Using positive psychology to lessen the pain of cognitive therapy for depression

Sometimes using cognitive techniques can make you feel worse to start with, until you find good answers to talk back to your painful thoughts.  Here’s a simple technique I happened on that takes some or all of the pain out of challenging depressing thoughts.  I know some people avoid looking at their thoughts because it hurts, so I thought this might help.

I came up with this when I was doing background research for the book I’m writing on transforming depression into happiness.  Positive psychology researcher Barbara Fredrickson’s found that one of the good things that happiness brings is increased creativity.  ‘D’oh’ I thought.  ‘What if you did something that made you feel good before you wrote down your thoughts?  It could provide a buffer zone of good feelings against the potential down when you look at thoughts like ‘I’m a failure,’ or ‘I can’t get on with people’.  Feeling better could also make it easier to come up with new ways of thinking because your mind is more open to new ideas.’  I tried it out and it seemed to work.

So here are the simple steps:

• ·         Pick an activity that routinely lifts your spirits – going for a walk, meeting up with friends, watching an uplifting movie, driving round and listening to music, surfing, cooking a great meal – whatever floats your boat!  Set a time and do whatever organising you need to
• ·         Just before you do the activity, write down some of the thoughts that have been flitting round your head like annoying little grey clouds (or huge overwhelming tornadoes!)  It may be a bit painful to focus on these thoughts, but that pain is about to be eased!
• ·         Go off and have fun
• ·         When you feel better after the activity, pick up the page and look at your thoughts again.  You may find it easier to see the gaps in logic and evidence, and come up with some good answers, in a relatively painless way.

The other good thing about this technique is that there seems to be some evidence that we are more able to remember things that fit with our current mood.  So when you’re feeling sunnier, you may be more able to access sunny memories that give the lie to your gloomy prognostications.

'Why bother with using cognitive techniques when you’re already feeling better?' I hear you ask  That’s a good question.  If you no longer feel depressed, then it may well not be worth the effort.  There is research that shows that activity can be just as effective in changing depressing thoughts as cognitive techniques.  I do it either when the activity wasn’t enough on its own to make me feel good, or as a way of buffering myself against future depression by coming up with some snappy answers I can use in the future.  Totally up to you!

How to choose a therapist

The first thing to remember is - you don't have to keep seeing a therapist or counselor just because you see them for one session. In fact, you don't even have to finish that session! If they feel wrong for you it's OK to politely excuse yourself before the hour (or 50 minutes!) is up and leave, provided you pay the bill for the full session. Warmth is a biggie for me so if the person concerned is cold and critical, I don't sign on for another session.

However, I would recommend seeing someone face to face even if they sound off-putting on the phone. My favorite ever counselor sounded awful on the phone but was lovely in person.

How do you know whether it's worth staying? Here's some tips:

• you feel listened to and understood
• you feel respected
• you feel safe
  
• the therapist wants to take the same approach as you.

The last cannot be guaranteed, even if you're seeing someone who specializes in the type of therapy you want to do. I once went to great lengths to get an appointment with a psychologist who did cognitive behavioral therapy, back in the days when it wasn't that common. But despite me telling her over and over again that this was the type of therapy I found helpful and wanted to do, she insisted I needed what she called 'supportive therapy'.

You would think 'listening' was a no brainer but no - I did see one person who couldn't stop telling me irrelevant and annoying stories about herself. Obviously you want the therapist to say something - just not too much! And you also want responses that acknowledge what you just said and how you're feeling.

As for 'safe' and 'respected', that means things like - the person doesn't insult you, patronise you, jump to conclusions about you or come onto you. (It happens!) I saw one psychologist who was very angry and aggressive towards me, because she was also seeing a friend of mine and didn't like the way I'd acted towards her. I lasted the hour, but after talking it over with my partner decided not to go back again! (N.B. while the therapist is long gone, my friend and I are still going strong!)

It may take a while of seeing different therapists before you work out what works for me. It took me a couple of disastrous people to work out I needed someone very warm and accepting to work with. One good way to work out what kind of therapist you might get on with is to think about what types of people you most like in every day life = and what sort of people you avoid!

As for what type of therapy to choose for depression, that's a big question that it will take me quite a few posts to answer.

Has anyone reading this post had an interesting experience trying to choose a therapist?

5 ways to feel better quickly

Here are my top 5 ways of feeling better quickly:

1. accept my emotions and just feel them - they tend to fade away
2. focus on what's happening around me - noises, smells, the temperature of the air on my skin
3. do something - it doesn't have to be grand, it can be doing the dishes, but taking action almost always makes me feel better. Going for a walk is a good one because it's a triple whammy - you get action, exercise and bright light all in one hit!
   
4. do something pleasurable - whether it's watching a favorite TV program or a funny movie, going for a walk, meeting a friend for a coffee or taking the dogs for walk in a beautiful park, this will almost always life my spirits
5. notice the good things in my life - whether it's once a day or less often it doesn't really matter, it can be written down or just in my head. The key thing is to focus on them.

Extra tip: reflecting on the good things in my day when I go to bed helps me get a good night's sleep!

Thinking myself happy

Sometimes I wonder if I can truly say I’ve transformed my depression into happiness, especially when I have a week or two when I feel low. At times like that I feel a fraud, and my motivation to write goes way downhill. I had one of those times recently, and thought seriously about throwing in the towel (on my book – not on my life!)

But then I took myself in hand and asked myself two questions. They were:

1. Why do I want to be happy? and

2. What is stopping me from being happy?

The answer to question 1 was pretty easy. I want to be happy because it feels good. I know from the work of Barbara Fredrickson and others that there are lots of positive downstream effects of happiness, like heightened creativity, more success at work and better relationships. But in those moments when I’m experiencing life through a filter of misery and emotional pain, feeling good becomes my overwhelming motivation for taking action.

The answer to the second question was also reasonably obvious. While it’s true that living away from my home town of many years and my close friends means I have less social support than previously, and being chronically ill and on a low income creates a lot of stress, I know that I can still be happy despite these things. What was clear to me from my journaling was that the main thing stopping me from being happy was my thinking.

I did some more journaling and isolated the two major thought patterns that were resulting in misery. They were oldies but baddies! One was about how hard life was. ‘Yes, it is,’ was my response, ‘but it’s even harder when I’m depressed! When I’m happy I can cope with the difficulties life throws at me and still enjoy it.’

Having worked on these thought patterns many times in the past I had some answers to them already. Over the period of a few days I kept jotting them down, looking for the ‘heavy hitters' - the answers that delivered the best payload in terms of making me feel better. Then I did my best to turn them into easy to remember catch phrases. One was ‘life is hard but full of opportunities’, another ‘the steps I’m taking now will make my future a lot easier’. That helped me re-frame my current circumstances.

The effect wasn’t instant, but over time I gradually started to feel better. After a week I was feeling pretty good indeed. I was enjoying my own company again, rather than trying to run away from the painful thoughts by reading, watching TV and working to an unhealthy degree. It gave me a lot of confidence to know I could get on top of painful feelings when they surfaced. It also reinforced my desire to write about how to do this so I can share the message with others who are depressed that it is indeed possible to transform depression into happiness.