Saturday, 31 October 2020

Who is depending on you?

I'm going to be alright The last thing that I want to mention about taking better care of yourself is some basic stuff. It's basic stuff you are probably terrible about adhering to, though. This is the part where I tell you that your body is a temple. Well it is! Take care of it. You don't have to do the whole ultra gluten free level 5 vegan juice diet crap, but treat your body well. Don't eat tons of junk food without getting some green in your life every once in a while. Communicator Similarity If we tend to be persuaded by those who are trustworthy, likable, and attractive, we must also be more persuaded by people who are similar to us, right? Here the answer is a bit more complicated. In some cases, people are more easily persuaded when the source of a message is similar to themselves (Mackie et al. Sometimes, however, people are influenced more by dissimilar others than by similar others. The key factor is whether the issue at hand deals primarily with subjective preference or objective facts (Goethals & Nelson, 1973). For issues dealing primarily with subjective preference--that is, when there is no correct answer--people are more confident in their attitude when similar others agree with them than when dissimilar others agree with them. So if you believe that Beyonce is the greatest recording artist alive, agreement from a similar other, such as a close friend, would make you more confident in that attitude than agreement from a dissimilar other, such as a foreign exchange student. In contrast, when people are trying to determine whether something is objectively true or factual, their attitudes are influenced more by the opinions of dissimilar others than by those of similar others. For instance, if you believe that Beyonce sold more albums than Rihanna (which is either factually correct or incorrect), agreement from a dissimilar other would make you more confident in that belief than agreement from a similar other. At the latest after saying the words cognitive restructuring of dysfunctional thoughts it is clear that this woman will never come back. A therapist in my neighborhood - a female psychoanalyst - once told me about a lady who has already come to therapy sessions for over 10 years.

In therapy, they chat about politics, philosophy, men - and this lady just loves it so much that she probably will come for another decade. This story suggests that patients of this kind do exist somewhere. In my CBT office, people at the end of the very first session are sometimes astonished that at minimum a second session would be necessary for them to make progress in solving their problem. Didn't the Internet say short-term therapy? In their CBT training, young therapists in Germany often get told by their supervisors, that the first 10 sessions of therapy are basically there for getting to know each other. Up to this point, not much therapeutic change has to have happened. This message sounds very good to trainees, and is thought to reduce the inner pressure that is quite common among them. The problem, however, comes from the fact that their later patients don't know about this 10-session-rule, and often come with a different expectation. Don't drink excessive amounts of alcohol when it's not your birthday. Try to drink more water than you do now, because I'm sure you don't drink enough of it. Sleep is a topic for another article, but resting is really important. Interestingly, sleep is totally vital for learning new skills, which is what I've been bitching at you about this whole time. During sleep, you consolidate new memories, so that you can reach up in there and pull them out when you need to. So get plenty of sleep and keep beating that brain into submission with your new awesome anxiety slaying skills. The matrix has you. We are all plugged in and as much as we like to think that we use technology as a tool. Don't get me wrong, I blinking love technology. If it weren't for google drive, e-readers, text messaging, and internet radio, this project would have never seen the light of day. When similar others agree with us on matters of fact, we are often uncertain whether they agree simply because they like us or perhaps because they have been exposed to the same faulty information that we have been exposed to. But when a dissimilar other who does not have those biases verifies our belief, we assume that the belief must be objectively true.

APPLICATION Similarity and Morality in Politics Understanding the influence of communicator similarity gives us some insight into why appeals to morality in political rhetoric often fall on deaf ears and fail to change attitudes. Some research shows that liberals and conservatives have somewhat different moral priorities (Graham et al. Conservatives, more than liberals, for example, value loyalty to the group and respect for authority as moral principles. From this cultural perspective, morals are more subjective than objective. And the problem, according to Feinberg and Willer (2015), is that political candidates often advocate their positions based on their own sense of morality, not the moral principles of the audience they are presumably trying to convince (ie, undecided voters or those leaning toward the other candidate). This suggests that if communicators pitch their message in line with the moral principles of those they are trying to persuade, they should be more effective. Indeed, across such issues as military spending, same-sex marriage, and English as the official language of the United States, Feinberg and Willer find that framing the issue in terms of liberal morals (eg, fairness) better persuades liberal audiences, whereas framing the same message with conservative morals (eg, loyalty) better persuades conservative audiences. It's getting even more difficult, when patients have to pay for their therapy themselves. People who have their Euros flying out of their wallets with every passing minute often appear less interested in slowly establishing a therapeutic relationship, and rather ask for precise instructions about what to do to reduce their symptoms. But what instructions could that be? People often come to my office like pilgrims in search of a guru, who they assume to have a mysterious secret knowledge, and whom they now want to ask an important question. For example: How do I get rid of my binge eating attacks? Since there is rarely a really good answer to questions likes these, the visit often leads to disappointment. If the psyche was a car, and you would look into a random CBT textarticle for a guide about how to replace a defective injection pump, the preciseness of the instruction would often go like this: Initiate the replacement procedure. Use tools that are suited for this task. Evaluate your progress. Then the article ends. One thing I've noticed in my professional training as a therapist is that the older generation of shrinks out there just don't quite get the influence of technology on modern life and modern mental health. I really think that technology has changed the landscape of anxiety.

There are many things that it is great for. You can use technology to really facilitate your domination of anxiety, but it can also feed into that anxiety and the bitch about it is that sometimes those two scenarios look almost identical. This topic is very personally loaded. Not just in my personal experience, but for my wife, who has been gracious enough to allow me to blab about her in this article. She has issues with anxiety. Sometimes it's not so bad and she can go about her day and do important things. Other days, she can get thrown into a panic attack as she's trying to go to sleep and completely unravel within a few minutes. The reason I'm talking about her here is that she is self-employed as a blogger, author, calligrapher, wedding designer etc Like so many of you out there who are self-employed or just work for modern companies, that means she lives her life on the internet and interfaces with technology for everything. This can be seen as a specific example of a broader tendency for communicators to be more effective when they present audiences with messages that fit with values the audience finds personally important (Blankenship & Wegener, 2008). SECTION REVIEW Characteristics of the Source The power of a message to influence attitudes depends, in part, on who is delivering that message, or its source. Credibility Credible communicators are both expert and trustworthy. Legitimate expertise persuades through the central route. The appearance of expertise persuades through the peripheral route. Attractiveness Communicators can be persuasive when they are attractive, even if their credibility is low. Attitudes about subjective preferences are influenced more by a similar source than by a dissimilar source. How less stressful all this would be if my role as a therapist was indeed just to listen to stories about egoistic husbands and wicked wives, and here and there join in with an empathic Oh, my goodness! But as long as there's the omnipresent advertising message: CBT - highly effective techniques for defeating psychic problems, many come to meet a mechanic for a quick-fix, and not somebody to talk to.

