Author: Diana Gordon, Psy.D.
As anxiety specialists, we often work with patients who are struggling to manage anxiety about one or more major areas of their lives. We have a lot of different strategies that we use to work with anxiety, including skills from CBT (Cognitive Behavior Therapy), ACT (Acceptance and Commitment therapy), and DBT (Dialectical Behavior Therapy). Our goal is to teach people concrete skills that they can carry with them after therapy is complete to continue to manage challenging emotions, including anxiety.
One thinking pattern that is very common in anxious people is catastrophizing. Catastrophizing simply means imaging the worst case scenario, or the worst possible outcome, for any given situation. In this blog post, we will take you through a CBT tool for decatastrophizing. This process will teach you to identify your thoughts, evaluate whether they are factual, and identify alternative beliefs.
Step 1: Specify the catastrophic consequence clearly
Step 2: Change any “what if” statements into concrete declarations of fact
Step 3: Challenge your thoughts
Step 4: Come up with at least three true, balanced thoughts that reflect the evidence you discovered in step 3
Step 5: What are your next steps?
This decatastrophizing process is one way to cope with anxious thoughts that are based on feared outcomes that are unlikely to actually happen. When we are able to look at our situation rationally, we often find that anxious thoughts are not based in reality. When we decatastrophize, this often helps us bring our anxiety down to a manageable level so we can decide what to do next. At SF Bay CBT, our goal is to teach you a variety of tools that you can use when you’re feeling overwhelmed, anxious, or depressed to help yourself feel better. Feel free to reach out to us for a free phone consultation to learn more about the tools we use in our work.
Many of our patients come to us with sleep difficulties. Sometimes we may have trouble getting to sleep at night, and when we do it can be especially challenging to wake up in the morning. If you’re struggling with sleep difficulties, take a look at our blog post on CBT for Insomnia, or schedule a free phone consultation to learn more about how we can help with these concerns.
For those struggling with more occasional and/or less severe sleep concerns, getting up in the morning can still be challenging. In this blog post, we will explore some strategies to help you get out of bed and tackle the day, even when you’re not feeling as well rested as you would like. The single most effective thing you can do to help yourself sleep better is to wake up at the same time every day. In our clinical experience, this is often a suggestion that is very difficult for patients to implement. Common concerns our patients express about this are:
Sometimes it can be challenging to overcome these concerns and get out of bed anyways. In our practice, we observe that people who do manage to get out of bed at the same time every day are more satisfied with their sleep and well rested than those who do not. These are some strategies that our patients have found helpful when they are trying to get themselves out of bed:
Author: Katie Leoni, Psy.D.
In part one of this series, we introduced you to three components self-compassion and highlighted the main differences between self-compassion and self-esteem. Today we will teach you numerous ways to practice self-compassion in your life. Since there is a wide array of ways to practice self-compassion, try out the ones below a few times and see which ones resonate with you. As with any new skill, it’s like working a new muscle. It may take some time to get used to but as you continue to practice it gets easier and more automatic.
Ideas for Practicing Self-Compassion
There are various guided meditations that exist. Dr. Kristin Neff's self-compassion website has seven great ones to choose from, all of which can be downloaded to your computer.
As you breathe in and out, see if you can allow yourself to enjoy the sensations of breathing. Let it be a pleasant sensation and enjoy it as deeply as you can. Repeat for five breaths.
Ask yourself: How would you treat a friend? What would I tell a friend in this instance?
Often times, we are far less critical and judgmental of our friends than we are ourselves. These questions allow you to tap into a more compassionate stance.
Ask yourself if there is any part of you that resists self-compassion. If so, ask that part, “How are you trying to keep me safe?” Can you attend to those needs rather than attacking?
Journaling: Critical Voice vs. Compassionate Voice
One a piece of paper, write for 1-2 minutes in a critical voice. Then, switch to writing in a compassionate voice. Notice the difference between the way these two voices sound and the way that they make you feel. It’s likely the compassionate voice makes you feel good compared to the critical voice, why not try using that voice? Try saying to the critical voice, “I know you criticize me because you are suffering. I want to care for you.”
Wrap your arms around yourself and give yourself a big hug for five breaths. Try saying, “I love you just as you are.” Notice how these words make you feel.
Make Yourself Comfortable
Check in with your body. Ask if needs anything to feel more comfortable. To stretch, walk, relax, sleep, breathe? Give yourself permission to enjoy whatever action you take.
Put your hands on your heart and say to yourself, “May you be happy. May you be healthy. May you be safe. May you be loved.” Repeat four times.
Identify Positives About Yourself
Name three things that you like about yourself. Notice how receiving recognition makes them that much stronger.
Notice an unpleasant emotion.
Allow for it to be for a few moments.
Watch it Go.
