Feeling Good: The New Mood Therapy

by Burns, David D.

  Chapter 5

  Do-Nothingism: How to Beat It

  In the last chapter you learned that you can change your mood by changing how you think. There is a second major approach to mood elevation that is enormously effective. People are not only thinkers, they are doers, so it is not surprising that you can substantially change the way you feel by changing the way you act. There’s only one hitch—when you’re depressed, you don’t feel like doing much.

  One of the most destructive aspects of depression is the way it paralyzes your willpower. In its mildest form you may simply procrastinate about doing a few odious chores. As your lack of motivation intensifies, virtually any activity appears so difficult that you become overwhelmed by the urge to do nothing. Because you accomplish very little, you feel worse and worse. Not only do you cut yourself off from your normal sources of stimulation and pleasure, but your lack of productivity aggravates your self-hatred, resulting in further isolation and incapacitation.

  If you don’t recognize the emotional prison in which you are trapped, this situation can go on for weeks, months, or even years. Your inactivity will be all the more frustrating if you once took pride in the energy you had for life. Your do-nothingism can also affect your family and friends, who, like yourself, cannot understand your behavior. They may say that you must want to be depressed or else you’d “get off your behind.” Such a comment only worsens your anguish and paralysis.

  Do-nothingism represents one of the great paradoxes of human nature. Some people naturally throw themselves into life with great zest, while others always hang back, defeating themselves at every turn as if they were involved in a plot against themselves. Do you ever wonder why?

  If a person were condemned to spend months in isolation, cut off from all normal activities and interpersonal relationships, a substantial depression would result. Even young monkeys slip into a retarded, withdrawn state if they are separated from their peers and confined to a small cage. Why do you voluntarily impose a similar punishment on yourself? Do you want to suffer? Using cognitive techniques, you can discover the precise reasons for your difficulties in motivating yourself.

  In my practice I find that the great majority of the depressed patients referred to me improve substantially if they try to help themselves. Sometimes it hardly seems to matter what you do as long as you do something with the attitude of self-help. I know of two presumably “hopeless” cases who were helped enormously simply by putting a mark on a piece of paper. One patient was an artist who had been convinced for years that he couldn’t even draw a straight line. Consequently he didn’t even try to draw. When his therapist suggested he test his conviction by actually attempting to draw a line, it came out so straight he began drawing again and soon was symptom-free! And yet many depressed individuals will go through a phase in which they stubbornly refuse to do anything to help themselves. The moment this crucial motivational problem has been solved, the depression typically begins to diminish. You can therefore understand why much of our research has been directed to locating the causes of this paralysis of the will. Using this knowledge, we have developed some specific methods to help you deal with procrastination.

  Let me describe two perplexing patients I treated recently. You might think their do-nothingism is extreme and wrongly conclude they must be “crazies” with whom you would have little in common. In fact, I believe their problems are caused by attitudes similar to yours, so don’t write them off.

  Patient A, a twenty-eight-year-old woman, has done an experiment to see how her mood would respond to a variety of activities. It turns out that she feels substantially better when she does nearly anything. The list of things that will reliably give her a mood lift includes cleaning the house, playing tennis, going to work, practicing her guitar, shopping for dinner, etc. Only one thing makes her feel reliably worse; this single activity nearly always makes her intensely miserable. Can you guess what it is? DO-NOTHINGISM: lying around in bed all day long, staring at the ceiling and courting negative thoughts. And guess what she does weekends. Right! She crawls right into bed on Saturday morning and begins her descent into inner hell. Do you think she really wants to suffer?

  Patient B, a physician, gives me a clear, definite message early in her therapy. She says she understands that the speed of improvement is dependent on her willingness to work between sessions, and insists she wants to get well more than anything else in the world, having been wracked by depression for over sixteen years. She emphasizes she’ll be happy to come to therapy sessions, but I must not ask her to lift one finger to help herself. She says that if I push her to spend five minutes on self-help assignments, she’ll kill herself. As she describes in detail the lethal, gruesome method of self-destruction she had carefully planned in her hospital’s operating room, it becomes obvious that she is deadly serious. Why is she so determined not to help herself?