The future of CBT We must slowly come to an end. That which applies to a session of CBT also applies to this article. Have a nice week, see you next time. Oh, you want to hear something about the future of CBT? Well, here's a picture with a cautious guess about how therapy may look like in 10 years from now: At first glance, a psychotherapy without the necessity of a human psychotherapist would have a lot of advantages: lower costs (or even none at all), availability 24/7, and the option of skipping the search for a parking spot in the therapist office's neighborhood. The idea isn't new: already in 1966, the German-American computer scientist Joseph Weizenbaum created ELIZA, a simple computer program that does conversation in the style of a Rogerian psychotherapist. It's amazing what you can do with the world at your fingertips. Just right now, she was like, Hey send me a quote from the article to make a graphic out of, and I was all like, Yo. Pretty awesome. With the pervasiveness of technology and our lives becoming one with the cloud it is sometimes hard to understand where work ends and life begins. When part of your job is keeping up with blogs, does reading them count as a break anymore? Having emails delivered directly to your phone is great, but what about when it is interrupting dinner or stressing you out right before you go to sleep? You gotta get that shit under control before it controls you. Rage against the machine, my friend. There is no one right answer to the correct way to interface with technology, but in general, you want to set yourself up for success. You want to do a little bit of lifestyle min-maxing. Attitudes about objective facts are more influenced by a dissimilar source. Characteristics of the Message

Setting your own deadline for your projects

How does it feel to work as a cognitive behavioral therapist? That probably depends on many different things, such as the kind of patients that typically come to your office, and their individual expectations. Recently, a CBT colleague from Munich wrote a little text about his subjective impressions from work. His intention was to tell his friends how wrong their views about psychotherapy are. Here is a translated version: THEY DON'T COME FOR TALKING When I occasionally get into a conversation with non-psychologist about psychotherapy, I am often amazed at their fantasies about what happens in such an office, and who are the men and women that go there. The views on patients are sometimes grotesque as if being taken directly from a bad joke. What if I said that they were not counterproductive but actually one of the most productive uses of your time? By giving yourself breaks, you are taking the time and investing it in your future self. If you let yourself snowball and reach the point of burnout (a state of pure blah), then any work you do is going to suck anyway. By investing time in yourself, you give yourself a chance to recharge your batteries. I'll talk more about different types of breaks and what you can do to invest in yourself, but the concept is really important. When you relax and recharge, you are gaining strength and clarity. You are enabling yourself to work, make decisions, and just exist more efficiently and effectively in the future. Well, what kind of breaks? That depends. What recharges your batteries? The phenomenon whereby people can remember a message but forget where it came from; Hovland and Weiss (1951) found the first evidence of the sleeper effect.

Recall the experiment showing that people were more likely to agree with high-credibility sources (eg, a medical journal) than with low-credibility sources. When the researchers again measured participants' attitudes four weeks after they were first exposed to the arguments, participants who initially had agreed with a position advocated by a high-credibility source showed less agreement, and those who disagreed with a low-credibility source had come to agree with the position (see FIGURE 8. Subsequent research has clarified that such sleeper effects are most likely when people learn about the credibility of the source after they have been exposed to the arguments (Pratkanis, 2007). When people know in advance that an argument comes from a low-credibility source, they are better able to discount the argument. At the same time, source credibility can also give rise to a sleeper effect. If people don't recall that a particular argument was weak, but do recall that it came from a credible source, persuasion can increase over time (Albarracin, Kumkale, & Poyner-Del Vento, 2017). The Sleeper Effect In this study, people were more likely to change their attitude to agree with arguments if the author was an expert and therefore credible. For example, that it's people who think they are Napoleon - or a chicken. People who sat down on the office floor, and with loud clucking trying to lay an egg. Cartoonic weirdos. You also meet many other stereotypic views, like that patients usually were very lonely, and would visit a therapist for the single reason of having at least one friend. Another of those views is, patients would come to have a place for crying. Since family and friends could no longer stand the constant whining, patients at some point would want to switch over to a professional listener, whose most important qualification in this scenario it is to not run away. How I wish all this was true! That the only expectation of me as a psychotherapist was to take the role of a silent muppet with the single task to sit around and watch people let it all out. It would probably be the most easily earned money in the whole health sector. The reality in my CBT office is quite different. Some people love going out and getting a drink with their friends to relax and recover energy. For those of you that are introverted in nature, a night out with friends would leave you feeling drained and empty when you get home.

Probably not the best choice for your breaks. You gotta do something that fits with you as a person. For me, a big one is playing video games. It seems lazy, but it relaxes me, and as long as I put limits on myself, I feel much better and more refreshed afterward. A few of these articles were cranked out in like 20 minutes right after a League of Legends game. Another way you can be nicer to yourself is by replacing some of that asshole language that you use toward yourself in your head. Since I already read my own article on cognitions, I know that I can't read your mind, but I can take a pretty educated guess that the things you say to yourself (self-talk) aren't always friendly. Things like, I'm bad at everything, I have terrible luck, that was my fault, or omg I look so stupid right now. But four weeks later, the credibility of the source no longer mattered, and arguments made by less credible sources were equally likely to have changed people's minds. A line graph demonstrates results of sleeper effect, with vertical axis labeled as Percentage of attitude change ranging from 0 to 24 in increments of 2 while the horizontal axis is labeled as Time interval, with left end marked as Immediate and right end marked as 4 weeks; The graph shows two colored lines- red (high credibility), initiating from between 22 and 24 declining to 12 touching the vertical line at 4 weeks while a green line (low credibility originates from slightly above 6 increasing diagonally to 14 touching the vertical line at 4 weeks; Communicator Attractiveness You may recall a commercial in which the actor Dennis Haysbert (who played the president of the United States in the first season of the popular TV show 24) recommended buying insurance from Allstate Insurance Company. In this context, Haysbert is not particularly high in credibility. But he is handsome and well dressed, and he looks straight at you as he asks you in his authoritative baritone voice whether you are in good hands. This example reveals how communicators can be persuasive when they are attractive, even if their credibility is low. The most obvious way that a communicator gains in attractiveness is by presenting an attractive physical appearance. Certainly you've noticed how magazines, billboards, and pretty much every other commercial medium features attractive models (some of which are computer-generated images rather than actual people). Often, a patient within the first minutes already lists all the symptoms that he wants to have removed by the expert. For example, the constant feeling of being close to suffocating, what apparently isn't caused by any kind of physical illness.

His doctors didn't know what to do anymore, and praised CBT as a true wonder therapy that will heal him in no time. Or a student with the wish to be cured from his long-time procrastinating. On the Internet he read that CBT was a scientifically based method with high effectiveness for virtually all psychic problems. The psychotherapist is now expected to transform the unmotivated into a well-oiled learning machine. After having stated what is wanted, and maybe already having placed the payment of 100Euro on the table, a patient takes a relaxed state in his therapy chair, and silently looks over as if to say: Please start the treatment now, doctor. I am ready. If it should be necessary for you to obtain further information about me, I am willing to answer the questions you might want to ask. Occasionally, however, you can meet the clear statement that one doesn't want to give any info about his private life and wishes for the conversation to be limited to the absolutely necessary medical aspects. This negative self-talk is something you probably aren't even aware of, but it eats away at you bit by bit and erodes that self-confidence you need to tackle your anxiety. It's not much use fighting your thoughts. Whatever you do right now. I bet you thought of a purple monkey. Fighting against your thoughts is not an effective strategy, so what you can do instead is focus on replacement language. Give yourself some mantras to repeat to yourself throughout the day or when you are actively experiencing symptoms. You can even write them on your bathroom mirror or put them as the wallpaper on your phone. Here's a few you can use: I'm allowed to make mistakes I'm allowed to feel good sometimes But does it work? People are more persuaded by arguments that come from communicators they consider physically attractive, even when the arguments are wholly unrelated to the communicator's attractiveness (Chaiken, 1979;

