances? Is it possible for you to forgive yourself, even if others won’t? ‘When the whole picture is taken into account, people always do the best they can’ – do you believe this? To what extent is personal pride or anger preventing you from moving on? (guilt is sometimes based on anger) What reparations or amends might you be prepared to make? These may be to heal the past, or to improve the future
    43. 43. Summary Understand why attempts to control our emotions fail Learn about ‘willingness to experience’ Learn about ‘thinking about thinking’ Understand the link between thoughts and symptoms Identify ways we can deal with ‘troubling thoughts’
    44. 44. Referencesorkovec, T.D. (1994). The nature, functions, and origins of worry. In G.C.L. Davey & F. Tallis (Eds), Worrying:Perspectives on theory, assessment, and treatment (pp. 5-34). New York: Wiley.orkovec, T.D., Alcaine, O.M., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R.G.Heimberg, C.L. Turk, & D.S. Mennin (Eds). Generalized anxiety disorders: Advances in research and practice (pp. 77 –108). New York: Guilford.avey, G. C. L., Tallis, F., & Capuzzo, N. (1996). Beliefs about the consequences of worrying. Cognitive Therapy andResearch, 20, 499-520.orkovec, T. D., & Roemer, L. (1995). Perceived functions of worry among generalized anxiety disorder subjects:Distraction from more emotionally distressing topics? Journal of Behavior Therapy and Experimental Psychiatry, 26, 25-30.orkovec, T. D. & Inz, J. (1990). The nature of worry in generalized anxiety disorder: A predominance of thought