  I know your procrastination is probably less severe and only deals with minor things, like paying bills, a trip to the dentist, etc. Or maybe you’ve had trouble finishing a relatively straightforward report that is crucial to your career. But the perplexing question is the same—why do we frequently behave in ways that are not in our self-interest?

  Procrastinating and self-defeating behavior can seem funny, frustrating, puzzling, infuriating, or pathetic, depending on your perspective. I find it a very human trait, so widespread that we all bump into it nearly every day. Writers, philosophers, and students of human nature throughout history have tried to formulate some explanation for self-defeating behavior, including such popular theories as:

  1. You’re basically lazy; it’s just your “nature.”

  2. You want to hurt yourself and suffer. You either like feeling depressed, or you have a self-destructive drive, a “death wish.”

  3. You’re passive-aggressive, and you want to frustrate the people around you by doing nothing.

  4. You must be getting some “payoff” from your procrastination and do-nothingism. For example, you enjoy getting all that attention when you are depressed.

  Each of these famous explanations represents a different psychological theory, and each is inaccurate! The first is a “trait” model; your inactivity is seen as a fixed personality trait and stems from your “lazy streak.” The problem with this theory is that it just labels the problem without explaining it. Labeling yourself as “lazy” is useless and self-defeating because it creates the false impression that your lack of motivation is an irreversible, innate part of your makeup. This kind of thinking does not represent a valid scientific theory, but is an example of a cognitive distortion (labeling).

  The second model implies you want to hurt yourself and suffer because there is something enjoyable or desirable about procrastination. This theory is so ludicrous I hesitate to include it, except that it is widespread and vigorously supported by a substantial percentage of psychotherapists. If you have the hunch that you or someone else likes being depressed and doing nothing, then remind yourself that depression is the most agonizing form of human suffering. Tell me—what is so great about it? I haven’t yet met a patient who really enjoys the misery.

  If you aren’t convinced but think you really do enjoy pain and suffering, then give yourself the paper-clip test. Straighten out one end of a paper clip and push it under your fingernail. As you push harder and harder, you may notice how the pain becomes more and more excruciating. Now ask yourself—is this really enjoyable? Do I really like to suffer?

  The third hypothesis—you’re “passive-aggressive”—represents the thinking of many therapists, who believe that depressive behavior can be explained on the basis of “internalized anger.” Your procrastination could be seen as an expression of that pent-up hostility because your inaction often annoys the people around you. One problem with this theory is that most depressed or procrastinating individuals simply do not feel particularly angry. Resentment can sometimes contribute to your lack of motivation, but is usually not central to the problem. Although
your family may feel frustrated about your depression, you probably do not intend them to react this way. In fact, it is more often the case that you fear displeasing them. The implication that you are intentionally doing nothing in order to frustrate them is insulting and untrue; such a suggestion will only make you feel worse.

  The last theory—you must be getting some “payoff” from procrastination—reflects more recent, behaviorally oriented psychology. Your moods and actions are seen as the result of rewards and punishments from your environment. If you are feeling depressed and doing nothing about it, it follows that your behavior is being rewarded in some way.

  There is a grain of truth in this; depressed people do sometimes receive substantial support and reassurance from others who try to help them. However, the depressed person rarely enjoys all the attention he receives because of his profound tendency to disqualify it. If you are depressed and someone tells you they like you, you will probably think, “He doesn’t know how rotten I am. I don’t deserve this praise.” Depression and lethargy have no real rewards. Theory number four bites the dust with the others.

