Introducing Cognitive Behavioural Therapy (Introducing...) (17 page)

Friends of Joe have witnessed great changes in his personality. He is confident that the dark moods are unlikely to overwhelm him in the future because he now uses the investigative tool of
mindfulness meditation
to determine the reality of any given problem. The illusions and distortions created by his early childhood do still crop up but he can now see them for what they are and not let them damage his health and relationships.

CBT recognizes the value of mindfulness meditation and it can become a useful tool to aid therapy.

Summary – the dos and don’ts of being in a depressed mood

7. Coping with bad times

People are like stained glass windows. They sparkle and shine when the sun is out. But when the darkness sets in their true beauty is revealed only if there is a light within
.

Elizabeth Kubler Ross

Chapters 4
and
6
describe how CBT highlights the way distortions in our thoughts and beliefs about events in our life lead to emotional distress and/or patterns of unhelpful behaviour. However, what does CBT say about situations where our so called negative thoughts could be correct? Perhaps you’ve lost someone you love. It might be accurate to say, ‘I’ll never see that person again.’ That’s no exaggeration, or other type of negative distortion – anyone, understandably, would be extremely upset. We all experience unpleasantness in our lives sometimes, but some people are faced with more, and tougher, things than others.

Think of any upsetting things you’ve experienced in the last five years. Write them into the table below. If need be, draw a bigger table.

Here are some events that within Western society have been shown to be potentially the most stressful. Have you experienced any of them?

• Death of a spouse, partner or close family member
  
• Prison sentence
  
• Death of a close friend
  
• Divorce/family break-up
  
• Relationship break-up
  
• Unwanted pregnancy/miscarriage (you or your partner)
  
• Period of homelessness/housing problems
  
• Significant debt/financial problems
  
• Unemployment
  
• Serious illness of you or family member.
  

Are there any others on your list? Do fill in the table and take the time and effort to write down your feelings too.

If you have experienced one or several from our list, research suggests you are more likely to experience both physical and mental health problems, and to find yourself less able to cope socially. The more you’ve experienced, the worse you are likely to feel.

Actually, it’s not quite as simple as this. Many variables dictate a person’s responses to stress. Some people are more resilient and therefore cope better with stressful events than others. While certain factors like biological vulnerabilities, upbringing or historical events are beyond our control, there are many things we can do to improve our chances of coping more successfully with stressful events. Contrary to popular belief, some people aren’t just stronger than others. Our resilience and ability to manage stress changes throughout our lifetime, and normally ‘strong’ people can at certain times find themselves feeling defeated by things which they coped well with at other times.

It’s helpful to think we all have a limited capacity for stress, rather like a bucket which holds a finite amount of water. We all experience some stress in everyday life. Indeed
some
stress is needed to motivate and energize us into action. However, if our stress bucket is consistently almost full, it won’t take very much more for it to overflow, or for us to develop difficulties in coping. This is why sometimes a seemingly small problem coming on top of many other comparatively small problems can finally make us feel we’re falling apart. We’ve perhaps coped very successfully with everything until then, but that’s where it all ends in tears.

Research shows that many factors dictate how we are affected by negative life events, both big and small. Some are discussed briefly in a moment. Read each one and think about your own life experiences. How have they equipped you to cope with stressful life events? Are there particular ways in which you are vulnerable to stress, or in which you are more resilient? Negative experiences can often work in different ways for different people at different times. Sometimes we can learn from things and become more skilled through our experiences. At other times we can’t and the identical negative experiences can have a much greater effect. If you find yourself less able to cope successfully with stress, there are probably many good reasons for this. It’s certainly
not
that you are just weak.

Key factors determining coping

• Meaning of the event
  
• Identification of your strengths and abilities
  
• Historical factors
  
• Personality traits.
  

Let’s look at these in a bit more detail.

