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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The Power of Paradox: to Change Negative Thinking, Say “Yes” When You Want to Say “No”

By Lynne Gots, posted on March 23rd, 2014.

Much of the advice I dispense daily in my clinical practice involves guiding people beset by negative thoughts and feelings to respond to emotional discomfort in counterintuitive ways.  Anxious? Approach your fears. Depressed? Get moving. Impulsive? Ride out your urges.

It all sounds rather simplistic. Yet changing behaviors in this fashion can improve your mood relatively quickly. Even more important, moving towards what feels scary or hard can help you build a protective core of confidence, making it easier to cope with the difficult times you’ll inevitably have to face in the future.

I won’t ask my patients to do anything I wouldn’t agree to do myself. Some of the “approach behaviors” I work on with them—touching a public toilet seat, say, or limiting themselves to only one glass of wine—don’t present personal challenges. But I certainly generate enough of my own worries to give me ample opportunity to practice what I preach.

Here’s an example: I just signed up for an eight-week course on Mindfulness-Based Stress Reduction (MBSR).

Silly that a program designed to reduce stress should significantly increase mine, right? But just thinking about it makes my mouth dry up and my heart beat faster.

I’d been looking for an opportunity to deepen my meditation practice for some time now. Periodically I’d google “Mindfulness Meditation in DC.” The Insight Meditation Community of Washington (IMCW) always came up. I’d pore over the course offerings and then reject them because the timing wasn’t right or the center’s Buddhist orientation made me uncomfortable.

I had many of the same automatic thoughts and a few new ones yesterday when I found the listing for an MBSR course given through the Insight Meditation Community starting in just two weeks. “Maybe everyone will be a Buddhist. I hope they don’t expect me to practice Buddhism.” “I won’t know what to do.” “Will there be chairs or cushions? Should I bring my own cushion?”  “Seven to nine-thirty on a Thursday night . . . I’ll be so tired after work, I won’t feel like going.” “I won’t have time to eat dinner and I’ll be starving.” “I won’t get home until after 10 and I’ll be so wound up I won’t be able to sleep.” “It might be lame, like that last mindfulness course I took.” “I might not be able to find parking.” “I won’t be able to walk the dogs or exercise on Thursdays.” “I don’t know what to wear. Should I wear yoga pants?” “I’’ll have to bring a change of clothes to work.” And even, embarrassing though it is to admit, “We’ll have to take off our shoes. I hope we can wear socks because I won’t have time to get a pedicure in the next two weeks.”

In the end, I recognized my reservations for what they were—excuses designed to avoid an unfamiliar situation causing me trepidation. I don’t like being a newbie, and this class raises all those old first-day-of-school insecurities (probably dating back to the start of kindergarten, when I wet my pants because I was too shy to ask my scary new teacher where the bathroom was and, humiliated, ran to hide in the coatroom when she asked the class who was responsible for the puddle on the floor).

So I did what I’d tell anyone else to do. I signed up.

To be continued . . .




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Posted in Acceptance and Mindfulness, Anxiety, Behavior Change, Cognitive-behavior Therapy, Depression, Obsessive Compulsive Disorder, Self-help, Techniques |

Seeking Reassurance or Just Being Thorough: How to Tell the Difference

By Lynne Gots, posted on March 10th, 2014.

My last post described the many ways the compulsion of seeking reassurance can interfere with decision-making and overall wellbeing. The differences between compulsively looking for validation and carefully weighing your options are easy to spot if you ask yourself the following questions.

  • Do you always have to ask other people for their opinions before you make a decision?
  • After making a decision, do you frequently second-guess yourself?
  • Do you change your mind often?
  • Does making a choice fill you with anxiety?
  • Do you worry about making mistakes?
  • Is the approval of your friends and family very important to you?
  • Does it take you a long time to make even a small purchase?
  • Do you know what you like when you see it?
  • When you buy an article of clothing, are you likely to return it after trying it on at home?
  • Do you think it’s irresponsible to make a decision without carefully researching it first?
  • In romantic relationships, do you often question whether your partner is right for you?
  • Do you ask for others’ opinions about your partner?
  • Would you call yourself indecisive?
  • Do other people get annoyed with you for asking so many questions?

