We Can All Use a Little CBT

CBT, or Cognitive Behavioural Therapy, is one of the more established psychotherapeutic modalities that’s been shown to be effective in the treatment of various concerns, including mood disorders, anxiety disorders, and eating disorders, among many others. But CBT isn’t just a treatment for those experiencing psychological distress; we can all use CBT-based practices to enhance our everyday lives.

CBT largely involves exploring our relationship with our thoughts, feelings, and behaviours –reality checks we could all use a healthy dose of from time to time. One exercise that might be particularly useful in our daily grind is to start identifying “cognitive distortions,” or mental habits.

Our brains and our bodies like to be as efficient as possible. We’re built to conserve precious resources. We have a finite amount of energy available for daily expenditure. Something along the same lines as the reasoning behind Steve Jobs wearing the same outfit each day…to cut down on extraneous decision-making mental activity. So our brains become efficient by creating mental shortcuts, or mental habits whichbecome physically reinforced. Neurological pathways that are used most often become stronger and myelinated(i.e. covered with a protective fatty sheath) making them lightening fast (i.e. more subconscious) and more easily activated for super-charged mental habit action. A similar analogy is how our most frequently used muscles become the strongest and most dominant. This allows many of our most common mental actions to become automated (e.g. just how driving a car becomes second nature once we become pros at it). Such mental efficiency is the reason we’re able to accomplish so many wonderful things in a day, but it comes with the downfall of making us susceptible to erroneous thinking. Below is a list of the most common “cognitive distortions” we all do. If you can catch yourself in the act, you can notice when your thinking may be unrealistic in order to come back to a more balanced appraisal of the situation.

  • All-or-nothing thinking (either/or, pass/fail thinking; perfectionism): seeing things as black and white and failing to see grey areas. E.g. using words like “always” and “never” as descriptors.
  • Overgeneralization: making a very broad conclusion based on a single event; expecting the same result to reoccur in future situations. Seeing a single event as a never-ending pattern of defeat.
  • Labeling and mislabeling: Attributing a person’s behaviour to his or her personality or character. E.g. “He cut me off in traffic. He’s a jerk.” “She yelled at me, she must be an angry person.”
  • Mental filter (selective attention): Only focusing on negative aspects of a situation and ignoring possible positives. Only focusing on information that confirms what you already believe. E.g. “I forgot a few of my lines. The whole presentation was a disaster.”
  • Disqualifying the positive: Rejecting positive experiences by insisting they “don’t count” for some reason or another. You maintain a negative belief that is contradicted by your everyday experiences. E.g. “That person is only flattering me because they’re my friend.”
  • Jumping to conclusions: Making hasty assumptions without thoroughly checking the facts.
    • Mind reading: Assuming what other people are thinking (and intending) without really knowing or checking it out. (And/or expecting others to know what you are thinking without clearly telling them).
    • The fortune teller error: Anticipating that things will turn out a certain way and being convinced that your prediction is an already-established fact.
  • Magnification (catastrophizing or minimization): Making things out to be worse than they really are. Magnification of the negative: emphasizing possible weaknesses, failures, and threats. Minimizing the positive: deemphasizing possible successes, strengths, or opportunities.
  • Emotional reasoning: Assuming that your emotions necessarily reflect facts and reality. (E.g. “I feel it, therefore it must be true.”)
  • ‘Should’ statements: Thinking you’re morally obligated to do things. Using “should” and “shouldn’t” statements to motivate behaviour and avoid guilt. “Musts” and “oughts” are also offenders. The emotional consequence is disempowerment and guilt. When you direct should statements towards others, you feel anger, frustration, and resentment.
  • Personalization (or self-centred thinking): Interpreting things as being necessarily and intentionally about you. Over-focusing on oneself and ignoring how events relate to others and the world. Taking things personally without checking them out. Being easily offended. Interpreting most things to be about yourself or personally referring to you.
  • Self-Blaming: Taking too much responsibility for situations you don’t have control over. Seeing yourself as the cause of some external event for which, in fact, you were not primarily responsible.
  • Other-Blaming: Holding others responsible for things done to you that they may not have control over.
  • Double standards: Holding yourself to a different standard than you would apply to someone else.
  • The fallacy of fairness: Expecting that life should always work out fairly.
  • Catastrophization: Over-exaggerating; making something seem worse than it is.

