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
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