Therapy with David Mellinger
CBT: Cognitive Behavioral Therapy
(Excerpted, with permission, from the Association of Behavioral and Cognitive Therapy website.)
Cognitive Behavioral Therapy (CBT) is the term for a group of psychological treatments based on scientific evidence that have proven effective in treating many psychological disorders, including most anxiety disorders. Treatment is goal-oriented and often short-term to resolve present-day problems; through this process, clients can overcome long-standing problems and disorders, as well.
CBT is focused on the ways that a person’s emotions, thoughts, and behaviors are all linked, allowing for the therapist to intervene at different points in the cycle of emotional disturbance. The CBT therapist and the client work together with a mutual understanding that the therapist has theoretical and technical expertise, but the client is the expert on him- or herself. The therapist seeks to help the client discover that he/she is powerful and capable of choosing positive thoughts and behaviors. Together, they develop goals for therapy, work collaboratively to achieve goals, and track progress throughout the course of treatment.
New-wave CBT strategies can help
It isn’t uncommon for someone with an anxiety disorder to also suffer from depression, or vice versa. There’s good news, though: Both disorders are very treatable, separately and together. According to the latest psychological research, to be optimal, therapy for anxiety and depression would likely need to focus explicitly on excessive worry and/or depressive rumination, when present – that is, on “sticky thinking”.
Sticky thinking is the repetitive, negative thinking of anxiety and depression. Interwoven with strong negative feelings like sadness, guilt , fear, or self-blame, sticky thinking can enmire us too intensely in long, complicated thinking about disturbing matters and amplify the disruptiveness of disturbed sensitive feelings.
A new wave of CBT is uniquely suited for relief of many people’s problems with anxiety and depression:
Cognitive Reappraisal and emotional exposure might be for you if you’re anxious or depressed, or if you simply worry too much – if you’ve realized your thinking at emotional times is sticky and unworkable and want to take action – to learn effective, scientifically proven techniques to counteract it. Utilizing Attention Training Techniques, you can develop the capability to shift away from negative trains of thought and toward the immediate environment or incompatible mental processes that counteract the brain mechanisms that sustain your sticky thinking. Mindfulness techniques like concentration on the breath and abiding with peaceful awareness provide training for shifting to states of mind where you can have negative feelings without getting stuck on a train of thought or caught up in a grim story. Mindfulness techniques can be honed to effectively counteract sticky thinking.
Emotional Awareness-based CBT (EACBT)
We can only start to feel better once we realize that we’re feeling bad and arrive at a clear sense of what’s really going on. Besides traditional CBT, I practice a variation dubbed Emotional awareness-based CBT, which helps clients expand their emotional awareness to enable and empower them to work directly on overcoming anxiety disorders and other emotional disturbances.
Clients learn to tune in to disturbing feelings like constant edginess, trepidation, and a sense of becoming flooded or overwhelmed by anxiety or other disturbances, to identify and acknowledge them. When clients overfocus on scary, disturbing stressors, they learn to mentally steady themselves so they can better work with their stress and anxiety. During episodes of disturbing anxiety or depression, our distress may be increased when we’re gripped by “sticky thinking”, when strong emotions like anxiety, sadness, or guilt, or self-blame get interwoven with our thoughts and enmire us too strong and long about disturbing matters and feelings. Uniquely, with EACBT learn “worry-busting” skills to release themselves from its sticky grip.
Expand your awareness of your values, the richness of your feelings, and the things you care enough about to change.
Learn to step through or past the cascade of mental events that draws us down into depression or unnerves and spooks us into anxiety.
Learn how to overcome emotional avoidance starting by deepening your familiarity with yourself emotionally. Become more aware of your strength and what you value as you become able to work with edginess, trepidation, and the sense of being flooded or overwhelmed and physical tension that sustain disturbing anxiety and worry.
Learn to face your fears while being kinder to yourself using psychological and mindfulness-based techniques of emotional exposure to gather your strength while becoming easier and more accepting of yourself.
Learn to gain the upper hand over unhealthy worry, obsessiveness, rumination, and other types of anxious, sticky thinking.
Learn to augment your trust that you will be okay at anxiety-provoking times. Enhance your acceptance of vulnerability and uncertainty while overcoming your fear and worry.
Meditation-Based Therapy (CBT)
Anxiety and depression can fill people’s minds with repetitive negative thoughts- even predatory worries – entwined with tension and fear. Our values and yearnings often keep flashing through our minds even as we’re caught in the throes of angst. Despite our awareness that our thoughts are irrational and distorted and our feelings disturbed, at times we can’t seem to right them.
Still, many of us who are stuck in negative thinking can learn to ride out the waves of nervous energy. We can remain focused on what we value and hold dear, while instilling and sustaining the awareness that it’s worthwhile to harness this energy to press ahead, regardless of doubt and dread. If you’re drawn to mindfulness meditation and are challenged by or struggle with disturbing thoughts, doubts, and tenacious uneasiness, then MBT might be just what you need.
Although anxiety is commonly perceived as an experience to be shunned, at the core of anxiety and worry is energy seeking access to pathways for living intensely and achieving what is meaningful and important. Meditation-based therapy (MBT) is powerful behavioral medicine–psychotherapy invigorated by mindfulness meditation, an ancient tradition of reflection and contemplation that’s swept into modern psychological thought and practice. Mindfulness is mental training to experience the present with an attitude of openness, freshness, and willingness to engage in the comings and goings of our thoughts, feelings, and sensations.
Many of us literally “worry ourselves sick” when anxiety or depression trouble us: We may concurrently experience physical tension, unsettled stomachs, or disturbed sleep, while our minds are aswirl with edginess, dread, and vulnerability – a disturbing process I’ve dubbed “sticky thinking”. The perspective of mindfulness meditation, based on this psychology, relates sticky thinking to the bad mental habits of worrying and the sense of being stuck or trapped inside ourselves and controlled by our experiences. Our troubles also relate both to our limited ability to “see what is” – to see ourselves, others, and the world clearly and objectively – and to our deep uneasiness with feeling vulnerable, our reflexive tendency to not trust ourselves and others.
Meditation and MBT can enable us to change and transcend these limitations. Formal meditation and psychological mindfulness both encompass three essential mindfulness meditation skills – focusing your attention, opening your awareness, and enhancing loving kindness. As your MBT therapist interweaves your therapy with these essential skills, you can face your problems afresh as they arise. We’re enabled to tune in to our nature and the nature of our troubles, augmenting our capacity to be kind, not harsh, to ourselves and others, more responsive to the freshness of nature and life experience, and open to the vast possibilities of openness and appreciation.
Many people with anxiety or depression can benefit from treatment with mindfulness-based treatment. Utilizing mindfulness-based techniques, you can become able to abide with disturbing feelings rather than getting drawn into negativity; “unstick” your persistent worry or rumination; prevent bad moods from materializing; and even change long-standing tendencies to worry or brood.