Feeling Good: The New Mood Therapy

by Burns, David D.

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  Figure 12–2. The Pleasure-Predicting Sheet.

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  Once you have filled in the columns, proceed with the activities. Once they are completed, record the actual satisfaction in the last column, using the same 0- to 100-percent rating system.

  After you have performed a series of such experiments, you will be able to interpret the data you have collected. You can learn many things. First, by comparing the predicted satisfaction (column four) with the actual satisfaction (column five), you will be able to find out how accurate your predictions are. You may find that you typically underestimate the amount of satisfaction you anticipate experiencing, especially when doing things alone. You might also be surprised to learn that activities with others are not always as satisfying as anticipated. In fact, you may even find that there are many times when it was more enjoyable to be alone, and you might discover that the highest ratings you received when you were alone were equal to or higher than those for activities involving others. It can be helpful to compare the amount of satisfaction you derived from work activities versus pleasurable activities. This information can help you achieve an optimal balance between work and fun as you continue to plan your activities.

  Questions are probably now crossing your mind, “Suppose I do something and it isn’t as satisfying as I predicted? Or suppose I make a low prediction and it really comes out that way?” In this case try to pinpoint the automatic negative thoughts that dampen the experience for you. Then talk back to these thoughts. For example, a lonely sixty-five-year-old woman whose children were all grown and married decided to enroll in an evening course. All the other students were of college freshman age. She felt tense the first week of classes because of her thought, “They probably think I’m an old bag with no right to be here.” When she reminded herself she had no idea what the other students thought of her, she felt some relief. After talking to another student, she found out that some of them admired her gumption. She then felt much better, and her satisfaction levels began to climb.

  Now let’s see how the Pleasure-Predicting Sheet can be used to overcome dependency. Joanie was a fifteen-year-old high-school student who had suffered from a chronic depression for several years after her parents moved to a new town. She had difficulty making friends in the new high school, and believed, as many teenage girls do, that she had to have a boyfriend and be a member of the “in crowd” before she could be happy. She spent nearly all her free time at home alone, studying and feeling sorry for herself. She resisted and resented the suggestion she start going out and doing things because she claimed there would simply be no point in doing them alone. Until a circle of friends magically dropped into her lap, she seemed determined to sit and brood.

  I persuaded Joanie to use the Pleasure-Predicting Sheet. Figure 12–2 shows that Joanie scheduled a variety of activities, such as visiting an arts and crafts center on a Saturday, going to a rock concert, etc. Because she did them alone, she anticipated they would be unrewarding, as indicated by her low predictions in column four. She was surprised to find she actually did have a reasonably good time. As this pattern tended to repeat itself, she began to realize that she was predicting things in an unrealistic negative way. As she did more and more on her own, her mood began to improve. She still wanted friends, but no longer felt condemned to misery when she was alone. Because she proved she could make it on her own, her self-confidence went up. She then became more assertive with her peers, and invited several people to a party. This helped her develop a network of friends, and she found that boys as well as girls in her high-school class were interested in her. Joanie continued to use the Pleasure-Predicting Sheet to evaluate the levels of satisfaction she experienced in dates and activities with her new friends. She was surprised to find that they were comparable to the enjoyment levels she experienced in doing things alone.

  There is a difference between wanting and needing something. Oxygen is a need, but love is a want. I repeat: LOVE IS NOT AN ADULT HUMAN NEED! It’s okay to want a loving relationship with another human being. There is nothing wrong with that. It is a delicious pleasure to be involved in a good relationship with someone you love. But you do not need that external approval, love, or attention in order to survive or to experience maximal levels of happiness.

  Attitude Modification. Just as love, companionship, and marriage are not necessary for happiness and self-esteem, they are not sufficient either. The proof of this is the millions of men and women who are married and miserable. If love were the antidote to depression, then I would soon be out of business because the vast majority of the suicidal individuals I treat are in fact loved very dearly by their spouses, children, parents, and friends. Love is not an effective antidepressant. Like tranquilizers, alcohol, and sleeping pills, it often makes the symptoms worse.

  In addition to restructuring your activities more creatively, challenge the upsetting negative thoughts that flow through your mind when you are alone.

  This was helpful to Maria, a lovely thirty-year-old single woman, who found that when she did activities on her own, she sometimes soured the experience unnecessarily by telling herself, “Being alone is a curse.” In order to combat the feelings of self-pity and resentment this thought created, she wrote a list of counterarguments (see Figure 12–3, page 323). She reported this was very helpful in breaking the cycle of loneliness and depression.

  Over a year after terminating my work with her I sent her an early draft of this chapter, and she wrote back: “Last night I read very thoroughly the chapter … It proves that it is not being alone that is so bad or so good, but rather how one thinks regarding that or any other condition of being. Thoughts are so powerful! They can make or break you, right? … It is almost funny, but now I am almost afraid to ‘have a man.’ I do rather well, maybe better, without one … Dave, did you ever think you would hear this from me?”

