Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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How to Get through Trying Times without Losing Your Mind

By Lynne Gots, posted on January 22nd, 2017.

As a cognitive-behavioral psychologist, I teach people how to handle distress by changing the thinking patterns and behaviors that negatively affect their emotional well-being. The inauguration of the new President has stirred up strong feelings for many on both sides. So it seems fitting to offer some coping advice for weathering this highly polarized and emotionally charged political climate.

First, I’d like to correct one misconception. Contrary to what many journalists reported during the campaign and following the election, I haven’t seen an uptick in referrals due to anxiety about the new administration. My practice is just as busy now as it’s always been, but no one has contacted me specifically because they can’t deal with the current state of affairs. To be sure, discussions about politics and heated emotional reactions have come up frequently during recent therapy sessions–I work in DC, after all, and see many lobbyists, lawyers, Hill staffers, and Federal employees from both ends of the political spectrum. But anxiety, for those who are prone to it, tends to attach itself to whatever happens to be in the headlines of the moment. Today it’s the roiling political climate; at other times it’s been Anthrax or West Nile Virus or bedbugs. The important point to remember, as I’ve noted before, is that the content of anxiety is irrelevant in learning how to manage it.

1. Practice selective avoidance

Although I don’t typically encourage avoidance as a way to reduce anxiety, I do advise managing triggers strategically. So if you know reading the Comments section of a blog post or news article will send your blood pressure through the roof, skip it. Likewise with Facebook and Twitter. You already know what the people you follow think, so you won’t be missing anything important.

2. Limit the time you spend reading the news

For any compulsive behavior–and checking the news for a media junkie can become as uncontrollable as washing for a germophobe–coming up with a reasonable schedule can help dampen the urge to check and keep your emotional reactions from coloring your entire day. If this is a problem for you, try limiting the number of sites you read to two or three major news outlets; don’t go on your phone the moment you wake up; decide only to look, say, after breakfast, lunch, and dinner– and never before bed.

3. Challenge your thoughts 

A standard CBT technique is to identify cognitive distortions contributing to intense, negative emotions such as anger, anxiety, and depression. Two common distortions, labeling and overgeneralization, may lead to anger towards those whose political beliefs differ from our own. In a Pew Research Center Poll, Republicans attributed these qualities, ranked from highest to lowest, to Democrats: close-minded, immoral, lazy, dishonest, unintelligent. The view of Democrats towards Republicans differed only in the order of the ranking: close-minded, dishonest, immoral, unintelligent, lazy. Clearly, such sweeping generalizations and negative labels create acrimony and even hatred of The Other.

4. Practice mindfulness

Railing against what should or shouldn’t be happening can make a difficult situation unbearable. As a Buddhist saying goes, “If you get struck by an arrow, do you then shoot another arrow into yourself?” The Second Arrow–our reaction to a bad event–only adds suffering to the pain. We can cope more effectively if we adopt an attitude of acceptance. Keep in mind that acceptance doesn’t mean liking the status quo or giving up. It simply involves seeing things for how they are without judgement.  Dialing down our emotional reactivity allows us then to make more clear-headed decisions about the course of action we want to take.

5. Cultivate compassion 

Attempting to understand another’s point of view, even if you never arrive at any common ground, can help you feel less angry. Berkeley sociologist Arlie Hochschild, a Progressive academic who couldn’t be more different from the residents of St. Charles, Louisiana, where she embedded herself during a 5-year study, scaled what she calls “the empathy wall” to understand the economic and social forces that led them to embrace the Tea Party. Over time she came to see them as people rather than stereotypes. They, in turn, came to accept her as a human being rather than dismissing her as a “West Coast liberal.” In the end, they developed a mutual respect for each other even though their political positions never changed.

Emotional resilience requires the ability to see moods as transient, like the weather. We can apply the same approach to preserving our sanity in today’s stormy political climate. Lay in ample reserves of acceptance, empathy, compassion. Take constructive action. Batten down the hatches. And wait for the hurricane to pass.




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Posted in Acceptance and Mindfulness, Anxiety, Cognitive-behavior Therapy |

Coping with Loneliness during the Holidays

By Lynne Gots, posted on December 23rd, 2015.

For many people, the holiday season, filled with greeting-card images of family gatherings and communal good cheer, can heighten feelings of loneliness. Those who are grieving the loss of loved ones may miss them especially keenly during this time of year. Memories of happier times can cause the pain of past relationships ended through divorce, a break up, or estrangement to surface unexpectedly. And for those who lack any intimate relationships, overhearing discussions of colleagues’ vacation plans or seeing constant reminders on social media and in seasonal advertising of others’ connections can intensify an already pervasive sense of social isolation.