If you're interested in learning how self-compassion can help you and other ways to incorporate it into your life, please contact us to schedule a free phone consultation.
Author: Kari Kagan, Psy.D.
Most people experience rejection at some point in their lives. Whether being rejected from a job, a school program, a relationship, or a group of friends, we all experience a similar kind of pain, sadness, and anxiety, that can stay with us as we endeavor to try again, or maybe even get in the away of trying at all. A recent New York Times article written by organizational psychologist, Adam Grant, discussed strategies for coping with rejection that can help increase resilience. The two main strategies he discusses are 1) to conceptualize rejection as a mismatch between two people, or a person and a job, instead of a problem with you or a problem with them, and 2) to turn to other parts of your identity when another part is being rejected. For example, focusing on building and deepening your relationships when your career isn't where you want it to be. This article offers great perspective and advice on how to deal with rejection, and if you would like more support on coping with rejection in your life, please feel free to contact us for a free phone consultation.
Author: Diana Gordon, Psy.D.
Many patients come to us looking for fast relief from their symptoms. We are passionate about offering CBT for anxiety disorders because this treatment is fast, effective, and allows people to resume their normal lives quickly. In this article, Scientific American examines the efficacy of brief and accelerated treatment for Anxiety Disorders. To learn more about how you can quickly alleviate your symptoms, contact us for a free phone consultation. Click here to read more.
Author: Katie Leoni, Psy.D.
In this blog series, we will introduce you to the topic of self-compassion and provide you with ways to practice self-compassion on your own.
What is Self-Compassion?
Dr. Kristin Neff is one of the leading world experts in the field of self-compassion, having been the person to operationally define and begin to study self-compassion over ten years ago. Through her pioneering work, she has developed a solid understanding of what self-compassion is, how it can help you, and ways to utilize it in everyday life. On her website, she states that “self-compassion involves acting the same way [as you would toward another person] towards yourself when you are having a difficult time, fail, or notice something you don’t like about yourself.” It involves noticing that you are suffering, responding to your own pain with a caring, warm approach, and acknowledging that suffering is a part of life and you are only human. It essentially means that you honor your human experience.
We often treat our loved ones kinder than we do ourselves. Tuning into how we respond to others sufferings can help us to identify ways that we can turn that compassion towards ourselves. Can you think back to the last time your loved one went through a difficult time or had a tough day (i.e. break-up, poor performance review etc.)? What did you say to them? Chances are it was something supportive, soothing, kind, and compassionate, something along the lines of “I notice you’re in pain, I am here for you, and it’s okay to feel this way” as opposed to “Get over it, you’re not allowed to feel that way, quit being a baby.” Notice the difference between those two responses? The first one is a compassionate stance, the second one is not.
The Difference Between Self-Esteem and Self-Compassion
Self-esteem and self-compassion are not the same thing. Self-esteem refers to our sense of worth and it is ingrained in our brains, it’s how we feel about ourselves. If you get an A on a test, you feel good. If you get an F on a test, you feel bad. Self-esteem is fragile and depends on how you’re doing in life and what you are accomplishing. Self-compassion is a stable sense of worthiness regardless of what is going on in your life. Whatever grade you get on a test, you are a worthy person. According to Dr. Kristin Neff, “research indicates that in comparison to self-esteem, self-compassion is associated with greater emotional resilience, more accurate self-concepts, more caring relationship behavior, as well as less narcissism and reactive anger.”
Three Components of Self-Compassion
If you’re interested in learning more about self-compassion and ways that it can be incorporated into your life, please contact us for a free phone consultation. Stay tuned for part 2 of this series where you learn different ways to practice self-compassion.
Author: Kari Kagan, Psy.D.
Learning how to effectively communicate with others can be one of the most challenging and rewarding skills a person can learn in their lifetime. Even people who consider themselves “easy to get along with” or a “people person,” are at risk for getting caught up in the heat of a moment and not being able to communicate effectively and clearly. For this reason, it could be useful to have a “go-to” skill that can help to provide some guidance during interpersonal interactions that could easily go awry. Dialectical Behavior Therapy (DBT) offers a few different skills to help increase interpersonal effectiveness, but this article will focus on one that can be particularly useful for navigating conflicts, refusing a request by someone, and making a request of someone. The skill is called “DEAR MAN,” and I will go through the acronym and examples of how to use the skill below.
Example: Betty and Joe have been married for five years. They are trying to spend more quality time together so make plans to go on a dinner date on a Friday night. Betty arrives at the restaurant on time and Joe is not there. She waits at the table without ever hearing from Joe. He eventually shows up 30 minutes late. They proceed with dinner but Betty is distracted. She decides to talk to him about it later that night…
Joe, I would like to talk to you about when you were 30 minutes late to dinner tonight.