  How can you find the real cause of motivational paralysis? The study of mood disorders gives us the unique opportunity to observe extraordinary transformations in levels of personal motivation within short periods of time. The same individual who ordinarily bursts with creative energy and optimism may be reduced during an episode of depression to pathetic, bedridden immobility. By tracing dramatic mood swings, we can gather valuable clues that unlock many of the mysteries of human motivation. Simply ask yourself, “When I think about that undone task, what thoughts immediately come to mind?” Then write those thoughts down on a piece of paper. What you write will reflect a number of maladaptive attitudes, misconceptions, and faulty assumptions. You will learn that the feelings that impede your motivation, such as apathy, anxiety, or the sense of being overwhelmed, are the result of distortions in your thinking.

  Figure 5–1 shows a typical Lethargy Cycle. The thoughts on this patient’s mind are negative; he says to himself, “There’s no point in doing anything because I am a born loser and so I’m bound to fail.” Such a thought sounds very convincing when you are depressed, immobilizing you and making you feel inadequate, overwhelmed, self-hating, and helpless. You then take these negative emotions as proof that your pessimistic attitudes are valid, and you begin to change your approach to life. Because you are convinced you will botch up anything, you don’t even try; you stay in bed instead. You lie back passively and stare at the ceiling, hoping to drift into sleep, painfully aware you are letting your career go down the drain while your business dwindles into bankruptcy. You may refuse to answer the phone for fear of hearing bad news; life becomes a treadmill of boredom, apprehension, and misery. This vicious cycle can go on indefinitely unless you know how to beat it.

  * * *

  Figure 5–1. The Lethargy Cycle. Your self-defeating negative thoughts make you feel miserable. Your painful emotions in turn convince you that your distorted, pessimistic thoughts are actually valid. Similarly, self-defeating thoughts and actions reinforce each other in a circular manner. The unpleasant consequences of do-nothingism make your problems even worse.

  * * *

  As indicated in Figure 5–1, the relationship between your thoughts, feelings, and behaviors is reciprocal—all your emotions and actions are the results of your thoughts and attitudes. Similarly, your feelings and behavior patterns influence your perceptions in a wide variety of ways. It follows from this model that all emotional change is ultimately brought about by cognitions; changing your behavior will help you feel better about yourself if it exerts a positive influence on the way you are thinking. Thus, you can modify your self-defeating mental set if you change your behavior in such a way that you are simultaneously putting the lie to the self-defeating attitudes that represent the core of your motivational problem. Similarly, as you change the way you think, you will feel more in the mood to do things, and this will have an even stronger positive effect on your thinking patterns. Thus, you can transform your lethargy cycle into a productivity cycle.

  The following are the types of mind-sets most commonly associated with procrastination and do-nothingism. You may see yourself in one or more of them.

  1. Hopelessness. When you are depressed, you get so frozen in the pain of the present moment that you forget entirely that you ever felt better in the past and find it inconceivable that you might feel more positive in the future. Therefore, any activity will seem pointless because you are absolutely certain your lack of motivation and sense of oppression are unending and irreversible. From this perspective the suggestion that you do something to “help yourself” might sound as ludicrous and insensitive as telling a dying man to cheer up.

  2. Helplessness. You can’t possibly do anything that will make yourself feel better because you are convinced that your moods are caused by factors beyond your control, such as fate, hormone cycles, dietary factors, luck, and other people’s evaluations of you.

  3. Overwhelming Yourself. There are several ways you may overwhelm yourself into doing nothing. You may magnify a task to the degree that it seems impossible to tackle. You may assume you must do everything at once instead of breaking each job down into small, discrete, manageable units which you can complete one step at a time. You might also inadvertently distract yourself from the task at hand by obsessing about endless other things you haven’t gotten around to doing yet. To illustrate how irrational this is, imagine that every time you sat down to eat, you thought about all the food you would have to eat during your lifetime. Just imagine for a moment that all piled up in front of you are tons of meat, vegetables, ice cream, and thousands of gallons of fluids! And you have to eat every bit of this food before you die! Now, suppose that before every meal you said to yourself, “This meal is just a drop in the bucket. How can I ever get all that food eaten? There’s just no point in eating one pitiful hamburger tonight.” You’d feel so nauseated and overwhelmed your appetite would vanish and your stomach would turn into a knot. When you think about all the things you are putting off, you do this very same thing without being aware of it.