 

*We at Heartfulness Psychotherapy appreciate that CBT isn’t everyone’s cup of tea. We recognize that other approaches can be equally as effective and integrate flexible treatment options into our programs. Different strokes for different folks. 🙂

Why Are Middle Aged Folks Drinking So Much? Observations on Adult ADHD & Addiction

I’ve recently noticed a trend in my office: middle-aged people have been seeking me out because their drinking has become problematic. Their partners have expressed concern and they’re left wondering in bewilderment how it ever got to this point. They’re intelligent, motivated, successful, caring men and women leading generally satisfying lives as partners, parents, and professionals. They may have even seen a therapist or two already in the past in an effort to uncover possible issues from early life difficulties, seemingly to little effect. They wonder how our work together could possibly be any different.

What I’ve noticed is that many of these clients tend to share some commonalities:

  • They bore easily; they’re often restless and on the move
  • They’re energetic and talkative, often dominating the conversation and changing topics, perhaps interrupting frequently
  • They’re forgetful and/or struggle with time management and attending appointments
  • They’re generally quite interesting as they can share a flurry of ideas concurrently*
  • They’re quite intelligent* and high-functioning,* but may have had a history of being disruptive in grade school (and may have developed a complex about frequently being reprimanded*)
  • Perhaps they’ve wondered if they might have some attention deficits, but nothing’s ever come of this consideration or early childhood assessment*
  • They may be quite sensitive*

These characteristics are commonly seen in individuals with Attention Deficit/Hyperactivity Disorder (in addition to other diagnostic criteria). ADHD is frequently identified in young boys who exhibit behavioural disruptions in grade school, but less so in girls who tend to present somewhat differently (likely in part due to differential influences in socialization).

Perhaps parents from previous generations feared medicating their children and/or the stigma that might have accompanied seeking formal psychological assessment and diagnosis. In other cases, high-functioning intelligent children may have kept up with their academics, without much commitment to formal study practices, and thus flew under the radar. For various reasons, some people make it all the way into middle-aged adulthood without ever having their ADHD identified (or symptoms thereof, as it’s possible to experience symptoms on the spectrum without qualifying for a formal diagnosis).

Oftentimes such individuals resort to self-medicating symptoms they didn’t realize they were dealing with by using alcohol and other drugs to help with increased focus, productivity, and to escape the flurry of thoughts they’re so inundated by in order to unwind before bed. When thinking about ADHD, we seldom fully appreciate how exhausting it can be to have to constantly moderate attention away from countless distractions, personal “notes to self,” and new ideas, all within seconds just in time to return to the conversation at hand and appear attentive to the person in front of you! Seeing ADHD in this light helps me understand the high correlation with concurrent addiction.

Many factors contribute to the susceptibility and development of addiction; among them, genetic, psychological, sociological, and existential influences. It is also well known that most cases of addiction tend to correlate with some form of psychological trauma. To this end, addiction is often about self-medicating symptoms of distress. In therapy, while it’s essential to approach addiction from a trauma-sensitive lens, it’s also important to consider possible unidentified mental health concerns –likely also tied to trauma, which may independently perpetuate the cycle of addiction if left unaddressed.

Another important thing to realize is that addictive tendencies are degenerative in nature. Long-term substance abuse can create cumulative health impairments. Addictive tendencies can be progressive as they become ingrained behaviourally and neurologically (i.e. physically reinforced in the brain). As we age, we tend to lose water weight, so substances like alcohol can have greater influence than expected. It’s also easy to lose sight of the fact that substance abuse habits started in youth can subtly escalate over time, as greater tolerance and dependence develops –all of which can contribute to middle-age problem drinking.

