Healthy emotions spring from flexible, preference-based thinking. So, thoughts and beliefs like ‘I prefer others to treat me respectfully, but they're not bound to do so' and ‘I prefer to get what I want without hassle, but no reason exists that this should always be the case' can lead to healthy annoyance when other people and the world don't meet your preferences.
Rigid thinking is a reliable indicator that you're having an unhealthy feeling. When you think rigidly, you're more likely to underestimate your ability to cope with and overcome the negative event in question. The more adept you become at identifying your thoughts, beliefs and attitudes as either rigid and demanding or flexible and preferential, the easier you can work out whether your feelings are healthy or unhealthy.
When you feel guilty, you think in an unhealthy, rigid, demand-based manner and may say things like the following:
‘I absolutely shouldn't have left my aunt alone.'
‘Leaving my aunt alone was a bad thing and means I'm a bad person.'
‘I can't bear the pain of knowing that I've done this bad thing of leaving my aunt alone.'
You may then continue to think in the following guilt-enhancing ways:
You fail to acknowledge that your aunt ultimately chose to try to change the light bulb herself. You fail to acknowledge that other members of your family can also check in on your aunt.
You ignore the fact that you had no way of knowing that the light bulb needed changing, and that you had not foreseen your aunt taking such a risk.
You expect that your aunt will blame your entirely. You think about the punishment that you believe you deserve.
By contrast, if you feel remorseful, you think in a healthy, flexible, preference-based manner and may say things such as:
‘I wish I hadn't left my aunt alone, but regrettably I did.'
‘Leaving my aunt alone may mean that I've done a bad thing but not that I'm a bad person.'
‘I can bear the pain of knowing that I've done this bad thing of leaving my aunt alone.'
You can then continue to think in helpful ways:
You can acknowledge your part in the accident occurring, but you can also consider that other members of the family failed to check in on your aunt.
You can acknowledge that you didn't foresee your aunt taking the risk of changing a light bulb. Nor did you know that the bulb would burn out.
You can expect that your aunt may be upset with you, but you believe that you don't deserve a severe punishment.
Taking legitimate responsibility for what happens in a situation enables you to think about the event in a holistic way. You don't need to prolong uncomfortable feelings of remorse beyond what is reasonable and appropriate to the situation. Your ability to solve problems isn't impeded by feelings of guilt.
Spotting the difference in behaving, and ways you want to behave
Another way of figuring out whether your emotion is in the healthy or unhealthy camp is to have a look at your actual behaviour or the way in which you feel inclined to behave.
Healthy negative emotions are accompanied by largely constructive behaviours, whereas unhealthy feelings usually go hand-in-hand with self-defeating behaviours. Problem-solving is still possible when you're healthily sad, annoyed, remorseful or regretful, but you have much greater difficulty planning clear ways to surmount your problems when you're unhealthily depressed, enraged, guilty or ashamed.
For example, if you respond to your aunt's falling over with guilt-based action tendencies, you may do one or more of the following:
Go out and get quite drunk, trying to block out your guilty feelings.
Visit your aunt in hospital and plead for her forgiveness.
Promise that you'll never again let down your aunt, or anyone else dear to you, for as long as you live.
Decide that you won't go on any other trips while your aunt is alive.
The preceding behaviours are problematic because they're extreme and unrealistic. These actions focus on self-punishment rather than look at the reality of the situation and how you can, in this example, best meet your aunt's needs.
On the other hand, if you're feeling healthy remorse your action tendencies may include some of the following:
Endure the discomfort of knowing that your aunt has been hurt (rather than getting drunk to avoid it).
Visit your aunt in hospital regularly and apologise for having left her alone.
Understand that your aunt needs continuous support but that you have the right to go away with friends.
Plan to stay with your aunt for a week or so after she's discharged from hospital.
Resolve to plan your trips away more carefully and to arrange for nursing staff to be with your aunt when you're unavailable.
The preceding behaviours are geared towards making sure that your aunt doesn't hurt herself again during your absence. By taking an appropriate amount of responsibility for the accident, you can still look for ways to provide comfort for your aunt rather than concentrate on punishing yourself.
