Review your work in the previous sections of this chapter and make a numbered list of your personal priorities. Keep your list handy and refer to it regularly as a reminder of how you ideally want to live your life.
Priorities shift and shuffle according to what's actually going on in your life. For example, putting work first (for a time) if you need extra money to pay off debts is normal and constructive. Or you may carve out extra time for your elderly relative during his convalescence from an operation. Remind yourself, however, that changes in your fundamental priorities are usually temporary; reshuffle them once a crisis has passed.
Chapter 19: Overcoming Obstacles to Progress
In This Chapter
Getting to know the feelings that bind you
Taking a progressive attitude
Avoiding getting stuck on the road to recovery
Human beings have a keen way of blocking their progress and sabotaging their goals. Maybe you obstruct your progress without even being aware that you're doing it. Or perhaps you're conscious that you're sabotaging yourself with faulty thinking. Whatever the case, this chapter explores common obstacles that get in the way of positive change, and suggests some tips for overcoming blocks to progress.
Tackling Emotions That Get in the Way of Change
As if having an emotional problem isn't enough, you may be giving yourself an extra helping of discomfort and distress as a result of some of the meanings you attach to your original problems. Some of the feelings that you may experience about your primary emotional problems, such as shame, guilt or even pride, can result in progress paralysis.
Shifting shame
When people feel ashamed of their problems, they usually believe that their symptoms are a sign that they're weak, flawed or defective. If you feel ashamed, you're less likely to seek help, because you worry that other people may judge you harshly for having a psychological problem, such as depression or an addiction (see Chapters 12 and 10, respectively), or perhaps they may think that you're silly for having other types of problems, such as anxiety or social phobia. You may worry that anyone you tell about your problem will be horrified by some of your thoughts or actions, and reject you. If you suffer from obsessive-compulsive disorder (OCD), which is typified by unpleasant and unwelcome thoughts or ideas, you may worry that other people won't understand you. People with OCD frequently assume that no one else in the world experiences the kind of upsetting thoughts that they do. In fact, everyone has intrusive and upsetting thoughts from time to time. In Chapter 13, we talk about some of the intrusive thoughts that are common in OCD.
You may be too ashamed to even admit to yourself that you have a problem. Blaming the problem on external events or other people is often a result of shame. Shame is really corrosive to change because it can:
Make you isolate yourself, which can lower your mood even further.
Lead you to deny the problem. And you can't work on problem-solving if you're unwilling to acknowledge that the problem exists in the first place.
Result in you blaming other people and events for your problems, robbing you of your personal power for change.
Make you overestimate your symptoms as ‘abnormal', ‘weird' or ‘unacceptable'.
Lead you to overestimate the harsh degree by which others judge you for having the problem.
Stop you from seeking out more information that can help to make you realise that your problem isn't so unusual.
Prevent you from getting appropriate psychological help, or the right medication.
Fight back against shame by refusing to hide your problems from yourself. Seek out information to make some of your experiences seem more normal. Practise self-acceptance beliefs like the ones we outline in Chapter 14. Take responsibility for overcoming your emotional problems - but resist blaming yourself for your symptoms.
Getting rid of guilt
Guilt is an unhealthy negative emotion that's particularly notorious for blocking positive change. You may be telling yourself guilt-provoking things like the following:
‘I'm causing my family a lot of bother through my problems.'
‘Other people in the world are so much worse off than me. I've no right to feel depressed.'
‘I should be more productive. Instead, I'm just a waste of space.'
Guilt sabotages your chances of taking positive action. Guilty thoughts, such as the preceding examples, can lead you to put yourself down further, thereby making yourself more depressed. Your depression leads you to see the future as hopeless and saps your motivation. (Have a peek at Chapter 6 for more information about unhealthy negative emotions and how they work against you.)
Even if the thoughts that are making you feel guilty about your depression, anxiety or other emotional problem hold some truth, try to accept yourself as someone who's unwell. For example, your diminished ability to be productive is a side effect of depression, not an indication that you're a bad or selfish person.
Shame and guilt grow in the dark. Hiding your problems, and your feelings about your problems, from other people tends to make things worse over time. Talking about your obsessions, depression, addiction or other problems gives you the chance to share your fears and discomfort with someone else, who may be far more understanding than you imagine.
