Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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How to Ride Out Difficult Emotions

By Lynne Gots, posted on September 21st, 2023.

As I’ve said before, avoidance may provide temporary relief from anxiety, but it makes it worse in the long run.  Like all emotions, anxiety is a transitory state—a weather pattern of the mind—and, sooner or later, it will blow over if you don’t respond to it. But most people can’t tolerate distress without trying to relieve it, so they unwittingly resort to strategies, such as analyzing and reviewing or relying on distraction, that ultimately prolong the discomfort.

One component of emotional resilience is “distress tolerance.” Some people are naturally better at it than others, and they tend to weather stormy moods more easily. But even if your emotional storms buffet you about, you can learn to ride them out more effectively without getting blown off course.

Emotion Efficacy Therapy is a mindfulness-based program for managing strong emotions. You can apply the techniques in any situation that stirs up an intense emotional reaction even without having gone through the full, eight-week protocol.  There are four basic steps to practice, first by visualizing a recent situation that evoked discomfort and later, after mastering the skills, in real time when you feel upset.

  1. Observe your physical reactions. Where do you feel the strongest sensations in your body? Are they spread out or concentrated in one area? Is there a temperature associated with them or a color? Try to be a scientist and objectively describe what you are noticing.
  2. Label the emotion. Is it anxiety or fear or dread?
  3. Note your thoughts.  Watch them as them come and go, prefacing each thought by silently saying to yourself, “I’m having the thought that…” You will be surprised at how effective this technique can be for diluting the intensity of an emotion.
  4. Identify the Urge. Typical responses to distressing feelings are to avoid them or engage with them in ways that actually intensify their impact. The challenge here is to sit with the urge and watch it rise, peak, and ebb like a wave.

You may need to repeat this process several times until you notice the physical sensations softening and the urge subsiding.

Emotions, like the weather, change. We have little control over the reactions in our mind and body, but we can know that even the most painful sensations will not last forever. That knowledge can help us navigate even the most tempestuous emotional storm.




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Posted in Acceptance and Mindfulness |

How to Stick with Meditation and Cultivate Mindfulness

By Lynne Gots, posted on July 10th, 2023.

When I finished meditating today, the 10% Happier app I use for my practice rewarded me with a burst of confetti signaling the completion of 365 straight days of meditation. One year without missing a day! (To be clear, I have many more years than one of meditation under my belt but there have been occasional missed days to break the streak.) I am proud of the accomplishment and think it has earned me the right to share some tips for how to stick with a formal meditation practice.

The terms meditation and mindfulness are often used interchangeably but they are not the same. Mindfulness, to use the definition popularized by Jon Kabat-Zinn, is being present, without judgment. Meditation is a way to cultivate the state of mindfulness. You can practice mindfulness without meditating but you cannot meditate without being mindful.

1.Aim for consistency rather than duration.

Beginning meditators often feel it “doesn’t count” if they sit for less than 10 or 15 minutes. Some protocols, such as Mindfulness-Based Stress Reduction, call for 45 minutes of daily practice, an unrealistic and discouraging time commitment for most. However, data from a 2019 research study suggest that emotional regulation improved in new meditators when compared with a control group of podcast-listeners after only 8 weeks of brief (13 minutes), daily guided meditation.

As with any new behavior, cultivating the habit is the hardest part. Once you have established a routine by practicing daily, even if only for a minute or two, you can work on increasing the time.

2. Make it a habit.

You don’t have to meditate at the same time every day, and it may not always be practical to maintain a rigid schedule. But as with exercise, having a routine can be a helpful way to remember to practice. Set an alarm, or link the activity with a daily occurrence, such as waking up in the morning, beginning or ending the workday, or getting ready for bed.

3. Let go of expectations.

The point of mindfulness meditation is to work on being present, not trying to achieve a goal. There is no such thing as a “good” meditation session. If your mind is wandering constantly, you have more opportunities to practice bringing it back. If you feel restless or bored, you can observe the sensations of restlessness or boredom in your body. Relaxation and calm can be the by-products of meditation but they are not the main purpose.

The benefits of mindfulness practices are subtle but empirically well established.  They can help develop psychological flexibility, relieve depression and anxiety, allow you to recognize negative thoughts as transitory mental events, improve focus, and cultivate compassion.

If you approach it with curiosity and let go of preconceived notions, meditation just might become an interesting and rewarding part of your daily routine.




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Making Peace with Anxiety

By Lynne Gots, posted on January 4th, 2023.

Anxiety is highly unpleasant. It causes physical discomfort—shortness of breath, muscle tightness, dizziness, queasiness—and mental anguish. In all my years of clinical practice, seeing thousands of people with anxiety, I have never encountered anyone who has not desperately wanted to get rid of it.

Earlier in my career, I was a dedicated advocate of techniques aimed to reduce, if not entirely eliminate, anxiety. I taught progressive muscle relaxation for tension- and pain-reduction, deep breathing to manage panic attacks, and thought-challenging to address catastrophic thinking. But in recent years, these approaches are no longer regular staples of my clinical repertoire.  Like many of my cognitive-behavioral colleagues, I have changed the focus of treatment from reducing anxiety to learning to accept and manage emotions, even negative ones like anxiety, while embracing uncertainty with the aim of living a richer life.

Practicing acceptance requires a major shift in attitude. For most people with anxiety, avoidance is the most common coping strategy. But avoiding anxiety-provoking situations and triggers comes with a steep cost: a flat, joyless existence.

Think about anxiety as a wave in the ocean.  If you try to outrun it, you may end up crashing into the shore with skinned knees and a mouthful of sand.  But if you dive into the middle of the wave, it will wash over you and lose its momentum as it reaches the beach. 

Why is it worth it for you to dive into the wave? If you can answer this question − hint: consider what values are important to you − you will finally be able to stop avoiding discomfort and start living a more fulfilling life, anxiety and all.




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Posted in Acceptance and Mindfulness, Anxiety |

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.

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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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