My Introduction to CBT

While I have been a proponent of the related Dialectical Behavior Therapy (DBT) for years, I always scorned Cognitive Behavior Therapy (CBT). The basic premise of CBT is that thoughts, feelings, and behaviors are all related and interdependent. It’s very hard to change your feelings directly, so instead, practitioners of CBT focus on changing thoughts and behaviors. Those things can, in turn, influence and ideally clear up unpleasant and unhelpful feelings. For example, if you feel like a failure, it may help you to think “I have achieved so much” and behave in ways that challenge you to achieve even more.

At its worst, CBT is a demand to “just think and behave differently,” as if it is that easy. When thought replacement and Behavior Activation are the only focus of a professional who thinks they understand CBT, the entire process can feel invalidating, unhelpful, and victim-blaming. This was my experience of CBT until very recently— I felt that since I have an extreme need for validation, CBT was my worst enemy.

Recently, however, I gave CBT another try, and guess what? It worked— immediately. The key is that this time around I am validating my feelings before I restructure them. For example, “It’s hard to feel like a failure, but I have achieved lots of things and can do this!”

Here’s a link to a short online course you can take to introduce yourself to CBT:

How to Work on Your Mental Health

If you are struggling with mental health problems, the obvious answers are therapy and medication. But what if you need more than that? How can you work on your mental health independently?

Here are some habits and ways of thinking that I’ve found to be very helpful in my recovery. Give them a try and see what works for you!

Get in the habit of problem-solving.

Problem-solving is in itself a huge topic, but it’s one of the most important aspects of working on your mental health. How do we problem solve mental health specifically?

  1. Identify a problem. Start small! You’re not going to fix your entire life in one day.
  2. Define the problem in as much detail as possible. Journal about it (see below) or make a note in your phone, whatever works. For example: “I drink too much on the weekends because I feel lonely.”
  3. See if maybe you can find the root cause of the problem, because knowing that might help you find solutions. Delve into the past. “I started drinking in college because I felt it would help me connect with people.”
  4. Define your goals as they relate to the problem. Maybe you already have a list of goals, but you need to be specific to the situation you’ve decided to problem-solve. Working on your mental health is a larger goal, but maybe you want to “drink no more than two beers on weekend days.”
  5. Brainstorm solutions. Come up with whatever fixes you can and write them down. You never have to show anyone this, so if some of them are ridiculous, that’s okay!
  6. Experiment. Test your solutions until you find one that sticks. “If I hang out with friends somewhere other than a bar, I won’t drink as much.” Maybe you went camping…. and drank just as much. Okay, back to the drawing board! Try a different solution and see if that one works. Repeat as many times as you need to.

If you need help problem-solving, don’t be afraid to recruit a friend! Ask someone you trust if they would be willing to help problem-solve your mental health, and then ask for their continued consent each time you have something to problem-solve. Hopefully the two of you together can find fixes that stick!

Journal about your mental health.

For some people, freewriting works wonders. It doesn’t do anything for me. Instead, I journal about my symptoms (emotional and physical) and what I was thinking about each day.

Find the type of journaling that works for you and do it. Not only is it good for you in the moment, but if you make it a habit, you will have lots of data to look back on in future problem-solving endeavors!

Regularly eat reasonably healthy food.

Note: I think a lot about how we treat our bodies is fucked up, so you will NEVER see me recommend a strict diet or intentional weight loss.

Getting quality fuel for your body can make a huge difference to your mental health. However, it’s not nearly as complicated as many would make it out to be. Eat things that nourish your soul as well as your body. For more information, check out Intuitive Eating resources like this one.

I tend to not eat enough— both in frequency and amount— and I don’t fare well when I am not fed. I get dizzy and depressed. Therefore, I do have some food rules. I try to feed myself about every four hours, and strive for a variety of food groups each day. (I use the old-fashioned 90s food pyramid as a guide.) I also make sure to eat some kind of carbs with every meal, because they help you feel full longer, as well as extra protein, because I’m a shitty vegetarian and often vegetarians don’t get enough of that. Of course, I also eat fruits and vegetables whenever I feel like it. That’s it— those are my dietary guidelines!

Spend some time experimenting and see what foods nourish you the best!

Eliminate stress wherever you can.

In college, I prided myself on showing up on time to my classes 15 minutes after waking up, having skipped breakfast and any sort of self-care. That’s no way to live! Ten years later, I wake up two hours before I have to be at work. I drink coffee leisurely (my favorite part of the day) and allocate enough time afterwards to make myself a reasonably quality breakfast. This is just one way I have changed my life to eliminate extra, unnecessary stress.

Reducing stress wherever we find it will take some of the weight off our mental load. Even if the source of stress really isn’t that big a deal, lowering your overall stress levels will do wonders for your mental health.

