Dr. Russ Morfitt – Learn to Live Blog https://blog.learntolive.com Anxiety, CBT & more! Wed, 21 Feb 2024 17:47:38 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.5 https://blog.learntolive.com/wp-content/uploads/2026/03/cropped-LearntoLive_Primary_RGB-Orange-White_Outline-Icon-32x32.png Dr. Russ Morfitt – Learn to Live Blog https://blog.learntolive.com 32 32 Is it time to speak up?  https://blog.learntolive.com/is-it-time-to-speak-up/ Fri, 16 Feb 2024 19:31:24 +0000 https://blog.learntolive.com/?p=3981 How Learn to Live Delivers CBT: Part 11 

How do you handle situations where the other person is doing something that creates problems for you? We all respond in our own ways. Do you find yourself acting like a doormat? Do you become an aggressive bully? Are you someone who stings others from the side so you can’t be discovered? Are you someone who just speaks up? Which one do you think you are most of the time?  

We think it’s good to know how you react when things get hard. This can help you handle tough spots better and have good relationships with other people. Some of our programs offer an assessment that helps you learn your own style of resolving differences with others. Here’s what we find: 

  • 33% report that they are the doormats who feel like they get stepped on far too often. 
  • 4% learn that they are bullies who tend to step on others when they’re upset. 
  • 19% report that they are indirectly stinging others from the side when they’re upset. 
  • 44% speak up for themselves. 

People who let others treat them badly over and over tend to have less healthy and happy lives. The same is true for people who are always aggressive and those who hurt others in sneaky ways. 

There are great reasons why people really benefit from learning how to be direct and upfront in resolving challenges. We built our programs to show people how to be up-front in their communication. This direct style of communication is often called assertiveness. It tends to work the best because, when we speak up directly, people know where we stand and what we really want. And, because we are not trying to hurt anyone deliberately, we don’t unnecessarily make enemies. 

I think it’s important to teach people how to use two different models of assertiveness. These are the three-part and the one-part approaches. The traditional three-part model looks like this: “when you do X, I feel Y, so in the future please do Z.” And that tends to work well when we are engaging with someone who cares about our feelings. 

But what about the situation where the other person isn’t really interested in our feelings? What if your grumpy neighbor consistently blocked your driveway? Would saying “When you block my driveway with your street rod every Friday, I feel hurt and sad. In the future would you please park elsewhere?” How well would that work? There’s a good chance that that person does not really care how we feel. In this case, we suggest the one-part message, “please stop doing X”. With the one-part message we simply ask the neighbor who’s blocking our driveway to please park somewhere else.  

Great! You’ve taken the first step. But what if they still block your driveway? What if they don’t respond at all? Or avoid you? Or make a sarcastic comment? We call this pushback. But there’s good news. Anyone can use the broken record approach. I imagine you can guess how that might work. When they don’t respond or they give unclear responses, you can just repeat your request, even in the same words, until they respond. 

My hope is that if you’ve been feeling squashed like a doormat or you aren’t satisfied with how you’ve been either directly or indirectly aggressive toward others when you don’t like how things are going, that you will consider building some new direct assertiveness skills. It just might be time for you to speak up. 

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Play it safe. You can’t be too careful. https://blog.learntolive.com/play-it-safe-you-cant-be-too-careful/ Fri, 12 Jan 2024 01:05:58 +0000 https://blog.learntolive.com/?p=3956 How Learn to Live Delivers CBT: Part 10

Take a moment and think of the things you do to try to keep yourself from feeling unpleasant emotions. Consider the things you do so you don’t feel too scared, too upset, or too sad. You might think of all those unnecessary things we do to keep us from feeling too troubled as hacks for our emotions. Researchers often call them “safety seeking behaviors.” I just call them “precautions.”

It turns out those precautions can often be a big part of why we stay stuck. We may be stuck in our anxiety, depression, substances, or other challenges. These precautions include things like:

  • Overanalyzing to keep myself from making the wrong decision.
  • Avoiding sharing my opinions in a conversation.
  • Making sure I don’t say something to another person that they might disagree with.
  • Eating half a pan of brownies to food-medicate me from my troubling feelings.