Spotting the difference in what you focus on
In addition to differences in types of thinking and behaving, you can distinguish healthy from unhealthy emotions by checking out the focus of your attention. If you're having an unhealthy emotion, your mind is likely to focus on catastrophic possibilities in the future based on the primary event.
If you're responding to the injured auntie situation from a place of guilt, you may focus your attention on the following:
Blaming yourself for abandoning your aunt and for the accident happening.
Feeling the pain of your guilt whilst neglecting to consider potential solutions to the problem of your aunt needing continuous care.
Looking for evidence that your aunt blames you entirely for the accident.
Looking for blame from other people, such as hospital staff and family members.
You continue to give yourself an unduly rough ride, thereby prolonging your distressing, guilt feelings by focusing on the bleakest possible aspects of your aunt's accident.
If you respond to the situation from a place of remorse, you are likely to focus your attention on the following:
Accepting that leaving your aunt alone may have been a bad decision but that you had no intention of putting her at risk.
Feeling the pain of remorse over the accident but also trying to find ways to improve the situation.
Not seeking out evidence of blame from your aunt.
Accepting evidence that hospital staff or family members do not blame you for the accident.
Thus, your attention focus when you respond from a place of remorse enables you to take some responsibility for your aunt's broken hip, but you don't dwell on the potential for blame and punishment.
Spotting Similarities in Your Physical Sensations
Butterflies in your stomach, blood racing through your veins, light-headedness, sweaty palms, heart pounding. Sound familiar? We expect so. If someone described these physical symptoms to you, you may try to guess what emotion they were experiencing. However, it would be difficult to confidently determine the specific emotion, because these sensations can accompany several different positive and negative emotional states. For example, you may get butterflies in your stomach when you're excited, angry, anxious or in love, as illustrated in Figure 6-2.
Figure 6-2: Spot the similarities in your physical sensations.
The sensations that you feel in your body also tend to overlap in both healthy and unhealthy negative emotions. For example, you may get butterflies in your stomach when you're unhealthily anxious and when you're healthily concerned. Therefore, using your physical symptoms as a guide to judging the healthiness of your negative feelings isn't very reliable.
The main way in which your physical responses are likely to vary between the healthy and unhealthy categories is in their intensity. You probably find that sensations are more intense, uncomfortable and debilitating when you're having unhealthy emotions, such as anxiety
and anger. You may also notice that uncomfortable physical sensations last longer when you're experiencing unhealthy negative emotions.
Incidentally, we believe that if you're experiencing butterflies, sweaty palms, racing blood, light-headedness and a pounding heart all at once, then you really are in love!
Identifying Feelings about Feelings
Getting two emotions for the price of one isn't such a great deal when two unhealthy negative emotions are on offer.
CBT professionals call feelings about feelings meta-emotions. The prefix meta comes from Greek and means ‘beside' or ‘after'.
Sometimes, you can give yourself a second helping of unhealthy emotion by holding rigid demands about which emotions you believe are acceptable for you to experience in the first place.
A common example of feelings about feelings is found in depression. Many people have guilty feelings about their depression. This guilt often comes from the demands people make of themselves, for example that they mustn't let other people down or put undue strain on loved ones. Here are some typical guilt-producing thoughts that are common in depressed people:
‘I should be contributing more to the running of the home.'
‘I must be able to demonstrate love and care to my children.'
‘My partner and children are worried about me, and I'm making them suffer.'
‘I shouldn't be neglecting my friends in this way.'
Recognising your meta-emotions is important, because meta-emotions can prevent you from dealing with your primary emotional problems. For example, you may be feeling guilty about having depression. If you can stop feeling guilty, you'll almost certainly find that you can work on overcoming your depression more effectively.
If you find that the concept of feeling guilty about being depressed really does strike a chord with you, go to Chapter 12, where we discuss it in more detail.
Handy emotional health checklist
The following is an abbreviated list of ways that can help you to find out the nature of a feeling and give it a name. The list can also help you assess whether an emotion is of the healthy or unhealthy negative variety.
Have you identified a word to describe how you feel inside?
Can you identify the theme of your emotion?
How does your emotion lead you to behave? Are your actions or urges to act helpful or unhelpful?
Are you thinking in a flexible way, or are you thinking in a rigid and demanding way?
What are you paying attention to? Are you looking at the event from all angles?