If you’re wondering whether your substance use could be an issue, consider:

  • Is it interfering with your relationships and other commitments?
  • Do you continue to ‘use’ despite significant adverse consequences?
  • Is the use compulsive?
  • Do you experience craving and preoccupation?
  • Is it difficult or impossible to control the amount or frequency of use?
  • Have others expressed concern?

Therapy can be helpful in identifying and learning to manage symptoms of addiction and ADHD. Sometimes simply acknowledging such concerns can be a first step that brings considerable relief. If you think you could be affected by similar challenges, reach out to a regulated healthcare professional to see how you could be supported and what options are available.

*Such characteristics are not formally included among the diagnostic criteria, but reflect anecdotal observations I’ve made in working with ADHD.

Nipping Jealousy in the Bud

Jealousy is wanting something someone else has for oneself. It’s usually accompanied by feelings of dissatisfaction, possible resentment, and yearning for the desired thing/person in some cases. It by definition comes out of a place of insecurity and a sense of feeling lacking or not having enough without the desired object of one’s affection. Jealousy becomes problematic when we don’t recognize it for what it is: i.e. a signpost of something that holds some value to us; a beacon pointing us in the direction of an underlying aspiration. Jealousy becomes an issue when we make it more about others when it is really our own journey.

To transform jealous energy into constructive energy, first hear what it’s telling you. What do you feel lacking in? What would you like to acquire or improve upon?

Ask yourself what you need to help you feel more abundant rather than lacking.

Once you have the goal framework in place, set an intention as to how you might achieve the desired outcome. This might require shifting your mindset. Adopting a problem-solving attitude puts you in the driver’s seat, which is more empowering than passively wishing for something to happen. Envision yourself working toward this goal. Mentally imagine what it will feel like once you have it. And remember patience with the process: everyone has their own path and their own pace; some people will meet their goals faster than others and we cannot always get the exact version of what it is we seek, but with patience, tenacity, and listening, we can be headed in the right direction.

CBT in the Treatment of Chronic Pain

Cognitive Behavioural Therapy (CBT) is one of the leading psychotherapies used to address chronic pain, and there’s good reason why. CBT explores clients’ underlying thought, behavioural, and emotional patterns, the relationship between them, and associated environmental circumstances that might sustain symptoms of distress. It encourages clients to develop new skills to change unhealthy ingrained patterns to in turn change their symptoms. CBT has been extensively researched and is widely used in the treatment of depression, anxiety, stress, anger, addictions, eating disorders, obsessive compulsive disorder, panic disorder, bipolar affective disorder, schizophrenia, and chronic pain, among other concerns.

Pain refers to an unpleasant sensory experience usually accompanied by a strong adverse emotional response. In fact, the same centres of the brain that process physical pain also process emotional pain, so oftentimes when one form [of pain] exists, the other may follow. Chronic pain can contribute to low mood (depressive symptoms), increased worry about health concerns (anxious symptoms), and increased use of the healthcare system, which can be emotionally taxing in itself. It can cause strain on relationships, long-term disability, a loss of one’s life as they knew it, and a loss of one’s identity. CBT is an effective treatment to address all of these concerns, because it emphasizes changing one’s habits within the means available to them, which can be empowering, because even if we can’t change our external or physical realities, we retain the option to shift our mindset.

With increased studies in neurobiology, largely due to advancements in brain imaging technology and accessibility of these technologies, the leading approaches in the field are shifting away from the older thinking that our brains and bodies should be treated separately. A more holistic approach is being adopted, treating the brain and body concurrently to affect changes in clients’ presenting symptoms. You might notice that if we change how our bodies feel physically, we tend to change how we feel emotionally, which often brings changes in our thoughts and behaviours, and vice versa, since they’re all considered interconnected in the CBT model. It also follows that the saying “it’s all in your head” misses the mark, because even if a difficulty is originally psychological in nature, if left untreated, it can impact one’s physiology, disrupting hormones, neurotransmitters, blood pressure, and various other body functions. And our mental and/or physical states can become entrenched; that is, our systems can become acclimatized to staying stuck in a certain ‘mode’ (e.g. feeling depressed or stressed), thereby contributing to symptom chronicity, thus calling for an active, change-oriented approach to therapy.

