Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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2440 M Street, NW
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On Coping with Adversity

By Lynne Gots, posted on October 28th, 2015.

I’ve been extremely fortunate with my health. No major illnesses or injuries. I even walked away unscathed from a head-on collision with a drunk driver who plowed through a traffic light at the intersection where I was stopped, totaling my car.

So my accident a few days ago, which landed me in the emergency room and required extensive oral surgery, was a new experience for me.

I went out for my usual walk with my dog. Wearing headphones and listening to a podcast, I was “distracted walking.” My foot caught on a bump in the sidewalk. I fell forward, tried to brace my fall with my hands, and landed hard on my chin.

Let’s just say the damage, in the medical-speak of the ER, was “impressive,” the sort usually only seen in major automobile accidents, or among young men who’ve been in bar fights or crashed into trees while snowboarding.

My jaw is now wired shut to heal the fractures. I’ve heard from friends who are envious of the enforced opportunity to shed a few pounds on a liquid diet, or who’ve known of people who voluntary opted for jaw-wiring as part of a weight-loss plan. I am not amused.

Nevertheless, I’m trying to make the best of a bad situation. While waiting for hours in the ER, I researched expensive Vitamix blenders,which I’d been eyeing for awhile but felt were too extravagent, and treated myself to one (with a single click on amazon). I’m using up my CSA produce in kale smoothies and creamed vegetable soups. I’ve been catching up on emails and on the latest novel I’ve been trying to get through for weeks. I’m writing a long-overdue blog post.

And, to my surprise, I’m even feeling a little grateful. While I was undergoing a CT scan of my skull, a worried thought of the kind health-anxious folks are frequently plagued with popped into my head: “What if this is one of those situations you hear about, where someone goes into the hospital for one thing and finds out they have something else much more serious? What if I have a brain tumor?”

Thankfully, I don’t. I’m just facing a somewhat arduous process of recovery. But I will heal over time.

I think I’m practicing acceptance. It’s not a situation I like. I’m not a good patient. I want to be in control.

But it is what it is. So rather than wallowing, I’m trying to treat myself kindly (when I’m not berating myself for my carelessness), connect with friends over email, arrange milkshake dates for when I can be seen in public, allow my husband to run around doing errands for me, and experiment with new soup recipes.

Mindfulness practitioners tell us you can accept something without being happy about it. If there’s a secret to getting through life’s ups and downs in the best way possible, I think cultivating an attitude of acceptance (which isn’t the same as resignation) is key.

We’ll see. I’m working on it.



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“Meditation Doesn’t Work for Me.”

By Lynne Gots, posted on August 22nd, 2015.

Learning to disentangle ourselves from distressing thoughts and observe our internal reactions before responding are skills worth cultivating. They can help us cope better with a wide variety of emotions—anxiety, depression, and anger, to name a few—without resorting to avoidance, withdrawal, distraction, or lashing out to deal with them.

Mindfulness, defined by Mindfulness-Based Stress Reduction (MBSR) founder Jon Kabat-Zinn as “paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment,” is a way to change the way we respond to our thoughts. A growing body of evidence from brain-imaging studies suggests that regular meditation practice—one important means of cultivating mindfulness—actually alters the brain structures involved in attention, concentration, and willpower, as well as the areas central to emotional reactions.

These findings have been compelling enough to convince me to develop a personal meditation practice (I’ve described my own experience with MBSR in previous posts) and also to add meditation to my cognitive-behavioral therapy repertoire.

It’s been a hard sell, and I understand why. I was a mindfulness skeptic myself. I’m not a fan of approaches smacking of New Age pop psychology, and the currently voguish “mindful revolution“, which has spawned to date 462 iPhone apps along with the titular Time cover story, carries with it that woo-woo whiff. But, as I said, the science backing it has sold me.

Not so for many of the people I think might benefit from practicing meditation. I can’t count the number of times I’ve heard, “Meditation doesn’t work for me.” I’m always curious to understand what that means. If meditation were “working,” what would be happening?

The most common answers I get to my question are: “I can’t empty my mind,” or, “I’m always thinking,” or “I just can’t relax.”