These are some of the things we do to try to feel better. We play it safe so we don’t suffer too much. But in the end, they might just keep us stuck. How does it work? Why do they keep us stuck? Because when we use many of these precautions, we miss the chance to see if the threat was real. If I don’t self-medicate my hurt feelings with alcohol, is there a chance that I will find that my big emotions simply come and go on their own? If I don’t over-censor my words as I talk to my date, is there a chance I’d find that they can accept mistakes and even feel MORE comfortable with me if I am not perfectly polished? If I don’t cover up the shaking when I’m nervous, might the other person feel relieved that they aren’t play it safe and avoid talking about delicate subjects with friends, is there a chance I’ll find that talking about big issues might draw us closer? And if I don’t have a drink prior to dealing with a difficult conversation, might I find that I can deal with emotions that come and go, even the unpleasant ones?

And for someone specifically on a quest to face their fears—of bugs, others’ judgment, their own worries, whatever—letting go of these precautions is often one of the big challenges. The best and most potent fear-facing includes dropping the precautions. I can’t truly face my fears if I know full well that I’m also doing some things to try to keep myself extra safe.

Of course, not everybody plays it too safe. Some are too reckless at times. But for those of us who are too cautious about our feelings, we know who we are. And for us, it just might make sense to do some tests and see if the sky really does fall if we give up some of these precautions.

Maybe the old adage is wrong. And there are times when maybe you can be too careful.

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Why not find out for yourself? https://blog.learntolive.com/why-not-find-out-for-yourself/ Mon, 04 Dec 2023 15:49:00 +0000 https://blog.learntolive.com/?p=3903 How Learn to Live Delivers CBT: Part 9

One of the best ways to find out if what we believe is really true is to check it out, right? Is the pizza place they bragged about really that great? Is that online recipe as tasty as they claim? You might want to find out for yourself.

In our program for people with social anxiety, we help people who think this way: Everyone is looking at me. They don’t think I should be here. They are all talking about me. Or they all think I’m dumb or boring. The program helps people see if those anxious thoughts are true. (Hint: They usually are not!)

Here’s how we encourage them to use the Find Out for Myself process. They choose to look at others in the room they are entering. That means they don’t avoid eye contact like they did in the past. They walk in the restaurant they are passing through and then simply observe. Because some of the scary things we imagine can be directly checked-out.

None of us can really know if others think badly about us. But we often guess they do. People who worry a lot think things are risky unless they see clear proof it’s safe. If you always expect the worst, ask yourself if you really see strong proof that there is danger ahead. Do people who look at you really think bad things and not like you? If they’re not giving mean looks or rolling their eyes, we don’t really have good proof they’re judging us, right?

Just like a scientist

The idea of looking around and gathering facts as we look is based on a simple idea. All of us work like scientists. We start with certain beliefs then gather facts, and check if our beliefs are right as we review those facts. Lastly, we update what we believe based on what we learned as we go through life. But those of us who worry a lot about people find our wrong beliefs never seem to get fixed by new facts. The reason might be that our attention was focused on three things when we were around others:

  1. The physical red flags that might have shown others that we were nervous, like blushing or shaking.
  2. Thinking about all the bad things that might happen. Like picturing the other person judging me right now. We imagine it so clearly, it almost seems like we are watching a movie of it all happening in front of us.
  3. We focus on ways to feel safe from their judgement no matter what. Like “hmmm, how exactly can I say this next thing, so they won’t think I am weird.” Or “How can I pretend I feel okay about myself?” We try to feel safe.

Think about it. If our focus has been only on physical red flags, our minds’ movie screen pictures of people judging us, scenes, and all the ways to feel safe from judgment at all costs, who has our attention NOT been on? It hasn’t been on the real people around us! So we have often failed to notice when others were warm and accepting, or distracted, or when they even seemed to like us. All because our attention was consumed by those three things.

There is great news. Many people struggling with worry about others have been relieved when they start looking around on purpose. They find that they don’t see hard facts that large groups of people are clearly rejecting them. Sure, there is the occasional unkind person out there, but who cares what they think anyway? And they often see smiles, which is nice, or others focused on their own lives, which is good too.

What about you? Are there some beliefs about the world or yourself that hold you back? Is it possible they are not really true? Maybe it’s time to go and find out for yourself.

