Level IV
Cognitive Methods
Build a more positive self-concept.
More and more evidence is accumulating that positive self-esteem is an antidote
to depression. Examples of helpful action: make more positive self-evaluations
by noting your successes, abilities, good morals, traits, and actions (Homme,
1965; Vasta, 1976). This is especially important for the depressed people who
have a severe internal critic. You must challenge and silence your unreasonable
critic. Also, personal pride comes from believing that your successes are due to
skills and discipline you developed and utilized to meet a challenge. Being
successful because you inherited wealth or a good brain doesn't build the ego as
much as "coming up the hard way."
If a person grew up in a non-rewarding, inattentive family,
he/she may feel like an underdog and have little self-respect. Such people
frequently drift towards "a bad crowd" and become antisocial because they gain
some self-esteem in that way (Kleinke, 1991). They will probably need more than
a shot of self-administered esteem-building cognition; they may need new social
skills, educational-career-life plans, and a different peer environment. It
takes courage to leave friends, especially if they are, for the moment, our only
support system.
It is very important. Evidence suggests that self-esteem
buffers us from the onslaught of anxiety, guilt, depression, shame, criticism
and other internal or external attacks.
Challenge faulty perceptions, irrational ideas, automatic
ideas, faulty conclusions, and excessive guilt. If your "automatic negative
thoughts" slip by too quickly for you to notice (but they still cause sadness),
try starting your search for the negative thoughts at the moment the emotions
occur. Ask yourself, "What was I thinking when I got upset?" Or, "What was my
view of the situation when I started to feel depressed?" These questions and the
answers may help you uncover the well hidden self-blaming antecedent thoughts or
interpretations of the situation. Write down your thoughts, then objectively
ask:
What is the evidence for this idea (that may be causing me to
feel bad)? Is it true?
Is there another way of looking at the situation?
Even if my first thought were correct, is it really as awful
as I feel it is (or is the situation just "lawful" reality)?
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Feeling
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Unreasonable thought
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Reasonable thought
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Self-critical
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I can't do anything right.
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I messed this up, but I can do better.
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I'm rotten
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If they knew me, they'd hate me.
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I'm not all bad; they'd see that.
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I'm odd & ugly
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I'm so tall, I'm a freak
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There are real advantages to being tall.
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I'm lacking...
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I hate being so flat chested.
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I'm a beautiful & good person, so forget it.
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I look old
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My bald head looks awful.
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My brain and personality will hide my baldness.
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I'm stupid
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I'm a terrible speller, I'm ashamed.
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I can't spell but I'm a hell of a mechanic.
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These methods, primarily from Beck and Ellis, involve
detecting very primitive thoughts, checking their accuracy and replacing the
harmful, inaccurate ideas with rational thinking (often based on observations of
what really happens around us). Here are some more specific examples of methods:
Tolerance training (challenging your irrational demands).
Learn that you don't have to get what you want and that you can't always avoid
unwanted outcomes. Challenge the "tyranny of the shoulds" or the "musts."
Examples: "Everybody should like me" (that's impossible!). "I must have a lover"
(learn to enjoy being alone for a while). "They shouldn't lie to me" (they have
their problems). There are reasons for everything; learn them and accept
reality.
"Whether or not it is clear to you, the world is unfolding as
it should."
Challenge false conclusions. The depressed person has been
preprogramd to think negatively and irrationally. This is not a conscious,
intentional effort to come to negative conclusions; it is an automatic process.
You just assume your negative thinking is right because you have always thought
that way and no one has challenged your thinking. Now, you have to be your own
challenger:
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False conclusions
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More reasonable
idea
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I forgot the assignment, I'm irresponsible. (self-blaming)
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A mistake, I'll not do that again.
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John snubbed me, nobody likes me. (over-generalization)
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I'd better talk to John; others like me because I'm so good
to them.
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It's terrible if I can't be an MD. (absolutism)
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What a downer. What is my next choice?
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I'm a nerd, always will be.
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I need some better social skills.
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I failed once, I'll always fail.
(irreversibility)
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I'll learn and practice more next time.
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The teacher is mad because I forgot
to do the paper. (personalization)
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Half the class is doing poorly, not just me.
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After my accident, they'll never trust me. (over reaction)
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One mistake doesn't destroy trust.
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If some relatively minor event (not like death or divorce)
has gotten us down--and we have stayed down too long--we must examine our
conclusions about that event. Remember that depressed people demand too much
sometimes, get obsessed with a loss, blame themselves (no benefit of the doubt),
let events get them down, and don't think they can do anything about the
depression. That is the nature of depression and low self-esteem. They see no
silver lining, no light at the end of the tunnel, no opportunity for growth in
this crisis. They aren't thinking rationally.