Putting aside pride
Having too much pride can get in the way of your progress. Sometimes, pride is a sort of compensatory strategy for feelings of shame. Your pride may protect you from the shame that you think you'd experience if you were to accept that the methods you've used thus far to overcome your problems have been less than ideal. The following are common pride-based attitudes that may be stopping you from making positive changes:
‘It's absurd to say that I can help myself - if I could make myself better, I'd have done it ages ago!' Actually, people very rarely know how best to help themselves out of emotional problems. Often, you need to read some self-help books or have techniques explained to you before you really understand how to implement specific techniques, and why these methods work.
‘I'm an intelligent person and I should be able to work out this stuff on my own!' Maybe you can work out how to help yourself overcome emotional problems without any help whatsoever. But remember: even the most intelligent people need to see specialists for advice from time to time. For example, you may be very bright but you still need to take your car to a mechanic to be fixed.
‘I like to think of myself as strong. Admitting to having these problems shows me up as weak.' Getting a bout of flu doesn't make you a weak person - and neither does a bout of depression or anxiety. For example, refusing to seek medical treatment for an infected wound is foolish, not an example of strength.
Swallow your pride and be ready to seek advice and help. Recognising and accepting that you have a problem and that you need to get guidance on how to deal with it, takes strength, not weakness.
Seeking support
After you begin to get over your shame, guilt and pride, you can start to look for help in earnest. The help you seek may take the form of reading a self-help book like this one, approaching a therapist, talking things over with a friend (who could even support you using this book) or looking through some online resources. Some people find that self-help techniques are enough. But if you think you need more support, be sure to get help sooner rather than later. Putting off seeking professional help when you need it only prolongs your discomfort. Don't wait until your problem has advanced to the stage where your relationships, employment situation or daily functioning are suffering before you take positive action. (In Chapter 21 we explain how to seek professional help.)
Trying a little tenderness
Shame and guilt involve kicking yourself - and really putting the boot in - when you're already feeling down. Kicking someone in an attempt to get them back on their feet just doesn't make sense.
You haven't chosen your problems, although you may accept that you're stuck in a pattern that's making your problems wors
e. Take other contributing factors into account when you think about how your problems may have started.
You can take responsibility for overcoming your emotional disturbances and you can be compassionate with yourself in the process. Being kind to yourself when you're working hard to get better makes sense, particularly if you consider that a lot of the work involves making yourself uncomfortable in the short term. Surely you deserve to give yourself a little encouragement during exposures and behavioural experiments, rather than piling on the self-criticism.
Try being your own best friend instead of your own worst critic for a while, and see whether this helps you to make some positive strides. (Have a look at Chapter 14 for more tips on how to treat yourself with compassion.)
Book now to avoid disappointment
Many people with emotional problems wait months or even years before sharing them with anyone else. For example, people with OCD put up with their symptoms for an average of ten years before they seek professional help - they may even keep their problems secret from their friends and family. People with depression and other anxiety problems can also wait for months or years before talking about their problems with another person.
The most common reason for keeping problems under wraps is shame. Thinking that you need to keep problems a secret is quite tragic, because you end up suffering in silence needlessly. You can refer to the list of professional resources we supply in Appendix A. Exploring your options now can assure you that your symptoms are common and that you have nothing to be ashamed of. Get yourself on the road to recovery now to avoid feeling disappointed that you didn't get help sooner, and you can start to begin reclaiming enjoyment from life.
Adopting Positive Principles That Promote Progress
Some of the attitudes you hold probably aren't going to do you any favours as you try to overcome your emotional problems. Fortunately, you can swap your unhelpful attitudes for alternative beliefs that can give you a leg-up on the ladder to better emotional health.
Understanding that simple doesn't mean easy
Most of the steps to overcoming psychological problems with CBT are relatively simple. CBT isn't rocket science - in fact, many of the principles and recommendations may seem like common sense. However, CBT may be sense, but it ain't that common - if it was, fewer people would be suffering with emotional problems.
Even if CBT is as simple as ABC, the actual application of CBT principles is far from easy. Using CBT to help yourself requires a lot of personal effort, diligence, repetition and determination.
Because CBT seems so simple, some people get frustrated when they discover that they're not getting well fast or easily enough for their liking. If you want to make CBT work for you, take the attitude that getting better doesn't have to be easy. Your health is worth working for.
Being optimistic about getting better
One of the biggest blocks preventing you from getting better is refusing to believe that change is possible. Be on the lookout for negative predictions that you may be making about your ability to get better. Challenge any thoughts you have which resemble the following:
‘Other people get better, but they're not as messed up as me.'