CBT encourages goal-setting, which can help address the low motivation frequently seen in clients dealing with chronic pain. It involves practices to identify and challenge inaccurate beliefs accompanying the pain, and helps develop cognitive behavioural coping strategies, such as pacing daily activities and shifting negative thoughts. CBT also integrates relaxation practices which teach clients how to decrease emotional reactivity to physical pain by changing how they respond to it (e.g. with calming practices rather than panic), which uncouples the negative association between experiencing physical pain and getting emotionally upset. Relaxation practices are helpful because decreased body tension is less likely to exacerbate the experience of physical pain (think about the powerful impact lamaze can have on childbirth, or relaxing your muscles when getting a needle).

CBT is often combined with mindfulness-based practices, such as Mindfulness-Based Cognitive Therapy (MBCT), which teaches participants to notice pain non-judgmentally, with curiosity and acceptance. This change in perspective often results in less emotional reactivity to pain (mental or physical), thereby cultivating a greater tolerance, which can be a central goal in the treatment of chronic pain. Luckily, in Canada it’s becoming increasingly common for rehab centres to integrate these types of approaches to enhance recovery.

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Pain management strategies you can try at home:

  • Notice your beliefs about pain. Are they limiting you?
  • Practice spreading out your daily activities and/or planning to tackle strenuous tasks when you tend to feel better in the day, or leave them for “good days”
  • Anticipate needing extra recovery time after strenuous activities and don’t judge yourself for it.
  • Resist the urge to push beyond your limits. Take a break if you need one. Pushing yourself too hard can be counterproductive, leading to longer recovery times.
  • Getting proper sleep can reduce emotional reactivity (i.e. crankiness).
  • If the pain disturbs your sleep, relaxation training and meditation can offer a restful alternative that’s nearly as restorative as REM sleep.
  • Practice mindfulness: focus on the present moment with non-judgment, curiosity, and acceptance. Connect with a mindfulness-based therapist if you’d like to learn more.

Stop Judging Your Nervous System

We can’t judge ourselves for our responses to trauma. A judgement is a cognitive (thinking) action. It doesn’t matter what we think should be easy to deal with or talk about, or how we think we should have responded. Trauma is registered in the body in the nervous system, so our responses to trauma happen subconsciously. That’s why we need to go at the body’s pace in recovery and learn to speak our body’s language.

#traumaawareness #traumasense

The Importance of Somatic Approaches to Trauma Treatment

There are often a lot of misconceptions about therapy. Many of the therapy sessions we see in Hollywood films depict clients pouring their hearts out to silently nodding, onlooking therapists, usually wearing trendy spectacles. (I don’t wear spectacles. Yet.) While this approach to therapy does exist, it reflects a less frequently employed modality. It lends to the common idea that clients have to purge all details of their past to their therapists, sometimes within their first meeting! This can create an intense sense of pressure on the first meeting. But not all therapists or therapies are alike, and there are times when such cathartic monologues may be harmful; especially when trauma is concerned. That’s why it’s important to work with practitioners who specialize in trauma treatment, specifically somatic, or body-oriented, approaches, if you experience these types of concerns.

To understand the importance of this, one must grasp how the nervous system works. When a person is confronted with something their brains and bodies perceive to be threatening (a stressor), their nervous systems automatically react with the stress response, putting them into a state of fight, flight, or freeze, and when these are ineffective, a submit or feigned death (dissociative) state. These are our natural survival mechanisms. Neurologically, during this process, our frontal cortex (or thinking/executive brain) and hippocampus effectively shut down. The evolutionary psychological explanation for this is simple: when we’re confronted with a potential life-threatening stressor, we don’t need to be eating a ham sandwich, reproducing, or thinking analytically; we simply need to mobilize our survival instincts to ensure our safety. And it’s for this very reason that top-down therapy approaches miss the mark when it comes to trauma treatment, because it’s at this level of functioning that we’re most affected by trauma.

Thinking more about neuroanatomy, the frontal cortex, or “primate brain,” responsible for our executive cognition (thinking), uses verbal language and analytical reasoning; the mid-brain, referred to as the limbic system, or “mammalian brain” speaks the language of emotion; and the brainstem, or “reptilian brain” speaks the language of sensation and impulse (Ogden, 2002). There are psychotherapeutic approaches which address each part of the triune brain (the three subsections previously described), such as: CBT for the “thinking brain;” emotion-focused approaches for the “feeling brain;” and sensory-oriented approaches for the “sensory brain.” When we are traumatized, our brainstems are overwhelmed by the threat; the frontal cortex is compromised and we don’t fully encode or process the experience analytically or emotionally. Our trauma response gets ‘stuck’ in the body and continues to activate primitive parts of the brain, implicating impulses and reactions that don’t get fully ‘metabolized’ in higher-level cortical areas. That’s why we need to start with the body in trauma treatment in a bottom-up approach to address the impact of trauma that was stored somatically before we can facilitate subsequent emotional and thinking processes (which happen later in therapy).

Somatic approaches help clients respect their personal limits, such as, how much they can comfortably tolerate in discussion before becoming flooded or overwhelmed. Such approaches incorporate the most recent advancements in the field of neuroscience and teach clients how to regulate their bodies to achieve greater personal safety…before going into the stories. It’s for these reasons that I stop clients from going into detailed accounts of their trauma histories during our first moments together. While my interruption may seem surprising, to allow them to continue may compromise their nervous system functioning and possibly retraumatize them.

In my office, we’ll likely get to the trauma histories and move past them, if a client is ready; but we always go at the nervous system’s pace.

A Commentary on ‘The Lifelong Effects of Early Childhood Adversity and Toxic Stress’

[Article cited: “The Lifelong Effects of Early Childhood Adversity and Toxic Stress,” by Shonkoff and Garner, (2012)].

This is an excellent article that comprehensively outlines the connection between early childhood stress with disease and disorder in adulthood. Although highly scientific and medically focused, the implications this article point to (i.e. correlations between early life adversity and subsequent susceptibility to mental health concerns and chronic disease) needn’t be pathologized; rather, I see these biological changes merely as our body’s way of promoting a prolonged stress response to adapt to and survive difficult experiences. Certainly this can lead to increased disease, disorder, and/or morbidity later in life, but if we develop self-awareness of our weaknesses (i.e. an over-developed stress response), we can develop skills and strategies to overcome them. Thank goodness for neuroplasticity, neurofeedback, yoga, meditation, and psychotherapy which help to restructure our brains, rebalance hormonal and biochemical processes, and promote psychological resilience. (For example, mindfulness meditation has been shown to reduce grey (brain) matter in the amygdala (a neurological structure responsible for processing fear), thereby counterbalancing the implications of toxic childhood stress discussed here.

For further reading on the mind-body connection and study on correlations between trauma and disease, I recommend Dr. Gabor Mate’s (2003) book, “When the Body Says No.” (Note that I don’t receive any endorsements for this recommendation, it’s just a really informative book by an insightful author.)

My Take on Mindfulness-Based Cognitive Therapy Vs. Neurofeedback

As all of you know, Heartfulness Psychotherapy is offering a Mindfulness-Based Cognitive Therapy (MBCT) group this spring and has also recently been involved in offering neurofeedback treatment. As such, I was asked by some very clever clients the difference between the two treatments and the associated benefits to be gained from MBCT versus neurofeedback, which I thought was a really interesting question. So let’s get into it.