Avoid assuming responsibility for bad events and feeling
guilt on and on. Recognize that it is unreasonable to assume that you are
responsible for just the bad things in your life and not the good. Try to reduce
your focus on your faults that may or may not have caused some loss in the past;
instead, focus on your strengths that could improve your future. Likewise, guard
against dwelling on and re-living the bad events and overlooking the good.
Unlike Seligman's dogs, challenge your assumptions that you
are helpless. Acquire Learned Optimism and the courage to "give it a try," and
you are on your way to success, more friends, less depression, and better health
(Seligman, 1991). In all the specific actions for coping with depression,
optimism is important: to some degree, the effectiveness of all anti-depression
methods is a function of how much the user believes in the methods (Kirsch,
Mearns, & Catanzaro, 1990).
Maybe (watch a 1-year-old trying to walk). Certainly
optimistic parents are a fortunate beginning, but even with pessimistic parents
there is hope...(an optimist sees how change is possible). Until we are about 8
years old, we tend to be optimists. By mid-adolescence our thinking style is
either optimistic or pessimistic and it tends to stay that way for the rest of
our lives, unless we are persuaded or choose to change. Hope and self-direction
are critically important factors in the outcome of human lives. Please pay
attention if you are a pessimist. It's hard to become an optimist, requiring
careful attention to every thought. The keys seem to be learning that:
(1) every failure
is an opportunity to learn,
(2) we can
change,
(3) success
depends on effort.
If you do any of the following: set your goals too low,
expect to fail or to be disliked, feel things aren't ever going to go well for
you, believe you just don't have the ability or the personality needed to
succeed, or have other pessimistic thoughts, then you need "learned optimism."
How can you get rid of the negative, defeatist ideas? Well, you might be able to
just ignore the pessimism. But if you have brainwashed yourself well, then you
will have to question the validity of your pessimistic ideas. Most self-putdowns
are wrong, especially in the sense that most people could accomplish a lot more
than they do--they sell themselves short. So, attack those self-destructive
thoughts by deciding to think clearly and objectively, like a wise adult, about
your feelings.
Look carefully at the typical pessimistic message: everything
is terrible, always will be, and I'm to blame. This is close to Murphy's Law:
Whatever can go wrong will. This is harmful, depressing crap you are feeding
yourself! Recognize that these thoughts are a "left over" from an earlier time
when things were going badly or someone was stuffing you with pessimistic
thinking. Times have changed; the situation is different; you can be different.
Rather than "nothing works out for me," how about "I'll try something new
today." Rather than "he didn't want to play tennis with me--no one really likes
me," how about "maybe he was busy," " maybe he isn't very good at tennis," or "
I'll bet he'd like to do a lot of other things with me." For optimism it is
important to have self-esteem and self-efficacy--faith in your ability to change
things based on past experience.
Pessimism provides an important explanation of depression and
learned optimism provides a means of recovery from hopelessness and depression.
In fact, being optimistic has many advantages. A recent book chapter written by
Shatte, Reivich, Gillham & Seligman (1999) describes an experimental depression
prevention program for children (Penn Optimism Program or POP). Depression and
feeling helpless, in part, comes from using certain learned ways of explaining
things. Example: a depressed child tends to blame him/herself for things going
wrong ("I'm so dumb") and sees the cause--his/her dumbness--as stable and
influencing almost everything ("I mess up all the time and always will"). Even
though still self-blaming, the child who says, "I did poorly because I didn't
study enough," is much more optimistic because a change is possible--a solution
is available. An optimistic child often thinks troubles are caused by external
factors which are changeable or avoidable and have limited influence, i.e. "I
can avoid this minor problem." Not uncommonly, the explanations may involve
external but untrue causes ("The teacher has it in for me" or "He meant to hit
me") and need to be changed to more self-responsible thoughts ("I'd get better
grades if I studied" or "Maybe I bumped him."). To start thinking more
optimistically and accurately requires careful attention to and explicit
instructions (from trainers or yourself) concerning the details of one's
thoughts and reasoning. No easy educational/therapeutic/self-help task.
In 12 weeks, the POP 2-hour groups of 10 to 12 depression
at-risk children were taught (a manualized curriculum) to recognize how their
interpretations of the causes of problems lead to their feeling depressed or
optimistic, helpless, angry and so on. Then each child was given "reattribution
training," i.e. they were taught to use an optimistic "explanatory style" rather
than a pessimistic line of reasoning (see Cognitive and Rational-Emotional
methods). In this program, the POP staff taught children to think of many
alternative explanations--both optimistic and pessimistic--of behaviors and,
then, to decide which causes are the more accurate explanations, asking others
for feedback in the process. The training demonstrated that pessimism leads
directly to "catastrophic thinking" about the future. To counter this, the POP
children were asked to write out their predictions of the future ("I'm sad
because my Dad will probably leave") and then check how realistic those
expectations really are (How often do other parents fight? Does that mean they
will divorce? If divorced, does that mean you wouldn't see Dad? Are some kids
happier after divorce?). The children come to see that optimism is a necessary
part of problem-solving too, because in order to find a solution one has to
consider the more relevant, more useable, more powerful ways of influencing the
problem situation. So, the POP program also trained children to identify the
best ways of changing or accepting bad situations... that's realistic optimism.