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  Figure 12–3. “Being alone is a curse.” Counterarguments: The advantages of being alone.

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  The double-column technique can be especially useful in helping you overcome the negative thinking pattern that makes you fear standing on your own two feet. For example, a divorced woman with one child contemplated suicide because her lover—a married man—had broken off with her. She had an intensely negative self-image, and didn’t believe that she would ever be capable of sustaining an ongoing relationship. She was sure she would always end up a reject and a loner. She wrote in her journal the following thoughts as she contemplated a suicide attempt:

  The empty place in the bed next to me silently mocks me. I am alone—alone—my greatest fear, my most dreaded fate, a reality. I am a woman alone and in my mind that means I am nothing. The logic I am operating on goes something like this:

  1. If I were desirable and attractive there would be a man beside me now.

  2. There is no man beside me.

  3. Therefore I am undesirable and unattractive.

  4. Therefore there is no point in living.

  She went on to ask herself in her journal, “Why do I need a man? A man would solve all my problems. He would take care of me. He would give my life direction and most importantly he would provide me with a reason to get out of bed each morning when all I now want to do is put my head under the covers and sink into oblivion.”

  She then utilized the double-column technique as a way of challenging the upsetting thoughts in her mind. She labeled the left-hand column “Accusations of My Dependent Self,” and labeled the right-hand column “Counterarguments of My Independent Self.” She then carried out a dialogue with herself to determine what the truth of the matter realty was (see Figure 12–4, page 325).

  After doing the written exercise, she decided to read it over each morning in order to develop the motivation to get out of bed. She wrote the following outcome in her personal diary:

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  Figure 12–4.

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  I learned to see that t
here is a big difference between wanting and needing. I want a man but I no longer feel that I must have a man to survive. By maintaining a more realistic inner dialogue with myself and by looking at my own strengths, by listing and reading and reading again the things that I have obtained on my own, I slowly am beginning to develop a sense of confidence in my ability to handle what might come. I find that I am taking better care of myself. I am treating myself as I would have treated a beloved friend in the past with kindness and compassion, with a tolerance for flaws and an appreciation of assets. Now I can view a difficult situation not as a pestilence especially contrived to plague me but as an opportunity to practice the skills I am learning, to challenge my negative thoughts, to reaffirm my strengths and to enhance my confidence in my ability to deal with life.

  Chapter 13

  Your Work Is Not Your Worth

  A third silent assumption that leads to anxiety and depression is “My worth as a human being is proportional to what I have achieved in my life.” This attitude is at the core of Western culture and the Protestant work ethic. It sounds innocent enough. In fact, it is self-defeating, grossly inaccurate, and malignant.

  Ned, the physician described in earlier chapters, called me at home one recent Sunday evening. He had been feeling panicky all weekend. His upset was triggered by plans to attend the twentieth reunion of his college class (he graduated from an Ivy League college). He had been invited to give the keynote address to the alumni. Why was Ned in such a state of apprehension? He was concerned that he might meet up with some classmate at his reunion who had achieved more than he had. He explained why this was so threatening: “It would mean I was a failure.”

  Ned’s exaggerated preoccupation with his achievements is particularly common among men. While women are not immune to career concerns, they are more likely to be depressed after the loss of love or approval. Men, in contrast, are especially vulnerable to concerns about career failure because they’ve been programmed from childhood to base their worth on their accomplishments.

  The first step in changing any personal value is to determine if it works more to your advantage or disadvantage. Deciding that it will not really help you to measure your worth by what you produce is the crucial first step in changing your philosophy. Let’s begin with a pragmatic approach, a cost-benefit analysis.

  Clearly, there can be some advantage to equating your self-esteem with your accomplishments. In the first place, you can say “I’m okay” and feel good about yourself when you have achieved something. For example, if you win a golf game, you can pat yourself on the back and feel a little smug and superior to your partner because he missed his putt on the last hole. When you go jogging with a friend and he runs out of breath before you do, you can puff up with pride and tell yourself, “He’s a good guy for sure, but I’m just a little better!” When you make a big sale at work, you can say, “I’m producing today. I’m doing a good job. My boss will be pleased and I can respect myself.” Essentially, your work ethic allows you to feel you’ve earned personal worth and the right to feel happy.

  This belief system may make you especially motivated to produce. You might put extra effort into your career because you’re convinced this will give you extra worthiness units, and you will therefore see yourself as a more desirable person. You can avoid the horrors of being “just average.” In a nutshell, you may work harder to win, and when you win you may like yourself better.