Mills & Aronson, 1965). When the communicator's attractiveness is irrelevant to the true merits of the position he or she takes, as when a supermodel graces a billboard for an energy drink, it influences the audience's attitudes through the peripheral route. It is important to note, though, that the communicator's attractiveness also can influence attitudes through the central route when it is an argument for the validity of the message (Shavitt et al. THINK ABOUT Consider an attractive, muscled spokesperson for a rather odd-looking exercise machine who says, If you use the Abdominator for just 20 minutes every day, you will have rock-hard abs like mine. Is the spokesperson's physique relevant information for evaluating whether the exercise machine works? What if the spokesperson were sporting a bit of a belly (perhaps more of a keg than a six-pack)? What reason would you have to believe that the machine works? When I watch Hollywood movies in which patients in a psychotherapy are pictured, it all seems so different. It always looks like these are desperately longing for a place to talk about their life, irrespective of any possible symptoms. When the therapist after 50 minutes taps on his wristwatch to indicate the end of the session, they seem to be very satisfied, as if it was exactly that what they hoped to experience - and a bit sad, because they now have to wait for a full week to continue telling their story. Let's jump back into the reality of my daily work. A businesswoman, around 50, comes to the office and tells that she was lacking energy and motivation for the last few months. Her doctor told her to go see a cognitive behavioral therapist. She straight out admits that she has a very low opinion of psychotherapists in general, but since these symptoms interfere with her work, she sees no alternative but to follow the orders of her doctor. She asks for a precise specification of what is the therapy, that is, what will the exact content of those 50 minutes every week be, and by what mechanism that is supposed to make her depressive symptoms go away. Neither the vague description that an individual therapy plan based on an analysis of her life situation has to be created, nor a detailed overview on CBT methods in general may convince her. Unfortunately, there's also no apparent wish to just talk and let's see where it takes us. Anxiety is my bitch I don't like these feelings, but they won't hurt me

Undertaking a 30-day challenge you set for yourself

Half the participants were told the article was from the New England Journal of Biology and Medicine (an expert source), whereas the others were told it came from a popular magazine such as those you see in the supermarket (a nonexpert source). As you might expect, participants were more likely to agree with the position if they thought the articles came from expert sources rather than nonexpert sources (Pornpitakpan, 2004). Source credibility The degree to which the audience perceives a message's source as expert and trustworthy. The Appearance of Expertise and Trustworthiness Although real expertise can convey strong arguments that persuade people through central-route processing, the appearance of expertise often persuades through the peripheral route. For example, a commercial advertising mouthwash may feature a spokesperson wearing a white lab coat and a stethoscope around his neck, giving him the appearance of a medical expert when in reality he is most likely an actor. A viewer who takes the peripheral route without paying close attention to the substantive claims being made might just assume that the mouthwash is effective because the spokesperson appears to know what he is talking about. In theory, this ban now raises the desire to bite into the forbidden fruit. If it doesn't go as planned, then this official extra-time gives birth to a whole new generation of World of Warcraft characters. CBT in Germany What happens in CBT might be quite similar from country to country. But the circumstances vary, such as how easy it is to find a qualified therapist. If you like to compare the therapeutic care of where you live with another region, then here is a brief description of how it is in Germany. If you are interested in getting a CBT treatment in Germany, you are basically in a good spot. This is because in this country you usually don't have to pay anything for it as it's covered by public health insurance. The downside of this is that free therapy sounds very good to a huge number of people, which leads to a serious shortage in available appointments. Many patients tell within the first phone call, that they have already contacted more than 20 psychotherapists, all of whom had told them they would have to wait for several months to start a therapy. Just pop in your headphones, close your eyes for a bit, and bliss out. I'm going to include a script I've written for a full body progressive muscle relaxation that you can read.

I guarantee that it will make you feel good if you decide to breathe along while you read. I'll put this script into the appendix at the back, though. I take my guided relaxations seriously. I don't swear at you or make bad jokes in the script. We'll keep that gentle stuff separate. Just promise me you'll imagine that my voice sounds like Bob Ross when you read through it. Seriously, just don't be. It takes more than the strategies I've described so far to really kick anxiety in the ass. Indeed, speakers can appear more credible, and thus be more persuasive, simply by speaking with confidence, quoting statistics, or even just by speaking quickly--none of which necessarily means they have expert knowledge (Erickson et al. Miller et al. The source of a message can also gain credibility by being perceived as trustworthy or unbiased in his or her views. One way to accomplish this is to express an opinion without the audience realizing that it is the target of persuasion. Imagine that you overhear some people at a coffee shop praising a new restaurant. You have no reason to believe that these people are biasing their opinions to influence you (they don't even know you're eavesdropping! When Walster and Festinger (1962) arranged such a situation, that is exactly what they found. People were persuaded more by someone's opinion when they believed they were eavesdropping on a conversation. The power of overheard messages hasn't been lost on advertisers. Just think of all the commercials you've seen that attempt to portray a private conversation between two people (Gee, Tyler, your glasses really do sparkle! Since people usually seek out psychotherapy in times of crisis, even 2 weeks of waiting time can feel like an eternity. A few years ago, the results of a survey were published in Germany: according to this, the average waiting time in 2017 was 20 weeks [25].

While in big cities you only had to wait for about 3 1/2 months, in some rural areas it was more than half a year (fewer psychotherapists live there). These numbers are not CBT exclusive and also include other psychotherapies, such as psychoanalysis. There's an everlasting conflict in Germany about this issue: psychologists, psychiatrists, health insurance companies and politicians argue about what might be the true reason for those enormous waiting times. The most common criticism towards the psychotherapists is that they would conduct too few therapy sessions per week, would give preference to patients with minimal problems to the disadvantage of the seriously ill, and would eternally delay the end of therapies, instead of quickly taking on new patients. However, from the point of view of many psychotherapists, the problem lies in the fact that there are too few Kassenzulassungen. Imagine these as some kind of German certificate, which enables the therapist to get paid for conducted psychotherapy sessions by the public health insurance companies. But these certificates are limited in number - every city or region has its fixed maximum. That means: one psychotherapist (often older in age) first has to return his Kassenzulassung to the pool, then another therapist (often younger age) can get one - the amount of available psychotherapy stays the same. You need to set yourself up for success, too. You need to invest in yourself. You need to stop being a butthead and sabotaging yourself. Let me take a wild guess here. Your life is pretty stressful. Things seem to happen quickly, and often times there are factors that are out of your control but that significantly contribute to your level of anxiety. You have this high level of kinetic energy inside of you, and sometimes it feels like you can't stop the hamster from running at full speed and it just won't fall off the wheel even though it's so tired that it could die. About 60% of you just nodded your heads, so I feel good about this next part I'm going to advise you on. YOU NEED TO TAKE A DAMN BREAK. Actually, you need to take several breaks. What dish detergent do you use? In fact, advertising and public relations agencies often pay writers to masquerade online as delighted consumers, writing positive reviews of their products or services on various web sites such as Amazon.