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Islands of Worry­­—Better than Huge Continents of Worry https://blog.learntolive.com/islands-of-worry-better-than-huge-continents-of-worry/ Thu, 02 Nov 2023 12:50:30 +0000 https://blog.learntolive.com/?p=3908 How Learn to Live Delivers CBT: Part 8

If you tend to worry, you know just how sticky worry can be. Maybe people around you tell you to just let it go. They may tell you to move on. Or they might point out to you just how unnecessary all that worry is. But even though you try, letting go of that worry isn’t easy.

If that’s you, then the idea of Worry Time might be helpful for you. Here’s the idea: even though it seems like worry is voluntary, it isn’t.  Worry doesn’t just show up. In reality, it serves a purpose.  Think about it, why do you worry? We might think we need to worry to be responsible, we worry about A instead of worrying about B. We may worry because we think will come up with a solution for the thing that we’re worried about.

In any case, here’s what worry time might look like. Instead of worrying over a long period of time, I can plan to do it during specific time blocks–say from 7:00 to 7:20 every evening. Then, in between scheduled worry blocks, if I’m tempted to worry about, say, whether or not my kids are going to get sick, I remind myself “just wait, you can just worry about this during your worry time.” Then when 7:00 shows up I give myself permission to worry as much as I want to.

This is not the act of trying NOT to think about something. Studies show that trying to not think about X causes me to think about it many times more. When I suppress certain thoughts, it  usually backfires. But worry time is different. Instead, with worry time, I allow myself to worry but to do it later. I can limit my worry time to scheduled time blocks.

Many people are amazed by the impact of  worry time. They’re surprised that it’s possible to catch themselves starting to worry. When they do, they can defer that worry to their worry time.  And then they’re surprised by the impact on their anxiety. No, it doesn’t serve as a magic carpet ride out of worry land for everyone. But it can be really powerful for many people. And that’s consistent with CBT research.

But what if these are real things I should think about and act on? I just don’t want to think about them all the time. In our Learn to Live Stress, Anxiety and Worry program, we make it clear that it’s OK to use this worry time for actual problem-solving. If someone uses their worry time to think about concerns about, say, their cat’s health, that’s okay. The worry time becomes problem-solving time instead. It still serves the same great benefit. If they felt anxious all day about their cat, reminding themselves “I’ll think about this later, when it’s time” helps. Then they worry less while waiting for the scheduled time.

Now some people are surprised to find that, when worry time shows up, they actually don’t experience significant anxiety. Sometimes they find themselves saying that the thing they were worried about at 11:00 AM doesn’t seem like something worth worrying about during their 3:00 PM worry time. But that’s OK—they can use their worry time for doing something fun, like a rousing game of solitaire.

Whether worry time is filled with worry or not, many find that a small island of worry in the day makes for a much richer life than a whole continent, err, day, filled with worry.

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Catching the Third Wave https://blog.learntolive.com/catching-the-third-wave/ Wed, 06 Sep 2023 19:18:09 +0000 https://blog.learntolive.com/?p=3872 How Learn to Live Delivers CBT: Part 7 

Should we teach mindfulness skills in our programs? We talked about this several years ago when I was writing the initial content for our first program for Social Anxiety. At that time, there was not enough research to support using mindfulness. But soon research on mindfulness began to emerge. Within a few years, there was enough research to show it helps. So we were happy to add it. 

Nowadays, mindfulness is seen as the third wave of CBT. The first wave was behavioral strategies like facing fears. Then cognitive strategies were introduced in the 1960s, 70s, and 80s. Now I make sure we include all three waves in our programs, since all help. 

Mindfulness is based on this idea: We can let worrying thoughts and feelings come and go. We can allow our physical sensations and our impulses to act just come and go.  We don’t have to fight them. This is different from trying to change thoughts, relax tense muscles, or get active to feel better. With mindfulness, we treat thoughts and feelings like background noise. We let them come and go instead of fixing them. Then we each focus on what we truly care about and being the person we want to be. 

We use mindfulness in several programs. For example, we have a strategy called “present awareness.” With nervousness, I might think things will be terrible and feel anxious. I want to stop feeling nervous. With present awareness, it’s alright to feel anxious and have nervous thoughts for a bit. I let the anxious feelings come and go instead of fixing them. Then I focus on what I really wish to do. SO I find myself less consumed by my thoughts and feelings. 