In conjunction with or in addition to more optimistic
reattribution training, the 5th and 6th graders in POP were taught several
cognitive skills: assertiveness, negotiation, relaxation, anger and sadness
control, how to deal with procrastination, social skills, and decision-making.
The results were impressive. As intended, the 12-week treatment program resulted
in more optimism when compared to a control group. More importantly, only twelve
percent (12%) of the at-risk children in the treatment program had suffered
moderate to severe depression by the end of the 24 month follow-up period.
However, thirty-eight percent (38%) of the untreated matched control group had
suffered depression. Apparently, teaching cognitive methods for increasing
optimism and accuracy in thinking as well as a variety of other coping skills
helps prevent depression. If a 12 week, 2-hour-a-week psychology class can
reduce childhood depression in at-risk children by half or 2/3rds, surely the
world needs to pay attention.
Whenever you have a self-defeating pessimistic thought, ask
yourself these five questions:
(1) Is it
really true that you are helpless in this situation? How certain can you be that
something unavoidable and awful is going to happen? Are you sure you couldn't
get an A in math? Why couldn't you build your own house? What are the real
chances of a catastrophe?
(2) Is
there another way to explain this event? Did he/she leave me for other reasons
rather than my being boring? Find as many possible reasons as you can.
(3) So
what, even if it is partly true? Must it last forever? Must it mess up
everything? Suppose he/she did think you were a little boring, there is a lot
more to it than that. Besides, it won't be hard to become more interesting to
someone else.
(4) Is this
pessimistic idea doing me harm right now? If so, put it aside. Of course, you
must not hastily dismiss every pessimistic idea: it is wise to heed your
negative feelings about many things, such as driving while drunk, getting into a
fight, burning down your house for insurance, etc. In short, simply insist that
the negative idea be rational and useful before it shuts down your life.
(5) What is
the best possible outcome I can hope for in this situation? Logically, what do I
need to do to turn this crisis into an opportunity? Question the rational basis
for your guilt.
Optimists, who try the hardest, believe success depends on
effort, not on innate ability or luck or social class or looks. So, work harder
and become an optimist. Be responsible and become proud.
The depressed person is prone to believe "this bad situation
will never get better," "it will ruin my whole life," and "it's all my fault."
If those views of the situation were accurate, the person has a right to be
depressed. However, these pessimistic views are never accurate.
Changing your explanation of the situation can change your
emotional reactions, obviously. If you shift your attributions so that you see
yourself as less responsible for an unfortunate happening (divorce, failure,
accident, thoughtless inconsiderate act), you should feel less guilty or
depressed. If you change your attributions so that there is more hope of
improving the situation in the future, even though you are held more responsible
for the unwanted situation, you should feel less hopeless and more
self-confident. For example, deciding "I'm going to have to work harder to
succeed" is self-blaming for past failures, but it may be an accurate and
hopeful assessment of the situation because you can work harder.
Likewise, starting to see an unpleasant situation as being
caused by temporary or easily changed causes is hopeful (as compared with
unchangeable causes). Example: "My grades were low because I had the flu... (or)
I tried to study in the living room where there is TV, stereo, and lots of
activity." Also, if the cause of an unwanted situation influences very few other
things (vs. a cause that disrupts almost everything), that is a happier
situation. Example: being six foot seven inches tall may only keep you from
being a fighter pilot but a bad temper may destroy many jobs and relationships.
Finally, depressed people use several attributions that may at first seem
unchangeable (low ability, bad luck, they're against me), but these causes can
be seen as modifiable (learn skills, change luck, avoid or disarm enemies).
There are so many ways to make changes, we should almost never feel powerless.
For practice at changing your attributions (these are old
thought patterns that don't change easily), try listing your weekly successes
and explain them in terms of your personal traits and skills that are rather
permanent and potentially useful in several areas of your life. This also keeps
you from dwelling on your failures. Example: "My grades in math and social
science went up because I learned to get myself organized every day, to enjoy
studying these topics, and to use the SQRRR study method." (See #4 above)
In your ability to make your world better. Sounds simple but
much is involved: you must select some meaningful life goals, then acquire
knowledge, skills, and role models so you can achieve these goals, and finally
exert considerable effort so the achievement of the goals creates pride. Just
saying "I can help myself" is not nearly as impactful as actually changing
yourself (sort of like saying "I care for starving kids" and doing nothing
versus saying "I care" and actually taking a hungry child on your lap and
feeding him/her).