When you show up late, I feel sad and unimportant. Quality time is important to maintaining relationships and I feel worried that if we don’t prioritize it, we will grow distant.
I would like you to commit to showing up on time to future dates. If you can’t make it on time, please call me with advanced notice to let me know when you plan to get there.
Doing your best to show up on time and to prioritize quality time with me would mean a lot to me and make me feel closer to you. I think it will also improve our relationship in the long-term.
In our example, if Joe starts to point out times that Betty has been late or when he felt deprioritized for some other reason, we want Betty to stay focused on the current situation instead of getting locked into a battle of who has done what to whom. For example, Betty could say, “I understand that I am not perfect either and would be happy to discuss that another time. For now, I am still asking that you try your best to be on time or inform me if you will be running late.”
In our example, Betty should make direct eye contact with Joe, sit up straight, and have a firm tone in her voice that lets him know that she is confident in what she is asking for and that it is a reasonable request.
In our example, Joe does not feel he can commit to calling with advance notice if he is running late as he has a job that requires him to be in meetings that prohibit him from calling. In this situation, Betty might ask Joe, “What do you think we should do here? How can we solve this problem?” In the end, they come up with a solution that works for both of them, which is for Joe to send a text if he is unable to call.
The DEAR MAN skill is a great strategy to help you navigate difficult interpersonal interactions and to help get your needs met. If you would like to learn more skills for communicating effectively, please reach out to us for a free phone consultation.
Author: Diana Gordon, Psy.D.
In parts one and two of our crisis survival series, we introduced the ACCEPTS, self-soothing, and TIPPs skills. Today we will review one more Dialectical Behavioral Therapy (DBT) skill, IMPROVE the moment, that can be helpful when you are experiencing powerful emotions.
When you are in a moment of crisis, it can be really difficult to problem solve or to think rationally. Sometimes when we are experiencing powerful emotions, we need to first calm down and get through the moment before we can move into problem solving. IMPROVE the moment is an acronym you can use to think about ways to make yourself feel better quickly. You might not be able to do much about the thing that is causing you to feel distressed, but you can change your emotional response to it and start to feel better. Once you are feeling calmer and more grounded, you can then apply your other skills.
Author: Katie Leoni, Psy.D.
DBT presents three basic states of mind: Reasonable Mind, Emotion Mind, and Wise Mind. In this post, we will look at the idea of Wise Mind and ways to practice Wise Mind in your daily life.
Reasonable Mind is logical, rational, and task-focused. Facts and reason are the foundation of Reasonable Mind, emotions and values do not live here. When in Reasonable Mind you are able to plan and evaluate things pragmatically and engage in such behaviors like figuring out Muni, creating a budget, or building a house. This is helpful as it allows you to learn and synthesize information to complete tasks and helps in your ability to call forth said information when needed. It is much easier to access Reasonable Mind when you are not emotionally triggered or experiencing acute emotional distress. However, it can become a problem to solely be in Reasonable Mind because it does not account for emotions, needs, or desires. It can feel cold and almost robotic to be in Reasonable Mind.
Emotion Mind is reactive, mood-dependent, and emotion-focused. When in Emotion Mind you are likely to act impulsively based on intense feelings and a strong sense of urgency and engage in such behaviors like using drugs or saying something hurtful to someone you love. Your mood dictates your actions, logical and reasonable thinking are hard to engage in while in Emotion Mind. Experiencing intense emotions allows for passion, intense love, and an ability for a person to strongly connect to various interests. On the flip side, it can make a person feel out of control, flooded by their emotions (anger, anxiety), have a lack of energy (sadness, hopelessness), and create a failure to look at a situation clearly.
Wise Mind is the the integration of Reasonable Mind and Emotion Mind. As you can see in the picture, it is the overlapping region of a venn diagram that has Reasonable Mind and Emotion Mind existing together. It allows a person to tune into and see the value of both logic and emotion in order to form a balanced view of the world, our approach to living in it, and our capacity to cope. Wise Mind has a certain calmness about it and is similar to intuition, which makes it advantageous to experience and live in. It should be noted that the majority of people do not live in Wise Mind as depending on the situation and person, emotion or rationality can reign supreme. It takes continuous deliberate practice to be in Wise Mind. Below are some helpful ways to practice Wise Mind.
If you are interested in learning more about Wise Mind and ways to access it, please reach out to schedule a free phone consultation.
Diana Gordon, Psy.D., Kari Kagan Psy.D., and Katie Leoni, Psy.D.
Drs. Gordon, Kagan, and Leoni practice psychotherapy in downtown San Francisco and Oakland. Their areas of expertise include anxiety, sleep, stress, depression, and addiction. They blog about these topics to provide research-based information about common problems and strategies to help manage them.