  4. Jumping to Conclusions. You sense that it’s not within your power to take effective action that will result in satisfaction because you are in the habit of saying, “I can’t,” or “I would but …” Thus when I suggested that a depressed woman bake an apple pie, she responded, “I can’t cook anymore.” What she really meant to say was, “I have the feeling I wouldn’t enjoy cooking and it seems like it would be awfully difficult.” When she tested these assumptions by attempting to bake a pie, she found it surprisingly satisfying and not at all difficult.

  5. Self-labeling. The more you procrastinate, the more you condemn yourself as inferior. This saps your self-confidence further. The problem is compounded when you label yourself “a procrastinator” or “a lazy person.” This causes you to see your lack of effective action as the “real you” so that you automatically expect little or nothing from yourself.

  6. Undervaluing the Rewards. When you are depressed you may fail to initiate any meaningful activity not only because you conceive of any task as terribly difficult, but also because you feel the reward simply wouldn’t be worth the effort.

  “Anhedonia” is the technical name for a diminished ability to experience satisfaction and pleasure. A common thinking error—your tendency to “disqualify the positive”—may be at the root of this problem. Do you recall what this thinking error consists of?

  A businessman complained to me that nothing he did all day was satisfying. He explained that in the morning he had attempted to return a call from a client, but found the line was busy. As he hung up, he told himself, “That was a waste of time.” Later in the morning he successfully completed an important business negotiation. This time he told himself, “Anyone in our firm could have handled it just as well or better. It was an easy problem, and so my role wasn’t really important.” His lack of satisfact
ion results from the fact that he always finds a way to discredit his efforts. His bad habit of saying “It doesn’t count” successfully torpedoes any sense of fulfillment.

  7. Perfectionism. You defeat yourself with inappropriate goals and standards. You will settle for nothing short of a magnificent performance in anything you do, so you frequently end up having to settle for just that—nothing.

  8. Fear of Failure. Another mind-set which paralyzes you is the fear of failure. Because you imagine that putting in the effort and not succeeding would be an overwhelming personal defeat, you refuse to try at all. Several thinking errors are involved in the fear of failure. One of the most common is overgeneralization. You reason, “If I fail at this, it means I will fail at anything.” This, of course, is impossible. Nobody can fail at everything. We all have our share of victories and defeats. While it is true that victory tastes sweet and defeat is often bitter, failing at any task need not be a fatal poison, and the bad taste will not linger forever.

  A second mind-set that contributes to the fear of defeat is when you evaluate your performance exclusively on the outcome regardless of your individual effort. This is illogical and reflects a “product orientation” rather than a “process orientation.” Let me explain this with a personal example. As a psychotherapist I can control only what I say and how I interact with each patient. I cannot control how any particular patient will respond to my efforts during a given therapy session. What I say and how I interact is the process; how each individual reacts is the product. In any given day, several patients will report that they have benefited greatly from that day’s session, while a couple of others will tell me that their session was not particularly helpful. If I evaluated my work exclusively on the outcome or product, I would experience a sense of exhilaration whenever a patient did well, and feel defeated and defective whenever a patient reacted negatively. This would make my emotional life a roller coaster, and my self-esteem would go up and down in an exhausting and unpredictable manner all day long. But if I admit to myself that all I can control is the input I provide in the therapeutic process, I can pride myself on good consistent work regardless of the outcome of any particular session. It was a great personal victory when I learned to evaluate my work based on the process rather than on the product. If a patient gives me a negative report, I try to learn from it. If I did make an error, I attempt to correct it, but I don’t need to jump out the window.