Feeling Good: The New Mood Therapy (12 page)

We then worked on answering several “automatic thoughts” she had written down after the call from Bobby’s teacher (see Figure 4–4, below). As Nancy learned to refute her self-critical thoughts, she experienced much-needed emotional relief. She was then able to develop some specific coping strategies designed to help Bobby with his difficulties.

Figure 4–4.
Nancy’s written homework concerning Bobby’s difficulties at school. This is similar to the “triple-column technique,” except that she did not find it necessary to write down the cognitive distortions contained in her automatic thoughts.

The first step of her coping plan was to talk to Bobby about the difficulties he had been having so as to find out what the real problem was. Was he having difficulties as his teacher had suggested? What was his understanding of the problem? Was it true that he was feeling tense and low in confidence? Had his homework been particularly hard for him recently? Once Nancy had obtained this information and defined the real problem, she realized she would then be in a position to work toward an appropriate solution. For example, if Bobby said he found some of his courses particularly difficult, she could develop a reward system at home to encourage him to do extra homework. She also
decided to read several books on parenting skills. Her relationship with Bobby improved, and his grades and behavior at school underwent a rapid turnabout.

Nancy’s mistake had been to view herself in a global way, making the moralistic judgment that she was a bad mother. This type of criticism incapacitated her because it created the impression that she had a personal problem so big and bad that no one could do anything about it. The emotional upset this labeling caused prevented her from
defining
the real problem,
breaking it down
into its specific parts, and
applying appropriate solutions
. If she had continued to mope, there was the distinct possibility that Bobby would have continued to do poorly, and she would have become increasingly ineffectual.

How can you apply what Nancy learned to your own situation? When you are down on yourself, you might find it helpful to ask what you actually mean when you try to define your true identity with a negative label such as “a fool,” “a sham,” “a stupid dope,” etc. Once you begin to pick these destructive labels apart, you will find they are arbitrary and meaningless. They actually cloud the issue, creating confusion and despair. Once rid of them, you can define and cope with any real problems that exist.

Summary
. When you are experiencing a blue mood, the chances are that you are telling yourself you are inherently inadequate or just plain “no good.” You will become convinced that you have a bad core or are essentially worthless. To the extent that you believe such thoughts, you will experience a severe emotional reaction of despair and self-hatred. You may even feel that you’d be better off dead because you are so unbearably uncomfortable and self-denigrating. You may become inactive and paralyzed, afraid and unwilling to participate in the normal flow of life.

Because of the negative emotional and behavioral consequences of your harsh thinking, the first step is to stop telling yourself you are worthless. However, you probably won’t be able to do this until you become absolutely convinced
that these statements are
incorrect
and
unrealistic
.

How can this be accomplished? You must first consider that a human life is an ongoing process that involves a constantly changing physical body as well as an enormous number of rapidly changing thoughts, feelings, and behaviors. Your life therefore is an evolving experience, a continual flow. You are not a thing; that’s why any label is constricting, highly inaccurate, and global. Abstract labels such as “worthless” or “inferior”
communicate nothing
and
mean nothing
.

But you may still be convinced you are second-rate. What is your evidence? You may reason, “I feel inadequate. Therefore, I must
be
inadequate. Otherwise, why would I be filled with such unbearable emotions?” Your error is in emotional reasoning. Your feelings do not determine your worth, simply your relative state of comfort or discomfort. Rotten, miserable internal states do not prove that you are a rotten, worthless person, merely that you think you are; because you are in a temporarily depressed mood, you are thinking illogically and unreasonably about yourself.

Would you say that states of mood elevation and happiness prove you are great or especially worthy? Or do they simply mean that you are feeling good?

Just as your feelings do not determine your worth, neither do your thoughts or behaviors. Some may be positive, creative, and enhancing; the great majority are neutral. Others may be irrational, self-defeating, and maladaptive. These can be modified if you are willing to exert the effort, but they certainly do not and cannot mean that you are no good. There is no such thing in this universe as a worthless human being.

“Then how can I develop a sense of self-esteem?” you may ask. The answer is—you don’t have to! You don’t have to do anything especially worthy to create or deserve self-esteem; all you have to do is turn off that critical, haranguing, inner voice. Why?
Because that critical inner voice is wrong
! Your internal self-abuse springs from illogical,
distorted thinking. Your sense of worthlessness is not based on truth, it is just the abscess which lies at the core of depressive illness.

So remember three crucial steps when you are upset:

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: