Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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COVID-Fatigue or Depression: How Can You Tell?

By Lynne Gots, posted on February 9th, 2021.

In the last week, everyone I’ve seen virtually for therapy has voiced increasingly familiar complaints. They are bored; they cannot get motivated to work or study; they have no appetite or have put on pounds from mindless snacking; they cannot practice healthy sleep habits even though they know too much screen time before bed and staying up past midnight will make it harder to function at peak efficiency the next day.

A lack of interest and motivation, along with appetite and sleep changes, can signal depression. And, certainly, we all are experiencing what feels like a collective state of depression after nearly a year of living with the drastic changes raised by a global pandemic, a situation that appears endless to many of us.

So, if your mood is low and you are having trouble concentrating, take heart. You are not alone.

As we know from a large body of research on mindful self-compassion, acknowledging the struggle, rather than beating yourself up for going through a hard time, can help, especially when you can connect with a common humanity (“Life is different for all of us right now.”) Treat yourself with the same kindness you would offer a close friend or family member to ease the unpleasant feelings. 

Other coping strategies include seeking out social interactions, even if they might be less satisfying through a virtual platform, and breaking out of the daily routine by creating some novelty. Try learning a language, experimenting with new recipes, or practicing a different exercise routine. If you have trouble pushing yourself to do anything right now, keep in mind a lesson psychologists have learned from behavioral activation for depression: just doing something – anything, in fact –can pull you out of the doldrums, even if nothing sparks your immediate interest. 

That said, although your current feelings of ennui may be nearly universal, they still could signal the onset of depression. If you have had a history of depression, you may be more vulnerable than someone with no previous episodes. Be on the alert for warning signs: constant rumination, feelings of hopelessness, extreme changes in sleep and appetite, and persistent thoughts of self-harm or suicide. Please seek help if those symptoms persist or worsen. 

If you are just weary from the daily dreariness and not clinically depressed, you might try observing your emotions through the lens of mindfulness. A common approach in meditation is to view your thoughts and feelings as transient, like clouds in the sky or a stormy weather pattern: they change from moment to moment.

I had the opportunity to practice observing my response to an actual meteorological event recently when I woke to a heavy snowfall. My first reaction was irritation at the inconvenience of it. “I won’t be able to walk the dogs without worrying about being pulled over on the ice.” “We’ll have to dig out the cars.” “It’s so annoying.”

But instead of continuing to wish it were different and getting upset about a situation I had no power to change, I decided instead to work on accepting the state of affairs. While I drank my coffee, I gazed out the window at the wooded path behind my house and noticed how peaceful it looked. I bundled up, took the dogs for a walk, and let them enjoy sniffing and digging in the soft mounds of snow. I laughed out loud watching Roland drag a shovel down the stairs and across the yard like a prized game specimen. I stopped my internal grumbling, and my mood lifted.

And, then, much to my surprise, the sun came out, it warmed up, and the snow melted. Of course, the puddles will freeze tonight when the temperature drops. And tomorrow, we will begin, again.




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Posted in Acceptance and Mindfulness, Cognitive-behavior Therapy, COVID-19 Mental Health, Depression, mindfulness |

How to Get through Trying Times without Losing Your Mind

By Lynne Gots, posted on January 22nd, 2017.

As a cognitive-behavioral psychologist, I teach people how to handle distress by changing the thinking patterns and behaviors that negatively affect their emotional well-being. The inauguration of the new President has stirred up strong feelings for many on both sides. So it seems fitting to offer some coping advice for weathering this highly polarized and emotionally charged political climate.

First, I’d like to correct one misconception. Contrary to what many journalists reported during the campaign and following the election, I haven’t seen an uptick in referrals due to anxiety about the new administration. My practice is just as busy now as it’s always been, but no one has contacted me specifically because they can’t deal with the current state of affairs. To be sure, discussions about politics and heated emotional reactions have come up frequently during recent therapy sessions–I work in DC, after all, and see many lobbyists, lawyers, Hill staffers, and Federal employees from both ends of the political spectrum. But anxiety, for those who are prone to it, tends to attach itself to whatever happens to be in the headlines of the moment. Today it’s the roiling political climate; at other times it’s been Anthrax or West Nile Virus or bedbugs. The important point to remember, as I’ve noted before, is that the content of anxiety is irrelevant in learning how to manage it.

1. Practice selective avoidance

Although I don’t typically encourage avoidance as a way to reduce anxiety, I do advise managing triggers strategically. So if you know reading the Comments section of a blog post or news article will send your blood pressure through the roof, skip it. Likewise with Facebook and Twitter. You already know what the people you follow think, so you won’t be missing anything important.