We also include other mindfulness-based strategies in our programs. An example is “crave riding” in our substance use program. It provides a strategy for dealing with the cravings that almost always go with dealing with substance challenges. 

For some people it’s helpful to think of a word picture—it’s like you’re on a boat, and on that boat is a barrel. And out of the barrel comes all kinds of troubling noises. Those noises represent all the sensations, impulses, emotions, and thoughts we all face.  And we can do all kinds of things to try to get rid of the barrel or race to various destinations to settle all the troubles from the barrel. But all that keeps us from going where we really want to go. So, we can decide to let the barrel make its noise and have its drama and we simply point that boat to where we want to go.  

The response from our members has been almost unanimous. By including these mindfulness-based strategies of CBT, people are getting more help in finding solutions that are the best fit for them. And that’s gratifying.  Maybe we can help you catch the third wave. 

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Don’t Even Think About That  https://blog.learntolive.com/dont-even-think-about-that/ Wed, 09 Aug 2023 21:18:10 +0000 https://blog.learntolive.com/?p=3846 How Learn to Live Delivers CBT: Part 6

Many times we hear “Don’t even think about that!” This is to avoid a bad thing happening or feeling troubled. But we know thinking something does not make it happen. That is magical thinking. 

In fact, the opposite is true. Thinking about what we fear can help us become unafraid. This is called imaginal exposure. With it, we think on purpose about things we worry about happening. Some people have used virtual reality to help imagine feared things. Research shows imagining bad outcomes can sometimes work as well as virtual reality. 

We use these strategies in our Stress, Anxiety & Worry program. The “worry facing” tool helps thousands. By thinking over and over about feared outcomes actually happening, people can become less afraid of those outcomes. 

Worry has a purpose. We often use it to try to feel safer. But it often backfires and leaves us more afraid. Our minds think worrying will find solutions. But it just sticks us in fear of the worry itself. 

I’ve seen in my work how imaginal exposure helps when facing real fears is not possible. At Learn to Live, facing imagined fears helps us get past those fears. 

Some positive thinking folks say to never think bad thoughts, only positive ones. They confuse cognitive behavioral therapy (CBT) with positive thinking. CBT is about realistic thinking, not positive thinking. CBT research shows facing feared thoughts and images helps. It is not dangerous. 

The good news is worry facing works if we do it right. We make it D-U-N-E: 

Deliberately 

Uncomfortable  

Using No precautions 

For an Extended time

So a parent can imagine their kid flunking out of school for 30 minutes. A student can imagine classmates thinking they are stupid or boring, making it worse than usual. The key is to become deliberately uncomfortable for an extended time while we face our fears. 

Many Learn to Live strategies are obvious. This one is less obvious but very helpful for many. 

Don’t even think about it? Maybe do the opposite – think about those fears on purpose, over and over! 

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Getting Back Up When You Fall Down https://blog.learntolive.com/getting-back-up-when-you-fall-down/ Tue, 11 Jul 2023 17:25:01 +0000 https://blog.learntolive.com/?p=3815 How Learn to Live Delivers CBT: Part 5

If you fall off the horse, you better get right back on that horse. 

Why do they say that anyway? Have you ever actually fallen off a horse? I have many times. Sometimes it really hurts. But the reason to get back on that horse is because, once you start avoiding that horse, you risk a lifetime of continuing to fear the horse. I also like to say that if it’s a little too scary to immediately get on that horse, you might want to at least try getting on a smaller pony for starters.  

We address fear facing in many of our programs. It is likely the single most impactful thing we can do in response to our fears and anxiety. It’s powerful. Whether we are dealing with fear of places or situations or ideas or others’ judgments, or things we might experience in our bodies. In each case, the most powerful thing we can do is to move closer and closer to the things that we fear.  

Think about a few examples. 

If you have social discomfort, you can face your fear by interacting with other people or entering a room.  You might even make a social blunder on purpose. If you’re afraid to even think about the things that worry you, deliberately thinking about the bad consequences for a long time can be a kind of fear facing. If your substance use has destroyed your relationships and you worry about reconnecting, you can face your fears of spending time with those you have hurt. If you have panic attacks and fear the next one, you can face your fear of the sensations and the places and the activities that scare you. And if you are a perfectionist, you can face your fears by doing things imperfectly even though it’s scary. 

