Dr. Levy's CBT Blog
Insights on Well-Being, Contentment, and Cognitive Behavioral Therapy
I recently finished the book "Dedicated" by Pete Davis, a Harvard Law graduate who gained online notoriety thanks to a viral graduation speech in the youtube video below. Mr. Davis has expanded the concepts in his graduation speech into a bestselling book that questions how we can find commitment and purpose in a fluid society that values open choice, freedom, and individualism. It is an interesting and well-written book, focused largely on civic involvement. But as far as CBT is concerned, the sections about choice are particularly relevant.
Mr. Davis makes the case for the impossibility of making "right" choices. When we call a path the "right" one, we assume that there is only one perfect future and that this one path is the absolute best way to get there. This is obviously as fallacy, as the future doesn't exist. We make it with our actions today. There are many, many choices that can conceivably lead to great places down the road. Failing to recognize that keeps us stuck in search of that one winning ticket.
If we can't make the "right" choice, what we can do is make our choices right. The book quotes executive coach Ed Batista as highlighting that if we commit to the choices that we make, those choices have a much greater chance of leading us to a positive outcome. So after we make a choice, any choice, the key lever that we have to make it work well is commitment.
Commitments, Mr. Davis argues, are living things. And like all living things, a commitment needs to be nurtured and nourished. When we work towards making our choices right, we are feeding that commitment and giving it a fair chance to thrive. We don't constantly revisit the choice, we don't move backwards or in circles, we don't get stuck. We commit and we move.
However, like all living things, commitments can sometimes wither and fade, in spite of receiving good care. If or when that happens, it is likely time to let that commitment go, without regrets. And make a new choice. And make that choice right.
In TEAM-CBT, we use the Decision Making form to help guide clients through the analytics of of a hard decision. If needed, we can process the emotions behind that choice through empathy or using a thought log. There are many therapeutic tools and interventions that can help us make careful, deliberate, well-intentioned decisions. But it is ultimately the voluntary act of committing to the direction that you choose that will make those decisions right.
How do you define competence? Your answer to this seemingly simple question can have a large impact on how you interpret your academic and professional achievements and how satisfied you feel about them. Some views of competence can be particularly detrimental to your emotional well-being, so it’s worth watching out for them.
Dr. Valerie Young has described five unhelpful “competence types”: views of what defines aptitude and proficiency that actually hold us back. They are:
1-The Perfectionist: in this view, competence is defined by “how” things are done. If they are 100% correct, 100% of the time, then you’re competent. Any small deviation from that equals total defeat. And since it’s impossible to get everything right all of the time, you are often aware of your misses and the distress that accompanies them in the form of self-doubt, worry, or shame.
2-The Natural Genius: here, competence is defined by “when” things are done right. For the Natural Geniuses out there, being competent means getting it right the first time, and doing it naturally, effortlessly, and immediately. This is the view that talent is congenital and you either have it or not. If you don’t get it right on the first time or struggle to master a skill or project, then you’re actually not that competent. That’s a huge disappointment.
3-The Soloist: This is the “who” view of competence, in which it equals the ability to perform tasks independently at all times. If you need help, you are incompetent, so you might as well take on immense mountains of work to do all by yourself. When you struggle or get stuck, feelings of failure, shame or defeat follow.
4-The Expert: The focus of competence for the Expert is in “what”. If you are competent in this definition, then you know everything there is to know about a task, challenge, or project even before you start. You fear being exposed as ignorant or inexperienced, so you spend inordinate amounts of time getting better educated, more informed, and more deeply acquainted with whatever topic is at hands; often times, at the expense of actually getting stuff done.
5-The Superhuman: For this type, competence is measured in throughput. It parallels how many roles you can juggle, how many projects you can deliver, how often you volunteer, or how much time you spend on turbocharge, doing more than everyone else around you. This overload can lead to many short-term accomplishments, at the cost of long-term stress and burn out.
Do you see yourself in any of the types above? If so, how has this definition of competence served you over time? If the answer is not that well, then you can start working on changing it. You can do that with the help of a CBT therapist by first understanding your current belief system, then challenging assumptions that are unhelpful, and finally building new ones that are more realistic, take into account several viewpoints, are more complete, and help you truly succeed in the long-term.
Many mothers - both those staying-at-home with the kids as well as those working out of the house - often struggle with "mom guilt." Those are nagging feelings of guilt, shame, sadness, anger and despair that may be temporary or pretty pervasive. They are difficult and unpleasant. Older parents will tell you to let go, to enjoy the journey as time flies: "they grow up so fast." And yet, day to day those pesky feelings pop up, sometimes on cue and many times unannounced.
