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Chronic Illness Q&A with Dr. B.

larryB&W@300This question & answer column is for people living with chronic health challenges and their family caregivers, who want to learn to increase the odds of improving their health by learning to live with mastery & wellbeing.

I invite you to post your questions in the comments box below and I will answer them on a future Friday in this column.

I post to this blog three times per week. Monday posts are published articles. Wednesday posts are interviews—mostly video. Friday posts consist of your questions about living better with chronic health challenges, and my answers to them.

Question: I learned in psychotherapy how to dispute my self-critical thoughts. I’ve gotten pretty good at finding evidence to dispute all my self-criticisms and other troubling thoughts. But my automatic, default thinking is still to put myself down and to engage in negative thinking. Instead of going around putting out fires all the time, is there a way to prevent the fires from starting?

Answer: Yes, there is a way to do that through mindfulness practice, which can be learned in an 8-week MBSR class or at any Buddhist meditation center such as Spirit Rock in Woodacre California. The practice of mindfulness will allow you to gradually begin to see the spark that ignites the self-critical thought. This is important because as neuropsychologists have now proven, the more we reinforce any thought  the more durable it becomes. The unwanted thoughts will still appear, but by learning to step back from them and acknowledge them with some objectivity, the thoughts will gradually weaken and can even be a source for humor.

What you described working on in therapy sessions is known as cognitive restructuring. It can be very effective in helping you to see that your thoughts are often not based on fact. Once you see that there is no evidence to support your self-critical thought, you can hopefully let it go and no longer be a slave to it.

However, cognitive restructuring doesn’t always work so easily.  In fact, what you have described very clearly reveals the shortcoming to that method, which is that working with your thoughts in that way can often seem futile because you’re trying to dispute unhealthy thoughts once they have already taken hold of you.

The new mindfulness-based psychotherapies such as Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Dialectical Behavior Therapy (DBT) can offer new skills that allow you to cut through those unwanted thoughts before they grab hold of you.  

The cognitive restructuring you learned is a wonderful skill. However, it can be dramatically enhanced with mindfulness practice. MBCT is a therapy that actually combines cognitive restructuring with mindfulness training.

If you are currently in therapy with a traditional cognitive behavioral therapist (CBT), you can stay in that therapy and enhance it by signing up for an 8-week MBSR class.

This website is offered as a free public service, supplying information that has been found helpful to certain people living with chronic health challenges. No treatment is offered on this website. The advice is general, and may or may not apply to your individual situation, and is not a substitute for psychotherapy or medical treatment.

What questions do you have about how to live better with chronic health challenges?  Each Friday, I will answer your questions in Chronic Illness Q&A with Dr. B.

Just scroll down and type your question in the comment box and you’ll see my response to you in an upcoming Friday post.

 

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