Research has shown that MBCT has been beneficial for treating numerous concerns, such as:

  • Stress
  • Anxiety
  • Anger
  • Depression
  • Postpartum depression
  • Bipolar disorder
  • Chronic pain
  • Addictions
  • Trauma
  • Eating disorders
  • Fibromyalgia and chronic fatigue
  • Sleep difficulties
  • Compulsive behaviours
  • ADHD
  • Acquired brain injury (ABI & TBI)
  • Sexual difficulties
  • Relationship functioning
  • High blood pressure
  • Stress factors in heart disease
  • Increased self-awareness
  • Genetic resilience from illnesses, including cancer
  • Increased control of thoughts & emotions
  • Emotional dysregulation, thus having beneficial implications for borderline personality disorder

MBCT is a particular type of mindfulness-based approach. It’s a manualized 8-week course that teaches techniques to manage difficult thoughts, feelings, emotions, stress, and pain to promote health and relaxation using guided meditation exercises. It’s not a therapy or support group per se, but rather an experientially focused group that encourages participants to try exercises and share their experience in group.

Mindfulness is a practice. This is good news and bad news for some. It means that it offers life-long skills to manage life’s challenges, which is empowering! It means if you practice these tools, you’ll have access to long-term resilience and skillfulness for the rest of your life, and once you know the practice, it effectively becomes free (you can practice it on your own), or with minimal follow-up/ “booster sessions” required. It also means that it’s most effective if it becomes part of a lifestyle (i.e. if it’s done on a regular basis), which some people aren’t willing to do consistently.

Neurofeedback uses EEG (electroencephalography) to get a baseline reading of the brain’s electromagnetic frequency waves such as delta, theta, alpha, beta, and gamma which may be over or under active in various brain regions, consequently affecting a range of functions. Based on the baseline reading of one’s neural activity, and based on their subjective reports about the symptoms or complaints they’re experiencing, a recommended treatment protocol is generated by the system. While neurofeedback systems may differ slightly, the overall premise behind their effectiveness is that they provide stimulation [in the form of auditory, visual, or tactile rewards (less commonly used)] to help the brain “train” or learn how to function at the healthier brainwave frequency for that particular brain region, as determined by the particular system. Every system is different. The technology I worked with compared each individual’s brain reading to a vast normative database, which has pros and cons in itself (e.g. some systems employ technology that only trains the brain in comparison to itself, since some people prefer not to have their brainwave frequencies modelled based on a normative sample, while others don’t mind).

Based on the preliminary research I’m familiar with, neurofeedback has received empirical support most commonly for stress-related concerns such as:

  • Stress
  • Anxiety
  • Sleep difficulties
  • ADHD
  • Depression
  • Trauma
  • Acquired brain injury (ABI, TBI, & post-concussive syndrome)
  • Enhancing cognitive performance
  • ASD
  • Chronic pain
  • Eating disorders
  • Learning difficulties
  • It has been used with some benefits in Alzheimer’s disease

MBCT Vs. Neurofeedback (My Pros and Cons List)

Neurofeedback is purported to have lasting effects that are produced within 10-40 weekly treatments. It is often extremely costly but beneficial results can be seen relatively quickly, although the experienced benefits differ between individuals.

MBCT also has lasting impact but requires maintenance for best results. While the 8-week course can cost generally $600 -$975, it tends to be considerably more economical than neurofeedback and/or individual psychotherapy. However, neurofeedback might appeal to those looking for a ‘quick fix,’ which tends to be attractive in our fast-paced society.

Neurofeedback reflects new technology and all the benefits and limitations that come along with it, while MBCT has its origins in ancient Eastern traditions, thus carrying a sense of tried and true organic wisdom.

Mindfulness empowers individuals to cultivate internal skills and self-control, whereas neurofeedback requires that patients be dependent on the skillfulness of the practitioner and the particularities of the technology being employed, thereby relinquishing personal agency. Because of this, it is also possible for neurofeedback to occasionally train brainwave frequencies that yield less desirable outcomes (e.g. increased fatigue versus mental focus).