Is another emotion getting in the way of you being able to identify your first emotion? For example, are you feeling guilty or ashamed about your anger, depression or other emotion?
Defining Your Emotional Problems
The aim of CBT is to help you overcome your emotional problems and move you towards your goals. As with all kinds of problem-solving, defining your emotional problems is the first step in solving those problems.
Making a statement
Writing down a problem statement has three main components - the emotion, the theme or event (what you feel your emotion about), and what you do in response to that emotion. You can effectively describe an emotional problem by filling in the blanks of the following statement:
Feeling____________________ (emotion) about _______________________ (theme or event), leading me to___________________________________ (response).
For example:
Feeling anxious about my face turning red in social situations, leading me to avoid going out to bars and clubs and to splash my face with water if I feel hot.
Feeling depressed about the end of my relationship with my girlfriend, leading me to spend too much time in bed, avoid seeing people and take less care of myself.
When positives are negatives
Although this chapter deals with unhealthy negative emotions because these are the most common factors in emotional disturbance, you can't forget that negative positive emotions do also exist.
An example of a negative positive emotion is holding a rigid demand, such as ‘I must get approval from my boss' and then feeling a surge of delight when the demand is met. You may feel good about the approval and your confidence may soar for a time, but you're still vulnerable to unhealthy negative feelings if you later fail to get your boss's approval. If you hold a flexible preference for your boss's approval, you can feel healthily pleased if you get approval and healthily disappointed if you don't.
Another example of unhealthy positive emotions is the feeling of euphoria associated with hypomanic (excessively happy or ‘high') states. People who suffer from bipolar affective disorder (formerly known as manic depression) can experience alternating periods of extreme low-mood and extreme high-mood. During high periods, people with bipolar affective disorder are often prone to making rash decisions and behaving in erratic, sometimes risky ways. People with bipolar affective disorder may seem to be very happy when in fact they're hypomanic and suffering from a genuine psychiatric condition. Bipolar affective disorder can be treated effectively with medication and CBT. Many of the tips for overcoming unipolar (or general depression) that you can find in Chapter 12 are also very helpful for people with bipolar disorder. Appendix A lists organisations that you may find helpful.
If you think that you, or someone close to you, may have bipolar affective disorder, we strongly recommend seeing a psychiatrist to get a comprehensive assessment. Prescribed medication is an important part of managing the distressing conditions of this disorder. Psychiatrists generally have more specialised knowledge about the disorder and appropriate medications than general physicians.
One key CBT strategy for helping people to manage bipolar depression involves making an activity schedule (see Chapter 12). Write down a plan of your daily activities and stick to doing them regardless of your mood to help you achieve balance and consistency. The crucial point is to establish a consistent level of activity in your daily life. Sticking to a daily schedule of activities can help you avoid being under-stimulated during lows (thereby combating a downward spiral into depression) and help you avoid becoming over-stimulated during highs (thereby preventing an upward spiral into hypomania).
Rating your emotional problem
Human nature leads you to focus on how bad you feel, rather than how much better you feel. As you reduce the intensity of any emotional disturbance, you can find motivation in being able to see a difference. After you describe a problematic emotion, rate it on a scale of 0-10, based on how much distress the emotion causes you and how much it interferes with your life.
As you work on resolving your emotional problem by making changes to your thinking and behaviour, continue to rate the distress and interference it is causing you. Your ratings are likely to go down over time as you make efforts to overcome your unhealthy negative emotions. Review your ratings regularly, once a week or so. Doing this review helps remind you of your progress and replenishes your motivation to keep up the good work!
Share your ratings with your CBT therapist if you have one. Your therapist can haul out your rating records and show you the progress you've made if your motivation begins to flag.
Chapter 7: Identifying Solutions That Cause You Problems
In This Chapter
Understanding how common coping strategies can maintain (and worsen) your problems
Examining and eliminating safety behaviours
Understanding why doing the opposite of your current strategies can help you
The first step in any kind of problem-solving is to define the problem. This chapter is about assessing your problems and putting your finger on the way in which your current coping strategies are part of your specific problem.
Often, the problematic behaviours that maintain or worsen emotional problems are the very behaviours that people use to help themselves cope - hence the common CBT expression ‘your solution is the problem'.
Cognitive Behavioural Therapy For Dummies Page 11