  Let’s look at the other side of the coin. What are the disadvantages of your philosophy of “worth equals achievement”? First, if your business or career is going well, you may become so preoccupied with it that you may inadvertently cut yourself off from other potential sources of satisfaction and enjoyment as you slave away from early morning to late night. As you become more and more of a workaholic, you will feel excessively driven to produce because if you fail to keep up the pace, you will experience a severe withdrawal characterized by inner emptiness and despair. In the absence of achievement, you’ll feel worthless and bored because you’ll have no other basis for self-respect and fulfillment.

  Suppose as a result of illness, business reversal, retirement, or some other factor beyond your control, you find you are unable to produce at the same high level for a period of time. Now you may pay the price of a severe depression, triggered by the conviction that because you are less productive it means you are no good. You’ll feel like a tin can that’s been used and is now ready for the trash. Your lack of self-esteem might even culminate in a suicide attempt, the ultimate payment for measuring your worth exclusively by the standards of the marketplace. Do you want this? Do you need this?

  There may be other prices to pay. If your family suffers from your neglect, a certain resentment may build up. For a long time they may hold it in, but sooner or later you’ll get the bill. Your wife has been having an affair and is talking about divorce. Your fourteen-year-old son has been arrested for burglary. When you try to talk with him, he snubs you: “Where’ve you been all these years, Dad?” Even if these unfortunate developments do not happen to you, you will still have one great disadvantage—the lack of true self-esteem.

  I have recently begun treating a very successful businessman. He claims to be one of the top money earners in the world in his profession. Yet he is victimized by episodic states of fear and anxiety. What if he should fall off the pinnacle? What if he had to give up his Rolls-Royce Silver Cloud and drive a Chevrolet instead? That would be unbearable! Could he survive? Could he still love himself? He doesn’t know if he could find happiness without the glamour or glory. His nerves are constantly on edge because he can’t answer these questions. What would your answer be? Would you still respect and love yourself if you experienced a substantial failure?

  As with any addiction, you find that greater and greater doses of your “upper” will be needed in order to become “high.” This tolerance phenomenon occurs with heroin, “speed” (amphetamines), alcohol, and sleeping pills. It also happens with riches, fame, and success. Why? Perhaps because you automatically set your expectations higher and higher once you have achieved a particular level. The excitement quickly wears off. Why doesn’t the aura last? Why do you keep needing more and more? The answer is obvious: Success does not guarantee happiness. The two are not identical and are not causally related. So you end up chasing a mirage. Since your thoughts are the true key to your moods and not success, the thrill of victory fades quickly. The old achievements soon become old hat—you begin to feel sadly bored and empty as you stare at your trophy case.

  If you do not get the message that happiness does not reliably and necessarily follow from success, you may work even harder to try to recapture the feeling you once had from being on top. This is the basis for your addiction to work.

  Many individuals seek guidance or therapy because of the disillusionment that begins to dawn on them in their middle or later years. Eventually these questions may confront you as well: What’s my life all about? What’s the meaning of it all? You may believe your success makes you worthwhile, but the promised payoff seems elusive, just beyond your grasp.

  As you read the above paragraphs, you may suspect that the disadvantages of being a success junkie outweigh the advantages. But you may still believe it is basically true that people who are superachievers are more worthwhile—the big shots seem “special” in some way. You may be convinced that true happiness, as well as the respect of others, comes primarily from achievement. But is this really the case?

  In the first place, consider the fact that most human beings are not great achievers, yet most people are happy and well respected. In fact, one could say that the majority of the people in the United States are loved and happy, yet by definition most of them are pretty much average. Thus, it cannot be the case that happiness and love come only through great achievement. Depression, like the plague, is no respecter of status and strikes those who live in fancy neighborhoods as often—if not more frequently—as it does those of average or below-av
erage means. Clearly, happiness and great achievement have no necessary connection.

  Does Work = Worth?

  Okay, let’s assume you’ve decided that it’s not to your advantage to link your work and your worth, and you also admit that achievement will not reliably bring you love, respect, or happiness. You may still feel convinced that on some level, people who achieve a lot are somehow better than others. Let’s take a hard look at this notion.

  First, would you say that everybody who achieves is particularly worthwhile just because of their achievement? Adolf Hitler was clearly a great achiever at the height of his career. Would you say that made him particularly worthwhile? Obviously not. Of course, Hitler would have insisted he was a great human being because he was a successful leader and because he equated his worth and achievements. In fact, he was probably convinced that he and his fellow Nazis were supermen because they were achieving so much. Would you agree with them?

  Perhaps you can think of a neighbor or someone you don’t like very much who does achieve a lot and yet seems overly grasping and aggressive. Now, is that person especially worthwhile in your opinion just because he or she is an achiever? In contrast, perhaps you know someone you care for or respect who is not a particularly great achiever. Would you say that person is still worthwhile? If you answer yes, then ask yourself—if they can be worthwhile without great achievement, then why can’t I be?