Introducing Cognitive Behavioural Therapy (Introducing...) (7 page)

If you aim for excellence you might be happy a lot of the time. If you aim for perfection you will never be happy.

Examine your beliefs about worry

Lots of people find worry a problem because of the beliefs they hold about the process of worry. Some people have positive beliefs about worry such as:

• Worrying helps stops bad things happening and helps me stay safe
  
• Worrying helps me be more organized
  
• If I didn’t worry constantly, I’d always get things wrong.
  

At the same time they may also have negative beliefs about worry such as:

• Worrying could drive me crazy
  
• Worrying could make me ill
  
• Worrying puts a strain on my heart.
  

With beliefs like these no wonder some people find it hard not to worry – and then feel very afraid when they can’t stop. Think about your own worry beliefs. Write them down in the table below.

Now try to think them through logically. When we worry, we are actively trying to anticipate every bad thing that could possibly happen in order to (somehow) prevent it. But is this actually possible? Isn’t it true that sometimes unfortunate things just happen no matter how much we have thought about things beforehand? Can we really cause things to happen or not happen with our thoughts? Most worry is unproductive. Time we spend on it doesn’t help us to be more organized or effective. The outcome of worry is usually just more stress, tension and anxiety. Research shows that stress can affect us physically. However there is very little evidence that stress and worry alone (in the absence of pre-existing medical problems) can actually cause lasting or catastrophic damage to us physically. Worry is unlikely to harm either your physical or mental health. However, what we can guarantee is that worry will cause you to be more miserable and enjoy life less – all the more reason to work on dropping it.

The beliefs we have about worry can cause us more distress. Examine and question these beliefs – are they really true?

Use the worry decision tree

In the table you’ve probably written down quite a few worries about your worrying. Are you now worrying what to do about it? Fear not, an exercise is at hand. Let’s deal with our worries by having a worry plan. When you notice yourself worrying go through the following exercise …

Ask yourself: What am I worrying about? Write down each worry separately. Keep going until you have listed them all. Then for each separate worry go through the following diagram:

The Worry Tree

Absorbing yourself in something else

It’s very easy for psychologists to tell you to ‘distract yourself’ when you are worrying or in the middle of a panic attack – but very difficult to do this in practice! Frustration with this is very natural. Our minds are very busy places – they are designed that way. We experience countless thoughts in a day and emotionally charged ones like our worries can be very hard to ignore. However, we know that with practice and patience you can learn to move on rather than remain stuck with them. Telling yourself ‘Don’t think about it!’ most certainly won’t help. Be firm (but kind) with yourself and your busy mind. Once you have run through the worry decision tree and have identified that you have done all you can, remind yourself that further worry will just be unproductive. Don’t berate yourself – just gently direct your attention elsewhere, on to something absorbing. Choose an activity that will easily hold your attention and focus all of your senses on it. Maybe you will choose talking to a friend or family member, watching a TV programme or doing some housework or physical exercise. Whatever it is, practice focusing all of your attention on it. Your mind will try to intrude on this with worries, but each time it does firmly remind it that this is not helpful and return your focus to what you are doing. You may have to do this a great many times at first and this can be frustrating. Don’t give up or tell yourself you can’t do it – that will only undermine your good work. Nobody gets this straight away. It will take a lot of practice but over time it will become easier to do.

Getting involved in alternative activity isn’t easy. Patience and practice is the key.

And now … relax …

Believe it or not, being able to physically relax is quite a skill – one which unfortunately many of us have never learnt adequately. When we are busy rushing about from one task to another, day after day, we can very often find that we carry a lot of tension in our muscles. Do you ever find your shoulders, neck or back aching by the end of a long or stressful day? Much of this may be due to muscle tension. When we are stressed, worried or anxious, this tension increases and can result in aches and pains, headaches and fatigue. Spending some time learning to relax physically can be a worthwhile investment to help you to cope better with anxiety or stress. Like learning any skill it takes practice. The following exercises should be repeated daily when you are learning. Setting some time aside each day to carry out an exercise like this will also help you develop the good habit of prioritizing a short time for daily relaxation. Once you know how to relax, keep up this habit – finding a time each day to help yourself relax physically can make a big difference.

Exercise 1: deep muscle relaxation

• Select a place that is warm and comfortable, where you won’t be disturbed. Initially, choose a time of day when you are likely to be feeling most relaxed.

• Lie down, get comfortable and close your eyes.

• Concentrate on your breathing for a few minutes. Breathing slowly and calmly, count ‘in-two-three, out-two-three’.

• You will now work through different muscle groups, teaching yourself first to tense, then to relax. You should breathe in whilst tensing and breathe out when you relax.

• Start with your hands. First clench one tightly. Think about the tension this produces in the muscles of your hand and forearm.

• Study the tension for a few seconds and then relax your hand. Notice the difference between the tension and the relaxation. You might feel a slight tingling. This is the relaxation beginning to develop.

• Now do the same with the other hand.

• Each time you relax a group of muscles think how they feel when they are relaxed. Don’t try to relax, just let go of the tension. Allow your muscles to relax as much as they can.

• Focus on the difference in the way they feel when they are relaxed and when they are tense.

• Now do the same for the other muscle groups in your body. Each time, tense them for a few seconds and then relax. Study the way they feel and then let go of the tension in them. It is useful to keep the same order as you work through the muscle groups …