I suspect the impossible goal of mind-emptying comes from all the yoga teachers who end their classes with Shavasana, inviting practitioners to let go of their thoughts and relax. While relaxation is indeed a major benefit of yoga, it’s not the goal of mindfulness meditation (although it sometimes can be a pleasant by-product). Perhaps, fittingly, Shavasana is also known as “corpse pose,” reminding us that as long as we’re living, breathing, sentient beings, our minds will always be busy thinking.

So if achieving a relaxed feeling and a blank mind aren’t the point of mindfulness meditation, why do it?

The major benefit of practicing mindfulness for emotional health is to learn to let experiences unfold without filtering them through the layers of thoughts, comparisons, judgments, interpretations, and memories often taking us away from the present and into a morass of negative mental activity. It’s not about stopping thoughts but about redirecting them, taking a more objective perspective, and focusing on what’s important in any given moment.

In short, meditation is weight-training for the brain. It strengthens the mental muscles for attention and concentration. And, as with lifting weights, results don’t happen overnight. You can’t expect to become a power lifter after one or two sessions in the gym. Yet many would-be meditators get discouraged and give up when they don’t see immediate changes.

And what if your mind keeps going a mile-a-minute and it wanders and you get lost in thought and your attention can’t stay on your breath (the most common focal point used in mindfulness meditation) for more than a second at a time before you start thinking again about that conversation you had with your boss or what you’re going to make for dinner tonight or how you’ll find the time to finish the project that’s due tomorrow or where you’re going to get the money for your daughter’s orthodontia or whether that weird mole on your arm is cancer or what a loser you are because you can’t even concentrate on your breath and meditate right?

Then I’d say you’ll get lots of practice refocusing, again and again and again, which will help build those mental muscles.

And I’d also say,”Congratulations!” Because you’re alive.






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MBSR, Week 8: What Do You Get from Practicing Mindfulness?

By Lynne Gots, posted on June 2nd, 2014.

Our MBSR class wrapped up a few days ago. We spent the last session reflecting on where we were when we started and where we are now after eight weeks of intensive mindfulness training.

It’s very hard to quantify the benefits of a consistent mindfulness practice (although brain imaging studies are attempting to do so). In our group, participants talked of feeling more patient, handling difficult situations more effectively, communicating more clearly, and recognizing physical responses to stress earlier. But these qualitative experiences are hard to measure.

I’ve noticed a subtle improvement in my ability to concentrate, sustain attention, and maintain an even emotional keel. Nothing dramatic, but enough to make me curious about what might develop over time and to keep me plugging away at it. Daily meditation doesn’t bring me bliss or elevate me to a higher plane of consciousness. More often than not, I have to push myself to do it. Sometimes it’s boring. Just sitting and doing nothing frequently makes me wonder if my time would be better spent in a more obviously productive endeavor, like weeding the garden or writing a blog post. But I’ve continued to maintain my streak (272 days and counting) because a growing body of research touts the merits of meditation.

So what has mindfulness done for me?

Well, I’m pretty sure it’s making my manicures last longer. I’m serious. I used to be able to keep my nails polished for a day, maybe two at the most. I’d see a chip and would be unable to resist peeling it off until every nail would be ruined. But since I started meditating, my manicures stay intact for a week.

There’s actually some evidence basis for my observation. Mindfulness is being used as a component of treatments for body-focused repetitive behaviors, such as trichotillomania, nail biting, and skin picking, to develop impulse control. So it might be helping me resist the urge to pick at my nail polish.

My manicures also may be lasting because I’m actually waiting for the polish to harden. I used to feel so antsy while my nails were drying that I’d leave the salon after a few minutes, reach into my purse for my keys, and mar the finish before I even got into my car to drive home. Now I take the opportunity to practice observing my breath while I wait, sometimes for as long as half an hour.

And one other mindfulness lesson may be helping preserve my nails: the acceptance of imperfection. In my premeditation days, I’d see a slight chip and not be able to stand it. But now I can notice the flaw, cover it up with a topcoat to keep it from getting bigger, and let it be.

You may think the grooming improvements I’ve reaped from practicing mindfulness are trivial. After all, a long-lasting manicure hardly qualifies as a major quality-of-life booster. But if you consider the value of learning how to wait patiently, resist impulses, and accept what isn’t perfect, you might agree it’s much more significant than it seems.

Fellow MBSR classmates:  What has practicing mindfulness done for you? I’d love to post your comments.



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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


2440 M Street, NW
Suite 710
Washington, DC 20037

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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.

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