Dr. Levy's CBT Blog
Insights on Well-Being, Contentment, and Cognitive Behavioral Therapy
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.
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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! 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: lwww.nytimes.com/2017/07/17/smarter-living/how-to-find-the-right-therapist.html 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!
Dying for a Paycheck is a book by long-time Stanford GSB professor and business guru Jeffrey Pfeffer. In it, Professor Pfeffer argues that the long hours and round-the-clock availability expectations of today's fast-paced workplaces have led to unprecedented levels of high stress, burn out, disengagement, as well as low physical and emotional health. His findings and viewpoints match well with my own academic research on Work Attitudes and Behaviors Among Professional Women. I posit that it is not simply how much you work, but how you relate to your work that determines its repercussions on your satisfaction and wellbeing. A summary of the study methods, analyses and conclusions is included below. If you find yourself struggling with career and balance issues, take a break, do something pleasurable or meaningful to you, and connect with friends and loved ones. If you find yourself in need of greater support, consider seeking a therapist. As we start the new year, several of us have 'new year resolutions' that may include goals to eat healthy, exercise more, learn new skills, sleep better, travel, etc. If you picked the exercise category, you will be happy to hear that you are in the right path to improve your mental health along with your physical health.
A recent study in the American Journal of Psychiatry highlights the benefit of regular exercise in the prevention of depressive disorders. Here is an exerpt from the abstract: Undertaking regular leisure-time exercise was associated with reduced incidence of future depression...The majority of this protective effect occurred at low levels of exercise and was observed regardless of intensity...12% of future cases of depression could have been prevented if all participants had engaged in at least 1 hour of physical activity each week. Easy - and cheap! Now, if you need help overcoming that pesky procrastination habit and changing those behaviors for good, your therapist can give you a much needed push to get finally get started! Some clients go through years of psychotherapy without attaining meaningful change in their lives. When we look deeper into those situations, it is easy to understand why. Their reality is such that feeling joyful, free, satisfied just doesn't make sense. For example, if I am failing a class, having conflict in my marriage, or fearing riding any and all elevators, there are very valid and straightforward reasons for feeling distraught. In many instances, the very feeling of sadness, nervousness, or distrust is a reflection of something beautiful and positive about that person's value system. I would not be feeling sad for failing my classes if achievement and responsibility weren't important to me!
When therapists try to change a client's emotional reactions without honoring the positive facets and functions of those reactions in the context of the individual's overall experience, the efforts are doomed to fail. That is why, in TEAM-CBT, we spend a healthy amount of time in Agenda Setting, before moving forward with any attempt for change. Dr. David Burns explains why some clients may not want to change - and why helping is not always helpful - in this insightful article in the latest issue of Psychotherapy Networker: https://www.psychotherapynetworker.org/magazine/article/1076/when-helping-doesnt-help ![]() TEAM-CBT is a framework for providing evidence based psychotherapy. It was developed by Dr. David Burns, MD, Adjunct Emeritus Professor at Stanford School of Medicine. What is Evidence-Based Practice in Psychotherapy? Evidence-based practice in psychology is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. It leverages evidence-based treatments. This designation describes specific clinical interventions that have been validated as efficacious for certain mental health conditions under rigorous academic research. Many cognitive and behavioral interventions (e.g., thought re-structuring, exposure therapy) are recognized by the American Psychological Association as evidence-based treatments. What is CBT? Cognitive Behavioral Therapy is a type of evidence-based treament. It examines our thoughts processes - our idiosyncratic way of seeing the world around us -, our typical behaviors or actions, and our emotions in defined moments in our lives. It then providers actionable, well-defined, and simple ways of modifying thoughts and behaviors, with the ultimate goal of changing our feelings - for the better. It is focused on the here and now and aims to deliver symptom reduction in a fast but sustainable way. What is TEAM-CBT? TEAM, as mentioned above, is a framework for compiling cognitive and behavioral therapy interventions and delivering them through powerful, results-driven psychotherapy. TEAM stands for four key elements in this therapeutic approach: T = Testing In this type of therapy, clients are asked to gauge their level of distress and life satisfaction on a regular basis. Looking at metrics over time, the client and therapist can then determine whether their work together is helping the patient objectively improve their well-being. E = Empathy Before the more active part of the therapy begins, it is imperative that the therapist and the client be on the same page. TEAM-CBT offers specific techniques for increasing openness, authenticity, and vulnerability in the therapy sessions. A = Agenda Setting This is where TEAM combines evidence-based practices of traditional CBT with elements of Motivational Interviewing, a therapeutic method that works on facilitating and enhancing intrinsic motivation within the client in order to change behavior. The client and the therapist develop a shared agenda for the overall work and for each session where the client is effectively arguing for change - and thus melting away the psychological resistance to upset the status quo. M = Methods TEAM brings together over 50 cognitive and behavioral methods for change, from traditional thought analysis and behavior experiments to innovative role playing techniques, compassion-based techniques, communication training, and much more. For each angle of unhelpful thought processes, TEAM has a number of powerful techniques that can help the client find more constructive alternatives. The goal of TEAM therapy is to help the client, over time, become their own therapist. For individuals motivated to change their lives, it can lead to meaningful gains in happiness, peace, fulfillment, and contentment in short periods of time. To lear more about TEAM therapy, visit Dr. Burns's Feeling Good website or call me for a free phone consultation. 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. https://www.healthiguide.com/health/what-marijuana-really-does-to-your-body-brain/ 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! Mindfulness is "in" these days across health care and business settings. But beyond being cool, does it work? Or better, what is it good for? Always on top of popular trends, the Harvard Business Review published an essay recently by renowned author and psychologist, Dr. Daniel Goleman. In it, Dr. Goleman reviews the scientific literature about the positive effects of mindfulness and draws conclusions about the areas where enough data is available to support its benefits.
According to this analysis of the research, there are four areas where meditation and mindfulness practices lead to better performance and outcomes, as follows:
Altogether, the research indeed corroborates that living a more mindful, present-focused life can enhance mental fitness and wellbeing. If you are interested in starting a mindfulness practice, I recommend checking out the Google Play or App Store for popular apps such as Insight Timer, Breathe, and Headspace. A licensed mental health provider can also help you learn how to use mindfulness to better your mood, change your thought processes, and embrace more helpful everyday behaviors. |
AuthorDr. Daniele Levy is a licensed psychologist offering CBT in-person and via Teletherapy in Menlo Park, CA. Her background uniquely combines leading edge training in behavioral sciences with deep expertise coaching and mentoring working professionals in dynamic organizations. Categories
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California License PSY 27448
Copyright © 2014 Daniele V. Levy, PhD Bay Area Cognitive Behavioral Therapy (CBT) Office: 830 Menlo Ave, Suite 200, Menlo Park CA Mailing: 405 El Camino Real #256, Menlo Park CA www.cbttherapy.com |