The writers are paid to appear like average people--for example, by intentionally inserting typos into their reviews. In this way, advertisers hope that the fake reviewers appear trustworthy and, thus, persuasive because the writers do not seem to have a stake in the sale of the product or service. After learning about the strategies that advertisers use to market their goods, you are smart to be skeptical of some of the claims and endorsements you read or hear. Another way in which a communicator gains in trustworthiness (and persuasiveness) is if he or she argues in favor of a position that seems to be opposed to his or her self-interest. Imagine that you, like participants in a classic study by Walster and colleagues (1966), heard Joe `The Shoulder' Napolitano, a habitual criminal and drug dealer, arguing for more lenient court proceedings. Even if he is making some good arguments, you might not be very persuaded because you know that he personally has something to gain from convincing you of his position. Indeed, participants in the study were completely unconvinced. But when the same alleged criminal argues for stricter court proceedings, how do you think you would respond? The argument now is that if more of these certificates would be given out, then more offices could offer psychotherapy, and therefore the waiting times would be lower. The opposite of free therapy is paid therapy. This clearly sounds less attractive, but that is what can be offered by all those psychotherapists who didn't succeed in getting a Kassenzulassung, even though being highly trained professionals. Therefore, in most German areas you will meet two types of therapist's offices: those offering free treatment to patients, with the downside of them having to wait for an eternity for it to start, and offices where you have to pay for it yourself, but with the advantage of getting an appointment maybe as early as the next day. Since a single session of CBT in Germany costs about 100Euro, for the majority of people, this isn't really a choice. A unique thing in Germany is that it's allowed for nearly everybody to offer psychotherapy. All you have to do to get permission is to pass a 28-item multiple choice test about health basics, providing proof that you haven't been a criminal in the past, and have a public health official certify that you don't seem to pose a threat to the health of the German population. Therapists of this kind often have very well-designed homearticles. Because of that, it can be very hard for patients to distinguish between experts and non-experts. Maybe the phone number you just called belongs to a therapist who finished university with an academic title, spent hundreds of hours in CBT training workshops and supervision sessions, and finally passed the difficult German state exam for psychotherapists. Actually, you should take several breaks EVERY DAY. Crazy concept, right?

One of the annoying things about anxiety is that it almost never occurs in isolation. If you are the type of person to carry a lot of worry, especially about unfinished business, you are also probably the type to feel really guilty when you do things other than those pieces of unfinished business. Guilt is such a shitty thing. As if things weren't hard enough with the anxiety symptoms, guilt just creeps right up in there and makes things exponentially more difficult. I like to call this snowballing. You get worked up and then getting worked up makes you feel bad and then you get more worked up about feeling bad about getting worked up and then. So yeah, back to the breaks. What if I told you that taking breaks and doing nice things for yourself was not a waste of time? Participants in the study were much more likely to agree with his position. The Sleeper Effect Credibility can be a peripheral cue when people are not elaborating on the persuasive message. It's a handy heuristic simply to decide, She's an unbiased expert, I'll believe that, or I'm not buying anything that sleazeball says. However, this kind of peripheral influence of source credibility may not last long. The decay of source effects can happen when, over time, people forget the source of the message but remember the message content, a concept known as the sleeper effect. Suppose you scan the front article of a sensationalistic gossip magazine while waiting on the grocery checkout line (come on, we all do it at least occasionally), and it claims that new evidence calls global warming into question. A few weeks later, the topic of global warming comes up in a conversation, and you remark that you read a story arguing that global warming may in fact not be happening, but you can't remember where you read it. Might that argument be more compelling now that you've forgotten that it came from a not-so-credible source? Sleeper effect However, it could also belong to a person who only watched some CBT videos on YouTube before creating a professional homearticle and offering this service to the public. A little CBT story

Deciding to chat with an accountability partner once a week

I know I said there's no voodoo involved in these, but for me, these numbers are magic. As soon as I hit my second or third 8 count exhale, I can feel the relaxation inject itself into my bloodstream like I'm mainlining tranquility itself. The beauty of using this technique to cope with anxiety is that it's not an obvious one. You don't look like some tool sitting cross legged, touching your belly button, and exhaling ahhhhhhhhh with every outbreath. You can look like a tool on your own time. When you are in the middle of a coffee shop and you feel the monster creeping up, you don't want to worry about looking like a tool. You can use 4-7-8 without anyone else knowing. If anyone is looking at you close enough to notice that you are using a breathing pattern, then they are creepy and you should probably back away slowly. The elaboration likelihood model proposes that a persuasive message can influence attitudes by two different routes, depending on a person's motivation and ability to think carefully about the message. When people are motivated to think carefully about the message, they take the central route, basing their attitudes on argument strength. If people are less motivated, they take the peripheral route, basing their attitudes on emotional and other such cues. When people have the mental resources to think carefully about the message, they take the central route. If people are cognitively busy, they take the peripheral route. Persistence Attitude change produced by central-route processing is more durable and resistant to other influences than change produced by peripheral-route processing. Characteristics of the Source Learning Outcomes Identify the factors that influence who best delivers a message persuasively. Interventions Once the therapeutic goals have been set, there remains the question of how they are to be achieved.

For this, a behavioral therapist will suggest certain therapeutic techniques - interventions. These are often tailored for specific problems, like for example, exposure and response prevention for the treatment of OCD, or worry exposure if someone suffers from a generalized anxiety disorder. The CBT classics, that you will meet most often, you already know by now: confrontation of anxiety-provoking stimuli, cognitive restructuring, training of social skills, relaxation and mindfulness exercises. But this is only the tip of the iceberg. Let's have a brief look at some of the things with which therapists came up in the last 50 years. Implosion is flooding, but with one difference: the phobic situation is only confronted in the fantasy. The imagined scene is drastically enhanced, so there's not only a spider shower, but it's more akin to I'm a Celebrity. Get Me Out of Here! Don't forget that this takes practice. The only reason that I can give myself a quick shot of relaxation in the middle of a stressful situation is that my body and mind have been trained to do so. You need to practice this often in non-stressful situations. When you are at home by yourself, right before you go to bed, in the car on the way to work. My suggestion when starting out is to practice this at least three times per week. Here's what a typical practice session looks like for me: I lie down on the couch and close my eyes. I let myself breathe normally for a few seconds and just notice the rate that I am naturally breathing. I feel the rise and fall of my chest as I start to slow my breathing down. Before jumping into the 4-7-8, I will usually do a few sets of 4-4-4 just to get in the mood. Then I will start my 4-7-8s and do this for as few as 5 minutes or as long as 15 minutes. Describe why persuasive impact can change over time. What's most important is: what gets the job done.

I don't think that the Democratic Party has a monopoly on good ideas. I think that the Republicans have a lot to offer. And what I will do is listen and learn from my Republican colleagues, and any time they can make a case that this is something that would be good for the American people, just because Democrats didn't think of it, and Republicans are promoting it, that's not a good reason not to do it. If somebody presents to me a plan that they are ideologically wedded to, but they can't persuade me that this will actually be good for the economy, then we're not going to do it. Then President-elect Barack Obama made this remark when asked about his willingness to incorporate ideas offered by the Republican Party into his plan for improving the U. And technically he is correct: Logic suggests that a good argument should be persuasive, regardless of who delivers it. Although this view is admirable, messages delivered by likable, attractive, powerful, and famous sources are more often met with approval than the same messages delivered by sources lacking these characteristics (Chaiken, 1979, 1980; French & Raven, 1959; The enhancement is the compensation for the fact that you can do this exercise while comfortably sitting on the chair in the therapist's office. THOUGHT STOPPING Technique for interrupting rumination. Clap your hands and shout Stop! Experts don't have to shout anymore, but stop themselves just by visualizing a Stop-sign. METACOGNITIVE TRAINING Made in Germany: classical cognitive therapy under a new trendy name. Metacognitive means thinking about the thinking. The special target audience: patients with psychosis or depression. PROBLEM-SOLVING THERAPY Try not to stress yourself out about the particulars. Don't make it an unpleasant experience, because then you will start to resent it.