2. Limit the time you spend reading the news

For any compulsive behavior–and checking the news for a media junkie can become as uncontrollable as washing for a germophobe–coming up with a reasonable schedule can help dampen the urge to check and keep your emotional reactions from coloring your entire day. If this is a problem for you, try limiting the number of sites you read to two or three major news outlets; don’t go on your phone the moment you wake up; decide only to look, say, after breakfast, lunch, and dinner– and never before bed.

3. Challenge your thoughts 

A standard CBT technique is to identify cognitive distortions contributing to intense, negative emotions such as anger, anxiety, and depression. Two common distortions, labeling and overgeneralization, may lead to anger towards those whose political beliefs differ from our own. In a Pew Research Center Poll, Republicans attributed these qualities, ranked from highest to lowest, to Democrats: close-minded, immoral, lazy, dishonest, unintelligent. The view of Democrats towards Republicans differed only in the order of the ranking: close-minded, dishonest, immoral, unintelligent, lazy. Clearly, such sweeping generalizations and negative labels create acrimony and even hatred of The Other.

4. Practice mindfulness

Railing against what should or shouldn’t be happening can make a difficult situation unbearable. As a Buddhist saying goes, “If you get struck by an arrow, do you then shoot another arrow into yourself?” The Second Arrow–our reaction to a bad event–only adds suffering to the pain. We can cope more effectively if we adopt an attitude of acceptance. Keep in mind that acceptance doesn’t mean liking the status quo or giving up. It simply involves seeing things for how they are without judgement.  Dialing down our emotional reactivity allows us then to make more clear-headed decisions about the course of action we want to take.

5. Cultivate compassion 

Attempting to understand another’s point of view, even if you never arrive at any common ground, can help you feel less angry. Berkeley sociologist Arlie Hochschild, a Progressive academic who couldn’t be more different from the residents of St. Charles, Louisiana, where she embedded herself during a 5-year study, scaled what she calls “the empathy wall” to understand the economic and social forces that led them to embrace the Tea Party. Over time she came to see them as people rather than stereotypes. They, in turn, came to accept her as a human being rather than dismissing her as a “West Coast liberal.” In the end, they developed a mutual respect for each other even though their political positions never changed.

Emotional resilience requires the ability to see moods as transient, like the weather. We can apply the same approach to preserving our sanity in today’s stormy political climate. Lay in ample reserves of acceptance, empathy, compassion. Take constructive action. Batten down the hatches. And wait for the hurricane to pass.




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Posted in Acceptance and Mindfulness, Anxiety, Cognitive-behavior Therapy |

Coping with Loneliness during the Holidays

By Lynne Gots, posted on December 23rd, 2015.

For many people, the holiday season, filled with greeting-card images of family gatherings and communal good cheer, can heighten feelings of loneliness. Those who are grieving the loss of loved ones may miss them especially keenly during this time of year. Memories of happier times can cause the pain of past relationships ended through divorce, a break up, or estrangement to surface unexpectedly. And for those who lack any intimate relationships, overhearing discussions of colleagues’ vacation plans or seeing constant reminders on social media and in seasonal advertising of others’ connections can intensify an already pervasive sense of social isolation.

A study described in a recent NY Times Magazine article  found that people who perceived themselves as lacking close connections (the “lonely” experimental group) were much more reactive than the socially well-integrated comparison group (as measured by electrical activity in the brain) to words suggestive of social isolation, such as “excluded,” “foe,” and “detached”. The researchers concluded that lonely people selectively attend to negative social information. This hypervigilance to perceived threats paradoxically heightens their loneliness and social withdrawal by making them “act in a more defensive, hostile way toward the others with whom they would like to connect.”

So if you’re feeling lonely this holiday season—regardless of whether your loneliness is acute or chronic—be aware of the temptation to compare yourself to others whose holidays seem brighter than yours. Focusing on the negative aspects of your situation may make you withdraw even more and sharpen the pangs of loneliness.

Instead, try reaching out. Accept invitations even if you feel you’re only being included because “they feel sorry for me.” If no invitations are forthcoming, consider extending one to an acquaintance who also is alone. Or volunteer to serve turkey dinner at a homeless shelter or distribute presents at a children’s hospital.

Connection comes in many forms. The Norman Rockwell version of the family holiday table is only one of them.

 




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Posted in Cognitive-behavior Therapy, Self-help |

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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