Cognitive theory will tell you that those unwelcome emotions stem from your thoughts, the stories that you tell yourself in your head. It can be a thought that you may not be doing enough, a notion that you are not sacrificing enough, or just a belief that you are not getting things right while everyone else has it together. In terms of concrete thoughts, they might span the range from "I should be playing with the kids right now (as opposed to doing something else I also enjoy!)", "they are watching too much TV", "I shouldn't loose my cool", "I actually want to complete this work assignment but feel I should be spending more time with the kids."
If you can't change your reality short-term, how can you deal with these thoughts and feelings more effectively? First, if I offer you a magic button that would make all of those beliefs and reactions go away, consider whether you'd press the magic button. It sounds like a good deal, right? Yet, these negative thoughts and feelings tell us a lot of beautiful things about you...They show you care, you want to do what is right by your children, that you are willing to look at your choices critically, and that you have really high standards and goals for yourself. All of those things are good!
Rather than pressing the magic button and make the "mom guilt" disappear altogether, how about figuring out how to modulate it? You can find a way to hold on to some of the healthy aspects of the guilt - after all, wanting to be the best mom you can be is an awesome goal! - but it is not so high that takes away from your chance to enjoy your children and your limited time with them. That is very doable with CBT.
To get to this lower level of distress, you will need to revisit the stories that you are telling yourself in your head. In CBT, we embrace the idea that your thoughts drive your emotions. Change your thoughts, change your emotions. There are a myriad techniques to re-write the automatic thoughts and ideas in your head around your parenting choices. You can learn about them in CBT-driven books such as Dr. David Burns' new Feeling Great book. Or you can work with a CBT therapist who can guide you in understanding and applying these techniques to the specific circumstances in your life. Your family will thank you!
"Impostor syndrome" (also known as impostor phenomenon, fraud syndrome, or impostor experience) is a term initially coined in 1978 by psychologists Clance and Imes to describe describe high achieving individuals who, despite their objective accomplishments, persist in holding a belief that they are unworthy of their success and that others will eventually recognize them as a fraud . The early psychological literature on this topic (see original article) proposed that the phenomenon was prevalent among women. Since then, dozens of studies have shown that it is equally common among men and particularly troublesome among minority groups.
Professionals with impostor syndrome tend to attribute their strong performance to external factors such as luck, support from others, or extreme effort, rather than internal factors such as talent, competence, and acumen. Setbacks, on the other hand, are viewed as proof of unshakable weaknesses. Indeed, Clance described impostor syndrome as an “internal experience of intellectual phoniness in individuals who are highly successful and unable to internalize their success.” This unwarranted sense of insecurity can often result in distress, depressive feelings, anxiety, loneliness, and frustration.
A recent review of over 62 studies on the topic of Impostorism showed that the prevalence rates of impostor syndrome is hard to gauge. Depending on the screening questionnaire and cutoff points used, the research showed that 9 to 82% of the participants would qualify for the label. It appears that age is negatively correlated with impostor Syndrome (i.e., it lowers as one ages).
So...do you have Impostor Syndrome? Honestly, only you can answer that. If you're struggling with feelings of perfectionism, insecurity, and fear in spite of sustained academic and professional success, it is possible that you do hold beliefs that could be described as Impostorism. Many times, as hard as they might be, these feelings motivate you to keep striving and achieving, But at other times, they can stand in the way of you actually enjoying your life and the many contributions that you make to your organization.
There are many ways to "treat" Impostor Syndrome. if you look in the lay media, you will find many recommendations, ranging from “own your accomplishments” to “comparing notes with peers and mentors about shared impostor feelings” and "remind yourself that you are good at what you do." I am sure those are helpful and can alleviate the suffering momentarily. However, from a CBT perspective, Impostor Syndrome is more likely a reflection of core values, intermediate beliefs and automatic thoughts that pop up in many areas of your life. Getting to those is the key to long-lasting change.
You can fight Impostor Syndrome with the help of a therapist by learning to be aware of your automatic thought patterns, recognize unhelpful thinking styles, and generate alternative appraisals that help you move forward in the direction of your values and your goals.
Self-care is "in." At work, with friends, and even at home, we often hear about and proclaim the benefits of self-care. Popular self-care ideas range from a hot bath or a manicure to a fancy spa treatment or a vacation in Hawaii. All of those activities are useful and effective ways to take a break or disconnect from everyday life.