Breathing is your friend. Remember that whole beating your brain into submission thing from before? Well the same thing applies here. Your body is going to resist you at first. You're going to feel like this is the most boring damn thing in the world and that you could really spend your time more effectively. Your mind will race and relaxation won't come easily. That's okay. Keep practicing. Whittler & Spira, 2002). Former President Barack Obama claimed at the beginning of his first term that he can be persuaded equally by Democrats and Republicans if the ideas are good. Research on persuasion suggests that it is often not this simple. How the message is delivered matters, too. Potential employers were more interested in hiring a job candidate when they heard, rather than read, a brief pitch by the candidate even though the content of the pitch was the same (Schroeder & Eply, 2015). Keep this in mind the next time you're applying for jobs. Even those brief elevator conversations can help convey a more thoughtful and intelligent person than can the written word. Communicator Credibility Messages are especially persuasive when they are delivered by a person (or a group) perceived to have source credibility--that is, someone who is both expert and trustworthy. Consider a study by Hovland and Weiss (1951). This is a kind of guided brainstorming about how an undesired as-is state could possibly be transformed into a desired should-be state. For the therapist, this can become hectic - he or she stands at the flipchart and has to quickly write down all the voiced ideas.

ASSOCIATION SPLITTING Another German thing - a relatively new technique for treating OCD. The aim is to weaken mental association chains like red - blood - HIV by training the brain for new, harmless associations such as red - love or blood - orange. This is done by reading those word connections over and over again, and visualizing them. SYMPTOM PRESCRIPTION Also called paradoxical intervention or reverse psychology. The therapist directs a patient to perform the problematic behavior. For example, students with procrastination issues are not allowed to learn at specific times. Once you forge those pathways and develop that muscle memory just like the basketball free throws, it will come so much more easily. This means that when you are first trying to learn a breathing technique, you need to put in a lot of work and practice as often as you can. Once you start to get the hang of it, you can back off a bit and just do some maintenance training every once in a while. I hope that once you learn this skill, you never have to use it during a panic attack or something. I really do. But if you do find yourself in that situation, believe me when I say that you will be thanking your past self for practicing when you did. The last thing I want to mention about breathing is another resource that is available for when you have a few minutes to really focus on your relaxation. There are a lot of great guided relaxations out there that walk you through different steps designed to bring you into a state of calm and relaxation. Guided relaxations (or guided meditations) can come in several forms including text, audio, or video. There are tons of great free ones on Youtube or through apps on your phone. Participants read articles that advocated various positions on different issues. For example, one article advocated that antihistamine drugs should be sold without a doctor's prescription.

Setting your own goals and making them public

After quitting the horror job with permanent overtime and a devilish boss, quite a few people with depression recovered even without undergoing cognitive restructuring or some other CBT magic. Therapy goals A special feature of behavioral therapy is the definition of specific goals. When a therapist asks a patient in the first session about his or her wished-for therapy results, the answers are often: better sleep, no more anxiety or greater self-esteem - very plausible things. However, in his sweetest fantasies, the behavioral therapist dreams about answers like this one: In behavioral therapy, goals are considered as good, when they are precise, achievable, reaching them depends only on yourself, and the progress is measurable. Good: precise, measurable, and under the own control. The desired outcome: being less anxious in the future. That's because you suck at breathing. Let me teach you how to suck less. The reason you haven't been able to simply breathe your way out of a panic attack is because you haven't effectively practiced breathing. Practice breathing? Imagine that you are playing basketball. In fact, imagine that you are on an NBA team playing in front of a ginormous crowd. Pretty sweet, right? It is until you get fouled and have to step up to the free throw line and remember that you never practiced free throws during training. Now that the heat is on and you don't have that bionic muscle memory that most professional players have, you sure as hell aren't going to be very consistent in your shots. Breathing is the same way. While they listened to the message, participants repeatedly were asked to record the location of an X which appeared at various spots on a screen in front of them. For some participants, the Xs flashed every 15 seconds.

You can imagine that this would be mildly distracting. But other participants had to identify the X every 5 seconds--very distracting. As you can see in FIGURE 8. But participants who were highly distracted were less influenced by the strength of the argument and generally saw the tuition cut as a good idea. The Effects of Distraction on Persuasion In this study, people who were only mildly distracted were persuaded through the central route; But being highly distracted switched them to the peripheral route, and their agreement with the proposal was unaffected by the strength of the argument. A vertical bar graph corelates argument strength with level of distraction of the participants, with vertical axis labeled as Agreement with argument for tuition cut ranging from negative 2 to 1. Being happy unfortunately isn't a thing that's directly under the own control, but can only be achieved indirectly. However, what would have to change in life to make one feel better? Good: a cognitive goal, where it's about changing the usual automatic thinking. Although, it might be more difficult here to measure the progress as in the case of behavioral goals, it is quite typical for CBT. The problem with this goal is not your gigantic nose. It's the unfortunate fact that you only have direct control over your own behavior, but not over the feelings you evoke in others. But how about another goal: getting better at making contact with women, and being able to act assertively? Good: precise goal, with the progress being measurable. Well, whether this is a realistic goal or not may be debatable. There are mothers out there, who would make even Buddha himself freak out. I want you to think of breathing as a tool that you have in your tool belt. In order to effectively use that tool under pressure (like a panic attack), you need to first practice under non-stressful conditions.

Then you keep practicing until it becomes second nature, and you can press that big shiny relaxation button at a moment's notice. Once you achieve that level of comfort and mastery with deep breathing, you will have added another awesome weapon to your anxiety slaying armory. While it probably won't solve the root of your anxiety symptoms, it WILL bring you down a couple notches and help you think more clearly. You can also think of it this way: Say you wanted to learn how to shoot a bow and arrow in order to hunt your food. Well, the first time you decide to go out and practice, it probably shouldn't be when a lion is chasing you down. You will likely shoot wildly and miss your target. If instead you practice your shooting intentionally over time on other objects, you are much more likely to hit that lion exactly where you want to when it does show up. What kind of breathing am I talking about? The graph for participants mildly distracted shows magnitude of blue box ranging from 0 to slightly below 1 while the magnitude of red bar ranges from 0 to slightly above negative 1. Why It Matters Why does it matter which route people take if either one can lead them to change their attitudes? Compared with attitudes formed through the peripheral route, attitudes formed through the central route are stronger--more durable and resistant to contrary information and more likely to determine how people behave (Chaiken, 1980; Petty & Cacioppo, 1986). Think about it: If you form an attitude through the central route, you are elaborating on the arguments relevant to the issue, rehearsing them in your head, and considering them in light of other evidence. The resulting attitude is therefore more likely to be supported by a range of knowledge. This means the attitude is likely to remain in your memory even if one piece of evidence in support of that attitude is forgotten or contradicted by other evidence. Attitudes formed through the peripheral route, in contrast, are usually supported by a single, simple association or inference (My favorite celebrity uses this product, so I do, too) and therefore may decay over time. For example, in one study students were presented with a proposal to require psychology majors to participate in research. Why not plan something a little easier first? In his office, a behavioral therapist is confronted with all kinds of different issues.