MBCT is an entirely non-invasive approach with mostly beneficial side effects. Participants are in control throughout their practice and the most adverse side effect of mindfulness ever reported (that I’m aware of) is increased awareness of difficult mental, emotional, or physical events (which is a benign side effect that can be supported and coped with). Thus, MBCT has few (if any) contraindications and to my knowledge has not been known to cause harm to anyone. Neurofeedback on the other hand is contraindicated for various conditions (e.g. epilepsy), and can be harmful if the clinician implementing it is not properly trained. While neurofeedback is marketed as a non-invasive approach because most systems do not introduce instruments or matter into one’s body –with the exception of Neurostimulation, which does input a mild electrical current into the brain– it is still possible to experience considerable adverse side effects during the course of neurofeedback treatment. These side effects may be intense enough in sensitive individuals to require time off work (e.g. symptoms similar to post-concussive syndrome have been reported for several days following treatments, or the possibility of increased seizures early in seizure treatment).

Neurofeedback is intended to result in lasting neurological change. The number of brain regions “trained” or targeted during a 10-40 session treatment protocol largely depend on the particular system being employed. The neural regions selected for training are often partly determined by the clinician and partly by the treatment protocol generated by the technology. Therefore, while there is greater ability to individualize which brain regions (and which associated symptoms) will be addressed, there are often a limited number of options of which regions and conditions a particular course of treatment will address. Of course one could pay for subsequent treatments and train additional regions. Mindfulness meditation (and MBCT) affect significant beneficial brain changes too, (see Psychology Today’s listing and Harvard’s recent study) they’re just less individually customizable. Such practices affect the brain’s electromagnetic frequencies as well; again, they’re just less individually customizable than in neurofeedback treatment.

Since MBCT is manualized, it should theoretically be offered in a consistent manner irrespective of the group facilitator and facilitators are expected to be experienced meditation practitioners. Neurofeedback, however, may vary depending on the technology employed and operating clinician.

Both approaches require prolonged sitting (20-60 minutes). Both approaches can make people feel slightly sleepy afterward. MBCT requires approximately 1.5 – 2 hours a week commitment for an 8-week period, while neurofeedback generally requires a one hour assessment, a 30-minute report reading, and 30-60 minute subsequent training sessions a week or twice a week for a minimum of 10-40 sessions, thus, neurofeedback is more time intensive. And it involves hair gel that may hamper your plans if you have a date scheduled after your appointment. Just saying.

MBCT is offered amongst groups, while neurofeedback is offered individually, thus providing a greater sense of privacy during treatments. While some may shy away from groups, I’ve received a surprising amount of feedback suggesting that the group atmosphere helped individuals learn from one another, normalize their own experiences, and feel part of a supportive community. (Note that speaking in group is only voluntary). Nevertheless, it’s up to personal preference.

Conclusion

I prefer MBCT over neurofeedback because I like the self-empowerment, life-long skill acquisition aspect of it rather than feeling dependent on yet another service provider. It helps me feel greater alignment with my spirituality, (note: this component is NOT taught or required in MBCT groups but may be a pleasant and optional byproduct). It also supports my yoga practice since it incorporates some gentle yoga postures. Overall, both approaches are great non-medical alternatives, and both treatments are known to be helpful for a variety of concerns, so it all depends on the treatment outcome you’re looking for. Ideally, we should be so lucky to use both treatments!

Please note that this is my professional opinion on these practices based on my experience with them; feel free to offer your feedback if you feel I’ve missed something; I’m happy to start a dialogue. Happy brain health everyone!

Neurofeedback

15 Ways to Overcome Negativity

Negativity is often a lot about being in a protective, defensive state of mind. Evolutionary psychologists believe negativity served an important adaptive evolutionary function: it helped keep our ancestors alive long enough to procreate succedent generations of offspring to eventually produce you and me. That’s how researchers explain the negativity bias: the fact that it takes us about 20 seconds longer to encode positive thoughts or memories than we do negative ones. It would have been advantageous for our ancestors to attend to negative, possibly threatening events in their environment, such as floods, droughts, competing tribes, or dangerous packs of animals nearby, as this would have increased their chance of survival and reproduction (i.e. the goal of our genes). This negativity bias formed the foundation of our cognition (i.e. human thinking processes and associated neural/brain architecture), thus shaping how we think in modern life, since we still share the same cortical architecture as our forbearers.

