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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Posted in Acceptance and Mindfulness, mindfulness |

Why You Should Avoid Avoidance if You Have Anxiety

By Lynne Gots, posted on March 7th, 2023.

If you struggle to cope with anxiety, I guarantee you have developed patterns of avoidance to minimize feelings of distress. The current prevalence of trigger warnings accompanying TV shows, live performances, and social media posts may make avoidance appear to be an appropriate strategy. But protecting yourself from potential triggering content or situations will only heighten your anxiety, make it harder to tolerate in the long run, and seriously affect your enjoyment of life.

I am not suggesting a head-first plunge from the high board into the deep end of the anxiety pool as a means of overcoming trauma or unpleasant feelings. You can start at the shallow end, dip a toe in, and then ease in slowly, if the gradual approach suits you better. Ultimately, though, you have to get wet.

Minimizing avoidance is the rationale behind Exposure and Response-Prevention treatment, the primary evidence-based behavioral treatment for OCD and other anxiety-driven syndromes. There is even a protocol called Prolonged Exposure used to treat PTSD symptoms stemming from serious traumatic events such as combat. Any type of exposure treatment involves seeking out triggers and learning to tolerate the discomfort they provoke (or, in the case of Prolonged Exposure for PTSD, reliving the trauma over and over by visualizing it repeatedly).

For debilitating anxiety or trauma, you should undertake exposure exercises only with the support and guidance of a qualified professional.  But if you see yourself opting out of situations that simply make you uncomfortable, such as social events, driving, or even shopping at a different grocery store, you can find opportunities to push yourself toward the discomfort every day.

Whenever I catch myself finding excuses not to engage in an activity that makes me nervous, I try to practice what I preach and do it anyway. 

In the fall I organized a group of neighbors to play Pickleball. We were all beginners, equally clumsy and clueless, and it was fun. But then an injury sidelined me. I didn’t play again for four months, until a few weeks ago, when I was invited to join a group of regular players. Most of them play daily. They are at a level far above mine, and they are very competitive.

Despite considerable trepidation, I forced myself to go. I was embarrassed by my lack of skill and felt myself transported back to middle school, when I was the last to be picked for the team in whatever sport we were playing. I am not exaggerating when I say I felt close to tears.

I really wanted to make an excuse never to return. Which is exactly why I forced myself to go back the next week, and then again a few days later.

I am still the weakest link but my skills have improved. More important, I am proud I didn’t let my feelings of awkwardness and discomfort get the better of me. I may or may not keep playing with the group, but if I choose to stop or look for other, less intense Pickleball partners, I can be confident I am not letting anxiety drive my decision.

So get out there. Force yourself to do whatever your anxious brain is telling you to avoid. Don’t let it boss you around. You will be glad you pushed back and stopped letting anxiety control you.




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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.

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