‘I'll never change - I've been like this for too long.'
‘This CBT stuff will never work for someone as useless as me.'
If these thoughts sound familiar, check out the ‘Trying a little tenderness' section earlier in this chapter, which covers how to be a little kinder to yourself. Would you encourage a friend to believe such thoughts, or would you urge her to challenge her thinking? Try to give yourself the kind of good advice that you'd give another person with your type of problem.
Look for evidence that you can make changes. Remind yourself of other things you've done in the past that were difficult and required lots of effort to overcome. If you don't give a new treatment method a fair shot, then how can you possibly know it can't work?
Don't fall into the trap of deciding that your problems are so special and unusual that you can't be helped by conventional methods like CBT. Sometimes, people can be quite defensive about their emotional problems because they believe that they're part of what makes them unique. You'll still be a unique person when you've recovered from your problems - you'll just be happier. Clinging to the idea that no one can possibly understand or assist you can become a self-fulfilling prophecy. You may hold rigidly to the idea of being a hopeless case because it protects you from getting your hopes up and being disappointed. Take the risk of possible disappointment for the chance of success.
Staying focused on your goals
If you want to continue making healthy progress, occasionally you need to renew your commitment to your goals. You may find that you stop dead in your tracks because you've forgotten what the point is. Or perhaps you find yourself feeling ambivalent about getting over your problems. After all, staying anxious, depressed or angry may seem easier than changing.
Remind yourself regularly of your goals and the benefits of striving to achieve these goals. You can use the cost-benefit analysis (CBA) form to reaffirm the benefits of making goal-directed changes. In Chapter 8, we describe the CBA form and give you some more information about setting goals. Turn to Appendix B for a blank version of the CBA form.
Always try to set goals that are within your grasp, and you can establish shorter-term goals along the way. For example, if your goal is to move from being largely housebound to being able to travel freely, set a goal of being able to go to a particular shop to buy something specific. You can then concentrate on the steps needed to reach that particular smaller goal, before moving on to tackle larger goals.
Persevering and repeating
We often hear people say that they tried a technique or experiment once but that it didn't make them feel better. The reason for this lack of success is that once is very rarely enough. When you work at changing ingrained patterns of thinking and behaving, you're likely to have to try out new alternatives many times before you appreciate any beneficial change. You need to give yourself plenty of opportunity to get used to the new thought or behaviour. Also, you can expect new ways of thinking and behaving to feel very unnatural at first.
Think of your core beliefs and old ways of behaving as automatic responses, just like using your right hand to apply your lipstick. If you break your right arm, and are unable to use it for a while, you have to use your left hand to do so. Imagine that your new healthy beliefs and behaviours are represented by your left hand. Each time you go to use your new beliefs, they feel awkward and don't seem to work very well. Every morning when you reach for your lipstick with your broken right arm, you have to remind yourself to struggle with using your left arm instead. You find it difficult to make a good outline of your lips and on some occasions look almost clown-like. However, over time you get better and better at using your left hand to apply make-up, until one day your automatic response is to reach for the lipstick with your left hand.
People can retrain themselves into using new patterns of behaviour all the time. Think about people who are giving up smoking or changing their diets. Even moving house and altering your route to work are examples of behavioural retraining. You can retrain your thinking as well as your behaviour - perseverance and repetition apply to both.
Tackling Task-Interfering Thoughts
The ‘Tic-Toc' technique is a simple yet effective way of unblocking obstacles to change. The technique gives you a helping hand toward achieving your goals.
TICs are task interfering cognitions, the thoughts, attitudes and beliefs that get in the way of your progress. You need to respond with TOCs - task orienting cognitions, which are constructive alternatives to TICs. The list of unhelpful attitudes (sand traps) in the nearby sidebar is helpful for getting some ideas about task interfering cognitions.
Fill out the Tic-Toc sheet by following these steps:
1. Identify the goal or task you want to focus on.
2. In the left column (TICs), list yo
ur thoughts, attitudes and beliefs that get in the way of you achieving your aim.
3. In the right column (TOCs) put responses to each of your TICs that will help you achieve your goal or task.
You can find a blank Tic-Toc form in Appendix B. Use it whenever you notice that you're not pursuing a goal or carrying out a self-helping task. Table 19-1 is an example of a Tic-Toc sheet.
Cognitive Behavioural Therapy For Dummies Page 34