Still don’t want to face your fears?

Every once in a while, I will encounter someone who will say that fear facing doesn’t work. They say they’ve been doing the scary thing for an extended time and are still afraid. So, I offer them this checklist for effective fear facing. It forms the acronym DUNE. 

First, we start with the D in DUNE. It stands for Deliberate. I tell them to ask themselves this question. “Did I deliberately seek out the scary situation?” 

Once they have done that, they can move on. The U stands for Uncomfortable. “Did I feel uncomfortable (necessary for effective fear facing?” 

Next, they ask themselves “Did I do things to try to feel safer and more comfortable in that situation and thereby undermine the fear facing attempt?” This is the N part of DUNE. The N stands for No Precautions. 

Lastly, they ask this question. “Did I stick with it for a long time, long enough to really assess whether the bad things happen and ultimately whether I could handle the fear I felt?” This is the E in DUNE. The E stands for Extended. 

There are few things as exciting as seeing someone stare their fears in the face until they no longer live with that fear. It takes courage and character. So many find it’s really worth it. 

Maybe there is another ride on that horse for you after all. 

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Wait, upon further examination, things look different… https://blog.learntolive.com/wait-upon-further-examination-things-look-different/ Tue, 27 Jun 2023 15:11:58 +0000 https://blog.learntolive.com/?p=3791 How Learn to Live Delivers CBT: Part 4

Thoughts affect our feelings

Around here, we put a lot of consideration into our approach to thoughts. Our cognitive behavioral therapy (CBT) programs include the idea that your cognitions (thoughts) — the C in CBT—affect how we feel and that idea can change our worlds. That realization was central to the cognitive revolution that was led by pioneers like Aaron Beck and Albert Ellis. So, their ideas are integrated into our programs.

To examine our thoughts, we must first identify them. We introduced the sentence stems I created several years ago (e.g., “They might think I’m ___” or “It’s all my fault that___.”).  But sometimes it is possible to identify thoughts from a menu. We do this in our social anxiety, panic, and insomnia programs. Once we know the thought, we can examine it.

Then, our members walk through a series of Socratic questions. Meaning, they ask themselves questions about their thought.

The first group of questions we ask ourselves addresses the question of whether we overestimate the risk of something bad will happen, or if it is true now. So, we start with questions about whether or not our personal history backs this up. For example, we would ask ourselves, “Has this bad thing come true for me before?” And how about the history of others. Has it come true for them? If not, am I jumping to conclusions?

Painting a New Picture

Then we stop and do some mental stretches. We do this as we try to paint a new picture of what might be true now or in the future. I like the idea of imagining it as a visual image. That means doing a cross-modal exercise to break out of our thinking rut. If I had originally imagined that the person who cut me off in traffic did so because they did not respect me (picture #1), I now take time and imagine other pictures that could be true. Perhaps they did not see me (picture #2). Or they were simply rushing to get to the emergency room (picture #3). When I imagine myself painting other pictures that COULD be true, I am forcing myself to be flexible in my thinking. I might quickly see that my original thought was not necessarily true. I might see mindreading or fortune-telling lurking in my thoughts.

By this point, we have made progress in examining whether or not the thought is likely to be true and accurate. Or maybe we began to imagine other less misery-inducing possibilities.

Note to reader here: this process is not about positive thinking. This is not painting a rosy picture and realizing everything is going to be fantastic. Instead, we really are trying to be more reasonable and flexible. So there is a chance I will conclude that things might go poorly because sometimes we really do have car accidents. Sometimes our kids really do get sick or make bad choices. People do get mad at us or judge us. Sometimes we do lose our jobs.

How bad would it really be?

At this point, we pretend for a while that the bad thing really came true, and ask ourselves several questions. So how bad is it, in the scheme of world events, if that driver of the blue SUV—who I will likely never see again—actually does not respect me? I rate it on the continuum between “Okay” and “Not Survivable.” And even if it is a big deal, is there a chance that I can find my way through it? Just like people often find their way through the big difficulties in life. Such as if I really do fail the final test, can I re-take the class?