The
meaning
we give to events can change both our reactions, and our ability to cope with them. For example, if we think we caused a problem by doing something wrong, our reaction will depend on whether or not we view our mistake as understandable. If we think the mistake was forgivable, we may be able to learn from it and make positive changes for the future. But if we judge ourselves as ‘bad’ or flawed we may feel helpless to change and learn from the experience. One view means we can still feel good about ourselves, the other means we don’t.

If we think we have the
strengths and abilities
to cope with a situation, and that it is manageable, however awful it may be, then we’ll use strategies which are more likely to have a positive outcome. These are
approach-related strategies
like problem-solving, learning from difficult experiences, and using support from others.

But if we think that we can’t cope, or that the problem is totally unmanageable, we’re more likely to use less successful strategies. These
avoidance-related strategies
include staying away from others, cutting down on the things we normally do, using drugs or alcohol to escape or pretending that the problem doesn’t exist, while vainly hoping it will simply disappear. Predictably, these strategies have been shown to be less successful.

Historical factors
like upbringing, education and early life experiences are also important in coping with stress. If we’ve been taught that showing emotion means we’re weak, we may be angry with ourselves for what are normal reactions under the circumstances. So for example, if we lose a very dear partner or friend, we may cope less well as we berate ourselves for feeling very normal emotions such as sadness and grief. But if we’ve been taught that we should express and share our emotions, though our grief will still be as strong, it will be easier to manage and we’ll cope better with it.

Personality traits
such as optimism or sociability may also make us more or less vulnerable to stress. Social support has been shown to be very important in how we manage after a stressful life event. People who are naturally sociable, or form close relationships therefore have an advantage here.

Many other factors have a role in how well you cope. These include your age, socio-economic status or life-stage. Clearly some factors above are more within our control than others. The meaning you give to events and your prediction of how you’ll cope are central to CBT. By the time you are finished with this book, you are likely to have learned to both identify and to handle these in very different ways.

As for the influence of historical factors and personality traits, the good news is that none of these are insurmountable. No matter what the situation, we can all learn to manage stress better, irrespective of our background, gender, age or experience.

The definition of a stressful life event differs for everyone. Just because your particular stressor isn’t on our list, this doesn’t make it any less difficult or challenging for you.

Golden rules for coping with stressful life events

In the following sections we will look at the golden rules for coping with a stressful situation and looking after yourself during a difficult time.

1. Take care of the basics

When bad things happen it’s tempting to curl up into a ball under the duvet and get out of your usual routines and habits. Taking care of your basic needs is even more important at these times. You may not feel like eating, and sleeping may seem impossible, but it’s vital you take care of yourself. Eat little and often rather than trying to force down normal meals, but make sure you do eat – emotional times can drain us of energy and our bodies need food, despite our minds insisting we’re not hungry and don’t want it. Try to rest even if your sleep is disturbed. Many people find that sleeping tablets used sensibly and for as short a time period as possible can be a useful way to get through the first few nights after something difficult has happened. If you are having problems sleeping, take a look at
Chapter 3
for some handy tips.

2. Keep (reasonably) busy

Going through the motions of our usual routines can actually be very helpful during difficult times. If you usually take the dog for a walk in the morning or pop out to the local shop for a paper in the afternoon, try continuing with these activities. We all have familiar tasks which can help keep us in touch with normal life and we do almost on autopilot. They can prove soothing at difficult times, and can also remind us that our life is still going on and that we can still control at least some aspects of it. Sometimes we have to go through the motions in order to then move on with life.

Case study – Bhaven

Bhaven, a recently widowed young husband, described how about a year after his wife died he went to a party. He went because his friends had asked him and he felt bad about declining yet another invitation. He didn’t particularly want to go and when there said that he did not really enjoy himself. However, Bhaven admitted afterwards that it had not been quite as bad as he’d anticipated, and was even able to think that next time it would be easier to go, and that eventually he might even be able to start enjoying parties, like he used to before his bereavement.