Sometimes, there comes a wife who basically just wants to rant about her husband, or a husband who basically just wants to rant about his wife. Those people often hope for nothing more than an official confirmation from the expert, that their partner is completely nuts. Every now and then, men show up who recently cheated on their girlfriends, got caught, and were forced by their partners to go to a psychotherapist. Here, the interest in other women is expected to get exorcised, and the cheater to be transformed into a loyal male. However, the motivation for undergoing psychotherapeutic treatment is mostly exclusively on the side of the betrayed. In many cases, there's a desperate guy sitting nervously on his chair, whose face silently expresses the unmistakable message: Help me! Please let me go, friend! There indeed are many instances, where behavioral therapy may not be the best solution to a problem. There are approximately one zillion different kinds of breathing exercises out there (seriously, google it). All of the different techniques have their own merits and most of the ones that I have tried are effective. There's no mystic voodoo here. In my opinion, there are basically two main components that make breathing exercises effective. The first one is obvious; The other is that they trick you into focusing on something other than your sense of impending doom. This sort of breathing is effortful, and if you are trying to keep track of how you are breathing, it is going to help take your mind off of flipping out. Here's one that is quick and dirty, but works wonders for me. It's called 4-7-8 breathing. I don't even remember where I learned this one, but it's come to my rescue for many a close call. Thus, attitudes formed through the central and the peripheral routes to persuasion might be equally favorable or unfavorable immediately following a persuasive message, but which route was used influences whether a change in attitude persists over time. To sum up, following the central or the peripheral route to persuasion orients people toward different aspects of a persuasive message.

We've looked at some of those aspects, such as the attractiveness of a celebrity. Next we consider those aspects in more detail, grouping them into three categories: who says what to whom. First, we'll see how attitudes are influenced by characteristics of the individual or group communicating the message (the who, or source). Then we'll look at the characteristics of the message itself (the what). Finally, we'll consider characteristics of the person or group receiving the message (whom, or the audience). The person or group communicating a message. The person or group receiving a message. SECTION REVIEW Elaboration Likelihood Model: Central and Peripheral Routes to Persuasion The punishment for the Tinder affair with Maria: off to the expert for crazy behavior! Why couldn't it just have been a simple slap in the face? There also exist people who have great difficulties in defining a precise goal for their psychotherapy. In such cases, therapists like to ask the miracle question. It goes like this: Imagine that a fairy comes at night and performs a miracle. By this, the psychic problem, that led you to this psychotherapeutic office, was dissolved. However, you didn't notice it because you were asleep. The next day: what are the things that make you realize that your problem has disappeared? If things go well, then this question inspires people to develop ideas for worthwhile changes in their lives. However, if the answer is I realize the miracle by not needing a therapist anymore, then the question didn't bring much progress. I hope you can count, because that's all you have to do for this one. Breathe in for 4 counts (you can count faster or slower depending on comfort), hold that breath for 7, and then release for 8.

Regular meetings with an accountability partner

Magnesium 20 25 Calories 2,000 2,500 Total Fat Less than 65 grams 80 grams Fat Less than 20 grams 25 grams Cholesterol Less than 300 milligrams 300 milligrams Sodium Less than 2,400 milligrams 2,400 milligrams Potassium 3,500 milligrams 3,500 milligrams Total carbohydrate 300 grams 375 grams What originally caused this time-consuming obsessive urge to count all things on the street in Mrs. X, because of which, she always comes much too late to her appointments? Trying to reconstruct something like this is like having a difficult crime case to solve. Detective Columbo always looks for three things in his murder cases: the motive, the opportunity, and the method. The behavioral therapist also looks for three things: the disposition, the trigger, and the maintenance. Besides genetics, it's about the question, which life experiences had a very strong influence on a person, so that he or she later developed a psychic disorder. In CBT, the focus usually is on central beliefs that were the consequence of those past occurrences. For example, the belief I must never say `no' to a request, otherwise I'm a terrible egoist, can lead to living a very stressful life. Those who rigorously follow such an idea are often exploited and overwhelmed with the fulfillment of countless requests - with burnout being a common result. The analysis of the biography now either reveals crucial events which may function as a plausible explanation for this absolutist thinking - or not. Feeling of choking Chills or hot flashes

I bet you've felt a few of those suckers before. Maybe you've even had a panic attack, which is basically when you have intense fear plus a few of those symptoms, and it pops up all of the sudden and prevents you from functioning normally. Panic attacks and physical anxiety symptoms in general are scary as hell. I don't get to that point often, but I have been there before and I've seen it occur in others countless times. When you have a panic attack, it feels like you are going to die. You might even webMD yourself (never webMD yourself) and find that your symptom profile is strikingly similar to a heart attack. I bet that realization did wonders for your anxiety. Here's the thing, though. Dietary fiber 25 grams 30 grams Of course, sometimes people do think more deeply. If Jill had been faced with the same choice, her deeper commitment to healthy eating might have led her to spend the time and effort to scrutinize the nutritional labels to make a more informed decision through central route processing. People who are highly motivated in a topic concentrate more attention on the quality of an argument, or pros and cons for one product over another. An influential study by Rich Petty and colleagues (1983) shows us how a message's relevance to people's goals influences which persuasion route they take. Participants took part in a study on consumer attitudes. They were told that, as a reward for participating, they would be able to choose a product from among a few different brands at the end of the study. Some participants were told they could choose from among different brands of razor blades; Later, when all participants were asked to flip through some ads, they came upon an ad for Edge razor blades. You can imagine that this ad was relevant for participants expecting to choose a brand of razor blades but not for those expecting to choose a toothpaste brand. If not, then the behavioral therapist may take all those little information snippets, form them into a creative story, and hope that no one will ask too many critical questions. Trigger means the critical event that directly starts a symptomatology.

In some cases, it's not very difficult to identify, such as when a person barely survives a plane crash, and afterwards develops symptoms of post-traumatic stress disorder (PTSD). Such a causation usually seems plausible to most people. But unfortunately, these things are rarely that obvious. Let's take people who suddenly get panic attacks on a regular basis - seemingly out of nowhere. This is a very common phenomenon, and it always raises the question: why is this happening at this exact point in time, and not 2 weeks earlier or a year ago? What is the immediate trigger? In most of these cases, neither a plane crash nor any other traumatic event preceded this. The common answer of CBT to this mystery may seem a bit disappointing and general - it's: accumulation of stress factors. I know it hurts, I know it sucks and it feels like you are going to die, but you will not. People don't die from panic attacks. It just doesn't happen. Your body is a dick, but it's not going to let you self-destruct like that. Even though the emotional pain and physical discomfort may be quite unbearable, anxiety will not physically hurt you. Now that we've gotten that out on the table, we can pack up and go home right? Problem solved? Probably not. Realizing that you are experiencing symptoms of panic and not having a legitimate medical emergency can help to bring down your stress level a little and it might stop you from needlessly calling the ambulance, but it still sucks really bad. That's okay, there's still more that we can do to help. The researchers introduced two other variables. First, half the participants read strong arguments for the Edge razor's quality, such as Special chemically formulated coating eliminates nicks and cuts and prevents rusting.

