Dr. Levy's CBT Blog
Insights on Well-Being, Contentment, and Cognitive Behavioral Therapy
I'll start with the bad news. If you are standing in one place waiting to find motivation before you take a step in any direction, you won't find it. We all think that we need to have motivation in order to move forward. The reality is, we don't.
I imagine that you brush your teeth every day, right? And how motivated do you feel each night before bedtime to pick up your toothbrush? Do you say to yourself, "I am looking forward to brushing my teeth tonight...and tomorrow night...and the day after?..." Probably not. Yet, you still do it. No motivation. Instead, just willingness to do what needs to be done.
To move forward in any direction, we need willingness. A stance of seeking movement even when you don't feel like it. Doing things because they need to be done, not because you're excited, giddy, or moved to do it. Odds are that once you get moving, motivation will follow. But you simply don't need it in order to get started.
That said, the New York Times just published an interesting article on small tasks that you can do to enhance your motivation. Note that all of them require you to take a step before you are motivated in order to find that motivation. Some ideas include rewards and treats, looking for meaning, relying on social support or competition, and using self-compassion. Check it out here.
Along those lines, in TEAM-CBT we have some really cool tools that can help with the procrastination that comes with lack of motivation, including Cost-Benefit Analysis, Triple Paradox, Devil's Advocate, and Problem-Solution techniques. You can learn more about them in therapy or independently through Dr. Burn's books.
Everyone has a sleepless night every now and then. What we do - and don't do - during the day, how we eat, what we drink, how much we exercise, our environment, our mental health, and how much stress vs. pleasurable activities we have in a typical day all influence the quality of our sleep. When insomnia hits for a night or two, it is easy to catch up. But when it becomes a chronic issue, it needs to be addressed before your health starts to suffer. One of the most effective and widely recommended treatments for insomnia is cognitive behavioral therapy (CBT).
There are two models of understanding and treating insomnia in CBT. The first approaches insomnia as the main focus of treatment. It starts by addressing behavioral modification, i.e., how long you stay in bed, and then moves on to address your beliefs about sleep. This line of treatment is often referred to as CBT-I, or cognitive-behavioral therapy for insomnia. CBT-I is shown to work better than sleeping pills, with no side effects! There are several self-help apps and websites for CBT-I. Personally, I recommend cbtforinsomnia.com, a five-week online intervention with some clinical oversight.
A second model of looking at insomnia is to view it as a symptom of another, bigger emotional health problem. Often times, insomnia is a consequence of depression or anxiety. For example, patients with excessive anxiety and worry may have trouble falling asleep as their mind starts racing - worrying about tomorrow's to-dos or ruminating about past events - the minute they lay their heads on the pillow. In this case, treating the underlying disorder (anxiety) with an approach such as TEAM-CBT will lead to the insomnia resolving itself short-term.
In either case, a well trained CBT therapist may be able to guide you on your path to a good night of restful sleep!
Finding the right therapist is a bit like finding a date. You have to understand what is it that you're looking for and prioritize characteristics such as cost, location, style, and availability. And then do the legwork of searching for them. You can search online at sites such as psychologytoday.com, ask your doctors or friends, call your company's EAP or insurance carrier, or look through neighborhood lists. Many therapists, myself included, will offer a free phone screening consultation in order to get a better understanding of your needs and share more about their background and work style. I highly recommend leveraging this opportunity before making the trek to someone's office.
Your first appointment with a new therapist is usually an intake, which is a longer visit focused on getting a history of your current concerns along with an overview of your social, personal, and professional history. Depending on the complexity of the case, a full intake can take up to 2 or 3 sessions, but it is generally quicker. After that, your therapist will discuss a treatment plan with you, which likely will involve regular (weekly) appointments. Most therapists work with a 50-minute visit, although a 80-minute visit can be very helpful in the beginning to get the treatment going faster. For then on, you and your therapist will work to monitor progress against goals and define new steps.
So, it all begins with finding the person that is right for YOU! The New York Times has posted an article discussing one reporter's path to find their perfect match:
Now it's your turn to take your first step to finding yours!
Dr. David Burns is a world renowned psychiatrist and one of the pioneers in the development of Cognitive Behavioral Therapy. In the past decades, Dr. Burns has been focusing on advancing the clinical applications of CBT through a new therapeutic approach that he calls TEAM-CBT. You can read more about the elements of TEAM-CBT in one of my early blog posts or on Dr. Burns website.
TEAM-CBT is a framework for delivering evidence-based interventions in psychotherapy (and evidence-based here means techniques that have been corroborated as effective by rigorous scientific research). It combines Routine Outcome Monitoring, Motivational Enhancement, and CBT Methods with a strong focus on empathy and rapport building to deliver meaningful symptom reduction in fast periods of time. Indeed, in his current clinical work, which revolves mostly around training of therapists and professional workshops, Dr. Burns has, on many occasions, observed that individuals who had been struggling with depression or anxiety for years can experience near complete recovery in just a few hours.
To explain how that can happen, and provide more background and perspective on the TEAM-CBT approach, Dr. Burns was interviewed by one of our colleagues, Lisa Kelley. The transcript of the interview is an excellent primer to learn more about this powerful new modality. Here it is:
As a Level 5 Certified TEAM-CBT trainer and Master Therapist, I would be delighted to help you learn more about these tools to to enhance your life or, if you are a health care provider, to revolutionize your clinical practice!
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.