Natural Highs: The Cutting Edge of Mood Alteration

1. Natural Highs: The Cutting Edge of Mood Alteration The Cognitive-Behavioral Revolution

2. Zest for life is a virtue • Compulsive pleasure-seeking can produce hardship & despair if not controlled. • Cognitive-behavioral revolution means humans are expected to take charge of emotions/actions by managing dysfunctional thought • Cognitive-behavioral restructuring (CBR) can improve quality of life by offering control of how we interpret events & respond

3. The greatest weapon against stress is our ability to choose one thought over another- William James • Acceptance and commitment therapy (ACT) • uses acceptance and mindfulness strategies together with commitment and behavior change strategies to increase psychological flexibility • ACT teaches them to "just notice", accept, and embrace their private events, especially previously unwanted ones • Dialectical behavioral therapy (DBT) • techniques for emotion regulation and reality-testing with concepts of mindful awareness, distress tolerance, and acceptance • goal is to become capable of calmly recognizing negative situations and their impact, rather than becoming overwhelmed or hiding from them

4. Mindfulness techniques allow one to observe events without judgment or reactivity • What to do skills in mindfulness: • Observing, noticing the present • Verbally describing what is experienced • Taking part & letting go • How to do skills in mindfulness: • Not being evaluative of the thoughts or experiences • Focusing on the present moment • Radical acceptance of things as they are • Engaging in actions congruent with one’s goals & values

5. Radical Acceptance- The Serenity Prayer • Exercise: Floating Leaves on a Moving Stream

6. The Cognitive-Behavioral Model • We are what we think- Buddha • Men are not disturbed by things which happen but by their opinions about things- Epictetus • Our life is what our thoughts make it- Marcus Aurelius • The greatest discovery of my generation is that a man can alter his life simply by altering his attitude of mind- William James • I am convinced that a person’s behavior springs from his ideas- Alfred Adler

7. Ellis developed rational emotive therapy (RET) • Ellis wanted a more efficient mode of behavior change than psychoanalytic therapy. • He realized he saw the error of clients’ thinking long before they did & they could benefit from seeing the rational errors they were making that caused them pain • REBT evolved to help clients dispute their irrational belief patterns

8. Primary themes of REBT • Rational vs. irrational beliefs • Rational beliefs help people get what they want; irrational beliefs interfere because they are inflexible & self-condemning (shoulds & musts) • ABC- Activating event produces beliefs which result in consequences • C can be changed by changing B whether A changes or not

9. Beck- Cognitive therapy for depression • Depression/anxiety are caused by faulty thinking- stinkin’ thinkin’ • Negative cognitive triad: negative thoughts about self, world & future • Automatic thoughts, expectations, appraisals & attributions are not helpful • Therapy teaches client to recognize cognitive errors by seeing schemas that guide automatic thinking • Maladaptive schemas (diathesis) may be dormant until a stressor activates core beliefs

11. How do people know they are reacting to automatic thoughts? • Strong emotions accompany these thoughts • In emotionally charged situations, there is a breakdown of logic & civility • Under stress, deep-seated beliefs erupt to drive thinking & behavior • Mel Gibson’s anti-Semitic tirade upon being arrested for drunk-driving • “The Jews are responsible for all the wars in the world. Are you a Jew?!” • Particularly interesting in the light of criticism of his film, The Passion of the Christ as anti-Semitic • Automatic thinking is subject to distortion of logic & overreaction • Mindfulness training can derail this pattern

12. Groups of Schemas • Simple schemas • Rules of general behavior, physical nature of the environment- get a good education • Intermediary beliefs & assumptions • Conditional beliefs- if-then statements that affect self esteem- I must be pleasing/ attractive to others all the time • Core beliefs about the self • Global rules for interpreting feedback regarding the self- I’m stupid, unlovable, better than others, can’t trust others…

13. Stress may activate dysfunctional core beliefs that produce automatic thoughts

14. Cognitive therapies reacted to narrow behavioral theories that denied internal thoughts affected behaviors • Bandura’s Social Learning Model • Reciprocal determinism • Modeling effects on aggression- Bobo doll • Vicarious reinforcement • Meichenbaum’s Stress Inoculation Model • Self-talk & private speech can regulate behavior & can be taught- • Stress inoculation: • Educational phase/ modeling & rehearsing new skills/ practicing in the environment

16. These techniques can aid addicts in remaining sober • Self-reinforcement is the combination of cognitive & behavioral approaches: • Bandura- social learning • Meichenbaum- internal dialogue • Beck- cognitive errors • The other part is learning to recognize high-risk situations & develop strategies to deal with stressors • As the client chooses positive behaviors/ thoughts there is reinforcement for ongoing positive thought processes (the opposite is true also)

17. We are never at the mercy of our thoughts We can always think differently The greatest weapon against stress is our ability to choose one thought over another- William James

18. How can CBT reduce relapse? • Helping the client recognize the thoughts s/he is generating that produces anxiety/ helplessness is the first step • I’m worthless. Life isn’t fair. I’ll never overcome this… • Tx helps the client to challenge polarized belief structures that box in thinking • It’s all my fault. My dad was right about me. I may as well drink, what difference does it make? I’ll never get another good job, lover… • Alternative ways of appraising asituation can be generated & practiced

19. Our choice of thinking produces outcomes that are reinforced No one determines our thinking except our selves

20. CBT similarities with Buddhism • Both approaches use the mind to heal the mind • They share goals of serenity, peace of mind, relief of suffering • They share common values- acceptance, compassion, knowledge, understanding, altruism & universalism (as opposed to groupism) • Buddhism focuses on positive thought to neutralize negativity • CT focuses on thinking errors • Both focus on the present, using imagery, exercises, perspective taking

21. Automatic thoughts exercise • Draw 3 columns on a sheet of paper- label them Event/ Thoughts/ Emotions • Recall a recent situation/memory that stirred up strong emotions • Try to imagine being back in the situation, just as it happened • What automatic thoughts were occurring in this situation? Write down the event, the thoughts, & the emotions in each column • Try to identify the underlying beliefs that energized these thoughts • What kind of errors in logic might you be using? • What alternative cognitive process can you use to alter your emotional states?