However, if you catch yourself yearning for that break all the time, that may be a sign that the life you've built is not the life you need. If you need to escape from reality at regular intervals, your reality may be misaligned with your values.
In this thought-provoking article, author Brianna Wiest advocates for taking care of yourself every day, not by pampering and withdrawing from your routine but by including healthy and responsible choices in it.
"If you find yourself having to regularly indulge in consumer self-care, it’s because you are disconnected from actual self-care, which has very little to do with “treating yourself” and a whole lot do with parenting yourself and making choices for your long-term wellness."
If you're looking to take better care of yourself, start by taking inventory of the values that matter to you and then assessing how well your life is aligned against them. If you need support going through that analysis, find a good therapist who can serve as a sounding board.
In evidence-based psychotherapy, we most often depart from the premise that the client is unwell. We diagnose disorders based on set lists of symptoms and tailor treatment to particular presenting concerns. The goal is to eradicate the illness and restore the client's functioning to its previous, higher level.
But what if we didn't have to get unwell to begin with? There is a whole field of psychology focused on that: Positive Psychology. Positive psychologists spend their days studying how we can make ourselves feel better and prevent the down periods in life. Live Happy Magazine published a comprehensive summary of widely embraced ideas to help us all lead healthier emotional lives. While none of them are going to jump out as new and surprising, it is a god reminder to heed some age-old advice to live fully and sensibly. Positive Psychology recommends:
With marijuana being recently legalized in California, questions about its positive and negative effects on health overall and mental health in particular have intensified. There is an appropriate amount of debate around it and a growing body of investigative research attempting to arrive at conclusive findings. But in short, we really don't know yet.
My overall take on the state of the literature is that, like with any other foreign substance that you are introducing into your body, avoid or limit it if you can. However, compared to other drugs that are commonly abused - and particularly alcohol - marijuana has a lower profile of long-term damage and side effects.
The article below does a good job of listing areas of interest in the research of clinical uses of marijuana and where we are in our understanding of them. For example, while we all know that marijuana's THC can have a 'feel good' effect on the brain, it also elevates heart rate and impacts coordination and balance. Cannabidiol (CBD) has been demonstrated to help in pain managemen, but marijuana can also affect memory, mood, and potentially activate schizophrenic symptoms in those prone to the condition.
If you are considering or actively using marijuana for mental health concerns, I suggest discussing it with your doctor to investigate any potential physical health risks and with a therapist to learn additional or alternative ways to manage your pain or mood.
All said, natural, healthy, and drug-free solutions are always best!
Those of us who are lucky enough to be able-bodied and perfectly capable of putting one foot in front of the other should be walking at least 30 minutes a day, 5 days a week. Why? Because walking brings enormous benefits for our health, both physically and mentally.
This article from Fresh Daily Health details several ways in which walking can help us lead healthier lives. Benefits of regular walks include:
On this last point, it is worth highlighting that walking can help reduce stress, ease anxiety, and combat that nagging desire to do nothing that comes with a clinically significant depression. So, if you can find a few breaks on your calendar daily, even if it is just 10 to 15 minutes two or three times a day, get out there and start putting one foot in front of the other! Your body will thank you.
When presented with important choices in their lives, clients often ask me "Is this the right choice?...Is this OK?..." The clear answer for that is "It depends!!!". What is right for your life obviously hinges on your personal values, dreams, and aspirations. While no one can give you answers on what to aim for, we can suggest parameters to consider when weighing your choices and making important (or even everyday...) decisions.
A "great life," however it looks like for you, should maximize your ratings and satisfaction across the dimensions below:
In short, choices that increase your purpose in life; social, financial, and physical well-being; or community belonging are likely "right" and definitely "OK." Sometimes we move along these axes in unison, other times we need to make trade-offs among them. But those are the key ingredients in a great life for everyone of us. How you mix them up to create your own unique recipe, it's up to you.
Dr. Daniele Levy is a licensed psychologist offering CBT via Teletherapy from Menlo Park, CA. Her background uniquely combines leading edge training in behavioral sciences with deep expertise coaching and mentoring working professionals in dynamic organizations.
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Copyright © 2014 Daniele V. Levy, PhD
Bay Area Cognitive Behavioral Therapy (CBT)
Office: 830 Menlo Ave, Suite 200, Menlo Park CA
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