Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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Don’t Let a Fear of Flying Ground You This Summer

By Lynne Gots, posted on July 12th, 2014.

DSC_0390In the last month, several fearful fliers I’ve worked with have successfully bought tickets, boarded planes, and arrived at their destinations without incident. Nobody went crazy, created a scene trying to get off a plane, or even white-knuckled it for the duration of the flight. All of them had avoided flying for years, making excuses for missing weddings and funerals and even turning down promotions if the new position would require travel.

I can’t say they loved their aviation experiences (varying in length from less than two hours to eighteen, involving layovers and connections). In fact, very few people actually enjoy air travel these days. Who would relish standing in long security lines, removing shoes and belts, being scanned by xray machines, cramming toiletries into tiny ziplock baggies, jostling for overhead storage space, and sitting thigh-to-thigh with sweaty strangers?

But we endure these indignities because we want to get places. Not being able to fly can be very limiting.

If you suffer from a flying phobia, you may worry about the plane’s safety even though you know the statistics: the probability of dying in a plane crash is much lower than the odds of suffering a fatal injury in an automobile accident. But the numbers probably don’t reassure you.

Many people who worry about flying aren’t even afraid of the risk. By far the majority of fearful fliers I see in my practice suffer from panic attacks, especially in situations where they feel trapped. So they’re terrified of becoming panicked aboard an aircraft where there’s no escape.

For those who’ve avoided flying for years, I often recommend they get a prescription from their primary care physician or psychiatrist for a short-acting medication for anxiety to take the edge off enough to get them on the plane. But other strategies can also make the flying experience easier.

Here are a few tips my patients have found helpful.

1)    PREP

Learn the facts about air travel and flight safety. Knowing that turbulence isn’t dangerous, for instance, can help ease qualms. You also can view plane interiors and flight videos online to familiarize yourself with the experience without actually having to get on a plane. One of my patients who recently flew all the way to Africa after a five-year hiatus from air travel discovered YouTube videos of the flight she would be taking. Watching it over and over allowed her to visualize the situation, feel the anxiety, and learn to work through it.

2)    PRACTICE

Most people who fear flying can replicate the dreaded physical sensations either by watching flight-related videos or by engaging in other activities they may find anxiety-provoking, such as riding the Metro or taking an elevator to the top of a tall building. Becoming familiar with the feelings and learning to tolerate them are important steps in the process of desentization.

3)    PACK

Avoid the last-minute jitters by packing early. Treat yourself with books you’ve wanted to read, make a playlist of favorite tunes, and download movies and TV shows on your tablet or computer. You might consider adding some guided relaxation audio files  as well. Remember you’ll  have to power off electronic devices during takeoff and landing—times when many people feel most anxious—so make sure you bring some reading material or crossword puzzles you can access nondigitally.

With preparation and practice, you nervous travelers can make it through a flight. But I can’t promise you’ll ever get used to the full body scan.

 

 

 




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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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MBSR, Week 7: For This Meditator, Less is More

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

When I signed up for an 8-week Mindfulness-Based Stress Reduction course, I thought it would help me “deepen” my commitment to mindfulness meditation. Now, going into the final stretch of the program, I’m wondering what, exactly, I was thinking.

I’ve had plenty of time on the cushion to contemplate the purpose of my intensive foray into the world of mindfulness—or, in the parlance of the meditation community, my “intention.” I think I was hoping to develop some serious meditation chops, to transform myself from a meditation amateur into a meditation professional.

Now I’m realizing the daily practice I’d fashioned for myself was deep enough just the way it was. Which, I guess, is the very essence of mindfulness: recognizing things for what they are, accepting them, and not trying to make them different.

For this achievement oriented striver, the concept of “good enough” has required a major mental attitude adjustment. You mean I don’t have to be an expert? And what would that even look like for a meditator? Going on a weeklong retreat? Becoming a Buddhist monk? No, I just have to keep plugging away to reap the subtle benefits—improved focus, better tolerance for frustration, more patience—I get from practicing meditation on a regular basis.

This observation came to me after the all-day retreat last week. (With hours devoted just to sitting and observing thoughts as they floated by like clouds in the sky, I’d have been disappointed if I hadn’t come away with at least one insight.)

I’d anticipated the day with a great deal of trepidation, as did many of the participants. Would I be able to stand being silent for 7 hours? Sit for long stretches without needing to get up and move? Endure just “being” without doing anything? Heck, I even wondered what to pack for lunch and how I’d slip away discretely if I needed a bathroom break.

But, as with many unfamiliar situations, the experience turned out to be far less taxing than I’d feared. We moved smoothly from one meditation to another—sitting, yoga, walking—so there was plenty of variety to break up the time. We could leave whenever we wanted and even had permission to take our lunches outside (which turned out to be an unexpected delight given the beautiful weather and fortuitous park bench I happened upon). The only rule was “No talking.”

Three hours passed surprisingly quickly. I enjoyed having nowhere to go and no chores to do. But when we returned from our lunch break, the afternoon started to drag. I felt drowsy. The last instruction of the day was to do any meditation of our choosing for a half hour. I welcomed the opportunity to stretch out on a yoga mat and close my eyes. And then I promptly fell asleep.

Even though improved sleep may be one positive outcome of meditation, sleeping isn’t meditating.  But given the intensity of the day’s activities—yes, just being can be exhausting—and the focus on self-acceptance, I cut myself slack for missing out on the last part of the session.

So what did I learn? I realized more isn’t necessarily better when it comes to meditation, or many other pursuits, for that matter. Sometimes you reach a point of diminishing returns.

I plan to continue meditating. But I probably won’t be putting in 45 minutes a day, and I certainly won’t be going on a 7-day silent retreat any time soon.

I’ve discovered the importance of evaluating—mindfully, of course—what you need in any given moment. It might be meditation. Or it might, in fact, be a nap.




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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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