Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

Toggle Menu

Contact Dr. Gots

202-331-1566

Email >

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.

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.




Leave a comment


Tags: , ,
Posted in Acceptance and Mindfulness, Anxiety |

Why Counting Streaks May Not be a Good Idea When Building Habits

By Lynne Gots, posted on March 4th, 2018.

I’ve been meditating daily for over three years, half of that time with the popular app, Headspace. But recently,thrown off by jet lag following a trip to the West Coast, I unaccountably forgot to meditate one day and broke my streak.

I was upset by my lapse and tried, as any good CBT practitioner would, to challenge my all-or-nothing thinking. One day out of over a thousand is no big deal. Less than a drop in the bucket. It didn’t negate my progress.

But Headspace didn’t see it that way. It reset my stats back to Day 1. Even more aggravating, it started sending me motivational messages like: “A 3-day run streak is a great start to your practice! Next stop 5!” And, after 5 days: “Nice job. This is precisely how you build a solid meditation practice. Think you can make it 10?” At 10 days, they told me: “Your consistency is outstanding. You’re starting to build a lasting, healthy habit.” And today, 15 days into my new streak, I got: “Great work. Maybe everything changes except your commitment to meditation.”

I decided I needed to say something. Here’s an excerpt from the email I wrote to Headspace:

I had over 450 consecutive days of Headspace under my belt until a few weeks ago, when travel to the West Coast threw me off schedule and I somehow forgot to meditate one day. I was upset to have broken my “streak,” but I tried to practice what I preach to the many perfectionists I work with by forgiving myself for the brief, and ultimately insignificant, lapse.

But Headspace is making it harder for me to let go of my mistake! It reset my progress back to zero and is giving me motivational messages after three, five, ten, fifteen days of consecutive practice to tell me I’m on my way to a solid practice and a commitment to meditation. I suppose I could use those statements as a mindfulness exercise, treating them as if they were just random thoughts of my own creation, but coming from the “experts,” they are not at all helpful.

I have continued to use the app but now am having second thoughts. I’m not sure whether such a quantitative, competitive (albeit only with myself) approach is really how I want to frame my meditation practice. And I certainly will be less enthusiastic in recommending it to my perfectionistic patients.

You might want to pass this feedback onto your software engineers to see if there could be a way turning off the streak function, or sending out messages of self-compassion to those who’ve accrued a lot of hours but miss a day here and there.

I’ll let you know what they say.

 

 

 




3 comments | Leave a comment


Tags: , , , ,
Posted in Behavior Change, mindfulness, Perfectionism |

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.




Leave a comment


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

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

202-331-1566

Email >

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
Categories
Archives
© 2008-2023 Lynne S. Gots, PhD. Photographs by Steven Marks Photography.