The other half read weak arguments, such as Designed with the bathroom in mind. Second, one version of the ad featured an attractive celebrity endorsing the Edge razor, whereas the other version featured anonymous, average-looking people endorsing it. What influenced participants' attitudes toward the Edge razor? When participants expected to choose a razor later on--that is, when the Edge ad was relevant to their decision--the most influential factor was the strength of the ad's arguments for the Edge brand's quality. If the arguments were weak, participants disliked the Edge razor; But a very different picture emerged among the participants who did not expect to choose a razor--that is, those to whom the ad was not relevant. They were not influenced by whether the ad's arguments were strong or weak. Instead, their attitudes were influenced by the spokesperson: They liked the Edge brand if it was endorsed by an attractive celebrity spokesperson but not when it was endorsed by the average Joe. And if there should come a person with panic attacks, who actually lives a very calm and stressless life, then a certain explanation for this can sometimes be heard in CBT offices, that (for the convenience of the therapist) cannot be disproved: unconscious stress. The next question is: why do psychic disorders not simply go away by themselves, but persist for months or even years? A few things that maintain such problems - from a CBT point of view - you have already encountered. Depression: social isolation and passivity, which leads to a lack of positive reinforcement. Social skills deficits, which makes contact to other people troublesome and unsatisfying. Self-harming automatic thoughts, which causes events to be seen in a negative light. Anxiety: avoidance and security behavior, which prevents the observation that specific things are not as dangerous as they subjectively appear. In most cases, however, the reinforcement of symptoms must be determined individually to find the maintaining factor. So, what exactly makes it so hard for the anorexic girl to eat a blueberry muffin? What is the gain of refusing to eat and losing weight? I'm going to tell you something really important here and I want you to memorize it. Symptoms of panic are fundamentally incompatible with deep breathing.

Let me say that again. Symptoms of panic are fundamentally incompatible with deep breathing. What I'm trying I say is that the process of breathing deeply, focusing your mind on your breath, and taking in a larger amount of oxygen will start to break down those physiological symptoms of anxiety. Imagine that your anxiety symptoms are a raging fire. Deep breathing is like turning on the sprinklers. The fire might continue to smolder, but it's definitely not going to be raging anymore. The last time you were freaking the hell out due to anxiety and you were in the presence of someone else who told you, Breathe. Just breathe, you probably felt like punching them in the face, right? Note, though, that among people who were motivated to think carefully about the message, the attractiveness of the spokesperson did not influence attitudes: People taking the central route to persuasion are not impressed by those kinds of peripheral cues. Ability to Think Let's revisit Jill, who is now contemplating buying a new computer and comes across a relevant commerical. Other things being equal, Jill will be motivated to think about the commercial's central arguments because they are relevant to her goal of purchasing a new computer. But of course things are not always equal: Perhaps Jill is watching the commercial while she is hungry, hung over, or bombarded with the sounds of a nearby construction site. According to the ELM, even if people are motivated to think carefully about a message, they may be unable to do so because of distractions and other demands on their attention. Under these conditions, people will tend to take the peripheral route to persuasion. This is demonstrated in another study by Petty and colleagues (1976). Participants listened to a recorded message arguing that the tuition at their university should be cut in half. Participants heard either strong arguments (such as The currently high tuition prevents high school students from going to college) or weak arguments (Cutting tuition would lead to increased class size). Those motives are usually more complex than just being thin and looking pretty. One additional thing is also true: sometimes, symptoms unexpectedly just dissolve.

A specific goal you set together with your coach

Much better. It is important to evaluate the likelihood of each of your alternate possibilities. Sure, you can plug in the B that you're going to suddenly going to win a zillion dollars, but that's not really going to change your mood too much unless the percentage likelihood of that actually occurring is at least moderately high. The beauty of this process is that much of the time, our beliefs that lead to anxiety (or depression for that matter) are distorted and off base. At the very least, they are hugely magnified versions of the real thing. I encourage you to try this process out with your own ABCs. Be a scientist and develop a few alternative hypotheses. What else could be true about the situation that might not be as upsetting? Potassium 3,500 milligrams 3,500 milligrams Total carbohydrate 300 grams 375 grams Dietary fiber 25 grams 30 grams Nutritional Facts Kellogg's Raisin Bran Serving Size 1 cup (59 grams) Amount per serving Cereal With half cup skim milk Calories 190 230 Calories from fat 10 10 Percentage daily value Total fat (1. In most cases, it's questionnaires about the individual biography, somatic and psychic symptoms, objects and places that trigger anxiety, frequency and intensity of problematic behavior, or the personal belief system. For example, in the last category you may be asked how much you agree to statements like Asking a question is a sign of inferiority or It's possible to earn the respect of others even without having any special talents.

A very popular test is the Beck Depression Inventory (BDI-II), which asks you about the extent to which 21 depressive symptoms (such as self-hate) have been present within the last 2 weeks. If you scored 50 points at the start of the therapy, and three months later the score is down to 3 points, then a behavioral therapist may draw the conclusion that you are feeling better now. But hopefully, your therapist doesn't need the help of a questionnaire to recognize this. For the diagnosis of personality disorders, many cognitive behavioral therapists like to use a test called SCID-II. This Structured Clinical Interview for DSM-IV Axis II is based on the older DSM, but is still widely used worldwide. Your task is to answer 117 questions like Do you often find yourself `coming on' to people? There are interesting differences in the languages: the German version of this question is about if you like to dress sexy even when only going to work or to the grocery store. But don't worry if you should heavily agree to this. In other words, how can you replace that bitch of B with something more realistic and less self-sabotaging? This may seem simple, but trust me when I say that it takes some practice and that when it is used consistently, it's a crazy powerful tool. The trick is repetition. You need to use this technique so many times that it seeps into your bones. When you first start doing this, it serves as more of an intellectual exercise. The brain a nifty organ, but it's also a lazy ass one. It is great at learning new skills, grouping large bits of information, and forging new pathways. Once it's built those synaptic shortcuts, though, it can't be bothered to listen to your silly notions of change and progress. This means that you really have to beat it into submission. You need to say, Hey, asshole. Saturated fat (0 gram) 0 0 Trans fat (0 gram)

Polyunsaturated fat (0. Monounsaturated fat (0. Cholesterol (0 milligram) 0 0 Sodium (210 milligram) 9 12 Potassium (390 milligrams) 11 17 Total Carbohydrate (46 grams) 15 17 Dietary fiber (7 grams) 28 28 Sugar (18 grams) In order to be suspected of having a histrionic personality disorder, more statements of this kind must be agreed to. Furthermore, this self-report is only the first step in the whole diagnostics - it is followed by an interview, in which all yes answers are checked as to whether a personality disorder criterion really has been met. The crucial point here is the large room for interpretation. The coming on / sexy outfit - questions both aim at the criterion inappropriate sexual, seductive or provocative behavior when interacting with others. What kind of cleavage was a sign for a pathological tendency to seduction will be judged very differently from therapist to therapist. The diagnosis of personality disorders has a high degree of subjectivity, despite having defined criteria. Diverging diagnoses regularly occur. There are countless different psychodiagnostic tests, some of which are surprisingly expensive and cost more than 1000Euro. Their usage differs greatly among cognitive behavioral therapists. Some will give you such a big pile of paper that you will need a whole afternoon to fill it all out, while others never use any questionnaires and simply ask directly what they want to know. I don't care if you want to or not. We are going to keep thinking this way until you get the hang of it.