Consider failure to be a sign you need to work harder or need
more practice, rather than proof you are "a failure." Moreover, wise people have
advised "learn from your mistakes" and "make mistakes--lots of mistakes--just
don't make the same mistake twice." If we can take that attitude, i.e. "I'm just
learning to master this situation," we could be much more tolerant of our
failures. We don't have to succeed. Many great people have only made it by
having the courage to face repeated failure: Lincoln, Van Gogh, Frank Lloyd
Wright, Gertrude Stein...
Watch for and change your overly negative, unquestioned,
self-blaming thoughts. Example: "I got a 'C' because I'm stupid" (no, because I
didn't study enough or have good study methods. I can't judge my ability to do
school work until I put my best efforts to an extensive and fair test).
Observe the relationship between your thoughts and mood;
prove that "illogical thoughts cause my depression, not my stupidity, looks, or
badness...and I can change those damned thoughts." Also note expectations and
outcome: if you expect little or nothing of yourself, you'll probably do poorly.
If you expect to do impossibly well, you'll certainly fail. Your ambitions need
to be challenging but realistic.
This is where you claim to have a handicap, perhaps "I'm
sick," "I was up all night," "I have test phobia," "I didn't prepare," "I'm
nervous and shy," "I've had a bad experience," "I'm on medication," etc. These
handicaps are designed to excuse a poor performance (if that is the outcome);
thus, prepared-in-advance handicaps reduce our motivation to do well. It is true
that no one will be able to tell how able or disabled we are as long as there is
no accurate test of our ability. That's the real pay off. But there are costs:
we never get to know ourselves, we are likely to feel inadequate (we know we
haven't tried), and we get little pride from always being handicapped.
If you have no purpose, if you are bored, if you feel
worthless or guilty or irresponsible, you need a guiding, inspiring philosophy
of life. A meaningful life needs to have a purpose that firmly guides what you
do every day. Life's purpose doesn't have to be grandiose or religious, but it
should increase the good in the world and reduce the bad; it should make you
proud. Self-esteem and self-efficacy also involve wanting to learn, mastering
challenges, and developing skills and competencies. Your 2 1/2 pound brain is a
fantastic organ. Don't waste it.
Disappointments could be reduced by lowering your aspirations
and/or just accepting reality ("that's just the way the ball bounced"). See 29b.
Guard against frequent obsessions with personal faults, such as being only
average in intelligence, being small and skinny, being tall, being "ordinary"
looking, having ugly ears, being shy, not catching jokes, and so on. Many of
these worries are not correctable or don't really matter; other worries can be
changed, but they aren't solved by just feeling depressed about the problem.
A deterministic view of how the world operates can make one
more tolerant of oneself, more accepting of others, and more hopeful of the
future. Self-acceptance may also come from a humanistic viewpoint in which each
person is intrinsically respected, valued, and loved. Each human is different
and makes an important unique contribution to the world.
Finding comfort in a religion and acceptance in support
groups has helped many people overcome depression. Every community has several
religious communities. There are many self-help groups (or you can start one).
There are also televangelists, many religious writers, and spiritually oriented
psychologists, such as Jampolsky (1985) and Peck (1993).
Sometimes the heavy weight of today's burden is lightened by
asking: What will life be like next month? in six months? in a year? in five
years? in ten years? All things change. Given a more distant perspective, there
may be less gloom and more hope.
Talk yourself up. As with anger, we can learn to interpose
positive thoughts or self-instructions between the disturbing event and our
emotional reaction so that the sadness is reduced. For instance, suppose you
have just been told by your boy/girlfriend that they want to terminate the
relationship. How can you reduce the pain and depression? The pain can't be
avoided but it may be dulled and shortened a little. Look for positive aspects:
"At least a decision has been made" and "It's good that I found out now about
her/his being unsatisfied, rather than after we were married." Look for your
good points: "I'm proud of how I handled the relationship" and "I didn't try to
just be what he/she wanted; I want someone to love the real me." Look for
support from others: "All my friends will support me; some didn't think he/she
was a good choice for me any way." Look for a positive future: "I will be a
better companion in the future and I know a lot more about what I want in a
relationship."
What seems nasty, painful, or evil, can become a source of
beauty, joy and strength, if faced with an open mind. Every moment is a golden
one for him/her who has the vision to recognize it as such.
-Henry Miller
If a loss can be anticipated (like a death), realistically
facing the situation, discussing it with others, and emotionally "working
through" the loss can reduce the impact. Also, if the loss can be seen as less
personal ("it's not my fault") and less catastrophic, it should be less
depressing and you will probably have a quicker recovery.
Note: obviously some of the behavioral and emotional
suggestions given above are partly cognitive in nature too.