A study described in a recent NY Times Magazine article  found that people who perceived themselves as lacking close connections (the “lonely” experimental group) were much more reactive than the socially well-integrated comparison group (as measured by electrical activity in the brain) to words suggestive of social isolation, such as “excluded,” “foe,” and “detached”. The researchers concluded that lonely people selectively attend to negative social information. This hypervigilance to perceived threats paradoxically heightens their loneliness and social withdrawal by making them “act in a more defensive, hostile way toward the others with whom they would like to connect.”

So if you’re feeling lonely this holiday season—regardless of whether your loneliness is acute or chronic—be aware of the temptation to compare yourself to others whose holidays seem brighter than yours. Focusing on the negative aspects of your situation may make you withdraw even more and sharpen the pangs of loneliness.

Instead, try reaching out. Accept invitations even if you feel you’re only being included because “they feel sorry for me.” If no invitations are forthcoming, consider extending one to an acquaintance who also is alone. Or volunteer to serve turkey dinner at a homeless shelter or distribute presents at a children’s hospital.

Connection comes in many forms. The Norman Rockwell version of the family holiday table is only one of them.

 




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Posted in Cognitive-behavior Therapy, Self-help |

“Do I Need Medication?”

By Lynne Gots, posted on February 18th, 2015.

 

I discuss this question so often in my practice—and have so frequently considered blogging about it—I had to scroll through my archives to see if I’d already written a post on the topic. But, apparently, it only existed in my mind.

I’m prompted finally to address the issue of medication because I attended an interesting discussion the other day about a book titled Does My Dog Need Prozac? Everyone in the group, including me, has a fearful dog (my Australian Shepherd Freddie, as I’ve mentioned before, is tightly wound and “reactive” to other dogs, people unknown to him, and the television). We talked about how to help our sensitive pets be more comfortable in the world while at the same time learning to accept them as they are rather than being disappointed when they don’t behave like TV dogs. Come to think of it, this attitude of acceptance would make it a lot easier to be content with children, spouses, friends, and colleagues who don’t quite meet our expectations, either.

Given the title of the book, the conversation eventually turned to the use of medication to help ease reactive animals’ fears. According to the animal behaviorist who moderated the discussion, people are as reluctant to medicate their anxious canines as they are to consider pharmacological treatments for themselves—although she encounters, as I do, less resistance to so-called “natural” remedies, such as herbal compounds and vitamin supplements. (I’m always puzzled when someone who is adamant about not taking medication will ingest an uncontrolled, unregulated substance, however natural it may be. After all, poisonous mushrooms and hemlock are natural, too. But lethal.)

My position on medication is flexible. I’m more than happy to try a course of CBT sans meds if someone comes to me with that preference. The research suggests that CBT alone can be as effective as a combination of medication and CBT together in treating anxiety. and I’ve certainly seen many people benefit from CBT interventions without the help of a prescription. Medication alone, on the other hand, is not as effective. It may lessen discomfort, but it won’t resolve the patterns of avoidance people develop—and often become consumed by– to cope with their distress.

Here’s the rub. If anxiety is off the charts, a person (or dog) won’t be able to think clearly enough or stay in a triggering situation long enough for tolerance and habituation to take place. So medication can be very helpful in dialing down the arousal enough to facilitate the behavioral practice crucial for success.

I doubt animals feel stigmatized if they need to take Prozac (though their owners certainly might). But many humans I’ve worked with are ashamed, or see themselves as weak, if they can’t white-knuckle it through without the aid of a pill. Despite advances in modern neuroscience, culturally we’re still stuck in the last century when it comes to psychiatry, seeing mental disorders as failures of will or character flaws rather than disturbances of brain chemistry.

I personally have nothing to gain from recommending a course of medication. I can’t even prescribe it. But I believe in doing what works best—for people and for pets. And sometimes that means using all the tools we have at our disposal, including pharmacology, to make the process of coping more manageable.

[For the record, we did try Prozac with my late Golden Retriever Calvin, who suffered from separation anxiety and compulsive licking. Freddie hasn’t been on any medication because we’ve taken great pains to work with him behaviorally, and he’s responded to the training. In the interest of full disclosure, I confess to having been one of those owners who gravitated towards holistic remedies, such as DAP (dog-appeasing pheromone) and lavender spray. Sadly, none of them worked, so we’re back to plain old desensitization. And lots of dog treats.]

 

 

 

 

 

 

 

 

 

 

 

 




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This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

Email >

If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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© 2008-2017 Lynne S. Gots, PhD. Photographs by Steven Marks Photography.