I then ask myself what the single most important question in this process may be. How could I coach myself through the bad thing? What could I tell myself? Maybe I can learn to remind myself that I’m upset right now about the other driver and their disrespect of me.  But I can also remind myself that this moment will pass. Plus I’ve bounced back from setbacks before. And what about the strong feelings if the bad thing happens? Well maybe I can take a page out of the mindfulness book. Simply let those strong feelings come and go on their own terms. Don’t fight them and don’t insist on feeling good right now.

I could go on and on — there are other good “putting-it-in-perspective” questions like “what would a caring friend say?” or “what would I say to a caring friend?”

At the end, I can button it all up with a new thought to replace my original thought. By the time I get to this point, I might’ve already seen that either it’s not likely to be true or even if it does come true, I can likely see that their judging of me or whatever really doesn’t matter that much to me. For some (like those with OCD), this process is not the answer at all. Good thing there are many other strategies in CBT.  For others, this can be a step forward, one among many. And still for others, it’s life-changing.  For them, it was very good to see just how different things looked, upon further examination.

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When the simplest answer is the most memorable and compelling https://blog.learntolive.com/when-the-simplest-answer-is-the-most-memorable-and-compelling/ Wed, 10 May 2023 00:04:54 +0000 https://blog.learntolive.com/?p=3744 How Learn to Live Delivers CBT: Part 3

When I was working in an inpatient mental health unit, I began an effort to focus groups on evidence-based cognitive behavioral therapy (CBT). We needed a topic that busy nurses could lead on Sunday nights. We picked one that was simple, but very useful: automatic negative thinking traps (ANTs). 

Many group members were new to the concept of ANTs, but I noticed that people remembered it. Even if they forgot everything else, ANTs stuck. 

What ANTs Really Are

ANTs aren’t the same as the emotion-causing thoughts, like I’m going to fail this test or they don’t respect me. They are the categories of problems that we can find in our thoughts. Some people refer to ANTs as automatic negative thoughts. But at Learn to Live we call them automatic negative thinking traps. We do this to avoid confusion with the specific thought.  

We are all familiar with ANTs. We experience them all the time. Here are a few examples: 

  • Fortune-telling—when I think I know what will happen in the future 
  • Mind reading—when I think I know what someone else is thinking or why they did something 
  • Shoulds—when I believe that there is a specific thing I should have said or done…or others should have…like it’s there is a written in stone…and I dwell on that

Identifying ANTs

There are many processes for examining our thoughts, but I have learned that it usually makes sense to start with ANTs. They are just easier to remember. The lightbulb can go on when someone realizes “Wait a second. The thought that I’ve just identified has an ANT in it. I can see the problems with it and I can let go of it.” When that happens, it is a beautiful thing. 

Think about a driver who is feeling stressed about other drivers on the road. They might realize that they were not only mind reading when they thought “Those other drivers disrespect me”. They were falling into disaster-making. Thinking of a stranger’s opinion as a disaster is not useful. Especially when they’ll never see that person again. This same goes for the student who finds themselves doing all or nothing thinking when they suddenly realize that getting a B is not failing. It’s not an A and but it’s also not an F.  And realizing that can be relieving.

Free from Frozen Thoughts

For many people, counting the number of times they catch themselves with ANTs like shoulds or fortune-telling can be useful. When they catch themselves doing those things, they are often able to change to more useful thinking patterns. And with that experience, they can be freed from the thoughts that got them stuck. 

Yes, CBT has many more strategies, but something as simple as ANTs can have great power.

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Breaking Down Emotions and Facing Negative Feelings https://blog.learntolive.com/breaking-down-emotions-and-facing-negative-feelings/ Mon, 03 Apr 2023 15:50:46 +0000 https://blog.learntolive.com/?p=3721 How Learn to Live Delivers CBT: Part 2

Have you ever wondered why you are having a pleasant emotion like happiness or peace? Most have not. We just accept those emotions and move on. But everything changes when we are feeling discouraged, fearful, or angry. I’d like to share with you a CBT strategy that has been helpful to many people who face negative feelings. I call it the STEPP model.

One of the key concepts of cognitive behavioral therapy (CBT) is the idea that our thoughts affect how we feel. Many people struggling with depression or anxiety say that these emotions make them feel stuck. When this happens, they often don’t know what really causes these feelings or what to do about them. The STEPP model is designed to break down your experiences. This will give you a better understanding so you can find ways to help get unstuck in the future.