This isn’t a scientific survey. But if you answered “yes” to many of these questions, you’re probably prone to seeking reassurance. A careful, deliberate person might do research and even ask for other’s opinions before making a decision but anxiety wouldn’t be the dominant emotion. And doubt wouldn’t typically accompany a choice as it often does with chronic reassurance-seekers.

After having read this, you may be tempted to ask the people close to you if they think you use them to provide reassurance. If so, don’t bother to pose the question. You already know the answer.




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Posted in Anxiety, Obsessive Compulsive Disorder, Perfectionism |

Seeking Reassurance: an Often Unrecognized Compulsion

By Lynne Gots, posted on February 21st, 2014.

If you’re prone to anxiety, you know how shaky it can make you feel—not just physically (that’s why it’s called “the jitters”) but also emotionally. When you’re stuck in a cycle of worrying, you start to question everything.

One common way to respond to doubt is by looking for reassurance. A person with Obsessive Compulsive Disorder (OCD), for instance, may lock the door and then return again and again to check it, or jiggle the knob five, ten, or twenty times to make sure it’s secure. Or she may leave but mentally reenact her departure on her way to work to convince herself she turned the key and heard the latch click.

In the case of repetitive door-checking or any other ritual involving actions you can observe, it’s easy to see how seeking reassurance can become a disruptive compulsion. But other forms of compulsive reassurance-seeking are less obvious, though no less problematic.

Many reassurance rituals take place internally, as with the OCD-sufferer who tries to picture locking the door after she’s left the house. Mental compulsions also occur frequently with the so-called “repugnant” obsessions—fears of being a pedophile or a murderer, say. While such obsessions are an extremely common manifestation of OCD, people who experience them usually feel intensely ashamed and will go to great lengths to keep them hidden.

Incessant questioning is another typical reassurance ritual aimed at minimizing anxiety about uncertainty. It might take the form of constantly polling friends for their opinions about a romantic partner or repeatedly asking a colleague if the boss seemed annoyed when you were five minutes late for the staff meeting. The key words here are “constantly” and “repeatedly.” Asking for others’ opinions and feedback isn’t necessarily an unhealthy practice. But when the need for reassurance is driven by anxiety, getting someone else’s take on a situation is never enough to quell the doubt and the feelings of dread accompanying it.

In our age of infinite information access, it’s especially easy to indulge the urge to question. Have your friends gotten sick of telling you they think your girlfriend is cool? No problem. Just google “How do I know if my partner is right for me?” and you’ll find countless answers*.

[Caution: Don’t read this if you’re prone to relationship anxiety.] *My own search turned up, just for starters: 31 Ways to Know You’re In the Right Relationship,     10 Ways to Know if the Relationship is “Right,” Courage to Know When a Relationship is Not Right for You, Should I Break Up with My Boyfriend Quiz,  How to Determine if You’ve Found Your Soulmate, and I’m Not Sure If I Want to Break Up with My Boyfriend.

For people with health anxiety, looking for reassurance online can be a particularly compelling ritual. Worrying about that suspicious lump? Ask WebMd! There are even sites where you can send photos of whatever ails you to be evaluated by a real doctor. (But, to be clear, I’m not recommending it.)

It’s easy to fool yourself into thinking you’re only being thorough if you’re in the habit of doing endless research before making a major life decision or even just a minor purchase. But anxiety about a wrong choice is often the driving force behind such indecisiveness. For those perfectionistic types, selecting a course of graduate study might involve looking into countless degree programs; taking the GRE, LSAT, and GMAT to cover all the bases; comparing employment statistics for different careers; going on dozens of informational interviews; and asking friends and family for their recommendations and advice.

If you feel you need to know all the options before making a decision, even a low-risk commitment like buying a pair of rain boots might set off the process of exhaustive research and advice-seeking.

I can relate. Even though I usually can decide with only a little hesitation about where to stay on vacations and which kitchen appliances to buy, I’m less confident when it comes to interior decoration. I confess to having recently wasted an entire afternoon searching for an end table after having uncovered the “25 Best” online design sites and looking at all of them. And I still haven’t ordered any furniture.

Seeking reassurance, whether through compulsive checking, mental reviewing, or information gathering clearly can get in the way of decisive action. So how do you know if it’s a problem for you or just an occasional annoyance? I’ll explain in my next post.

 

 

 

 

 




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Posted in Anxiety, Health Anxiety, Obsessive Compulsive Disorder, Perfectionism |

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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