This topic is highly relevant because depression, anxiety, and associated worrisome and/or negative thinking are among the most common psychological concerns seen in the psychology field today. So here are some strategies for dealing with negativity:

  • Identify the negative thought. Awareness is always the first step. Labeling it as such can help increase your awareness when it arises.
  • Learn to disengage from automatically believing every thought you have. Revisit my blog post, Just Because You Think it Doesn’t Mean it’s True
  • Note the underlying function the worry/thought is serving (e.g. it likely has your best interests at heart). E.g. the subtext might sound like: “Be careful not to get too excited and become disappointed”…or “If I anticipate bad things will happen, I will be less hurt if/when they do occur,”).
  • Give yourself permission to adopt new perspectives. You might even thank the negative thought, for example: “thank you worrisome thought for wanting to protect me from pain. I know you’re just trying to keep me safe, but I’m going to give myself permission to try seeing this differently…”. You might remind yourself that changing a habituated pattern may feel uncomfortable at first, but that’s often a sign of breaking the rut, and remind yourself of the good reasons for doing so. Sometimes we can get used to living in a certain state (e.g. unhappiness or stress), and need to consciously practice allowing ourselves the freedom to experience levity and optimism.
  • Become an observer: watch your thoughts like passing clouds in the sky; notice that they are fleeting if we do not hold onto them or endorse them with rumination, and that eventually they will be replaced by new thoughts (e.g. about what to have for lunch!).
  • Adopt a regular mindfulness practice as a way to disengage from troubling thoughts. If you’re new to mindfulness, seek out guided meditations online or in the app store.
  • Pick a mantra; any mantra. Kundalini yogis swear by repeatedly reciting uplifting mantras (aloud or internally), as they help reprogram our subconscious minds, rewiring us towards positivity and healing energy, or at the very least, acting as a welcome mental distraction.
  • Surround yourself with positive people. They say we’re the sum of the five people we’re closest to. Who’s in your inner circle?
  • Adopt a gratitude practice. Start keeping a written list of a few simple things you’re grateful for daily (there are apps for this!). It will shift your thinking to help you become better at recognizing and cultivating more pleasurable events.
  • Channel your inner 4-year old. You might envision yourself experiencing situations from fresh eyes the way children do. Use your sensory information to ground you in the present moment and stimulate your imagination. Try to savour the experience you take in through your senses. Allow yourself to experiment with different sensory stimuli. Play and feel fully alive. Spend time savouring small moments. By elongating your experience of pleasurable events, you’re more likely to reap their benefits and store them in memory for later.
  • Do the opposite. Mindfully choosing to do opposite action (or respond differently) can be helpful if you’re in a pattern that’s not working for you and you’re not sure how to break out of it. We usually have to change our behaviour to change the trajectory of the pattern, which reflects our ability to influence our circumstances and be empowered! This can be applied to relationships and other challenges. A good example is trying to break out of a depressed rut. Depression often causes a lack of motivation and increased isolation; but fighting against these impulses to hibernate can actually generate improved mood. Be mindful about the opposite actions you choose; ensure you’re choosing activities that are known to have a beneficial affect on you.
  • Consider the evidence for and against your negative thought. Make a list for both. Often there is more evidence supporting the contrary.
  • Practice reframing. Your reframes don’t necessarily have to be positive. Not everyone has a positive alternative thought handy, but just adopting an alternative perception could be enough to affect an emotional shift. Adopting other perspectives also reminds us that our original automatic interpretation is not a veridical truth, but rather, just one of many points of view, and we can switch them if we choose to.
  • Work with a professional. This can be hard work to do on one’s own when you’re already entrenched in a certain way of thinking or functioning. Therapists can be helpful catalysts for fostering movement out of old patterns. A good therapist should be a neutral observer, and they should create a sense of accountability in clients, gently motivating and supporting them through challenges.
  • Keep practicing. New habits take time!
  • Repeat.