Once you force feed it knowledge like that consistently over time, you will internalize the process and apply it to your life instantly without even realizing it. Real change can happen using this technique, I promise. So here's the thing. This technique is effective, but not it's not perfect for everyone. We are all different and for some of us, our anxiety is not cognitively driven (driven by thoughts), but it is somatically (physically) driven. What good is working through the ABCs if you can't even identify any particular activating event? Sometimes your heart and mind seem to start racing for no apparent reason and you are left sitting in the parking lot trying to cool your damn jets before you can even get out of the car. If you are like that, then this next article is for you. Protein (5 grams) Vitamin A 10 15 Vitamin C 0 0 Calcium 2 15 Vitamin D 10 25 Thiamin 25 30 Riboflavin 25 35 Niacin 25 25 Vitamin B 6 25 25 Folic Acid 25 25 The question why? Once a diagnosis has been made, the next topic of interest is usually the question: Why do I have this psychic disorder?

A very general answer exists, that is often given when no other is at hand: the biopsychosocial model. The basic idea here is that a mental illness is the consequence of several negative factors coming together. Bio = physical factors, such as genetic vulnerability, damage to the brain, hormonal disturbances, etc Psycho = mental factors, such as personality, belief system, automatic dysfunctional thoughts, inner conflicts, etc Social = environmental factors, such as family relationships, social integration, traumatic experiences, etc But technically, this model doesn't really provide an explanation about how psychic disorders develop. It only states that all sorts of things could be relevant, and that there are probably multiple ways by which it might happen. But how exactly? If you thought your mind had a monopoly on screwing you over, you were sorely mistaken. Your body seems to be in cahoots with the boss upstairs and has its very own contributions to that lovely beast we call anxiety. Don't worry if you are one of those lucky people who seem to have anxiety that is primarily driven by physical symptoms. You're not S. We just need to approach things a little differently. Physical anxiety symptoms vary from person to person, but there are some that tend to be pretty consistent: Pounding heartbeat Shortness of breath or hyperventilation Sour stomach Feeling of pressure on chest Vitamin B 12 25 35 Phosphorous 20 30

A 30-day challenge of any kind

ADDITIONAL SYMPTOMS Loss of confidence and self-esteem. Unreasonable feelings of self-reproach or excessive and inappropriate guilt. Recurrent thoughts of death or suicide, or any suicidal behavior. Complaints or evidence of diminished ability to think or concentrate, such as indecisiveness or vacillation. Change in psychomotor activity, with agitation or retardation (either subjective or objective). Sleep disturbance of any type. Change in appetite (decrease or increase) with corresponding weight change). Well, that is exactly what you should be wondering, because that is what we need to fill into the B section: our thoughts about the situation. In my example, this friend was someone that has some pretty serious health issues and I thought the bastard was trying to die on me. Let's pull back the curtain a little bit. A = Activating event, B = Beliefs, and C = emotional Consequence. If my friend let me know that we need to talk in a vacuum without any other influences, it would not be a bad thing in and of itself. Unfortunately, that's not how things work and instead, my jerk of a noggin had to interpret the event through the lens of my beliefs about the situation. Since I think that he is calling to tell me that he's dying, I'm sure as hell going to feel pretty crappy. Take a second to look through the cognitive distortions that I defined a little earlier. Can you see any of them that seem similar to my beliefs in this situation? I'm definitely engaging in a little bit of fortune telling. Calories 120 160 Calories from fat 10 10

Percentage daily value Total fat (1. Saturated fat (0 gram) 0 0 Trans fat (0 gram) Polyunsaturated fat (0. Monounsaturated fat (0. Cholesterol (0 milligram) 0 0 Sodium (110 milligrams) 5 8 The severity of a depression (mild, moderate, severe) is then determined by the total number of symptoms, with a special focus on the number of core symptoms. In addition, some exclusion criteria must be taken into account, such as whether there are also episodes of abnormally heightened mood, a brain disease exists, or the person recently consumed any drugs. Finally, how often the depressive episodes occur is observed, as well as how long they usually last. When the diagnostician has all this information, he can use it to make a diagnosis. Or he may come to the conclusion that the analyzed person does not meet the criteria for any psychiatric diagnosis. Behavioral therapists also like to use psychological tests in their diagnostics. Unfortunately, the entertainment value of those is usually far below the tests of other therapy schools. One of the things you will probably never encounter in a CBT office is the famous Rorschach test. Here, your task would have been to say what you see within this strange thing in the next picture. What is it? I don't know what he is going to tell me, but that's not stopping me from emotionally reacting with stress and anxiety. I'm probably doing a little bit of catastrophizing too, since he's really been in pretty good health lately.

Do the same thing for your Bs. See if you can identify some of those maladaptive thought patterns. I bet you can. I encourage you to write them down as well next to what you wrote in the B section. The next step in using a thought log like this is to challenge your negative thinking patterns. Pretend like you're a lawyer and your brain is on the stand. You get to ask it questions and hopefully reveal that it is guilty of sabotaging your sanity. How are you sure that he wants to tell you that he's dying? Potassium (95 milligrams) 3 8 Total Carbohydrate (27 grams) 9 11 Dietary fiber (3 grams) 13 13 Sugar (6 grams) Protein (3 grams) Vitamin A 10 15 Vitamin C 25 25 Calcium 0 15 Vitamin D 10 25 Thiamin 25 30 The joke answer: an ink blot probably won't earn you much laughter from your diagnostician. The disadvantage of this test is obvious: the correct answers can be found all over the Internet.

With those, even a psychopathic serial killer can disguise himself as the boring average guy. The last picture, by the way, is most commonly seen as being an animal hide on the ground. But don't worry if for you it's a groundhog lying on its back, having mutilated arms and a dragon head coming out of its butt. That doesn't mean there's something wrong with you. While this test in Germany and many other countries is used only rarely, it seems that it is still a big thing in Japan [24]. Another beautiful diagnostic which you unfortunately hardly ever see in a CBT office, is the Rosenzweig Picture-Frustration Test. Here, you look at single cartoons of people in a conflict situation. The speech bubble of one character is already filled in - finding the text for the other person now is the task. Has he ever wanted to talk about other important things? Did you have something that you are working on together that might have hit a snag? Once you develop a few good alternatives to your unhelpful belief, try them on for size. Scratch out your original B and instead put in an alternative. In my case, I can replace, I think he's dying, with, He screwed up on our project and we are back to the drawing board. Does that change anything? Sure it does. Now my C is boiling rage and anger instead of anxiety. Not that much better. Let's try another. Riboflavin 25 35 Niacin 25 25

Vitamin B 6 25 25 Folic Acid 50 50 Vitamin B 12 25 35 Calories 2,000 2,500 Total Fat Less than 65 grams 80 grams Fat Less than 20 grams 25 grams Cholesterol Less than 300 milligrams 300 milligrams Sodium Less than 2,400 milligrams 2,400 milligrams One of the cartoons, for example, shows a couple in front of their car. The man is searching his trouser pockets, while the woman is harshly complaining to him about apparently having lost the keys. What do you want him to answer? Maybe a defensive I'm so sorry! By means of a very complicated scoring procedure, the frustration tolerance of a person is determined. The original set of pictures dates back to the 50s, what makes some situations look a bit outdated. One situation, for example, is about a man in a public telephone box, who gets into trouble because of the telephone exchange making a mistake. If you now want to try out the test yourself, then here's a conflict situation from our times. What do you want the other person to answer? Now let's have a brief look at the tests that you are more likely to see in CBT offices. Maybe he wanted my advice about a new girl that he is seeing, because he knows that my game is hella tight. That actually makes my C transform into positive things like happiness and pride.