Cognitive Therapy: Lessons Learned

Alcatraz Prison Cell - Peel and Stick Wall Decal by Wallmonkeys
On a tour of Alcatraz, a former prisoner sat at a table answering questions. He said that those who obsessed about getting out were the ones who “didn’t make it.”

Cognitive Behavioral Therapy (CBT) would have helped those prisoners. Think about it: your thoughts are what determine how you feel. Even if you are in a cell after being captured by terrorists, you’ll be ok if you dwell on happy enough thoughts rather than thoughts of what might become of you or worries about your loved ones.

In my previous post, Two Shrinks, I promised to share what I have learned from cognitive therapy, lessons anyone can apply:

  • Ahead of time, think of something pleasant to recite whenever troubling thoughts plague you, for instance, as you’re trying to fall asleep. I like to list my friends. Not only does thinking of people I love fill me with warmth, but it also helps me drift off, sometimes after only a few names.
  • Getting enough sleep helps keep daytime thoughts from straying to worries. If a new set of worries starts playing in my head when I wake up, or any time of day, I try to remember to “change the channel,” do something else. As soon as I realize I’m lying in bed worrying, I jump up and tune into NPR.
  • Be aware that rumination and obsession are like drugs, in a bad way. They activate the pleasure center of the brain, so the more you obsess, the more you are drawn to obsess. It’s an addiction. If you think about it that way, it can help you realize what’s happening and put the brakes on some of that worry.

  • Assign a time of day to worry. I tell myself that, instead of now, at six o’clock I’ll worry about Casey soon becoming 14 years old; often the clock strikes six and I’m just not in the mood to worry how old my pound hound is getting.
  • If you are worried about an upcoming event, accept it the way you accept a cold. You know it will be unpleasant, but you know it will pass and you’ll feel well again.
  • Lower your expectations when holidays or other high-intensity events draw nigh. Perfection actually equals imperfection. Usually when I lower my expectations, I’m pleasantly surprised.
  • Lighten up on details and share responsibility for decision-making. I’m not planning a wedding, but if I were, I’d want to remember this one!
  • Prioritize your values. If you cut something out of your schedule, you’ll have more space around the other things you do. You will feel less stressed and enjoy everything more. I’ve decided to cut back on hopscotching around the Internet to drive traffic to my blog.
  • A short meditation can help too. In one I recently wrote about, you imagine your thoughts floating by like clouds. I like that idea for worrisome thoughts—I greet them and then we both move on in different directions.
  • Greet a worry when it arrives, then send it somewhere. For example, if you have a persistent worry about an upcoming trip, mentally say to it, “Oh you again, how do you do, now, get into the garbage bag.” Then imagine that bag being hauled off. Studies show that if
Banksy Graffiti Balloon Girl Street Art Print Poster

you simply push negative thoughts away without some acknowledgement, it will make them even more persistent.

  • Try to imagine sending your worries, each time they pop up, into the back of a bus, where you are the driver and they are seated behind you. This puts you in control. (It also conjures up a picture of my travel anxiety sitting next to my bedbug fears, chattering and singing camp songs. Bedbugs are a friend of mine, they resemble Frankenstein . . .  .) Another image is to put your woes into helium balloon and picture them sailing away. (Don’t actually do this with real balloons, as they are bad for birds and other living things.)
  • Realize that it’s not, say, an upcoming event that causes you to worry, it’s your beliefs about what might happen at the event that create your distress. See if you can modify your beliefs. For instance, when I feel blue that I don’t get to see all three of my daughters together often enough, I need to shift my thoughts to how special is the one-on-one time we share. While I’m at it, I think about how grateful I am for any time with my kids, and gratitude has healing power.

Two helpful books you can return to again and again are The Feeling Good Handbook by David D. Burns and Get out of Your Mind and Into Your Life by Steven C. Hayes.

By the way: Many psychotherapists say they have cognitive therapy in their toolboxes; however, that generally is quite different from pure cognitive behavioral therapy.

What techniques do you use to deal with unpleasant thoughts?

So many friends have asked me for these tips for themselves, their friends, families or co-workers. Please share this with anyone you think can benefit.


Confessions of a Worrywart: Husbands, Lovers, Mothers, and Others                                                  Check it out on, Kindle, and Smashwords

The perfect  gift for worrywarts and a compelling read for anyone who would enjoy a “neurotic, hilarious, poignant,” deeply personal story.

“With wit and grit, Susan Orlins inspires you to embrace your anxiety. She tells the stirring, startlingly candid story of one 1986 Chinese adoption, two husbands, two divorces, three daughters, several lovers, countless psychiatrists, and one singular, self-aware, captivating woman.” (culled from Amazon reviews)


See some of my Life Goes Strong articles:



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