Obviously, not every source of stress could or should be eliminated. You have to weigh the pros and cons as well as your priorities. Maybe you’ve identified that grocery shopping is a big source of stress for you, so you shell out a few extra bucks to get ingredients delivered by Instacart. That’s probably a worthwhile accommodation. On the other hand, maybe your job is also a source of stress because of the pressure of deadlines, but you also love it! I don’t recommend quitting your job, at least not before you have a better one lined up!

Learn to self-validate.

Mental health is a community effort, and often those with the “worst” mental health have been failed the most by their communities. That said, not relying on others to validate your feelings can be a great improvement.

This is one I’m still working on. I often struggle with feeling like I need other people to validate my emotions. Therefore, as soon as I have any feeling, I will text my loved ones and gauge how I should feel based on their reactions. It proves that I don’t trust myself to know how I feel and what needs to be done. Instead, I’d much rather be able to validate myself, so I am not reliant on other people to process my emotions.

For more information about self-validation, check out this link.

Make time for the things you love and build mastery at them.

Make a list of the things you love the most, and then do them. For example, maybe you’re like me and you really love to write. What kind of writing do you like to do? What subjects do you like to write about? Consider listing both a broad heading (”Writing”) as well as specifics (”writing nature poetry”). Is there anything else you need to make a part of your schedule for this to happen? (Like being out in nature?)

Building mastery is a related DBT skill that involves setting reasonable, reachable goals to build up your confidence as well as your skills. Maybe you could make a goal to write one index card a day, or just take a walk. Make sure that you congratulate yourself for each thing you accomplish!

Rest effectively.

Resting effectively can be tough. It doesn’t count as true rest if you’re laying down but you’re worrying about all the things on your mind. It might help you to have a designated Relaxation Zone— like your bed or a couch in your basement— where you turn off all your worries. Alternatively, or in addition, you could try a guided meditation to help your brain relax.

This is another one I’m working on, because I tend to hold myself to very high standards and feel like I shouldn’t be resting, even when I really need it.

Avoid mind-altering substances.

Everyone has their own opinion and their own comfort level in regards to substance use, and I’m not saying that you have to agree with me in order to truly be dedicated to healing. However, I have found that I am much happier when I am not doing substances. Substances tend to be unpredictable— you might have a good time on one day but a bad time another.

(Hint: you may want to consider replacing any substances you do with the non-inebriating forms of them. I am a big proponent of non-alcoholic beer and CBD cigarettes, and regularly use both of them when I feel like letting loose.)

Obviously, this doesn’t include prescribed medications— those are important, and you should continue to take them. If you don’t want to take them anymore, you should make a plan with your medical professional to taper safely off of them, because withdrawal can be really terrible.

For more information, check out these links:

9 Ways to Actively Take Care of Your Mental Health

Create a Plan to Take Care of Your Mental Health

Co-Regulation and Manipulation

I read a post the other day that rang true for me. (Unfortunately, I cannot find the source again.) It was about how manipulative people are often seeking out attention that they feel they couldn’t get otherwise. They so desperately need the presence of another individual that they will pull out every trick in the book to make sure someone stays or comes closer.

But why do people need attention so bad that they are willing to manipulate to get it? It’s not just loneliness. I think manipulative behavior is often subconsciously enacted in pursuit of something called co-regulation.

Co-regulation is what caregivers are supposed to do when we are babies and we have big feelings. We’re supposed to be picked up, comforted, validated, mirrored, and soothed. On a chemical level, babies need other people to react to their emotions to understand them with their rapidly growing brains. Eventually, they are supposed to learn how to validate and soothe their own emotions as they grow into adults.

On the other hand, people who are scolded, belittled, or ignored as babies never learn how to self-regulate. Therefore, they continue to have this co-regulating need even as adults, and when they have big emotions they will often do absolutely anything they can to get another person to relieve the pressure. (It’s worth noting that the manipulative methods by which people try to achieve this often knock the other person out of alignment and cause them to never get what they need, making things worse and often starting the cycle over again.)

How do I know this? Because I have done it. I require constant attention and validation because I got none for the first 22 years of my life. I try to go about getting it in a genuine and healthy way (by asking for attention and validation instead of manipulating to get it) but I don’t always succeed in the moment.

This does not mean that we should automatically forgive manipulative adults. People are still responsible for being healthy and assertive in their interactions. But maybe if you feel manipulated in a relationship that you intend on keeping, you can assertively address their behavior and, if they agree to respect you, problem-solve and agree to offer what they need.

For more information about attention and why needing it is not a bad thing, please see this article by Tamar Jacobson.

For more information about co-regulating, check out this article from Howard Bath.