Emotion – E in STEPP

Let’s start with the orange circle in the middle – the emotion. The question is where does this emotion come from? Many people incorrectly believe their emotions come from a situation, which you see at the far left of the model (the dark rectangle). 

Do you ever ask yourself “Why am I angry right now?” That anger is an emotion. That emotion can be triggered by many different things, such as two co-workers grinning at each other when you walk by. This is known as the situation.  

As you can see from the model, it is more complicated than that. Not every person would have the same emotion in that situation. Some people would feel embarrassed when they saw those co-workers smiling at each other. Others would have no strong emotion. And some might experience the warmth of happiness. 

Thought – T in STEPP

How could the same situation cause such different emotions? Looking at the model, it shows that thought; is in between situation and emotion. These thoughts are often a reminder of a past situation. Or a prediction of things to come.  

If the ‘thought’ was “those two grinning coworkers were laughing at me”, you would clearly feel anger. But if the ‘thought’ was “those smiling coworkers were happy and having a pleasant time,” I might feel my own smile appear. Maybe even feel a bit of happiness. See the difference? 

Developing the STEPP Model

When I developed the STEPP model several years ago, I looked at Albert Ellis’s ABC model, among other models of CBT. The A in the ABC model is for “Antecedent.” Since I am committed to avoiding complex language, antecedent had to go. Other models showed arrows going in both directions between our thoughts and emotions. While there are advantages to these models, I’ve found that with a cleaned up straight model, you can do a lot more. 

Emotion can be broken down into three smaller parts: 

  • The name of the emotion 
  • The physical sensations 
  • The impulses that go with that emotion 

When people have a hard time knowing how to label that emotion they are experiencing, it often helps to first identify the physical sensation and impulse. For example, if my physical sensations are tight muscles and feeling hot, and my impulse is to yell at someone, the emotion is most likely anger. You get the point. 

I wanted to make it easier to identify the thought. Usually, a well-trained CBT therapist would ask individual clients in their office, “What was going through your mind at the time?” Many clinicians can make this kind of questioning work well. However, there is risk of potential confusion. 

The person who walked past the grinning coworkers might say they were thinking “I just wanted to yell at them to go away”. Or maybe they were thinking, “Those two had big grins on their faces.” Those are thoughts, right? They certainly are, but notice that the thought of yelling at them was really an impulse. An impulse is the urge that goes with the emotions–to fight back when angry in this case.

Which Thought Caused My Emotion?

The reference to their big grins was more of a restatement of the situation. This is not a helpful thought that we can later inspect. And certainly not a thought that produced the emotion. To help identify the thought that caused the emotion, I developed something that I call “sentence stems.” 

For each emotion, there are a number of thoughts that are most likely to produce the emotion in question. If I am trying to identify a thought, I can start with the sentence stem. Then personalize it to my situation. Now I have a thought that matches what I was experiencing, that explains my emotion. I will now be able to examine closely in the future.  

Here are a couple examples of sentence stems:  

For anger:

  • ____ did it on purpose. 
  • ____ should not have done that. 
  • ____ did not respect me. 

For anxiety:

  • I might not be able to ____ 
  • They might think ____
  • What if ____

Performance and Precautions – P & P in STEPP

The two Ps in STEPP stand for performance and precaution. Performance are the things I say and do or don’t say and don’t do. Precautions, often called safety behaviors, are the things that I do to try to feel better that ultimately keep me stuck–things like comfort eating, substance use, blocking out my feelings. The fact that my performance does not match my impulses often is evidence that each of us possesses a high level of self-control. Meanwhile our precautions might seem like a way out of our struggles, but they just keep us believing we are unable to take on life’s challenges.

It All Comes Together

When we understand how all these pieces fit together, we can gather strength to handle those troubling emotions. When we look into the thoughts, we can often see that there are more accurate and helpful thoughts that could replace them, so have the opportunity to feel better. On the other hand, we can choose to form a new relationship with those troubling thoughts and learn to let them come and go. 

I hope that you have plenty of pleasant experiences to enjoy freely today. But any of us with strong troubling emotions might see a warm light of hope appear when we see that it was just a thought that was driving those troubling emotions. Sometimes, that is all it takes. 

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